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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
Failing the AMC Clinical Exam can feel disheartening, especially after months of hard work and sacrifices. You are not alone if you have faced this challenge. Only 21% of candidates pass the AMC Clinical Exam in recent years [1]. The AMC also confirms that each clinical station is 10 minutes and the circuit comprises 16 assessed stations plus 4 rest stations [2], with the pass requirement updated to 9 of 14 scored stations effective 21 March 2024 [6].
This blog, Why Candidates Fail the AMC Clinical Exam, and How to Pass on the Next Attempt, delves deeply into exactly where candidates commonly go wrong. We will explore real, evidence based reasons behind these outcomes and share practical strategies so your next attempt is successful and confident. For practical pacing strategies across written and clinical assessments, see our AKT timing guide and our free KFP case packs for structured safety netting practice.
Not Completing All AMC Clinical Exam Tasks Exactly
Candidates often fail by not completing every required task exactly as described in AMC guidance. AMC examiners explicitly note, “Incomplete performance of all the tasks is unlikely to constitute an overall satisfactory performance” [3]. Your first aim in every station is completeness and safety, not speed. A disciplined structure helps you hit every required step before the bell.
Common pitfalls include:
Mismanaging time by spending too long on one part of the task.
Forgetting key parts of examination or history due to rushing.
Jumping to conclusions or diagnoses too early, missing essential steps.
For example, in a chest pain station, jumping to a reflux explanation without a focused cardiovascular history and a targeted examination risks missing an emergency. Practising timed mock stations trains you to cover the brief precisely, to summarise briefly, and to close with clear next steps. Consider building a simple internal checklist for station types, history then focused exam then explanation then management then safety netting, so every patient interaction shows completeness that examiners expect [3].
For more granular techniques and checklists that align with Australian primary care consulting, see our consultation structure guide for GP trainees.
Incomplete Differentials and Lack of Safety Netting
Failing to provide complete differential diagnoses or clear safety netting is a common reason for station failure. Examiners expect you to name the likely diagnosis, to cover serious alternatives, and to say what the patient should do if symptoms worsen or change. Leaving out a red flag condition or forgetting explicit follow up instructions is scored as incomplete, even if your leading diagnosis is plausible [4].
To strengthen your performance:
State serious differentials early, for example acute coronary syndrome, ectopic pregnancy, appendicitis.
Provide specific safety netting, for example when to call an ambulance, when to return, who to contact after hours.
Practise generating succinct differentials and precise safety net steps in every mock case.
Imagine a patient with lower abdominal pain. If you do not mention ectopic pregnancy risk and if you do not tell the patient exactly when to seek urgent care, you have not demonstrated safe intern level practice. The AMC stations are short by design, 10 minutes per station [2], so crisp differentials and clear safety netting are essential signals of safe practice. Embedding this habit in mock circuits makes it automatic on exam day.
If you want targeted drills, see our differential diagnosis flashcards that pair red flag recognition with one line safety net statements.
Communication Style Not Suitable for Australian Patients
Poor communication is another major hurdle. AMC examiners discourage technical jargon and euphemisms. They explicitly recommend clear, compassionate explanations in everyday language, with checks for understanding and space for questions [3]. Your clinical reasoning only earns marks if the patient and examiner can follow your thinking.
To communicate effectively and naturally:
Translate clinical ideas into plain English and avoid jargon.
Check the patient’s understanding and confirm agreement with the plan.
Respond to concerns directly and show empathy with brief, sincere statements.
For example, rather than saying, you have essential hypertension, use, you have high blood pressure, which may increase your risk of heart problems, let us look at the best ways to bring it down and keep you well. This is patient centred, it is aligned with AMC expectations, and it is efficient within 10 minutes [2, 3]. If you want structured language templates, see our patient friendly explanation bank for common AMC scenarios.
Frequently Asked Questions (FAQ)
1. What is the pass rate for the AMC Clinical Exam
The AMC Clinical Exam overall pass rate reported in the most recent AMC Annual Report is 21% [1]. The AMC also notes a pass requirement of 9 of 14 scored stations effective 21 March 2024 [6] and confirms a station time of 10 minutes within circuits comprising 16 assessed stations plus 4 rest stations [2]. These figures frame the level of performance and consistency expected during the circuit.
2. Why is the AMC Clinical Exam so difficult
The exam assesses extensive clinical skills across multiple disciplines under strict time pressure. Each station lasts 10 minutes and requires you to collect key information, to reason aloud, and to communicate a safe plan clearly and briefly [2]. That combination of structure, breadth, and pace is challenging by design and reflects the safe intern standard expected in Australian settings [3, 4].
3. What common mistakes cause candidates to fail
Common errors include incomplete task execution, insufficient differential diagnoses that omit red flag conditions, inadequate safety netting, and explanations that are too technical or unclear [3, 4]. The cure is a short internal structure you can use reliably in 10 minutes and a communication style that is plain, compassionate, and efficient [2, 3].
