.png)
.png)
.png)
Dr Shaun Tan, FRACGP, MD, BMSC
Medical Examiner | Associate Lecturer
Scored 90% on the AKT & Top 15th percentile in the KFP
KFP scenarios, or Key Feature Problems, are concise clinical cases designed to assess your clinical reasoning and practical decision making in the RACGP exam. To pass comfortably, you need a clear grasp of exactly what these scenarios involve, how examiners award marks, how KFP is scored, including KFP partial marks, and how best to approach each clinical case.
Many GP trainees and IMGs preparing for RACGP exams feel apprehensive about tackling KFP scenarios. That is completely normal. By clearly understanding common KFP scenarios, mastering how they are assessed, and developing an effective practice strategy, you will significantly boost your exam day confidence and clinical performance.
This comprehensive guide covers:
• Detailed breakdown of what a KFP case entails
• In depth examples: diabetes management, asthma exacerbation, contraception counselling
• Practical, examiner approved study techniques
• Answers to frequently asked questions about KFP scenarios
What KFP Scenarios Look Like
A KFP scenario presents a realistic patient consultation with specific questions designed to test key clinical decision making steps. Each RACGP KFP exam includes exactly 70 multiple selection questions to be completed within 4 hours [1]. Therefore, careful time management and precision are essential.
Key points about KFP scenarios:
• Reflect real world general practice presentations.
• Require succinct, targeted answers, unnecessary details or irrelevant information reduce your score [1].
• Questions test diagnostic reasoning, management decisions, and patient education.
• Marking focuses on clinical reasoning rather than rote memorisation [1].
Commonly tested areas include:
• Chronic diseases, diabetes, hypertension, asthma
• Acute conditions, asthma attacks, chest pain, infections
• Women’s and reproductive health, contraception, antenatal care
• Paediatrics, growth, infections, developmental milestones
• Mental health, anxiety, depression, suicide risk assessment
• Ethics and professional practice, confidentiality, consent, boundaries
• Aboriginal and Torres Strait Islander health, culturally safe care, chronic conditions
Example 1: Diabetes Management Case
Diabetes is a frequent topic, given it impacts 1 in 20 Australians, approximately 5.1% of the population [2]. Diabetes related KFP cases typically involve patients struggling to achieve optimal glycaemic control or those with complications.
When approaching a diabetes KFP scenario:
• Conduct a comprehensive review: Examine current medications, adherence, lifestyle habits, and symptoms of complications such as neuropathy, retinopathy, or nephropathy.
• Optimise therapy: Metformin remains the first line treatment unless contraindicated. Add an SGLT2 inhibitor or GLP 1 agonist for patients with cardiovascular or renal risk factors [3].
• Monitor regularly: Order HbA1c tests every 3–6 months, and perform essential annual checks of feet, eyes, and kidney function [3].
• Provide holistic education: Involve diabetes educators, dietitians, and podiatrists for multidisciplinary care and empower patients through tailored education.
For example, you may encounter a patient whose diabetes remains poorly controlled despite adherence to medications. In such a scenario, appropriate adjustments, early recognition of complications, and consistent follow up are crucial.
For comprehensive diabetes management strategies, see our Diabetes Management Guide.
Example 3: Contraception and Counselling Case
Effective contraception counselling is a core part of general practice. Australian data show that about 26% of pregnancies in the past 10 years among surveyed women were unintended [6]. These KFP scenarios test your ability to communicate sensitively, tailor contraception to the patient, and apply safety considerations.
When handling a contraception KFP case:
• Take a detailed history: Discuss reproductive goals, previous contraceptive use, menstrual history, and coexisting medical conditions.
• Provide individualised counselling: Explain the benefits and potential side effects of options such as oral contraceptives, implants, and intrauterine devices, IUDs.
• Identify contraindications: Avoid oestrogen containing methods in women with migraine aura or thromboembolic history.
• Offer clear guidance: Explain proper use, missed dose protocols, side effect management, and follow up requirements.
Picture counselling a young woman with migraines who requests contraception. Guiding her toward safer alternatives and explaining the rationale demonstrates competent patient centred care.
