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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
Have you ever found yourself replaying a difficult patient consultation, doubting the decisions you made and feeling that lingering uncertainty long after the patient left your room? You're not alone. Every GP trainee faces moments of clinical ambiguity, unsure whether they chose the safest, most effective path. This is precisely the feeling that the RACGP KFP exam seeks to address.
The Key Feature Problem, KFP exam is designed not to test mere memorisation but your clinical decision-making skills. It helps transform that uncertainty into clear, confident, and clinically sound judgment. By mastering the KFP, you're stepping into the role of a trusted clinician, someone who not only knows medicine but knows how to use that knowledge wisely.
In this comprehensive guide, I'll share insights from my own experience as an examiner, highlighting exactly what you can expect from the RACGP KFP exam in 2025, common pitfalls to avoid, and how to prepare effectively.
What Is the KFP Exam?
The KFP exam is a cornerstone of the RACGP Fellowship assessments. It evaluates your clinical reasoning and decision-making, focusing on how well you can identify crucial next steps when managing real-life clinical scenarios.
Each question presents a patient scenario, much like one you'd encounter in practice, requiring you to choose the best clinical actions from multiple options. This format reflects the complexities of everyday general practice, assessing not only what you know, but how you apply your knowledge.
Key skills tested include your ability to:
Prioritise urgent patient issues accurately
Identify essential investigations and treatments without unnecessary tests
Recognise subtle red flags signalling severe underlying conditions
Apply clinical guidelines in a realistic context
Ultimately, the KFP exam measures your readiness to make safe, effective decisions independently.
Who Sits the KFP Exam?
The KFP is part of the RACGP Fellowship examinations. If you're pursuing Fellowship, it’s an inevitable, critical step in your journey.
You’re eligible if you are:
A GP registrar undertaking the Australian General Practice Training (AGPT) program
A participant in the Remote Vocational Training Scheme (RVTS)
An international medical graduate enrolled in programs like the Practice Experience Program or Fellowship Support Program
You need to clear both the KFP and the AKT exams before you can attempt the Clinical Competency Exam (CCE). Typically, most candidates approach the KFP after roughly 18 months of supervised clinical exposure, right when clinical reasoning starts to crystallise into instinctive judgment.
How the KFP is Scored
The scoring system rewards partial knowledge and correct reasoning, reflecting real-world practice. Here's what you need to know:
Partial credit system: each KFP question contributes equally to the final mark, making each question worth 1.43% of your overall score [1]
No negative marking for incorrect choices when you select only the requested number of responses [1]
If you shade more options than requested, a 0.35% deduction per additional bubble** is applied to your overall paper score [1]
Both AKT and KFP are automatically marked; pass marks are set by a modified Angoff standard-setting process for each cycle, then reported as pass or fail with a performance band [1]
This scoring approach ensures fairness, recognising your clinical judgment without penalising minor mistakes harshly.
How to Prepare Effectively for the KFP
Your success in the KFP exam largely depends on thoughtful, structured preparation. Consider the following strategies:
Understand the exam criteria: familiarise yourself deeply with RACGP guidelines, curriculum outlines, and exam day information [1]
Active practice: regularly work through scenario-based KFP questions to enhance your clinical reasoning and decision-making reflexes
Guideline mastery: review the RACGP Red Book, Therapeutic Guidelines, and other essential clinical resources
Real-world practice: apply KFP reasoning to actual patient consultations, mentally simulate exam conditions during clinical work
Routine study sessions: consistency is more effective than cramming; balance preparation with clinical duties and rest
Common trainee struggles include:
Balancing study with clinical responsibilities, such as full clinic days or demanding on-call schedules
Staying current with frequently changing guidelines amidst regular practice demands
Managing study stress and preventing burnout—maintaining your well-being is crucial for success
Proactively managing these challenges will significantly reduce exam-related stress.
Best Resources for KFP Preparation
Quality preparation resources streamline your revision and boost confidence. Essential resources include:
Fellow Academy’s exam-focused resources:
- Over 1,500 evidence-based flashcards designed for rapid revision
- Comprehensive scenario-based KFP question banks
- Concise summaries of clinical guidelines, ideal for exam revision
RACGP official exam day information and public exam reports [2]
Therapeutic Guidelines (eTG Complete) for reliable, guideline-based management advice
Utilising these resources ensures thorough, effective preparation tailored explicitly for the RACGP exams.
