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Dr Shaun Tan, FRACGP, MD, BMSC
Medical Examiner | Associate Lecturer
Scored 90% on the AKT & Top 15th percentile in the KFP
Summary
Roughly one in five candidates failed the KFP sitting. After speaking with many of them, the most common reaction was surprise. These candidates felt ready. Their practice scores suggested they were ready. But the real exam was substantially more difficult than anything they had studied for.
If you are preparing for the AKT or KFP, you are probably not short on study material. Between question banks, lecture slides, notes from colleagues and courses recommended across forums and WhatsApp groups, most candidates have access to more resources than they could work through in a year. The difficulty is not finding material. It is knowing whether the material you are using will actually prepare you for the exam you are about to sit.
Everything I will cover in this guide is drawn from patterns I see repeatedly across the candidates I support through Fellow Academy. It covers the preparation mistakes that consistently separate those who pass from those who do not, and how to structure your AKT and KFP study so your preparation matches the real exam.
What Are the AKT and KFP Exams?
To qualify as a Fellow of the Royal Australian College of General Practitioners (FRACGP), candidates must pass three exams:
The Applied Knowledge Test (AKT)
The Key Feature Problem (KFP)
The AKT and KFP are the two written components. They are typically sat first, before candidates progress to the CCE exam. Both the AKT and KFP are sat by Australian GP registrars and International Medical Graduates on the RACGP Fellowship pathway.
Please Note: We produced a separate Guide to CCE Exam Preparation for candidates who have already completed AKT and KFP.
AKT Exam
The AKT exam is a 150-question written exam completed in four hours. Questions are a mix of single best answer (SBA) with 5 options and extended matching questions (EMQ) with 8 to 10 options. The AKT tests applied clinical knowledge, including your ability to identify the correct answer among plausible alternatives, based on Australian guidelines and clinical reasoning.
KFP Exam
The KFP exam is a 70-question multi-select (MSQ) exam, also completed in four hours. Each question presents a clinical scenario with multiple answer options, and the question tells you how many to select (typically 2 to 6 correct answers). The KFP changed from a short-answer format to the current MSQ structure in the 2025.2 sitting. It assesses clinical decision-making: not simply whether you know the right answer, but whether you can prioritise between several options that are all clinically reasonable.
AKT and KFP Pass Rates
Pass rates for the AKT and KFP over the past 5 years have fluctuated between:
75-86% for the AKT
65-80% for the KFP
While both exams are high-stakes, the nature of the challenge is different. See our AKT vs KFP guide for a full breakdown. The AKT primarily tests whether you have the knowledge. The KFP tests whether you can apply it under ambiguity, distinguishing the most appropriate response from several that are technically correct.
For current exam dates, registration deadlines and fees, see our RACGP Exam Dates page.
The Gap Between Feeling Prepared and Being Prepared
There is a measurable gap between feeling confident in your AKT and KFP preparation and actually being prepared for the real exam. This gap is almost always created by the preparation materials themselves, rather than the candidates' clinical knowledge or skill.
Why Candidates Who Score Well on Practice Questions Still Fail
I see this pattern consistently. A candidate works through hundreds of practice questions, scores 80% (or higher) and goes into the exam feeling confident. Then they fail.
The issue is not their knowledge. The issue is that their practice questions were too easy. In the real exam (particularly the KFP), the difficulty is not the correct answer. It is the three or four other options that are clinically plausible, but not the most appropriate for the specific patient in front of you.
If your practice material does not replicate that level of ambiguity, you are not building the clinical reasoning the exam rewards. Perhaps more importantly, you risk creating a false confidence that collapses the moment the real exam introduces genuine complexity.
Key Takeaway: If your practice material does not challenge you at the level of the real exam, it is not preparing you - it is misleading you.
The Problem With Converting Short-Answer Questions to MSQ
When the KFP format changed to MSQ in the 2025.2 sitting, most exam prep companies simply converted their existing short-answer questions into multi-select format. In contrast, Fellow Academy spent eight months developing 1,100+ new KFP cases specifically for the MSQ structure, building every question from scratch.
Why does this matter? Short-answer and MSQ questions test different skills. Short-answer tests whether you can produce the right answer (recall). MSQ tests whether you can distinguish the most appropriate option from several that all look clinically reasonable (discrimination).
In the most recent KFP sitting, this problem was reflected directly in candidate feedback. Candidates who had prepared exclusively with converted question banks reported that the real exam was significantly more complex than anything they had practiced with.
More Resources Does Not Mean Better Preparation
Many candidates I speak with have access to thousands of practice questions, multiple courses, extensive lecture slides and notes shared across study groups. Yet they still feel unprepared - because volume without structure is not preparation.
