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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
A Message from One GP to Another
You’ve spent years caring for patients, learning the rhythms of general practice, and balancing study with long clinic days. Now, the RACGP Clinical Competency Exam (CCE) stands between you and Fellowship. It’s not just another exam, it’s a test of how you think, communicate, and manage real-world complexity under pressure.
Many doctors describe the CCE as the most confronting assessment in their training. The format feels personal, your reasoning is on display, and every interaction counts. Yet those who succeed don’t simply “get lucky”, they master structure, reasoning, and communication. The good news is that all of these are trainable skills.
If you want to pass CCE, this guide breaks down what examiners are really looking for, how to communicate clearly, reason safely, and manage time and anxiety with confidence. You’ll find practical RACGP CCE exam tips grounded in data, examiner feedback, and years of experience mentoring successful candidates.
Understanding What Examiners Are Looking For
Examiners aren’t testing if you can memorise guidelines. They’re testing whether you can think and act like an independent GP. The RACGP CCE includes 9 cases across two days on Zoom, 4 case discussions with an examiner and 5 clinical encounters with role-player patients. Each lasts 15 minutes with 5 minutes of reading time before you begin. [2]
They assess 12 core competencies, from communication and consultation to professionalism and population health. You are marked not on a single diagnosis but on your reasoning, empathy, and safe management across all domains. [1]
Exam statistics tell a clear story, in 2024.1, the overall pass rate was 89.10%. First-time candidates achieved 92.56%. In contrast, third-attempt candidates passed at only 38.89%, even though their clinical knowledge was often similar. The difference? Clarity, confidence, and exam technique. [1]
When you walk into each case, remember that examiners are observing three big questions:
Can this doctor think safely and logically?
Can they communicate and manage a consultation calmly under time pressure?
Would I trust this person to work unsupervised tomorrow?
If the answer to all three is yes, you will pass the CCE.
The Importance of Structure and Signposting
A structured approach is your best defence against nerves. It ensures you cover all critical areas without missing key details. Examiners report that disorganised consultations often lead to missing patient concerns, skipping safety-netting, or running out of time before management.
Start every consult with a clear roadmap. It keeps you calm and shows the examiner you are in control.
An effective structure:
Introduction, greet, confirm role, and set the agenda.
History, use open questions before narrowing down.
Explore ICE, ideas, concerns, and expectations.
Summary, reflect back what you’ve understood.
Differential reasoning, think aloud.
Management, cover immediate actions, prevention, follow-up, and safety-netting.
Closing, summarise and confirm agreement.
Signposting phrases to guide your flow:
“First, I’d like to ask a few questions about your symptoms.”
“Now, I’ll explain what I think may be happening.”
“Let’s talk through your management options together.”
These transitions reassure the patient and make your consultation sound cohesive.
In the RACGP’s 2024.2 report, examiners praised candidates who “clearly summarised, prioritised problems, and structured consultations”, and warned that vague, scattergun approaches often cost marks. [3]
Remember, you are not being scored for sounding robotic. Be natural but deliberate. Structure your conversation as if guiding a colleague through your thinking, and every case will feel more manageable.
How to Manage Time and Anxiety During Each Station
The CCE tests more than your knowledge. It tests how well you think while under time and emotional pressure. Every case is 15 minutes, and what you do with that time defines your score.
Managing time in the CCE:
Use the 5-minute reading time wisely. Identify key tasks, differential diagnoses, and structure your plan before you start speaking.
During the case, set a clear agenda, “Let’s talk through your pain first, then we’ll discuss how to manage it.”
Aim for roughly 5 minutes of history, 2–3 minutes of reasoning, and 5–6 minutes of management.
If you’re behind, summarise, “Given our limited time, I’ll focus on the main concern and arrange review for the rest.”
Close with a brief safety-net, “If symptoms worsen or new issues arise, please return or call immediately.”
Managing exam anxiety:
Even experienced GPs can feel their heart racing. Anxiety doesn’t mean you’re unprepared, it means you care. The goal is to channel it into focus.
Practise short breathing exercises before each case.
Rehearse under timed, simulated conditions so the real exam feels familiar.
Prepare your exam environment, good lighting, stable internet, water nearby, and no distractions.
Between cases, reset your mind. Let go of the previous station completely, nine fresh opportunities mean one bad case doesn’t define your outcome.