KFP vs AKT: What’s the Difference?
Knowing how the KFP differs from the AKT can refine your exam strategy effectively:
Question Style
KFP: Scenario-based questions, multiple correct answers.
AKT: Single best answer MCQs, 150 SBA questions [3]
Exam Length
Duration
Main Skill Tested
KFP: Clinical reasoning, prioritisation, and judgment.
AKT: Broad factual knowledge recall.
Scoring
KFP: Partial credit per question, each worth 1.43% [1]
AKT: No partial credit, single best answer approach, no negative marking [3]
Simply put, the KFP evaluates decision making and clinical reasoning in depth, while the AKT tests a broad scope of factual medical knowledge.
Exam Day Tips and What to Expect
Knowing precisely what happens on exam day can significantly alleviate anxiety:
Arrive early—at least one hour—and bring approved photo identification
All stationery is provided; personal electronics and watches are prohibited [1]
Both exams are held at 11 am local time at your venue [1]
Allocate time carefully, averaging 3 to 4 minutes per question
If stuck, mark your best response and revisit if time allows. Trust your preparation and judgment
Frequently Asked Questions
1. What are KFP questions?
In the context of the kfp exam, “KFP questions” refer to scenario-based items where you are presented with a clinical vignette and then asked to select the most appropriate management, investigation or differential diagnosis steps. The format emphasises clinical reasoning rather than simple factual recall. According to the official RACGP “AKT and KFP” guide, the KFP comprises 70 scenario-based items (one per stem) in the multiple-selection format. [1]
2. What is the new KFP format?
The kfp exam format changed for the 2025.2 sitting. The key changes include:
70 independent clinical scenario stems.
Each item is a multiple-selection question (MSQ) with two to six correct responses.
The exam is paper-based, answered via shading computer-readable bubble sheets (pens provided).
There is no handwritten short-answer requirement.
This change means you need to think like a practising GP: choose what must be done first, avoid unsafe or irrelevant options, and reflect real-world prioritisation. [5]
3. Is AKT a difficult exam?
The AKT exam (Applied Knowledge Test) is challenging for many GP trainees and IMGs, but “difficult” is a relative term: it requires broad factual knowledge, clinical application, and exam strategy. While pass rates vary by cohort and cycle, being well-prepared, disciplined, and understanding the format can turn it into an achievable step in your training journey. According to the RACGP guide, the AKT comprises 150 single best answer questions in a 4-hour paper-based format. 3 With appropriate preparation you can increase your chances of success.
4. How much is an AKT exam?
The fee structure for the AKT is set by the RACGP and varies by year and candidate category. Unfortunately, I could not locate a publicly confirmed current fee for the AKT exam in the Australian GP fellowship pathway that is universally published in the official RACGP candidate information. Therefore this question would best be answered by checking the current RACGP website or the candidate registration portal for the exact fee in the year you plan to sit the exam.
5. What is the RACGP SJT exam?
The RACGP SJT exam refers to the Situational Judgment Test which is part of select entry pathways or initial selection for Advanced Rural Skills Training (ARST) or certain supplementary entry processes, rather than the main fellowship written exams of AKT and KFP. It differs from the kfp exam in that the SJT assesses decision-making using written scenarios in a non-clinical format, often aimed at selection rather than fellowship assessment. As a GP registrar mentor I emphasise you focus first on KFP and AKT if you are on the standard Fellowship pathway.
6. How hard is the AKT exam?
The difficulty of the AKT exam depends on how well you are prepared. Because it covers a wide spread of general practice knowledge (chronic disease, acute care, diagnostics, pharmacology, health systems), many candidates who focus only on rote learning struggle. The key is to integrate knowledge with application (just like the kfp exam), time-management, exam technique, and practice under timed conditions. With adequate preparation you can approach it with confidence rather than anxiety.
Common Mistakes to Avoid
As an examiner, I've seen many capable trainees lose unnecessary marks due to avoidable mistakes. Being aware of these pitfalls is essential:
Overlooking scenario specifics: always tailor your answers to patient demographics and clinical context provided
Misinterpreting the question: answer precisely what is asked; avoid providing extra, unrelated information
Vague responses: specificity matters; “blood tests” will not suffice when “TSH level” is needed
Ignoring urgency: recognise and address clinical red flags immediately—missing critical issues is a costly error
Answering incorrectly: follow instructions on the exact number of selections required; too few or too many cost marks, including the 0.35% over-selection penalty [1]
Awareness and careful practice of these points can markedly boost your performance.