Practicing with a large bank of low-complexity questions is like learning to manage complex patients by reading single-symptom textbook cases. The exposure is there, but the messy clinical reasoning the exam tests is not.
Resource quality is only half the problem. The candidates I see who prepare most effectively do not necessarily study more hours than anyone else. They study with a clear structure that includes reliable processes for:
Identifying and addressing gaps
Consolidating new learning
Retaining knowledge through to exam day
AKT Exam Preparation: What You Need to Know
The AKT is often perceived as the more straightforward of the two written exams. In many respects it is, as it tests applied knowledge rather than the clinical prioritisation demanded by the KFP. However, a 79.41% pass rate means that roughly one in five candidates still fail.
In my experience, the candidates who fail the AKT do so for preventable reasons that are relatively easy to address.
What the AKT Actually Tests
The AKT is not a test of textbook recall. It is a test of applied clinical knowledge - specifically, whether you can identify the single most appropriate answer among multiple plausible options, based on Australian guidelines.
The exam uses two question formats:
Single best answer (SBA) - 5 options, one correct answer
Extended matching questions (EMQ) - 8 to 10 options, one correct answer
The EMQ format is more demanding because the number of plausible distractors increases, requiring stronger clinical reasoning to eliminate options that look similar.
The critical distinction for AKT preparation is that the exam is mapped to Australian guidelines. Clinical knowledge from overseas training or experience may be sound, but if your answer does not align with what eTG, Murtagh's or the RACGP Red Book recommends for an Australian general practice setting, it will not be marked as correct.
Following Australian Guidelines is one of the areas where I see internationally trained doctors lose marks. Not because they lack knowledge, but because their clinical reasoning is anchored to a different set of guidelines.
Advanced AKT Exam Day Techniques
Five specific exam day techniques consistently help candidates improve their AKT performance.
1. Read the answer options before you read the case stem. This is counterintuitive for most candidates, but it changes how you process the clinical information. When you read the options first, you know what the question is differentiating between, so when you then read the stem, you are actively looking for the clinical details that will determine the correct answer (rather than trying to absorb everything and then decide).
2. Do not spend more than five minutes on any question. The AKT allows roughly 1.5 minutes per question, but some questions will take longer than others. If you have spent five minutes on a single question and are still uncertain, mark your best answer and move on. There is no penalty for guessing.
3. Train your reading speed against full-length case stems. AKT case stems are longer and more detailed than most candidates expect, and they are designed to be read at speed under time pressure. Practising on shortened or simplified stems leaves you unprepared for the volume of clinical information you have to process per question - a gap that affects every candidate but compounds for those reading in a second language. Fellow Academy's AKT cases are written to the same stem length as the real exam, so candidates train their reading speed under realistic conditions rather than assuming the speed will come on exam day.
4. Read every word of the question. The precise wording of an AKT question changes the correct answer in ways that are easy to miss at speed. "What is the MOST IMPORTANT management?" and "What is the NEXT INITIAL management?" are two different questions with two different answers. Before you commit, identify exactly what the examiner is asking - not what a similar question might have asked, and not what you would ask in clinical practice.
5. Be decisive. The AKT awards one correct answer per question. Candidates who hesitate between two clinically reasonable options lose marks they could have earned by committing to the most appropriate answer for this specific patient. Once you have identified what the question is asking and which option best fits, commit and move on. I have seen candidates fail the AKT by two or three marks because they left ten questions unanswered at the end - questions they could have answered correctly if they had not spent too long on earlier items.
Where to Focus Your AKT Study
The high-yield distribution described earlier in this guide applies directly to AKT preparation.
Cardiovascular, gastroenterology, mental health, respiratory, dermatology and musculoskeletal presentations collectively account for roughly half the exam. Prioritising these six systems while still covering the remaining curriculum is the most efficient allocation of your study time.
Beyond topic selection, the quality of your practice questions matters. If you are consistently scoring above 80% on practice AKTs, ask yourself whether that reflects genuine readiness or whether your practice questions are simply easier than the real exam.
Effective AKT preparation involves working through questions that:
Match the actual exam difficulty
Include extended matching questions with realistic distractors
Test clinical reasoning rather than simple recall
How Three Candidates Turned a Failed KFP Attempt Into a Pass
The preparation patterns I have described are not theoretical. They are reflected in the experiences of candidates who have actually sat the KFP and in many cases, failed before changing their approach.
Dr Ahmed came to me after failing the KFP three consecutive times, having spent over $7,000 on the same course from a well-known academy. The course material had not changed substantially between her attempts, and neither had her results. After switching to Fellow Academy's structured flashcards and clinical topic guides, Dr Ahmed did not just pass her next attempt - she achieved a P3.
