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You’ve failed one or more of your GP fellowship exams, and maybe not for the first time.

A sense of shock, confusion, and dread may be just some of the emotions you are feeling right now as you start to prepare to sit the exams – again! How did you get here? What can you do to ensure you have a different result this time? Failure is never due to a single cause but usually due to a combination of reasons. Singling out only one reason can be deceptive and even dangerous as there are usually interconnections between internal and external factors. Blaming only the candidate or only the exam for failure is naive and will more likely lead to a missed opportunity to learn from the failure.

According to Harry and Bethelmy (2007), many doctors do not pass postgraduate examinations on the first attempt. Though reason for disappointment, repeated unsuccessful attempts multiplies feelings of being overwhelmed, frustrated, lowered confidence, and ultimately, demoralisation. This can lead to career delays despite having passed many exams in the past, leading to added stress in busy lives that often include demanding clinical practices, working on-call or in rural and remote areas, or family commitments, thus leaving little time or energy for further study and exam preparation (Harry & Bethelmy, 2007). The mental stress associated with not passing fellowship exams adds to the usual stress associated with exams, and the eventual build-up of tension can adversely affect performance (Harry & Bethelmy, 2007) and results, thus becoming a vicious cycle.

Harry and Bethelmy (2007) point out that in such cases, exams cease being just another test, but become a high stakes hurdle, which ultimately becomes the central focus of candidates’ lives, around which everything else revolves – candidates are unable to make any long term plans for the future until that hurdle is cleared.



So what are the main causes of failure in RACGP fellowship exams, and what can you do about it?


1. Unhelpful mindset

Negative or critical self-talk often comes in the aftermath of failure. However, an exam, although important, does not entirely determine how good a doctor you are. Remind yourself that your original intention in pursuing your career was to contribute to improving the care and overall treatment of patients.

What to do: Changing your mindset isn’t easy but it starts with being kind and compassionate to yourself for having failed and remembering that it doesn’t reflect who you are. Paraphrasing Bill Clinton, ex-President of the United States, if you live long enough you’ll fail at something. The important thing is what you do with that failure. Will you learn and improve from the experience or give up and hide from it?


2. Lack of motivation

Sometimes people say they lack motivation – motivation to study or to find time to study. In fact, they may find all sorts of reasons and excuses as to why they are not putting their time and effort into exam preparation. But motivation is really “a decision to invest in learning” and making opportunities to study by removing barriers – otherwise it’s really procrastination. Usually procrastination boils down to fear – fear of failure, of feeling overwhelmed, or sometimes, fear of success (which can be associated with a phenomenon called imposter syndrome).

What to do: The place to start is to reflect honestly on your feelings and avoidance measures, and ask yourself Why am I not prioritising studying? Why am I avoiding this? Do I want to fail (again)? What do I fear?


3. Ineffective study techniques

Learning by rote can be difficult, time-consuming, and rarely useful. Yet many doctors use ineffective study techniques to prepare for their GP Fellowship exams. Why is this? Often it’s habitual and how they’ve prepared before, and its worked in the past. But often candidates are now working full-time, have family commitments and lead busy lives meaning that study time is reduced and therefore needs to be more efficient as well as effective.

What to do: know which study techniques are more effective and use them! For example, deep learning involves relating different facts to each other, so that information is used insightfully and intellectually, as in problem-solving. This is more permanent and requires less time and memory. Relating what you read to the clinical situations that you encounter develops a greater understanding of what is being studied.


4. Poor time management

In today’s world, it’s easy to be busy and fill lots of ‘things’ into our lives. The truth is, though, that many of us wouldn’t be able to say what we do with our time or be able to show many results for that time. The Pareto principle or 80:20 rule is where 80% of our time and effort produces only 20% of our productivity or results. Basically, we waste a lot of time!

What to do: Learning how to better manage your time and putting effort where it counts is a great way to maximise your limited study time, thereby maximise your scoring potential in the long run. Start by identifying and minimising your daily time-wasters such as time spent on social media, online surfing or gaming.


5. Lack of an exam strategy or plan

Lack of a strategy or plan is like going on a road trip with no map and no idea where you want to go. It could lead to you not fully understanding the exam or what the expectations are. If you don’t know what the expectations are, how can you give them what they want (and thereby pass)?!

What to do: Having an exam preparation strategy and plan means you know what and how to study, as well as when and why. Develop a weekly study schedule, devise a range of study strategies, such as calculating how much time you have to complete each exam question, and then practice exam questions according to those parameters. Planning avoids wasting your precious exam preparation time.

Understanding the reasons for failure and addressing them can help you avoid making the same mistakes again. For a different result you need to approach the exam differently and optimise your study time to achieve exam success. Study smarter not harder. This is hard to do on your own – after all, study techniques and exam preparation is not your area of expertise. But it is ours. The ModMed Institute has helped many candidates achieve their fellowship goals through understanding where things can go wrong, and how to address these areas. Face your exams with confidence with the most comprehensive KFP, AKT and MCQ courses in Australia for registrars and international medical graduates. See Dr KFP, KFP Coach, or Dr MCQ as well as the Plus and Premium packages.


Dr Sonya Vandergoot

Organisational Psychologist and Performance Coach