Structure and Format of the Exam
Understanding exactly what you'll face in the RACGP KFP exam significantly reduces exam anxiety. Here's a clear breakdown:
70 scenario-based questions, each requiring you to select multiple appropriate actions from provided lists [1]
4 hours total duration, meaning roughly 3 to 4 minutes per scenario, so time management is critical [1]
Delivered as a paper-based exam at official RACGP venues nationwide, with answers shaded on computer-readable bubble sheets, pens provided, personal pens not permitted [1]
From 2025.2, handwritten responses are no longer required; the updated format retains the same content focus [5]
This format deliberately mirrors real patient encounters, requiring careful, timely decisions under pressure.
If you’re feeling overwhelmed, Fellow Academy is here with carefully designed AKT and KFP question banks, concise notes, and practical flashcards to guide your preparation compassionately and effectively. You're not alone—we’re here 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 shared 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). The strategies shared are intended as general study guidance only.
References
[1] Royal Australian College of General Practitioners. (2025, March 13). AKT and KFP information for candidates, exam day information and FAQs, including paper-based delivery, duration 4 hours, KFP equal weighting 1.43%, and over-selection penalty 0.35%. https://www.racgp.org.au/education/fracgp-exams/racgp-exams/exam-enrolment-instructions/kfp-and-akt-exam-day-information
[2] Royal Australian College of General Practitioners. (2025, March). Exam report 2025.1 KFP, public exam report, pass mark 60.63%, pass rate 76.89%. https://www.racgp.org.au/FSDEDEV/media/documents/Education/Registrars/Fellowship%20Pathways/Exams/KFP-2025-1-Public-Exam-Report.pdf
[3] Royal Australian College of General Practitioners. (2024 update). AKT and KFP guide, AKT consists of 150 single best answer questions, total 4 hours. https://www.racgp.org.au/FSDEDEV/media/documents/Education/Registrars/Fellowship%20Pathways/Exams/Examinations-guide.pdf
[4] Royal Australian College of General Practitioners. (2024, November 6). Your AGPT Program update, Fellowship Exam Candidacy section, clarifying 6 exam semesters over 3 years of candidacy. https://www1.racgp.org.au/CMSPages/Newsletters/GetEmailBrowserContent.ashx?hash=1404da5f648ceaab6ef076f4c050a808a9d19b5cb8207ff7735a299270ffc38f&issueGuid=29049036-bce9-402c-9459-bb8f2888ef4d
[5] Royal Australian College of General Practitioners. (2024, November 6). Your AGPT Program update, update to KFP exam format from 2025.2, 70 scenarios, MSQ on paper bubble sheet, exam remains 4 hours. https://www1.racgp.org.au/CMSPages/Newsletters/GetEmailBrowserContent.ashx?issueGuid=29049036-bce9-402c-9459-bb8f2888ef4d&recipientEmail=tony%40starkindustries.local&hash=1404da5f648ceaab6ef076f4c050a808a9d19b5cb8207ff7735a299270ffc38f
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
Have you ever found yourself replaying a difficult patient consultation, doubting the decisions you made and feeling that lingering uncertainty long after the patient left your room? You're not alone. Every GP trainee faces moments of clinical ambiguity, unsure whether they chose the safest, most effective path. This is precisely the feeling that the RACGP KFP exam seeks to address.
The Key Feature Problem, KFP exam is designed not to test mere memorisation but your clinical decision-making skills. It helps transform that uncertainty into clear, confident, and clinically sound judgment. By mastering the KFP, you're stepping into the role of a trusted clinician, someone who not only knows medicine but knows how to use that knowledge wisely.
In this comprehensive guide, I'll share insights from my own experience as an examiner, highlighting exactly what you can expect from the RACGP KFP exam in 2025, common pitfalls to avoid, and how to prepare effectively.
What Is the KFP Exam?
The KFP exam is a cornerstone of the RACGP Fellowship assessments. It evaluates your clinical reasoning and decision-making, focusing on how well you can identify crucial next steps when managing real-life clinical scenarios.
Each question presents a patient scenario, much like one you'd encounter in practice, requiring you to choose the best clinical actions from multiple options. This format reflects the complexities of everyday general practice, assessing not only what you know, but how you apply your knowledge.
