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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
Facing the Clinical Competency Exam, CCE, can feel daunting, especially as an International Medical Graduate, IMG. You might worry about whether your clinical reasoning aligns with Australian standards, or if your communication style will resonate effectively with Australian patients. These concerns are perfectly understandable because the CCE is specifically designed to test your ability to practise independently and safely within the Australian healthcare system [1].
With proper preparation, however, you can significantly reduce anxiety and increase your confidence. Remember, thorough preparation can lead you directly to first time success, and current RACGP reporting shows meaningful differences by attempt. In the 2025.1 CCE, pass rates were 83.86% for first attempt, 58.46% for second attempt, 46.15% for third attempt, and 30.00% for fourth or subsequent attempts [2]. Given the exam fee is $5,565 AUD per sitting as of 2025 [3], achieving first attempt success not only boosts your career but protects your finances too.
In this comprehensive guide, you will gain valuable insights into the key skills assessed by RACGP, master structured clinical reasoning and safety netting strategies, understand effective mock case practice, familiarise yourself with Australian communication standards, and learn how to integrate resources effectively.
Core Skills RACGP Expects
The CCE focuses heavily on real world GP skills, emphasising patient centred care, robust clinical reasoning, and an understanding of the Australian healthcare context [1]. Specific areas you must demonstrate clearly include:
Patient centred communication: demonstrating genuine empathy, clear explanations, and active patient involvement in decisions.
Structured clinical reasoning: clear articulation of your diagnostic thought process and management strategies.
Clinical information gathering: focused, targeted questioning without unnecessary detail, avoiding scattergun approaches [1].
Evidence based patient management: individualised plans consistent with Australian guidelines and the patient’s life circumstances.
Procedural competence: recognising when and how to undertake GP level procedures or appropriately refer.
Professionalism and ethical conduct: managing uncertainties ethically, maintaining patient safety, and professional integrity.
System awareness: knowing how Medicare, the Pharmaceutical Benefits Scheme, PBS, and Australian referral pathways work practically in daily general practice.
For more strategies on building these competencies, see our internal primer, How to structure a CCE case discussion, step by step.
Strengthening Clinical Reasoning and Safety Netting
Clear clinical reasoning forms the backbone of your exam performance. RACGP explicitly advises against unstructured, scattergun, questioning approaches, as these often fail to demonstrate clear clinical thinking [1].
To ensure robust reasoning, practise the following steps clearly and explicitly in mock cases:
Regularly summarise your findings succinctly to patients or examiners.
Clearly state your working diagnosis, supported by specific patient information.
Explicitly outline your reasoning process, demonstrating why you prioritised certain diagnoses over others.
Safety netting, equally critical, ensures patient safety and is consistently emphasised by RACGP examiners [1]:
Clearly educate patients on concerning symptoms or red flags.
Provide clear instructions about what to do if their condition worsens.
Ensure explicit follow up arrangements and document your contingency plans clearly.
For more techniques that you can practise today, see our CCE consultation closing checklist.
Australian GP Communication Style
Effective communication is foundational in Australian general practice. Examiners specifically assess your ability to communicate in a concise, empathetic, and patient centred manner [1]. Australian GP consultations typically involve:
Active patient involvement: encourage patients to participate in care decisions, and check their ideas, concerns, and expectations.
Clear, jargon free language: translate complex medical concepts into simple explanations that patients can act on today.
Empathetic interactions: demonstrate warmth and understanding, particularly in sensitive situations such as mental health or reproductive health.
Respectful and direct communication: balance clinical advice with respectful patient input, and signpost the plan.
Effective telehealth practice: the CCE is delivered online via Zoom, so practise clear virtual communication, camera etiquette, and comprehension checks [4,5].
Mastering these communication nuances enhances both your exam performance and future patient interactions significantly.
FAQ: RACGP CCE Preparation for IMGs
1: How can I pass the CCE on my first attempt?
Plan a structured study period of 3 to 6 months, practise timed cases twice weekly, and seek targeted feedback from supervisors. In the 2025.1 CCE, pass rates by attempt were 83.86% first attempt, 58.46% second attempt, 46.15% third attempt, and 30.00% fourth or subsequent attempts, underscoring the value of first attempt readiness [2].
2: What common mistakes should I avoid in the CCE?
Typical pitfalls include scattergun questioning, thin reasoning, missing the patient agenda, weak safety netting, and poor time management. The candidate guidance stresses structured reasoning and clear, patient centred communication [1].
3: What is different about CCE preparation for international doctors?
