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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
There is a unique tension that comes with preparing for your RACGP Clinical Competency Exam, the CCE. You are not just sitting another test, you are approaching the final milestone before independent practice. It is understandable to be anxious about being among the 10.88 percent who did not pass in the 2024.2 cycle [1].
Understanding the Common Reasons Candidates Fail the RACGP CCE and how to fix them is your best defence. This guide walks through the most frequent pitfalls, the practical strategies that address them, and the examiner aligned insights that have helped candidates move from near miss to a confident pass [1, 2].
Lack of Consultation Structure and Time Management
Poor consultation structure is a leading cause of failure in the CCE. Many candidates lose track of time, overlook essential tasks, and fail to cover clinical priorities because their consultations lack a clear framework. In the 2024.2 sitting, the overall pass rate was 89.12 percent with 672 of 754 candidates successful, which means over 10 percent struggled, often due to timing and structural issues [1].
To ensure your consultation structure is clear, practical, and exam ready, use a predictable rhythm that examiners can follow:
Set the patient’s agenda clearly in the first 1 minute.
Spend about 3 minutes taking a concise, focused history.
Dedicate 1 to 2 minutes to describe key examination steps you would perform.
Use 1 minute to summarise your clinical reasoning explicitly.
Provide a structured management plan for around 3 minutes, including risks, options, and rationale.
Reserve the last 1 minute for safety netting and checking patient understanding.
Consistent practice with this sequence in timed mocks helps you manage cognitive load and finish strong. For more applied pacing ideas, see our internal resource prompts: For structured timing walkthroughs, see our comprehensive AKT timing guide. For case flow templates, see our KFP study strategy resource.
Poor Communication Skills and Lack of Empathy
Clear, empathetic communication is essential in the CCE. Communication and consultation skills accounted for 21 percent of assessed criteria in the 2025.1 cycle, signalling how strongly this area influences outcomes [2]. Candidates commonly lose marks by using excessive jargon, missing emotional cues, or failing to check understanding.
Common pitfalls:
Missing the patient’s ideas, concerns, and expectations, the ICE framework.
Delivering monologues without pauses for questions or confirmation.
Using technical language without plain English explanations.
Rushing through sensitive or complex moments.
Practical fixes:
Explicitly address ICE in the first minutes and summarise what you heard.
Use teach back, for example, ask the patient to explain the plan in their own words.
Keep language simple, then signpost any necessary technical concepts.
Practise difficult interactions to build calm, consistent presence under pressure.
Examiners are looking for a human clinician who explains clearly and listens actively. The weighting underscores the value placed on patient centred communication [2].
Failing to Demonstrate Clinical Reasoning Skills
Examiners cannot score the thinking you do not articulate. In 2025.1, Diagnosis, decision making and reasoning accounted for 20 percent of the assessed criteria [2]. Candidates often list numerous differentials without prioritisation, order tests without linking them to clinical suspicion, or omit an explicit management rationale.
To strengthen examinable reasoning:
State your most likely diagnosis first and justify it in 1 to 2 sentences.
Name 2 or 3 plausible alternatives and explain briefly why they are less likely.
Link each investigation to a specific clinical question.
Explicitly state escalation thresholds and follow up parameters.
When you verbalise the why behind your choices, you convert invisible judgment into marks [2]. For worked examples, see our internal prompt: Review our KFP practice library for reasoning templates.
FAQ: RACGP CCE Preparation and Common Pitfalls
1. What makes the RACGP CCE challenging?
The CCE tests holistic GP capability, including communication, clinical reasoning, contextual care, and safe management under time pressure. Its assessed criteria are explicitly weighted, for example 21 percent communication and consultation skills and 27 percent clinical management and therapeutic reasoning in 2025.1 [2].
2. How can I improve consultation structure?
Adopt a repeatable sequence with clear minute by minute anchors, finish with safety netting, and practise with timers. Use public exam reports to calibrate what examiners expect [1, 2].
