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Failure rate of doctors sitting the GP fellowship exams and how to beat the statistics

Dr Sarah Parker
Dr Sarah Parker
Medical Educator

You don’t have to be ‘just a statistic’

Everyone wants to succeed. No one starts something with the goal of failing, but it happens. And at times it can be hard to understand why we failed when we feel we’ve done what was needed to pass. Especially if we have never failed before and this is the first time. Failing in these circumstances can feel confronting and disheartening.

In the years we’ve spent helping candidates to achieve their exam goals and support them to address any knowledge gaps or other issues, we’ve often been asked what is the biggest cause of failure and how to overcome them. Factors or beliefs can include:

  • KFP and AKT/MCQ relatively high failure rates
  • The apparent ‘randomness’ of responses and the feeling that you have to ‘read the examiner’s mind’ are common beliefs and concerns of candidates
  • The reputation, and associated fear, of the KFP exam
  • Thoughts and behaviors that can sabotage goals and good intentions before the exam, or focus and concentration during the

The facts

  • In the last 2 exam cycles (2019.2 and 2020.1) the pass rate of the Key Feature Problem (KFP) exam was 55.81% and 68.86% respectively.  Conversely, this means the failure rate was 44.19% and 31.14% respectively.
  • RACGP data shows that the pass rate in RACGP exams, and therefore the likelihood of passing, diminishes from the second attempt, with a maximum of 6 attempts allowed. (General Practice Registrars Australia)
  • The pass rate in the RACGP Fellowship written exams among International Medical Graduates (IMG) outside of registrar training programs is only 37% — nearly half that of GP registrars. (Aus doc – 10th September 2019)
  • In addition, there is a rapid decline in the pass rate for multiple attempts, leading to a pass rate of only around 16% for 4 or more attempts.

Here are the pass/failure results since 2016

Even though the statistics might sound daunting, we want you to know that you don’t have to be ‘just a statistic’. We have been able to map out the study techniques and behaviours of successful candidates to help you be on the ‘winning’ side of these statistics.


Here is the ‘reality’ of why candidates fail the RACGP and ACCRM exams:

1. Lack of knowledge or not studying the right content

It’s important to understand what you need to know, as well as knowing what you don’t know. Hence it is important to ‘research’ the exam to understand what type of knowledge or information is needed to be able to pass.

For the ACRRM curriculum, relevant to MCQ exam, start here

Further, to better understand your knowledge gaps, take an inventory of your confidence (low – medium – high) against areas in the relevant curriculum or as outlined in the BEACH study.  Those that you list as low confidence areas would be a good place to start. ModMed also has devised a knowledge self-assessment quiz.

2. Not understanding the exam format or technique

Though exams you have completed over your career will likely have similarities, they will all have had their own peculiarities or differences. These RACGP and ACRRM exams are no different. To be able to pass, it is very important to understand the intricacies of the particular exam you are sitting and not assume that they will be the same as other exams you have sat. To better understand the requirements of the exams, start with the Examination guide (available from the RACGP or ACRRM website) and the yearly exam reports. For example:

3. Not Planning

General practice is a broad clinical ‘area’ compared to other specialties. To be able to cover and revise all the areas you wish or you have identified as a ‘knowledge gap’, it is important to be able to map out what you want to cover against the amount of time you have before the exam and plan your exam preparation (including all the necessary tasks this may include, such as revision or practice exams). Without a study plan, it is less likely you will have completed the necessary exam preparation to pass.

4. Using less effective study techniques

Not all study techniques are equally effective! Some techniques have been shown to be more consistently effective with memory retention and recall than other techniques, such as practice testing (Dunlosky, Rawson, Marsh et al., 2013). Reading and highlighting text (without combining with other techniques) are the least effective. Hence it is important to use effective techniques that enable effective memory consolidation and recall. For more information about study techniques, see the TEDTalk by Douglas Barton, from Elevate Education What do top students do differently? or Dunlosky, Rawson, Marsh et al., (2013) literature review.

Why ModMed offers Performance Coaching? – There is a lot more than just good medical knowledge needed to pass GP fellowship exams. Dr Sonya Vandergoot and her team speak to doctors about the challenges they face in preparing for their fellowship exams and how they can do things differently or more effectively. This may include addressing areas such as motivation, self-confidence, procrastination, work/life/study balance and exam anxiety. Learn more

5. Fear of Failure

Procrastination is a common outcome of a fear of failure. Procrastination can sabotage your best intentions to study and prepare. But you cannot pass if you allow it to take over. One way to manage procrastination is to acknowledge that you are (people often deny and justify their avoiding behaviours) and utilise strategies to manage it, such as the Pomodoro technique for time-management.

6. Feeling overwhelmed

Procrastination is also a common outcome when feeling overwhelmed. If feeling swamped, break large tasks into smaller manageable ones (e.g., divide the task into daily or weekly tasks and to-do lists). Narrow your focus, like a spotlight, so you only consider small ‘chunks’ rather than the large all-encompassing task ahead. Focusing on the daily tasks assists with managing these feelings so you’re less likely to procrastinate.

7. Lack of accountability

Not doing the hard work – not always, but occasionally, candidates don’t actually do the hard work they plan or say they do; then they blame the exam or others for their failure. This lack of accountability can sabotage their future efforts to pass the exam. It is important after failing an exam to reflect on what went wrong, and what can be done better or differently. Honest reflection can only take place with accountability for previous actions or attitudes to ensure accurate ‘stock-taking’ of the situation, to enable better exam preparation for future exams.

References and resources 

  • Dunlosky, J., Rawson, K. A., Marsh, E. J., Nathan, M. J., & Willingham, D. T. (2013). Improving students’ learning with effective learning techniques: Promising directions from cognitive and educational psychology. Psychological Science in the Public Interest, 14(1), 4-58.
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