According to RACGP reports, first-attempt candidates achieve a 92.56% pass rate in 2024.1. That statistic should motivate you to prepare thoroughly the first time. Build your resilience now, so stress won’t steal marks you deserve. [1]
FAQs on How to Pass the RACGP CCE
1. How can I improve my communication skills to pass the CCE?
Practise active listening, empathy, and clarity in every patient encounter. Role-play with peers, record your sessions, and refine your tone and pacing. Frameworks like Calgary-Cambridge or SPIKES help maintain structure. Seek feedback from supervisors, small adjustments, such as pausing longer after patient responses, can raise your communication score significantly.
2. What clinical reasoning strategies will help me pass the CCE?
Focus on transparent reasoning. Always verbalise your differential diagnoses and justify each choice. Examiners can only mark what they hear. Integrate red-flag recognition and safety-netting into your reasoning, showing that patient safety is always your first priority.
3. What is the CCE process?
The process for the CCE is clearly described by the RACGP,
You must pass the Applied Knowledge Test, AKT, and Key Feature Problem, KFP, exams first. [2]
You then enrol for the CCE, nine cases delivered online via Zoom over two weekends, four case discussions and five clinical encounters. [2]
Each case comprises 15 minutes of active interaction plus 5 minutes reading time. [2]
Your performance is assessed across 12 competencies including communication, clinical reasoning, professionalism, preventive health, and Aboriginal and Torres Strait Islander health. [3]
Results are released after standard-setting and ratification, and you either pass or need to re-sit. This process demands you not just know medicine, but demonstrate safe independent practice under exam conditions.
4. What do examiners specifically look for in the CCE exam?
Examiners look for safe, empathetic, and structured consultations. They assess whether you can communicate effectively, apply evidence-based reasoning, and manage uncertainty. Demonstrate you can diagnose, explain, manage, and follow up safely within time constraints.
5. What common mistakes should I avoid to pass the CCE?
Avoid generic, unstructured consultations. Don’t rush through history without addressing the patient’s main concern. Avoid medical jargon without checking understanding. Never omit safety-netting or follow-up. Most importantly, avoid the “scattergun” approach, every test or treatment must have a clear rationale.
How to Practise for the CCE Effectively
The candidates who perform best are those who practise deliberately, not just reading notes but simulating the real exam. Every practice case should test your structure, reasoning, communication, and time management simultaneously.
How to build effective practice habits:
Practise in real time, run 15-minute mock cases using Zoom or Teams, with a peer acting as the patient.
Use a case bank, Fellow Academy’s CCE-style case bank lets you practise across all RACGP domains, including ethics, paediatrics, mental health, and Indigenous health.
Seek feedback, record your sessions and review them with a supervisor. Ask, “Did I address ICE? Did I summarise? Did I close properly?”
Refine your reasoning aloud, practise explaining your thought process. Instead of saying “I’ll order bloods,” say, “I’d order a full blood count to confirm infection because of her fever.” Examiners must hear your reasoning to award marks.
Stay current, regularly check the Therapeutic Guidelines, the Australian Immunisation Handbook, and PBS updates. Outdated management plans can cost marks.
Incorporate small, frequent practice sessions rather than cramming. For example, after each clinic day, choose one patient encounter and mentally “replay” it as if it were a CCE case. Ask yourself, “Did I clearly state my reasoning? Did I manage time? Did I address the patient’s perspective?”
The RACGP’s official CCE reports show that weak candidates often had sufficient medical knowledge but failed due to disorganisation or poor communication. Remember, practising your structure is practising for success. [3]
Common Scenarios and How to Approach Them
The CCE cases mirror the breadth of Australian general practice. They are not obscure puzzles but realistic situations drawn from everyday medicine. The difference is that each one compresses complexity into 15 minutes.
You can expect cases across:
Chronic disease management, diabetes, COPD, heart failure, hypertension.
Acute presentations, chest pain, febrile child, abdominal pain, shortness of breath.
Mental health, depression, anxiety, suicidal ideation.
Women’s health, contraception, antenatal checks, menopause.
Paediatrics, unsettled infant, immunisation, child protection concerns.
Ethics and professionalism, consent, confidentiality, medico-legal boundaries.
Aboriginal and Torres Strait Islander health, cultural safety, community health planning.
For example:
In a child protection case, the best candidates recognised the old clavicle fracture as a safeguarding red flag and explained how they’d act within mandatory reporting laws.