Dr Ali had exhausted multiple KFP question banks, all of which he found too easy and misaligned with Australian guidelines. After trying a sample of our KFP MSQ questions, he told me they were the most realistic, thoroughly referenced and similar in complexity to the official RACGP progress test questions he had encountered.
Dr Rahman is a busy mother with three young children who had failed her first KFP attempt and had only one attempt remaining. Understanding her time constraints, I recommended a simple, achievable daily goal: reviewing 20 targeted flashcards combined with concise clinical topic guides. With that structured but manageable approach, Dr Rahman passed her next attempt with a P2.
In each case, the issue was not knowledge or ability. It was the method and quality of preparation.
How to Structure Your AKT and KFP Study
Knowing what to study is only part of the equation for AKT and KFP exam prep. How you study - and specifically, how you allocate your limited preparation time - determines whether what you learn is retained through to exam day.
Structure Your Study Around Your Energy
Not all study hours are equal. For most candidates, a focused hour in the morning is worth more than two exhausted hours at night. However, it is not realistic to only study during peak hours, particularly if you are working full-time in clinical practice.
The approach I recommend is to match the type of study to your available energy:
High energy - Deep re-learning. Tackle content you have forgotten or never properly consolidated. Work through unfamiliar clinical topics, build understanding from scratch, memorise new content and engage with complex cases for the first time. This demands the most cognitive effort, so allocate it to whatever hours you are sharpest.
Medium energy - Active practice. Work through practice questions under timed conditions, review flashcards and test yourself on recently studied material. This still requires effort, but you are applying existing knowledge rather than building new understanding.
Low energy - Passive review. Read through familiar notes, revisit material you have already consolidated and review visual content such as dermatology images, ECGs and X-rays. This keeps knowledge accessible without demanding deep concentration.
This framework for AKT and KFP preparation is particularly relevant for doctors balancing clinical work, family responsibilities and exam preparation simultaneously. If you only have 60 to 90 minutes of study per day, directing that time according to your energy level compounds into a measurable difference over several months of preparation.
Use Active Recall, Not Passive Review
Most candidates default to passive study methods, such as highlighting notes, re-reading clinical topic guides and watching lecture recordings. These methods feel productive, but they only build recognition (the ability to identify correct information when you see it).
The problem is, the AKT and KFP do not test recognition - they test whether you can retrieve and apply clinical knowledge under time pressure, without prompts. Active recall trains that specific skill. Instead of re-reading a topic until it feels familiar, you close the material and force yourself to retrieve the information from memory.
That retrieval effort is what builds durable recall that holds up under exam conditions.
A practical self-test for whether you have genuinely learned something:
Close whatever you are studying
Try to explain the topic from memory, as if presenting it to a colleague
If you cannot do it fluently, you have not learned it at the level the exam requires - regardless of how well you understood it while reading
The difference between passive review and active recall is not about studying harder. It is about studying in a way that matches what the exam actually demands of you.
Proactively Address the Forgetting Curve
The volume of clinical content tested in the AKT and KFP is substantial. It is common to forget material well before exam day, particularly if you are preparing over a four to six month period while working full time.
Think of your memory as an inflatable pool with a small hole in it. Every time you study, you are filling the pool. But if you stop, the water level drops. Repetition tops it back up. But the real goal is consolidation: patching the hole so the knowledge stays.
This is why spaced repetition is effective. Rather than simply seeing the material again, you retrieve it at increasing intervals, which progressively moves information into long-term storage.
In practical terms, this means building regular review into your weekly schedule rather than relying on a final revision block before the exam. Short, consistent sessions are more effective for long-term retention than extended study sessions spaced weeks apart. Even 15 to 20 minutes of flashcard review between patients or during a lunch break builds genuine progress on days where dedicated study time is not possible.
The key is ensuring that your review is directed toward actual gaps rather than material you have already consolidated. A system that tracks what you know versus what still needs reinforcement makes that distinction for you - so your limited review time is spent where it will have the most impact.
Anchor Your Learning to Real Patients
The conventional advice for exam preparation is to "see more patients." That is not wrong, but it is incomplete. Seeing patients passively, without deliberately connecting the encounter to your study, does not build the structured clinical reasoning the AKT and KFP require.
A more effective approach is to use clinical encounters as study triggers. Here is an approach many candidates find useful:
When you encounter a presentation in clinic that you are not fully confident managing, note it down to return to later.
That evening, research the topic. Work through the differentials and review the relevant Australian guidelines.
If appropriate, schedule the patient for a follow-up and use that subsequent consultation to consolidate what you have learned by applying it in practice.
The approach above helps to connect abstract study material to real clinical encounters, which strengthens retention. It also ensures your study is proportional to your actual knowledge gaps, rather than determined by the sequence of a textbook or question bank.