3. Why is communication essential in the CCE?
It directly affects patient understanding and safety, and it is a formally weighted criterion at 21 percent in 2025.1 [2].
4. What is cultural competency in the CCE context?
It is respectful, tailored care that integrates cultural background, language needs, and community resources into your plan. It is assessed within preventive and population health, 8 percent in 2025.1, and across other competency areas [2].
5. What is the best approach to preparing for the CCE?
Blend guideline study with timed, case based practice, structured feedback, and technical rehearsal for Zoom delivery. Review RACGP public exam reports for cycle specific insights [1, 2, 3].
Inadequate RACGP CCE Preparation and Practice
Effective preparation increases the likelihood of passing on the first attempt. In 2025.1, pass rates by attempt were 83.86 percent for first attempts, 58.46 percent for second attempts, 46.15 percent for third attempts, and 30.00 percent for fourth and subsequent attempts [2]. In 2024.2, pass rates by attempt were 91.48 percent for first attempts, 76.92 percent for second attempts, 58.34 percent for third attempts, and 61.90 percent for fourth and subsequent attempts [1].
Common preparation gaps:
Too few realistic, timed practice sessions before the exam.
Little or no structured feedback from a supervisor or peer.
Limited familiarity with the online delivery format.
Stronger preparation:
Undertake regular full length, timed mocks that mirror session structure.
Record and review your performance to adjust pacing and clarity.
Use RACGP public exam reports to target recurrent pitfalls [1, 2].
Rehearse the Zoom workflow you will use on exam day, as the CCE is delivered via Zoom [3].
Deliberate practice, precise feedback, and environment rehearsal are key to consistent performance.
Neglecting Psychosocial Factors and Cultural Competency
Treating the biology while overlooking the person leads to incomplete performance. In 2025.1, Clinical management and therapeutic reasoning contributed 27 percent, and Preventive and population health contributed 8 percent of assessed criteria, reflecting the expectation to integrate context, risk, and prevention into your care [2].
Common gaps:
Not exploring social support, family context, or work related impacts.
Providing plans that are clinically sound but culturally misaligned.
Skipping targeted prevention that matches age and risk.
Missing interpreter use or community resource linkage when appropriate.
Better practice:
Include living situation, supports, and daily function in routine history.
Personalise preventive health advice to the person’s background and priorities.
Use interpreters early when communication barriers exist.
Involve Aboriginal Health Workers and culturally specific resources when appropriate.
Cultural safety and contextual thinking are assessed expectations in the CCE and part of safe everyday practice [2].
If you are feeling overwhelmed by RACGP exam preparation, 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 with confidence. You will 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.
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
[1] Royal Australian College of General Practitioners. 2024. Exam report 2024.2 CCE. East Melbourne, VIC: RACGP. Published December 2024. Available at: https://www.racgp.org.au/education/education-exams/fellowship/pathways/exams/cce (navigate to Exam reports, 2024.2 CCE)
[2] Royal Australian College of General Practitioners. 2025. Exam report 2025.1 CCE. East Melbourne, VIC: RACGP. Published July 2025. Available at: https://www.racgp.org.au/education/education-exams/fellowship/pathways/exams/cce (navigate to Exam reports, 2025.1 CCE)
[3] Royal Australian College of General Practitioners. 2025. Clinical Competency Exam overview. East Melbourne, VIC: RACGP. Page last updated 3 July 2025. Available at: https://www.racgp.org.au/education/education-exams/fellowship/pathways/exams/cce
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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
There is a unique tension that comes with preparing for your RACGP Clinical Competency Exam, the CCE. You are not just sitting another test, you are approaching the final milestone before independent practice. It is understandable to be anxious about being among the 10.88 percent who did not pass in the 2024.2 cycle [1].
Understanding the Common Reasons Candidates Fail the RACGP CCE and how to fix them is your best defence. This guide walks through the most frequent pitfalls, the practical strategies that address them, and the examiner aligned insights that have helped candidates move from near miss to a confident pass [1, 2].