In a postpartum check, they addressed both mother and baby holistically, covering maternal mood, contraception, and infant development.
In Indigenous health cases, they demonstrated cultural respect, acknowledged systemic barriers, and used practical strategies such as engaging an Aboriginal Health Worker or offering health checks under MBS item 715.
Examiners repeatedly emphasise that cultural sensitivity, context-awareness, and patient safety are weighted equally with clinical accuracy. They reward doctors who adapt care to the individual, rather than applying generic solutions.
A useful preparation strategy is to create a “case type map”, list 20 common GP presentations and, for each, practise reasoning, management, and communication under 15 minutes. The more diverse your practice, the stronger your adaptability in the exam.
The RACGP Clinical Competency Exam isn’t intended to trip you up, it’s designed to confirm your readiness for independent general practice. By honing clear, structured communication, systematic clinical reasoning, and confident time management, you're preparing yourself not just for an exam, but for a thriving professional life.
If you feel overwhelmed, remember, every Fellow GP has stood exactly where you are now. Through Fellow Academy, you’ll find targeted resources including realistic CCE-style case examples, examiner-aligned feedback tools, webinars, and high-yield notes designed specifically to ease your journey towards Fellowship.
You have everything it takes to pass CCE successfully, and confidently claim your future as a Fellow of the RACGP.
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 2024.1 CCE. East Melbourne, VIC, RACGP.
https://www.racgp.org.au/FSDEDEV/media/documents/Education/Registrars/Fellowship%20Pathways/Exams/2024-1-CCE-Public-Exam-Report.pdf
[2] Royal Australian College of General Practitioners. (2025). Clinical Competency Exam, CCE, Overview, page last updated 3 July 2025. East Melbourne, VIC, RACGP.
https://www.racgp.org.au/education/fracgp-exams/racgp-exams/clinical-competency-exam
[3] Royal Australian College of General Practitioners. (2024). Exam report 2024.2 CCE. East Melbourne, VIC, RACGP.
https://www.racgp.org.au/FSDEDEV/media/documents/Education/Registrars/Fellowship%20Pathways/Exams/2024-2-CCE-Public-Exam-Report.pdf
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
A Message from One GP to Another
You’ve spent years caring for patients, learning the rhythms of general practice, and balancing study with long clinic days. Now, the RACGP Clinical Competency Exam (CCE) stands between you and Fellowship. It’s not just another exam, it’s a test of how you think, communicate, and manage real-world complexity under pressure.
Many doctors describe the CCE as the most confronting assessment in their training. The format feels personal, your reasoning is on display, and every interaction counts. Yet those who succeed don’t simply “get lucky”, they master structure, reasoning, and communication. The good news is that all of these are trainable skills.
If you want to pass CCE, this guide breaks down what examiners are really looking for, how to communicate clearly, reason safely, and manage time and anxiety with confidence. You’ll find practical RACGP CCE exam tips grounded in data, examiner feedback, and years of experience mentoring successful candidates.
Understanding What Examiners Are Looking For
Examiners aren’t testing if you can memorise guidelines. They’re testing whether you can think and act like an independent GP. The RACGP CCE includes 9 cases across two days on Zoom, 4 case discussions with an examiner and 5 clinical encounters with role-player patients. Each lasts 15 minutes with 5 minutes of reading time before you begin. [2]
They assess 12 core competencies, from communication and consultation to professionalism and population health. You are marked not on a single diagnosis but on your reasoning, empathy, and safe management across all domains. [1]
Exam statistics tell a clear story, in 2024.1, the overall pass rate was 89.10%. First-time candidates achieved 92.56%. In contrast, third-attempt candidates passed at only 38.89%, even though their clinical knowledge was often similar. The difference? Clarity, confidence, and exam technique. [1]
When you walk into each case, remember that examiners are observing three big questions:
Can this doctor think safely and logically?
Can they communicate and manage a consultation calmly under time pressure?
Would I trust this person to work unsupervised tomorrow?
If the answer to all three is yes, you will pass the CCE.
The Importance of Structure and Signposting
A structured approach is your best defence against nerves. It ensures you cover all critical areas without missing key details. Examiners report that disorganised consultations often lead to missing patient concerns, skipping safety-netting, or running out of time before management.
Start every consult with a clear roadmap. It keeps you calm and shows the examiner you are in control.