IMGs should focus on Australian guidelines, Medicare and PBS processes, and local communication norms. The CCE resources and technical guide clarify expectations, delivery format, and preparation tips for remote assessment [4,5].
4: How far in advance should I start studying for the CCE?
Most candidates benefit from 3 to 4 months, extending to 6 months if balancing full time work. Build a weekly plan that alternates guideline review with timed case practice, and schedule a full rehearsal fortnightly.
5: Which resources are best for CCE preparation?
Start with RACGP’s candidate guidelines and technical guide for the CCE, then layer Therapeutic Guidelines and the RACGP Red Book for evidence based plans [1,4,5]. Add peer practice groups and targeted workshops to refine delivery.
Integrating Study Notes, Guidelines, and RACGP Resources
Combining your notes, Australian clinical guidelines, and RACGP specific resources effectively ensures comprehensive exam readiness:
Organise notes clearly: map your notes to Australian standards, use concise tables, flowcharts, and quick reference summaries.
Engage with key guidelines: build plans directly from Therapeutic Guidelines, the RACGP Red Book, and the Australian Immunisation Handbook, then practise applying them in cases.
Use official RACGP materials: align your practice with the Clinical Competency Rubric, the candidate guidelines, and technical guidance [1,4,5].
Target revision deliberately: identify gaps in PBS prescribing, Medicare referrals, fitness to drive, and local referral pathways, and schedule focused sprints to close each gap.
For timing strategies across the assessment suite, see our AKT timing guide and KFP study blueprint.
Mastering CCE Mock Cases and Role Play Techniques
Realistic practice significantly reduces anxiety and improves exam day performance. To effectively master mock cases and role play scenarios:
Simulate exact exam conditions: strictly allocate 5 minutes of reading time and 15 minutes of case time per station, delivered remotely via Zoom [4,5].
Vary scenario types: rotate through acute presentations, chronic disease reviews, preventive care, ethics, and multimorbidity.
Use feedback loops: seek detailed feedback on clinical accuracy, communication clarity, empathy, and time management, and track these in a logbook after each session.
Benchmark with official materials: review the CCE candidate resources and technical guidance to align your approach with examiner expectations [4,5].
For more structured practice, see our KFP mock case packs and CCE walkthrough webinars.
Feeling overwhelmed by RACGP exam preparation? Fellow Academy provides comprehensive AKT and KFP resources, concise exam notes, and evidence based flashcards designed to enhance your study effectiveness. Explore our free KFP case packs, informative webinars, and tailored study tools designed to support every stage of your preparation.
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 experiences of 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 experiences of 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. 2025. Candidate guidelines for the Clinical Competency Exam. East Melbourne, VIC: RACGP. Available from: https://www.racgp.org.au/education/fracgp-exams/racgp-exams/clinical-competency-exam
[2] Royal Australian College of General Practitioners. 2025. Public exam report, CCE 2025.1. East Melbourne, VIC: RACGP. Attempt based pass rates reported on the RACGP CCE page. Available from: https://www.racgp.org.au/education/fracgp-exams/racgp-exams/clinical-competency-exam
[3] Royal Australian College of General Practitioners. 2025. Enrolment dates and fees, RACGP exams. East Melbourne, VIC: RACGP. Available from: https://www.racgp.org.au/education/fracgp-exams/enrolment-dates-and-fees
[4] Royal Australian College of General Practitioners. 2025. Clinical Competency Exam overview page. East Melbourne, VIC: RACGP. Available from: https://www.racgp.org.au/education/fracgp-exams/racgp-exams/clinical-competency-exam
[5] Royal Australian College of General Practitioners. 2025. CCE candidate technical guidance. East Melbourne, VIC: RACGP. Available from: https://www.racgp.org.au/education/fracgp-exams/racgp-exams/clinical-competency-exam
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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
Facing the Clinical Competency Exam, CCE, can feel daunting, especially as an International Medical Graduate, IMG. You might worry about whether your clinical reasoning aligns with Australian standards, or if your communication style will resonate effectively with Australian patients. These concerns are perfectly understandable because the CCE is specifically designed to test your ability to practise independently and safely within the Australian healthcare system [1].
With proper preparation, however, you can significantly reduce anxiety and increase your confidence. Remember, thorough preparation can lead you directly to first time success, and current RACGP reporting shows meaningful differences by attempt. In the 2025.1 CCE, pass rates were 83.86% for first attempt, 58.46% for second attempt, 46.15% for third attempt, and 30.00% for fourth or subsequent attempts [2]. Given the exam fee is $5,565 AUD per sitting as of 2025 [3], achieving first attempt success not only boosts your career but protects your finances too.