Lack of Consultation Structure and Time Management
Poor consultation structure is a leading cause of failure in the CCE. Many candidates lose track of time, overlook essential tasks, and fail to cover clinical priorities because their consultations lack a clear framework. In the 2024.2 sitting, the overall pass rate was 89.12 percent with 672 of 754 candidates successful, which means over 10 percent struggled, often due to timing and structural issues [1].
To ensure your consultation structure is clear, practical, and exam ready, use a predictable rhythm that examiners can follow:
Set the patient’s agenda clearly in the first 1 minute.
Spend about 3 minutes taking a concise, focused history.
Dedicate 1 to 2 minutes to describe key examination steps you would perform.
Use 1 minute to summarise your clinical reasoning explicitly.
Provide a structured management plan for around 3 minutes, including risks, options, and rationale.
Reserve the last 1 minute for safety netting and checking patient understanding.
Consistent practice with this sequence in timed mocks helps you manage cognitive load and finish strong. For more applied pacing ideas, see our internal resource prompts: For structured timing walkthroughs, see our comprehensive AKT timing guide. For case flow templates, see our KFP study strategy resource.
Poor Communication Skills and Lack of Empathy
Clear, empathetic communication is essential in the CCE. Communication and consultation skills accounted for 21 percent of assessed criteria in the 2025.1 cycle, signalling how strongly this area influences outcomes [2]. Candidates commonly lose marks by using excessive jargon, missing emotional cues, or failing to check understanding.
Common pitfalls:
Missing the patient’s ideas, concerns, and expectations, the ICE framework.
Delivering monologues without pauses for questions or confirmation.
Using technical language without plain English explanations.
Rushing through sensitive or complex moments.
Practical fixes:
Explicitly address ICE in the first minutes and summarise what you heard.
Use teach back, for example, ask the patient to explain the plan in their own words.
Keep language simple, then signpost any necessary technical concepts.
Practise difficult interactions to build calm, consistent presence under pressure.
Examiners are looking for a human clinician who explains clearly and listens actively. The weighting underscores the value placed on patient centred communication [2].
Failing to Demonstrate Clinical Reasoning Skills
Examiners cannot score the thinking you do not articulate. In 2025.1, Diagnosis, decision making and reasoning accounted for 20 percent of the assessed criteria [2]. Candidates often list numerous differentials without prioritisation, order tests without linking them to clinical suspicion, or omit an explicit management rationale.
To strengthen examinable reasoning:
State your most likely diagnosis first and justify it in 1 to 2 sentences.
Name 2 or 3 plausible alternatives and explain briefly why they are less likely.
Link each investigation to a specific clinical question.
Explicitly state escalation thresholds and follow up parameters.
When you verbalise the why behind your choices, you convert invisible judgment into marks [2]. For worked examples, see our internal prompt: Review our KFP practice library for reasoning templates.
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.
FAQ: RACGP CCE Preparation and Common Pitfalls
1. What makes the RACGP CCE challenging?
The CCE tests holistic GP capability, including communication, clinical reasoning, contextual care, and safe management under time pressure. Its assessed criteria are explicitly weighted, for example 21 percent communication and consultation skills and 27 percent clinical management and therapeutic reasoning in 2025.1 [2].
2. How can I improve consultation structure?
Adopt a repeatable sequence with clear minute by minute anchors, finish with safety netting, and practise with timers. Use public exam reports to calibrate what examiners expect [1, 2].
3. Why is communication essential in the CCE?
It directly affects patient understanding and safety, and it is a formally weighted criterion at 21 percent in 2025.1 [2].
4. What is cultural competency in the CCE context?
It is respectful, tailored care that integrates cultural background, language needs, and community resources into your plan. It is assessed within preventive and population health, 8 percent in 2025.1, and across other competency areas [2].
5. What is the best approach to preparing for the CCE?
Blend guideline study with timed, case based practice, structured feedback, and technical rehearsal for Zoom delivery. Review RACGP public exam reports for cycle specific insights [1, 2, 3].
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.
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