An effective structure:
Introduction, greet, confirm role, and set the agenda.
History, use open questions before narrowing down.
Explore ICE, ideas, concerns, and expectations.
Summary, reflect back what you’ve understood.
Differential reasoning, think aloud.
Management, cover immediate actions, prevention, follow-up, and safety-netting.
Closing, summarise and confirm agreement.
Signposting phrases to guide your flow:
“First, I’d like to ask a few questions about your symptoms.”
“Now, I’ll explain what I think may be happening.”
“Let’s talk through your management options together.”
These transitions reassure the patient and make your consultation sound cohesive.
In the RACGP’s 2024.2 report, examiners praised candidates who “clearly summarised, prioritised problems, and structured consultations”, and warned that vague, scattergun approaches often cost marks. [3]
Remember, you are not being scored for sounding robotic. Be natural but deliberate. Structure your conversation as if guiding a colleague through your thinking, and every case will feel more manageable.
How to Manage Time and Anxiety During Each Station
The CCE tests more than your knowledge. It tests how well you think while under time and emotional pressure. Every case is 15 minutes, and what you do with that time defines your score.
Managing time in the CCE:
Use the 5-minute reading time wisely. Identify key tasks, differential diagnoses, and structure your plan before you start speaking.
During the case, set a clear agenda, “Let’s talk through your pain first, then we’ll discuss how to manage it.”
Aim for roughly 5 minutes of history, 2–3 minutes of reasoning, and 5–6 minutes of management.
If you’re behind, summarise, “Given our limited time, I’ll focus on the main concern and arrange review for the rest.”
Close with a brief safety-net, “If symptoms worsen or new issues arise, please return or call immediately.”
Managing exam anxiety:
Even experienced GPs can feel their heart racing. Anxiety doesn’t mean you’re unprepared, it means you care. The goal is to channel it into focus.
Practise short breathing exercises before each case.
Rehearse under timed, simulated conditions so the real exam feels familiar.
Prepare your exam environment, good lighting, stable internet, water nearby, and no distractions.
Between cases, reset your mind. Let go of the previous station completely, nine fresh opportunities mean one bad case doesn’t define your outcome.
According to RACGP reports, first-attempt candidates achieve a 92.56% pass rate in 2024.1. That statistic should motivate you to prepare thoroughly the first time. Build your resilience now, so stress won’t steal marks you deserve. [1]
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.
FAQs on How to Pass the RACGP CCE
1. How can I improve my communication skills to pass the CCE?
Practise active listening, empathy, and clarity in every patient encounter. Role-play with peers, record your sessions, and refine your tone and pacing. Frameworks like Calgary-Cambridge or SPIKES help maintain structure. Seek feedback from supervisors, small adjustments, such as pausing longer after patient responses, can raise your communication score significantly.
2. What clinical reasoning strategies will help me pass the CCE?
Focus on transparent reasoning. Always verbalise your differential diagnoses and justify each choice. Examiners can only mark what they hear. Integrate red-flag recognition and safety-netting into your reasoning, showing that patient safety is always your first priority.
3. What is the CCE process?
The process for the CCE is clearly described by the RACGP,
You must pass the Applied Knowledge Test, AKT, and Key Feature Problem, KFP, exams first. [2]
You then enrol for the CCE, nine cases delivered online via Zoom over two weekends, four case discussions and five clinical encounters. [2]
Each case comprises 15 minutes of active interaction plus 5 minutes reading time. [2]
Your performance is assessed across 12 competencies including communication, clinical reasoning, professionalism, preventive health, and Aboriginal and Torres Strait Islander health. [3]
Results are released after standard-setting and ratification, and you either pass or need to re-sit. This process demands you not just know medicine, but demonstrate safe independent practice under exam conditions.
4. What do examiners specifically look for in the CCE exam?
Examiners look for safe, empathetic, and structured consultations. They assess whether you can communicate effectively, apply evidence-based reasoning, and manage uncertainty. Demonstrate you can diagnose, explain, manage, and follow up safely within time constraints.
5. What common mistakes should I avoid to pass the CCE?
Avoid generic, unstructured consultations. Don’t rush through history without addressing the patient’s main concern. Avoid medical jargon without checking understanding. Never omit safety-netting or follow-up. Most importantly, avoid the “scattergun” approach, every test or treatment must have a clear rationale.
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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