In this comprehensive guide, you will gain valuable insights into the key skills assessed by RACGP, master structured clinical reasoning and safety netting strategies, understand effective mock case practice, familiarise yourself with Australian communication standards, and learn how to integrate resources effectively.
Core Skills RACGP Expects
The CCE focuses heavily on real world GP skills, emphasising patient centred care, robust clinical reasoning, and an understanding of the Australian healthcare context [1]. Specific areas you must demonstrate clearly include:
Patient centred communication: demonstrating genuine empathy, clear explanations, and active patient involvement in decisions.
Structured clinical reasoning: clear articulation of your diagnostic thought process and management strategies.
Clinical information gathering: focused, targeted questioning without unnecessary detail, avoiding scattergun approaches [1].
Evidence based patient management: individualised plans consistent with Australian guidelines and the patient’s life circumstances.
Procedural competence: recognising when and how to undertake GP level procedures or appropriately refer.
Professionalism and ethical conduct: managing uncertainties ethically, maintaining patient safety, and professional integrity.
System awareness: knowing how Medicare, the Pharmaceutical Benefits Scheme, PBS, and Australian referral pathways work practically in daily general practice.
For more strategies on building these competencies, see our internal primer, How to structure a CCE case discussion, step by step.
Strengthening Clinical Reasoning and Safety Netting
Clear clinical reasoning forms the backbone of your exam performance. RACGP explicitly advises against unstructured, scattergun, questioning approaches, as these often fail to demonstrate clear clinical thinking [1].
To ensure robust reasoning, practise the following steps clearly and explicitly in mock cases:
Regularly summarise your findings succinctly to patients or examiners.
Clearly state your working diagnosis, supported by specific patient information.
Explicitly outline your reasoning process, demonstrating why you prioritised certain diagnoses over others.
Safety netting, equally critical, ensures patient safety and is consistently emphasised by RACGP examiners [1]:
Clearly educate patients on concerning symptoms or red flags.
Provide clear instructions about what to do if their condition worsens.
Ensure explicit follow up arrangements and document your contingency plans clearly.
For more techniques that you can practise today, see our CCE consultation closing checklist.
Australian GP Communication Style
Effective communication is foundational in Australian general practice. Examiners specifically assess your ability to communicate in a concise, empathetic, and patient centred manner [1]. Australian GP consultations typically involve:
Active patient involvement: encourage patients to participate in care decisions, and check their ideas, concerns, and expectations.
Clear, jargon free language: translate complex medical concepts into simple explanations that patients can act on today.
Empathetic interactions: demonstrate warmth and understanding, particularly in sensitive situations such as mental health or reproductive health.
Respectful and direct communication: balance clinical advice with respectful patient input, and signpost the plan.
Effective telehealth practice: the CCE is delivered online via Zoom, so practise clear virtual communication, camera etiquette, and comprehension checks [4,5].
Mastering these communication nuances enhances both your exam performance and future patient interactions significantly.
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:
-
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.
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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.
FAQ: RACGP CCE Preparation for IMGs
1: How can I pass the CCE on my first attempt?
Plan a structured study period of 3 to 6 months, practise timed cases twice weekly, and seek targeted feedback from supervisors. In the 2025.1 CCE, pass rates by attempt were 83.86% first attempt, 58.46% second attempt, 46.15% third attempt, and 30.00% fourth or subsequent attempts, underscoring the value of first attempt readiness [2].
2: What common mistakes should I avoid in the CCE?
Typical pitfalls include scattergun questioning, thin reasoning, missing the patient agenda, weak safety netting, and poor time management. The candidate guidance stresses structured reasoning and clear, patient centred communication [1].
3: What is different about CCE preparation for international doctors?
IMGs should focus on Australian guidelines, Medicare and PBS processes, and local communication norms. The CCE resources and technical guide clarify expectations, delivery format, and preparation tips for remote assessment [4,5].
4: How far in advance should I start studying for the CCE?
Most candidates benefit from 3 to 4 months, extending to 6 months if balancing full time work. Build a weekly plan that alternates guideline review with timed case practice, and schedule a full rehearsal fortnightly.
5: Which resources are best for CCE preparation?
Start with RACGP’s candidate guidelines and technical guide for the CCE, then layer Therapeutic Guidelines and the RACGP Red Book for evidence based plans [1,4,5]. Add peer practice groups and targeted workshops to refine delivery.
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.
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