How to Structure Your AKT and KFP Study
Knowing what to study is only part of the equation for AKT and KFP exam prep. How you study - and specifically, how you allocate your limited preparation time - determines whether what you learn is retained through to exam day.
Structure Your Study Around Your Energy
Not all study hours are equal. For most candidates, a focused hour in the morning is worth more than two exhausted hours at night. However, it is not realistic to only study during peak hours, particularly if you are working full-time in clinical practice.
The approach I recommend is to match the type of study to your available energy:
High energy - Deep re-learning. Tackle content you have forgotten or never properly consolidated. Work through unfamiliar clinical topics, build understanding from scratch, memorise new content and engage with complex cases for the first time. This demands the most cognitive effort, so allocate it to whatever hours you are sharpest.
Medium energy - Active practice. Work through practice questions under timed conditions, review flashcards and test yourself on recently studied material. This still requires effort, but you are applying existing knowledge rather than building new understanding.
Low energy - Passive review. Read through familiar notes, revisit material you have already consolidated and review visual content such as dermatology images, ECGs and X-rays. This keeps knowledge accessible without demanding deep concentration.
This framework for AKT and KFP preparation is particularly relevant for doctors balancing clinical work, family responsibilities and exam preparation simultaneously. If you only have 60 to 90 minutes of study per day, directing that time according to your energy level compounds into a measurable difference over several months of preparation.
Use Active Recall, Not Passive Review
Most candidates default to passive study methods, such as highlighting notes, re-reading clinical topic guides and watching lecture recordings. These methods feel productive, but they only build recognition (the ability to identify correct information when you see it).
The problem is, the AKT and KFP do not test recognition - they test whether you can retrieve and apply clinical knowledge under time pressure, without prompts. Active recall trains that specific skill. Instead of re-reading a topic until it feels familiar, you close the material and force yourself to retrieve the information from memory.
That retrieval effort is what builds durable recall that holds up under exam conditions.
A practical self-test for whether you have genuinely learned something:
Close whatever you are studying
Try to explain the topic from memory, as if presenting it to a colleague
If you cannot do it fluently, you have not learned it at the level the exam requires - regardless of how well you understood it while reading
The difference between passive review and active recall is not about studying harder. It is about studying in a way that matches what the exam actually demands of you.
Proactively Address the Forgetting Curve
The volume of clinical content tested in the AKT and KFP is substantial. It is common to forget material well before exam day, particularly if you are preparing over a four to six month period while working full time.
Think of your memory as an inflatable pool with a small hole in it. Every time you study, you are filling the pool. But if you stop, the water level drops. Repetition tops it back up. But the real goal is consolidation: patching the hole so the knowledge stays.
This is why spaced repetition is effective. Rather than simply seeing the material again, you retrieve it at increasing intervals, which progressively moves information into long-term storage.
In practical terms, this means building regular review into your weekly schedule rather than relying on a final revision block before the exam. Short, consistent sessions are more effective for long-term retention than extended study sessions spaced weeks apart. Even 15 to 20 minutes of flashcard review between patients or during a lunch break builds genuine progress on days where dedicated study time is not possible.
The key is ensuring that your review is directed toward actual gaps rather than material you have already consolidated. A system that tracks what you know versus what still needs reinforcement makes that distinction for you - so your limited review time is spent where it will have the most impact.
Anchor Your Learning to Real Patients
The conventional advice for exam preparation is to "see more patients." That is not wrong, but it is incomplete. Seeing patients passively, without deliberately connecting the encounter to your study, does not build the structured clinical reasoning the AKT and KFP require.
A more effective approach is to use clinical encounters as study triggers. Here is an approach many candidates find useful:
When you encounter a presentation in clinic that you are not fully confident managing, note it down to return to later.
That evening, research the topic. Work through the differentials and review the relevant Australian guidelines.
If appropriate, schedule the patient for a follow-up and use that subsequent consultation to consolidate what you have learned by applying it in practice.
The approach above helps to connect abstract study material to real clinical encounters, which strengthens retention. It also ensures your study is proportional to your actual knowledge gaps, rather than determined by the sequence of a textbook or question bank.
AKT and KFP Exam Preparation With Fellow Academy
Everything in this guide reflects how I approach exam preparation with the candidates I support through Fellow Academy.
Our advanced exam preparation platform includes 1,250+ AKT questions and 1,100+ KFP MSQ cases, all developed by practicing GPs, medical specialists, experienced medical educators and official examiners. Every question is backed by detailed rationales with screenshot evidence from verified Australian guidelines - so you can see exactly where the answer came from and verify it at the source.