For detailed contraception guidelines, refer to Family Planning Clinical Recommendations or the AJGP Women’s Health Updates.
Frequently Asked Questions
1. What is a KFP scenario in the RACGP exam?
A KFP scenario, Key Feature Problem, is a short clinical case designed specifically to test clinical reasoning. Each scenario requires succinct identification of essential diagnostic or management steps to safely care for the patient.
2. How is the KFP exam structured?
The RACGP KFP exam consists of 70 multiple selection questions completed within 4 hours [1]. Each question instructs candidates on the number of responses to select, assessing clinical judgement and reasoning rather than rote recall.
3. What topics are commonly tested in KFP scenarios?
Frequently tested topics include chronic diseases, diabetes, hypertension, asthma, acute care, chest pain, asthma attacks, women’s health, contraception, antenatal care, paediatrics, growth and development, mental health, anxiety, depression, ethics, confidentiality, consent, and Aboriginal and Torres Strait Islander health, culturally appropriate chronic disease management.
4. How can I practise KFP sample questions effectively?
Complete timed practice sessions regularly, review answers critically, and align them with RACGP endorsed guidelines. Focus on concise, clinically relevant reasoning and efficient time use.
5. What mistakes should I avoid when answering KFP scenarios?
Common pitfalls include providing too many or overly detailed responses, over answering, vague responses lacking detail, under answering, ignoring scenario specific context, and not strictly adhering to question instructions. Precise, relevant answers aligned with guidelines are essential.
How to Practise KFP Cases Effectively
Preparing for KFP scenarios requires consistent, structured practice and reflection. The goal is not memorisation but mastery of applied reasoning and prioritisation.
Practical KFP preparation strategies:
• Simulate exam conditions: Regularly complete timed sets of realistic KFP scenarios to improve accuracy and pacing.
• Stay updated: Rely on authoritative Australian resources such as RACGP guidelines, the Australian Asthma Handbook, and AIHW epidemiological reports.
• Be concise and specific: Tailor responses directly to the question stem, avoid over answering or under answering.
• Reflect critically: Review model answers, identify reasoning gaps, and strengthen weaker clinical areas.
Common challenges faced by trainees:
• Managing study time while balancing long clinic hours or on call duties.
• Maintaining motivation during extended preparation periods.
• Balancing professional commitments and family life while studying.
Addressing these challenges proactively will enhance both your exam readiness and your long term clinical confidence.
For more practical study techniques, see our AKT Timing Guide.
Example 2: Asthma Exacerbation Case
Asthma commonly features in exams due to its prevalence, affecting around 11% of Australians, approximately 2.8 million people [4]. These KFP scenarios usually centre on acute exacerbations that test your emergency management and follow up planning skills.
Steps for managing asthma in KFP scenarios:
• Assess severity promptly: Observe speech, respiratory rate, oxygen saturation, and peak expiratory flow readings.
• Initiate immediate treatment: Administer inhaled salbutamol, via spacer or nebuliser, prescribe oral corticosteroids, and provide oxygen if needed.
• Identify triggers: Address infections, allergen exposure, or poor inhaler technique contributing to exacerbations.
• Implement preventive care: Supply a written Asthma Action Plan and arrange ongoing follow up to optimise control [5].
Imagine an anxious parent presenting with their wheezing child. Remaining calm, explaining management clearly, and ensuring continuity of care reflect the competence expected in the KFP exam.
For further reading, consult the Australian Asthma Handbook.
If exam preparation feels overwhelming, Fellow Academy offers high quality AKT and KFP questions, concise and comprehensive exam notes, and evidence based flashcards designed to help you study smarter and perform confidently. Explore free KFP case packs, webinars, and practical study resources that 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. Strategies and approaches shared are based on personal experiences of successful GP candidates and are intended as general study guidance only.
Disclaimer: This content is not affiliated with, endorsed by, or representative of the Royal Australian College of General Practitioners, RACGP. Strategies and approaches shared are based on personal experiences of successful GP candidates and are intended as general study guidance only.