4. How can I improve my communication skills
Practise with patient friendly explanations, check understanding routinely, and use short empathic statements that validate concerns. The AMC’s examiner guidance emphasises avoiding technical language and euphemisms, and demonstrating clarity throughout [3]. Targeted mock consults with structured feedback accelerate improvement and make these habits automatic in the circuit [5].
5. What should I do after failing the AMC Clinical Exam
Review your feedback and reconstruct the circuit from memory to identify recurrent misses, for example time loss during examination setup or thin differentials. Build a plan with regular mock stations, one measurable focus goal per session, and a feedback loop with a supervisor or peer [5]. This methodical approach restores confidence and improves the likelihood of meeting the 9 of 14 pass threshold within the 10 minute station structure [2, 6].
How to Use Mock AMC Clinical Exam Stations and Feedback Loops
Consistent practice with realistic mock AMC stations and structured feedback is one of the strongest predictors of improvement. Repetition under timed conditions builds fluency in structure, in communication, and in time management. Immediate feedback helps you correct misses before the next case and reduces the chance that you repeat the same error on exam day [5].
To optimise your preparation:
Schedule regular timed mock OSCE stations that mirror 10 minute timing and station variety [2].
After each station, request specific feedback on completeness, differentials, safety netting, and clarity.
Track recurring errors and set one focus goal per practice session to drive measurable improvement.
For instance, after a severe asthma scenario, ask whether you explicitly checked inhaler technique, demonstrated spacer use verbally, and gave precise emergency advice. This post case reflection, plus a written action point, closes the loop. If you would like structured peer feedback sheets aligned to AMC domains, download our mock OSCE feedback pack.
If you are rebuilding confidence after a setback, GPRA also recommends debriefing with supervisors and using a plan that targets your specific gaps, an approach that aligns well with what AMC candidates report as most helpful [5].
Examination Technique Not Aligned with Australian Practice
If your examination methods are not aligned with Australian clinical standards, your performance will suffer. Examiners look for explicit consent, visible hand hygiene, appropriate use of a chaperone for sensitive exams, and patient comfort throughout. They also expect you to integrate psychosocial context and cultural safety into your approach [4].
To align your skills effectively:
Study Australian clinical expectations, including consent language and infection control habits.
Obtain explicit verbal consent before examinations and narrate what you are doing.
Offer a chaperone for sensitive examinations and check comfort at each step.
Address psychosocial and cultural context explicitly to demonstrate whole person care.
For instance, say, I would like to examine your abdomen now, is that okay with you, and then explain what you will do. This shows respect, clarity, and safety. In Australian general practice, these basics are part of the standard of care, and examiners will award marks for these visible behaviours [4]. If you need a quick reference for etiquette and sequence, see our clinical examination etiquette checklist designed for AMC and RACGP style consultations.
If you are feeling uncertain about your AMC Clinical Exam preparation, Fellow Academy provides targeted, practical, and supportive resources specifically designed for AMC candidates. Explore our AMC Clinical Exam notes, realistic mock OSCE stations, structured feedback sessions, and other practical study resources to prepare effectively and confidently for your next attempt. For more strategies that complement AMC clinical performance, see our AKT timing guide and our free KFP case packs.
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] Australian Medical Council. 2023. Australian Medical Council Ltd 2022 to 23 Annual Report. Canberra, ACT: AMC. URL: https://www.amc.org.au/wp-content/uploads/2023/11/AMC-2022-23-Annual-Report.pdf
[2] Australian Medical Council. n.d. Clinical examination, format and timing, and specifications. Retrieved November 2025, from the AMC website. URL: https://www.amc.org.au/pathways/standard-pathway/amc-assessments/clinical-examination/
[3] Australian Medical Council. 2024. Tips from Examiners, Clinical Examination guidance, PDF. Retrieved November 2025, from the AMC website. URL: https://www.amc.org.au/wp-content/uploads/2024/10/2024-10-02-Tips-From-Examiners.pdf
[4] Royal Australian College of General Practitioners. 2020. A guide to understanding and managing performance concerns in international medical graduates. East Melbourne, VIC: RACGP. URL: https://www.racgp.org.au/education
[5] General Practice Registrars Australia. n.d. What if you fail an exam. Retrieved November 2025, from the GPRA website. URL: https://gpra.org.au/what-if-you-fail-an-exam/
[6] Australian Medical Council. 2024, April 25. Changes to the AMC clinical pass requirement, news update, pass requirement 9 of 14 effective 21 March 2024. Retrieved November 2025, from the AMC website. URL: https://www.amc.org.au/news-and-updates/change-to-pass-requirement-for-the-clinical-examination/
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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
Failing the AMC Clinical Exam can feel disheartening, especially after months of hard work and sacrifices. You are not alone if you have faced this challenge. Only 21% of candidates pass the AMC Clinical Exam in recent years [1]. The AMC also confirms that each clinical station is 10 minutes and the circuit comprises 16 assessed stations plus 4 rest stations [2], with the pass requirement updated to 9 of 14 scored stations effective 21 March 2024 [6].
This blog, Why Candidates Fail the AMC Clinical Exam, and How to Pass on the Next Attempt, delves deeply into exactly where candidates commonly go wrong. We will explore real, evidence based reasons behind these outcomes and share practical strategies so your next attempt is successful and confident. For practical pacing strategies across written and clinical assessments, see our AKT timing guide and our free KFP case packs for structured safety netting practice.