The platform also includes 300+ Clinical Topic Guides (in both concise and comprehensive formats) and 1,500+ high-yield flashcards designed for spaced repetition. These three resources are integrated into a single system that tracks your progress, identifies your gaps and directs your study time to where it is most needed.
If you would like to try our AKT and KFP exam preparation platform, we offer a free trial with 35 sample AKT and KFP MSQ cases, written to the exact standard of our full question bank.
For a full overview of our preparation system, visit our AKT and KFP exam preparation page.
KFP Exam Preparation: The Skills That Separate Pass From Fail
The KFP is where most candidates invest the majority of their preparation time and budget. While the pass rate is similar to the AKT, the KFP tests a fundamentally different and more complex skill: the ability to prioritise under clinical ambiguity.
KFP is the exam that generates the most anxiety, the most repeat sittings and the most frustration when preparation does not translate to exam performance. Here are my top tips for how to structure your preparation.
Understand What the KFP MSQ Format Demands
The shift from short-answer to MSQ in 2025.2 was not just a change in format. It changed what skill is being tested.
Old format (short-answer): Candidates had to recall and write the correct answer from memory. The skill being tested was recall.
Current format (MSQ): The correct answers are in front of you - but so are distractors that are clinically plausible, technically defensible and very close to correct. The skill being tested is prioritisation.
Each KFP question presents a clinical scenario where multiple options could be appropriate. But some are more appropriate than others given the specific key features of the case (eg, the patient's age, comorbidities, medications, clinical context and risk factors). These key features are what determine the correct response, and they are what distinguish a well-constructed KFP question from a simplified one.
This is why the KFP is difficult. It is not testing whether you know what to do - it is testing whether you can identify the most appropriate course of action when several alternatives also appear reasonable.
Use KFP Practice Questions That Match Exam Conditions
Not all MSQ practice questions train the skills required to pass the KFP.
As I described earlier in this guide, many providers converted their existing short-answer questions into MSQ format by adding distractors after the fact. The result is questions where the correct answers are obvious to anyone with a reasonable level of clinical knowledge, and the distractors are easily eliminated.
Effective KFP preparation requires questions where each answer option is justified with a clear rationale (correct, acceptable but less prioritised, or incorrect). The middle category is where most of the work happens. In the real exam, you will encounter options that are not wrong - they are simply not the most appropriate given the patient in front of you. If your practice material does not train you to make that distinction, it is not preparing you for the real exam.
At Fellow Academy, this is why we spent eight months developing our KFP MSQ cases from scratch rather than converting old questions. Every distractor is clinically plausible. Every case is built around key features that determine the correct response. And every rationale is hand-referenced by practising Australian GPs to the relevant sentence in the Red Book, Murtagh's or the Therapeutic Guidelines, with a screenshot of the source shown alongside so candidates can see exactly where the answer comes from.
Advanced KFP Exam Day Techniques
The KFP gives you 70 questions in four hours (roughly three to four minutes per case). That time is sufficient, but only if you approach each question efficiently. Here are three specific exam day techniques that consistently help candidates improve their KFP performance.
1. Read the answer options before you read the case stem.
KFP case stems are densely written and full of clinical information that may or may not be relevant to the question being asked. Reading the options first tells you what clinical decision the case is testing, so you can scan the stem for the key features that distinguish the most appropriate answer from the alternatives. Without that frame, you are processing every detail with equal weight and trying to retroactively work out which ones mattered.
2. Apply the five-minute rule.
If you have spent five minutes on a KFP question and cannot confidently distinguish between the remaining options, select your best judgement and move on. Returning to a difficult question with fresh perspective after completing the rest of the exam is almost always more productive than continuing to deliberate in the moment.
3. Use the key features to eliminate options.
When multiple answers look correct, return to the specific details of the case (the patient's age, their comorbidities, their current medications, their risk factors). These key features are included deliberately. They are what make one clinically reasonable answer more appropriate than another for this particular patient. If you are stuck between two options, the key features are almost always where the answer lies.
4 Common AKT and KFP Preparation Mistakes
Beyond the quality of practice materials, there are four specific preparation mistakes I consistently see in candidates who struggle with the AKT and KFP.
1. Repeating the Same Preparation After a Failure
After a failed AKT or KFP attempt, the instinct for many candidates is to re-enroll in the same course or work through the same question bank a second time. The logic feels sound: I did not study enough last time, so I will study more this time.
The problem is that effort is rarely the gap. When candidates fail the AKT or KFP, it is usually because something in their preparation - the questions, the system, or the topics they prioritised - was not aligned with what the exam actually rewards.
The three patterns that follow describe where the misalignment in preparation usually sits. If you have sat the AKT or KFP before and did not pass, use them as a diagnostic to see where you might have gone wrong. If your previous preparation addressed all three, sitting again with greater effort is a reasonable path. If it did not, the productive move is not more effort, it is a different approach.