Key skills tested include your ability to:
Prioritise urgent patient issues accurately
Identify essential investigations and treatments without unnecessary tests
Recognise subtle red flags signalling severe underlying conditions
Apply clinical guidelines in a realistic context
Ultimately, the KFP exam measures your readiness to make safe, effective decisions independently.
Who Sits the KFP Exam?
The KFP is part of the RACGP Fellowship examinations. If you're pursuing Fellowship, it’s an inevitable, critical step in your journey.
You’re eligible if you are:
A GP registrar undertaking the Australian General Practice Training (AGPT) program
A participant in the Remote Vocational Training Scheme (RVTS)
An international medical graduate enrolled in programs like the Practice Experience Program or Fellowship Support Program
You need to clear both the KFP and the AKT exams before you can attempt the Clinical Competency Exam (CCE). Typically, most candidates approach the KFP after roughly 18 months of supervised clinical exposure, right when clinical reasoning starts to crystallise into instinctive judgment.
How the KFP is Scored
The scoring system rewards partial knowledge and correct reasoning, reflecting real-world practice. Here's what you need to know:
Partial credit system: each KFP question contributes equally to the final mark, making each question worth 1.43% of your overall score [1]
No negative marking for incorrect choices when you select only the requested number of responses [1]
If you shade more options than requested, a 0.35% deduction per additional bubble** is applied to your overall paper score [1]
Both AKT and KFP are automatically marked; pass marks are set by a modified Angoff standard-setting process for each cycle, then reported as pass or fail with a performance band [1]
This scoring approach ensures fairness, recognising your clinical judgment without penalising minor mistakes harshly.
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 are KFP questions?
In the context of the kfp exam, “KFP questions” refer to scenario-based items where you are presented with a clinical vignette and then asked to select the most appropriate management, investigation or differential diagnosis steps. The format emphasises clinical reasoning rather than simple factual recall. According to the official RACGP “AKT and KFP” guide, the KFP comprises 70 scenario-based items (one per stem) in the multiple-selection format. [1]
2. What is the new KFP format?
The kfp exam format changed for the 2025.2 sitting. The key changes include:
70 independent clinical scenario stems.
Each item is a multiple-selection question (MSQ) with two to six correct responses.
The exam is paper-based, answered via shading computer-readable bubble sheets (pens provided).
There is no handwritten short-answer requirement.
This change means you need to think like a practising GP: choose what must be done first, avoid unsafe or irrelevant options, and reflect real-world prioritisation. [5]
3. Is AKT a difficult exam?
The AKT exam (Applied Knowledge Test) is challenging for many GP trainees and IMGs, but “difficult” is a relative term: it requires broad factual knowledge, clinical application, and exam strategy. While pass rates vary by cohort and cycle, being well-prepared, disciplined, and understanding the format can turn it into an achievable step in your training journey. According to the RACGP guide, the AKT comprises 150 single best answer questions in a 4-hour paper-based format. 3 With appropriate preparation you can increase your chances of success.
4. How much is an AKT exam?
The fee structure for the AKT is set by the RACGP and varies by year and candidate category. Unfortunately, I could not locate a publicly confirmed current fee for the AKT exam in the Australian GP fellowship pathway that is universally published in the official RACGP candidate information. Therefore this question would best be answered by checking the current RACGP website or the candidate registration portal for the exact fee in the year you plan to sit the exam.
5. What is the RACGP SJT exam?
The RACGP SJT exam refers to the Situational Judgment Test which is part of select entry pathways or initial selection for Advanced Rural Skills Training (ARST) or certain supplementary entry processes, rather than the main fellowship written exams of AKT and KFP. It differs from the kfp exam in that the SJT assesses decision-making using written scenarios in a non-clinical format, often aimed at selection rather than fellowship assessment. As a GP registrar mentor I emphasise you focus first on KFP and AKT if you are on the standard Fellowship pathway.
6. How hard is the AKT exam?
The difficulty of the AKT exam depends on how well you are prepared. Because it covers a wide spread of general practice knowledge (chronic disease, acute care, diagnostics, pharmacology, health systems), many candidates who focus only on rote learning struggle. The key is to integrate knowledge with application (just like the kfp exam), time-management, exam technique, and practice under timed conditions. With adequate preparation you can approach it with confidence rather than anxiety.
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.
-
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
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AKT vs KFP: Which RACGP Exam Is Harder (and How to Prepare for Both)