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How did candidates perform in the most recent Fellowship exam and what are some tips to improve?

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The 2022.1 CCE had a pass rate of 85%.

The Clinical Competency Exam (CCE) is the final exam on the pathway to Fellowship of the RACGP (FRACGP).

 

Blueprinted to both the RACGP Curriculum and the clinical competency rubric, the CCE is designed to assess clinical competence and readiness for independent practice as a specialist GP at the point of Fellowship.

 

The CCE was introduced in 2021 to replace the Remote Clinical Exam (RCE) and the Objective

Structured Clinical Examination (OSCE).

 

The 2022.1 CCE was delivered remotely to all candidates via videoconferencing technology in two streams on non-consecutive days: Saturday and Sunday, 18–19 June and Saturday and Sunday, 25–26 June.

 

The RACGP’s latest published report shows a total of 780 candidates sat the 2022.1 CCE, of whom 663 passed.

 

This translates to a pass rate – the percentage of candidates who achieved the standard expected at the point of Fellowship – of 85%.

 

Consisting of nine clinical cases, average reliability of the exam was 0.72, reflecting the clinical performance of the candidates.

 

From the report, the college identifies those successful candidates were able to demonstrate an ‘empathic and non-biased approach to patient management’, taking into consideration the context of each patient case study.

 

For those who did not perform as well, the report outlines areas which require improvement.

 

One key area was not demonstrating a patient-centred approach and lack of clinical reasoning ability and understanding of individual patient context and needs, for example culturally and linguistically diverse patients.

 

The college recommends competent candidates should demonstrate a non-judgemental and tailored approach to all patients, rather than formulaic responses or assumptions without considering individual circumstances, which may lead to incorrect conclusions.

 

Preparing for the exam is paramount, the RACGP reminds, and includes reflecting on areas of practice with which a candidate might be less familiar and addressing these gaps.

 

Continuing to work in, and reflect on, comprehensive clinical practice is a primary part of preparation.

 

‘It is essential to practice case-based discussions with supervisors and colleagues,

and it is important to understand and apply the clinical competencies, as outlined in the clinical

competency rubric,’ the RACGP exam report states.

 

‘A structured and systematic approach will assist candidates to encompass important potential

diagnoses that guide their history, examination, investigations and management.’

 

The exam report also reveals the pass rate by number of attempts for the 2022.1 CCE, further highlighting the importance of exam preparation:

  • First attempt: 90.09%
  • Second attempt: 64.37%
  • Third attempt: 57.89%
  • Fourth and subsequent attempts: 27.78%

To further assist candidates in preparation for the exam, the RACGP recommends a two-part CCE preparation course available on gplearning.
 
The first module includes information on the competencies being assessed in the CCE and how they can be demonstrated by candidates, with the second a guided exam preparation activity that includes cases, marking grids and video examples.
 
The college also has a suite of CCE support resources available.
 
This guidance may also support candidates who are preparing for the 2022.2 CCE and the other FRACGP exams – the Key Feature Problem (KFP) exam and Applied Knowledge Test (AKT).
 
The CCE 2022.2 is scheduled for:

  • Day one: Saturday and Sunday, 5–6 November 2022
  • Day two: Saturday and Sunday 12–13 November 2022

Results will be released Thursday 15 December 2022.
 
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By GIL