References
[1] Royal Australian College of General Practitioners. 2025. AKT and KFP Examinations Guide. East Melbourne, VIC, RACGP. Retrieved 31 July 2025.
https://www.racgp.org.au/FSDEDEV/media/documents/Education/Registrars/Fellowship%20Pathways/Exams/Examinations-guide.pdf
[2] Australian Institute of Health and Welfare. 2024. Diabetes: Australian facts, summary. Canberra, ACT: AIHW.
https://www.aihw.gov.au/reports/diabetes/diabetes
[3] Royal Australian College of General Practitioners. 2024. Management of Type 2 Diabetes: A Handbook for General Practice. East Melbourne, VIC: RACGP.
https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/management-of-type-2-diabetes/introduction
[4] Australian Institute of Health and Welfare. 2024. Asthma: Chronic Respiratory Conditions. Canberra, ACT: AIHW.
https://www.aihw.gov.au/reports/chronic-respiratory-conditions/asthma
[5] National Asthma Council Australia. 2025. Australian Asthma Handbook, Version current. South Melbourne, National Asthma Council Australia.
https://www.asthmahandbook.org.au
[6] Taft, A. J., Shankar, M., Black, K. I., Mazza, D., Hussainy, S., Lucke, J., & Pirotta, M. 2018. Unintended and unwanted pregnancy in Australia, a cross sectional, national random telephone survey of prevalence and outcomes. Medical Journal of Australia, 209, 407–408.
https://www.mja.com.au/journal/2018/209/9/unintended-and-unwanted-pregnancy-australia-cross-sectional-national-random
AKT Exam Preparation: Study Strategies That Work
AKT vs KFP: Which RACGP Exam Is Harder (and How to Prepare for Both)
Trial Fellow Academy for Free
Complete the Form to Access 30 FREE KFP MSQs & AKTs + Invite to Our Free 2026.1 RACGP Exam Prep Webinar
Dr Shaun Tan, FRACGP, MD, BMSC
Medical Examiner | Associate Lecturer
Scored 90% on the AKT & Top 15th percentile in the KFP
Summary
KFP scenarios, or Key Feature Problems, are concise clinical cases designed to assess your clinical reasoning and practical decision making in the RACGP exam. To pass comfortably, you need a clear grasp of exactly what these scenarios involve, how examiners award marks, how KFP is scored, including KFP partial marks, and how best to approach each clinical case.
Many GP trainees and IMGs preparing for RACGP exams feel apprehensive about tackling KFP scenarios. That is completely normal. By clearly understanding common KFP scenarios, mastering how they are assessed, and developing an effective practice strategy, you will significantly boost your exam day confidence and clinical performance.
This comprehensive guide covers:
• Detailed breakdown of what a KFP case entails
• In depth examples: diabetes management, asthma exacerbation, contraception counselling
• Practical, examiner approved study techniques
• Answers to frequently asked questions about KFP scenarios
What KFP Scenarios Look Like
A KFP scenario presents a realistic patient consultation with specific questions designed to test key clinical decision making steps. Each RACGP KFP exam includes exactly 70 multiple selection questions to be completed within 4 hours [1]. Therefore, careful time management and precision are essential.
Key points about KFP scenarios:
• Reflect real world general practice presentations.
• Require succinct, targeted answers, unnecessary details or irrelevant information reduce your score [1].
• Questions test diagnostic reasoning, management decisions, and patient education.
• Marking focuses on clinical reasoning rather than rote memorisation [1].
Commonly tested areas include:
• Chronic diseases, diabetes, hypertension, asthma
• Acute conditions, asthma attacks, chest pain, infections
• Women’s and reproductive health, contraception, antenatal care
• Paediatrics, growth, infections, developmental milestones
• Mental health, anxiety, depression, suicide risk assessment
• Ethics and professional practice, confidentiality, consent, boundaries
• Aboriginal and Torres Strait Islander health, culturally safe care, chronic conditions
Example 1: Diabetes Management Case
Diabetes is a frequent topic, given it impacts 1 in 20 Australians, approximately 5.1% of the population [2]. Diabetes related KFP cases typically involve patients struggling to achieve optimal glycaemic control or those with complications.