Not Completing All AMC Clinical Exam Tasks Exactly
Candidates often fail by not completing every required task exactly as described in AMC guidance. AMC examiners explicitly note, “Incomplete performance of all the tasks is unlikely to constitute an overall satisfactory performance” [3]. Your first aim in every station is completeness and safety, not speed. A disciplined structure helps you hit every required step before the bell.
Common pitfalls include:
Mismanaging time by spending too long on one part of the task.
Forgetting key parts of examination or history due to rushing.
Jumping to conclusions or diagnoses too early, missing essential steps.
For example, in a chest pain station, jumping to a reflux explanation without a focused cardiovascular history and a targeted examination risks missing an emergency. Practising timed mock stations trains you to cover the brief precisely, to summarise briefly, and to close with clear next steps. Consider building a simple internal checklist for station types, history then focused exam then explanation then management then safety netting, so every patient interaction shows completeness that examiners expect [3].
For more granular techniques and checklists that align with Australian primary care consulting, see our consultation structure guide for GP trainees.
Incomplete Differentials and Lack of Safety Netting
Failing to provide complete differential diagnoses or clear safety netting is a common reason for station failure. Examiners expect you to name the likely diagnosis, to cover serious alternatives, and to say what the patient should do if symptoms worsen or change. Leaving out a red flag condition or forgetting explicit follow up instructions is scored as incomplete, even if your leading diagnosis is plausible [4].
To strengthen your performance:
State serious differentials early, for example acute coronary syndrome, ectopic pregnancy, appendicitis.
Provide specific safety netting, for example when to call an ambulance, when to return, who to contact after hours.
Practise generating succinct differentials and precise safety net steps in every mock case.
Imagine a patient with lower abdominal pain. If you do not mention ectopic pregnancy risk and if you do not tell the patient exactly when to seek urgent care, you have not demonstrated safe intern level practice. The AMC stations are short by design, 10 minutes per station [2], so crisp differentials and clear safety netting are essential signals of safe practice. Embedding this habit in mock circuits makes it automatic on exam day.
If you want targeted drills, see our differential diagnosis flashcards that pair red flag recognition with one line safety net statements.
Communication Style Not Suitable for Australian Patients
Poor communication is another major hurdle. AMC examiners discourage technical jargon and euphemisms. They explicitly recommend clear, compassionate explanations in everyday language, with checks for understanding and space for questions [3]. Your clinical reasoning only earns marks if the patient and examiner can follow your thinking.
To communicate effectively and naturally:
Translate clinical ideas into plain English and avoid jargon.
Check the patient’s understanding and confirm agreement with the plan.
Respond to concerns directly and show empathy with brief, sincere statements.
For example, rather than saying, you have essential hypertension, use, you have high blood pressure, which may increase your risk of heart problems, let us look at the best ways to bring it down and keep you well. This is patient centred, it is aligned with AMC expectations, and it is efficient within 10 minutes [2, 3]. If you want structured language templates, see our patient friendly explanation bank for common AMC scenarios.
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:
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Review flashcards during commutes or between patients.
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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.
Frequently Asked Questions (FAQ)
1. What is the pass rate for the AMC Clinical Exam
The AMC Clinical Exam overall pass rate reported in the most recent AMC Annual Report is 21% [1]. The AMC also notes a pass requirement of 9 of 14 scored stations effective 21 March 2024 [6] and confirms a station time of 10 minutes within circuits comprising 16 assessed stations plus 4 rest stations [2]. These figures frame the level of performance and consistency expected during the circuit.
2. Why is the AMC Clinical Exam so difficult
The exam assesses extensive clinical skills across multiple disciplines under strict time pressure. Each station lasts 10 minutes and requires you to collect key information, to reason aloud, and to communicate a safe plan clearly and briefly [2]. That combination of structure, breadth, and pace is challenging by design and reflects the safe intern standard expected in Australian settings [3, 4].
3. What common mistakes cause candidates to fail
Common errors include incomplete task execution, insufficient differential diagnoses that omit red flag conditions, inadequate safety netting, and explanations that are too technical or unclear [3, 4]. The cure is a short internal structure you can use reliably in 10 minutes and a communication style that is plain, compassionate, and efficient [2, 3].
4. How can I improve my communication skills
Practise with patient friendly explanations, check understanding routinely, and use short empathic statements that validate concerns. The AMC’s examiner guidance emphasises avoiding technical language and euphemisms, and demonstrating clarity throughout [3]. Targeted mock consults with structured feedback accelerate improvement and make these habits automatic in the circuit [5].
5. What should I do after failing the AMC Clinical Exam
Review your feedback and reconstruct the circuit from memory to identify recurrent misses, for example time loss during examination setup or thin differentials. Build a plan with regular mock stations, one measurable focus goal per session, and a feedback loop with a supervisor or peer [5]. This methodical approach restores confidence and improves the likelihood of meeting the 9 of 14 pass threshold within the 10 minute station structure [2, 6].
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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