2. Practicing With Questions That Do Not Train Clinical Judgement
This is particularly relevant to the KFP. Some question banks mark five or six options as correct, when the real exam awards three. Over hundreds of practice questions, this trains candidates to treat all plausible answers as equally valid, which is precisely the mindset that costs marks in the real exam.
The real KFP tests your ability to distinguish between answers that are:
Correct - The most appropriate response given the specific case
Acceptable but less prioritised - Clinically reasonable, but not the best option for this patient
Incorrect - Not appropriate in this context
If your KFP practice questions do not train this judgement, they are training the wrong skill.
3. No System for What to Study, When and How
Access to content is not the same as having a preparation system. Many candidates accumulate huge amounts of AKT and KFP resources without a clear method for moving through them.
The result is that study time becomes reactive, which often shows up as:
Opening whatever is in front of you rather than what you most need to address
Working through questions without tracking which topics are consolidated and which still have gaps
Arriving at exam day uncertain about whether you have covered everything that matters
A structured AKT and KFP preparation approach does not require more time. It requires a defined sequence of identifying gaps, addressing them with targeted content and then consolidating with active recall so the material is retained.
Key Takeaway: The candidates who prepare most efficiently for the AKT and KFP are the ones who spend less time accumulating resources and more time working through a system.
4. Ignoring the High-Yield Distribution
Across recent sittings, roughly 50% of the AKT and KFP has been weighted across six clinical systems:
Cardiovascular
Gastroenterology
Mental health
Respiratory
Dermatology
Musculoskeletal
Studying every topic with equal depth means the six systems that carry half the marks receive the same attention as topics that are rarely tested. For example, spending as many hours on ophthalmology as on cardiovascular is not a productive use of preparation time.
This does not mean you should ignore lower-yield topics entirely. It means your preparation should be proportional. If you have limited study hours - and most candidates do - directing the majority of that time toward the six systems that carry the most weight is one of the clearest ways to increase your chances of passing.
AKT Exam Preparation: Study Strategies That Work
AKT vs KFP: Which RACGP Exam Is Harder (and How to Prepare for Both)
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Dr Shaun Tan, FRACGP, MD, BMSC
Medical Examiner | Associate Lecturer
Scored 90% on the AKT & Top 15th percentile in the KFP
Summary
Roughly one in five candidates failed the KFP sitting. After speaking with many of them, the most common reaction was surprise. These candidates felt ready. Their practice scores suggested they were ready. But the real exam was substantially more difficult than anything they had studied for.
If you are preparing for the AKT or KFP, you are probably not short on study material. Between question banks, lecture slides, notes from colleagues and courses recommended across forums and WhatsApp groups, most candidates have access to more resources than they could work through in a year. The difficulty is not finding material. It is knowing whether the material you are using will actually prepare you for the exam you are about to sit.
Everything I will cover in this guide is drawn from patterns I see repeatedly across the candidates I support through Fellow Academy. It covers the preparation mistakes that consistently separate those who pass from those who do not, and how to structure your AKT and KFP study so your preparation matches the real exam.
What Are the AKT and KFP Exams?
To qualify as a Fellow of the Royal Australian College of General Practitioners (FRACGP), candidates must pass three exams:
The Applied Knowledge Test (AKT)
The Key Feature Problem (KFP)
The AKT and KFP are the two written components. They are typically sat first, before candidates progress to the CCE exam. Both the AKT and KFP are sat by Australian GP registrars and International Medical Graduates on the RACGP Fellowship pathway.
Please Note: We produced a separate Guide to CCE Exam Preparation for candidates who have already completed AKT and KFP.
AKT Exam
The AKT exam is a 150-question written exam completed in four hours. Questions are a mix of single best answer (SBA) with 5 options and extended matching questions (EMQ) with 8 to 10 options. The AKT tests applied clinical knowledge, including your ability to identify the correct answer among plausible alternatives, based on Australian guidelines and clinical reasoning.
KFP Exam
The KFP exam is a 70-question multi-select (MSQ) exam, also completed in four hours. Each question presents a clinical scenario with multiple answer options, and the question tells you how many to select (typically 2 to 6 correct answers). The KFP changed from a short-answer format to the current MSQ structure in the 2025.2 sitting. It assesses clinical decision-making: not simply whether you know the right answer, but whether you can prioritise between several options that are all clinically reasonable.
AKT and KFP Pass Rates
Pass rates for the AKT and KFP over the past 5 years have fluctuated between:
75-86% for the AKT
65-80% for the KFP
While both exams are high-stakes, the nature of the challenge is different. See our AKT vs KFP guide for a full breakdown. The AKT primarily tests whether you have the knowledge. The KFP tests whether you can apply it under ambiguity, distinguishing the most appropriate response from several that are technically correct.