When approaching a diabetes KFP scenario:
• Conduct a comprehensive review: Examine current medications, adherence, lifestyle habits, and symptoms of complications such as neuropathy, retinopathy, or nephropathy.
• Optimise therapy: Metformin remains the first line treatment unless contraindicated. Add an SGLT2 inhibitor or GLP 1 agonist for patients with cardiovascular or renal risk factors [3].
• Monitor regularly: Order HbA1c tests every 3–6 months, and perform essential annual checks of feet, eyes, and kidney function [3].
• Provide holistic education: Involve diabetes educators, dietitians, and podiatrists for multidisciplinary care and empower patients through tailored education.
For example, you may encounter a patient whose diabetes remains poorly controlled despite adherence to medications. In such a scenario, appropriate adjustments, early recognition of complications, and consistent follow up are crucial.
For comprehensive diabetes management strategies, see our Diabetes Management Guide.
Example 3: Contraception and Counselling Case
Effective contraception counselling is a core part of general practice. Australian data show that about 26% of pregnancies in the past 10 years among surveyed women were unintended [6]. These KFP scenarios test your ability to communicate sensitively, tailor contraception to the patient, and apply safety considerations.
When handling a contraception KFP case:
• Take a detailed history: Discuss reproductive goals, previous contraceptive use, menstrual history, and coexisting medical conditions.
• Provide individualised counselling: Explain the benefits and potential side effects of options such as oral contraceptives, implants, and intrauterine devices, IUDs.
• Identify contraindications: Avoid oestrogen containing methods in women with migraine aura or thromboembolic history.
• Offer clear guidance: Explain proper use, missed dose protocols, side effect management, and follow up requirements.
Picture counselling a young woman with migraines who requests contraception. Guiding her toward safer alternatives and explaining the rationale demonstrates competent patient centred care.
For detailed contraception guidelines, refer to Family Planning Clinical Recommendations or the AJGP Women’s Health Updates.
Tools That Make Active Recall Easy
Digital tools simplify the process of integrating active recall and spaced repetition into your RACGP exam preparation.
-
Brainscape: Uses adaptive algorithms to determine when you should review each flashcard based on your confidence level.
-
Anki: Allows custom deck creation for topics like PBS rules or emergency management.
-
Quizlet: Offers collaborative decks for study groups.
Using these tools allows you to:
-
Review flashcards during commutes or between patients.
-
Automatically revisit topics you’re struggling with.
-
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.
-
Start early (at least 6–12 months before your exam).
-
Create flashcards for each guideline or high-yield topic.
-
Use Brainscape or Anki daily to review material in spaced cycles.
-
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.
Frequently Asked Questions
1. What is a KFP scenario in the RACGP exam?
A KFP scenario, Key Feature Problem, is a short clinical case designed specifically to test clinical reasoning. Each scenario requires succinct identification of essential diagnostic or management steps to safely care for the patient.
2. How is the KFP exam structured?
The RACGP KFP exam consists of 70 multiple selection questions completed within 4 hours [1]. Each question instructs candidates on the number of responses to select, assessing clinical judgement and reasoning rather than rote recall.
3. What topics are commonly tested in KFP scenarios?
Frequently tested topics include chronic diseases, diabetes, hypertension, asthma, acute care, chest pain, asthma attacks, women’s health, contraception, antenatal care, paediatrics, growth and development, mental health, anxiety, depression, ethics, confidentiality, consent, and Aboriginal and Torres Strait Islander health, culturally appropriate chronic disease management.
4. How can I practise KFP sample questions effectively?
Complete timed practice sessions regularly, review answers critically, and align them with RACGP endorsed guidelines. Focus on concise, clinically relevant reasoning and efficient time use.
5. What mistakes should I avoid when answering KFP scenarios?
Common pitfalls include providing too many or overly detailed responses, over answering, vague responses lacking detail, under answering, ignoring scenario specific context, and not strictly adhering to question instructions. Precise, relevant answers aligned with guidelines are essential.
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
-
GP Supervisors Australia. (2025). Study Skills Guide for GP Registrars: Studying Smarter, Not Harder. GPSA.
-
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.
-
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.
-
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)