For current exam dates, registration deadlines and fees, see our RACGP Exam Dates page.
The Gap Between Feeling Prepared and Being Prepared
There is a measurable gap between feeling confident in your AKT and KFP preparation and actually being prepared for the real exam. This gap is almost always created by the preparation materials themselves, rather than the candidates' clinical knowledge or skill.
Why Candidates Who Score Well on Practice Questions Still Fail
I see this pattern consistently. A candidate works through hundreds of practice questions, scores 80% (or higher) and goes into the exam feeling confident. Then they fail.
The issue is not their knowledge. The issue is that their practice questions were too easy. In the real exam (particularly the KFP), the difficulty is not the correct answer. It is the three or four other options that are clinically plausible, but not the most appropriate for the specific patient in front of you.
If your practice material does not replicate that level of ambiguity, you are not building the clinical reasoning the exam rewards. Perhaps more importantly, you risk creating a false confidence that collapses the moment the real exam introduces genuine complexity.
Key Takeaway: If your practice material does not challenge you at the level of the real exam, it is not preparing you - it is misleading you.
The Problem With Converting Short-Answer Questions to MSQ
When the KFP format changed to MSQ in the 2025.2 sitting, most exam prep companies simply converted their existing short-answer questions into multi-select format. In contrast, Fellow Academy spent eight months developing 1,100+ new KFP cases specifically for the MSQ structure, building every question from scratch.
Why does this matter? Short-answer and MSQ questions test different skills. Short-answer tests whether you can produce the right answer (recall). MSQ tests whether you can distinguish the most appropriate option from several that all look clinically reasonable (discrimination).
In the most recent KFP sitting, this problem was reflected directly in candidate feedback. Candidates who had prepared exclusively with converted question banks reported that the real exam was significantly more complex than anything they had practiced with.
More Resources Does Not Mean Better Preparation
Many candidates I speak with have access to thousands of practice questions, multiple courses, extensive lecture slides and notes shared across study groups. Yet they still feel unprepared - because volume without structure is not preparation.
Practicing with a large bank of low-complexity questions is like learning to manage complex patients by reading single-symptom textbook cases. The exposure is there, but the messy clinical reasoning the exam tests is not.
Resource quality is only half the problem. The candidates I see who prepare most effectively do not necessarily study more hours than anyone else. They study with a clear structure that includes reliable processes for:
Identifying and addressing gaps
Consolidating new learning
Retaining knowledge through to exam day
AKT Exam Preparation: What You Need to Know
The AKT is often perceived as the more straightforward of the two written exams. In many respects it is, as it tests applied knowledge rather than the clinical prioritisation demanded by the KFP. However, a 79.41% pass rate means that roughly one in five candidates still fail.
In my experience, the candidates who fail the AKT do so for preventable reasons that are relatively easy to address.
What the AKT Actually Tests
The AKT is not a test of textbook recall. It is a test of applied clinical knowledge - specifically, whether you can identify the single most appropriate answer among multiple plausible options, based on Australian guidelines.
The exam uses two question formats:
Single best answer (SBA) - 5 options, one correct answer
Extended matching questions (EMQ) - 8 to 10 options, one correct answer
The EMQ format is more demanding because the number of plausible distractors increases, requiring stronger clinical reasoning to eliminate options that look similar.
The critical distinction for AKT preparation is that the exam is mapped to Australian guidelines. Clinical knowledge from overseas training or experience may be sound, but if your answer does not align with what eTG, Murtagh's or the RACGP Red Book recommends for an Australian general practice setting, it will not be marked as correct.
Following Australian Guidelines is one of the areas where I see internationally trained doctors lose marks. Not because they lack knowledge, but because their clinical reasoning is anchored to a different set of guidelines.
Advanced AKT Exam Day Techniques
Five specific exam day techniques consistently help candidates improve their AKT performance.
1. Read the answer options before you read the case stem. This is counterintuitive for most candidates, but it changes how you process the clinical information. When you read the options first, you know what the question is differentiating between, so when you then read the stem, you are actively looking for the clinical details that will determine the correct answer (rather than trying to absorb everything and then decide).
2. Do not spend more than five minutes on any question. The AKT allows roughly 1.5 minutes per question, but some questions will take longer than others. If you have spent five minutes on a single question and are still uncertain, mark your best answer and move on. There is no penalty for guessing.
3. Train your reading speed against full-length case stems. AKT case stems are longer and more detailed than most candidates expect, and they are designed to be read at speed under time pressure. Practising on shortened or simplified stems leaves you unprepared for the volume of clinical information you have to process per question - a gap that affects every candidate but compounds for those reading in a second language. Fellow Academy's AKT cases are written to the same stem length as the real exam, so candidates train their reading speed under realistic conditions rather than assuming the speed will come on exam day.
4. Read every word of the question. The precise wording of an AKT question changes the correct answer in ways that are easy to miss at speed. "What is the MOST IMPORTANT management?" and "What is the NEXT INITIAL management?" are two different questions with two different answers. Before you commit, identify exactly what the examiner is asking - not what a similar question might have asked, and not what you would ask in clinical practice.
5. Be decisive. The AKT awards one correct answer per question. Candidates who hesitate between two clinically reasonable options lose marks they could have earned by committing to the most appropriate answer for this specific patient. Once you have identified what the question is asking and which option best fits, commit and move on. I have seen candidates fail the AKT by two or three marks because they left ten questions unanswered at the end - questions they could have answered correctly if they had not spent too long on earlier items.
Where to Focus Your AKT Study
The high-yield distribution described earlier in this guide applies directly to AKT preparation.
Cardiovascular, gastroenterology, mental health, respiratory, dermatology and musculoskeletal presentations collectively account for roughly half the exam. Prioritising these six systems while still covering the remaining curriculum is the most efficient allocation of your study time.
Beyond topic selection, the quality of your practice questions matters. If you are consistently scoring above 80% on practice AKTs, ask yourself whether that reflects genuine readiness or whether your practice questions are simply easier than the real exam.
Effective AKT preparation involves working through questions that:
Match the actual exam difficulty
Include extended matching questions with realistic distractors
Test clinical reasoning rather than simple recall
Tools That Make Active Recall Easy
Digital tools simplify the process of integrating active recall and spaced repetition into your RACGP exam preparation.
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Brainscape: Uses adaptive algorithms to determine when you should review each flashcard based on your confidence level.
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Anki: Allows custom deck creation for topics like PBS rules or emergency management.
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Quizlet: Offers collaborative decks for study groups.
Using these tools allows you to:
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Review flashcards during commutes or between patients.
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Automatically revisit topics you’re struggling with.
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Track progress and identify weak areas.
These platforms bring structure to your study plan, ensuring regular reinforcement and better recall.
(For time management strategies, see our AKT Study Planner.)
How to Combine These Methods for Peak Performance
When you combine active recall with spaced repetition, the results are exponential. This combination, known as “spaced retrieval practice”, creates a continuous cycle of learning, forgetting, and relearning that strengthens memory.
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Start early (at least 6–12 months before your exam).
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Create flashcards for each guideline or high-yield topic.
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Use Brainscape or Anki daily to review material in spaced cycles.
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Schedule mock exams every 3–4 weeks to test your applied knowledge.
Research indicates spaced repetition can significantly increase long-term retention, with spaced learners achieving approximately 58% accuracy compared to 43% among traditional learners (p<0.001) [4].
By six months into this method, most candidates report not only improved recall but also better confidence under pressure. You’re no longer scrambling to remember—you’re retrieving information automatically.
If you’re feeling overwhelmed by RACGP exam preparation, Fellow Academy offers high quality AKT and KFP questions, exam notes in concise and comprehensive format, and high yield, evidence based flashcards designed to help you study smarter and perform with confidence. You’ll also find free KFP case packs, webinars, and practical study resources to guide you every step of the way.
Disclaimer: This content is not affiliated with, endorsed by, or representative of the Royal Australian College of General Practitioners (RACGP). The strategies and approaches shared are based on personal experience and the experiences of other GP candidates who successfully passed their exams. They are intended as general study guidance only and should not be taken as official RACGP advice.
References
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GP Supervisors Australia. (2025). Study Skills Guide for GP Registrars: Studying Smarter, Not Harder. GPSA.
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Carpenter, S. K., Pan, S. C., & Butler, A. C. (2022). The science of effective learning with spacing and retrieval practice. Nature Reviews Psychology, 1(10), 496–511.
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Durrani, S. F., Yousuf, N., Ali, R., et al. (2024). Effectiveness of spaced repetition for clinical problem solving amongst undergraduate medical students studying paediatrics in Pakistan. BMC Medical Education, 24(1), 676.
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Price, D. W., Wang, T., O’Neill, T. R., et al. (2025). The effect of spaced repetition on learning and knowledge transfer in a large cohort of practising physicians. Academic Medicine, 100(1), 94–102.
RACGP Exam Mistakes: Common Pitfalls That Stop Candidates Passing the RACGP Exams
AKT Exam Preparation: Study Strategies That Work
AKT vs KFP: Which RACGP Exam Is Harder (and How to Prepare for Both)