AKT and KFP information for candidates

Page last updated 13 March 2025

Applied Knowledge Test (AKT) and Key Feature Problem (KFP) Frequently Asked Questions (FAQs)

 

Update to Key Feature Problem exam format

 

The Key Feature Problem (KFP) exam format has been updated to remove handwritten responses.

The exam consists of 70 individual scenarios, each with a multiple selection question (MSQ) that is answered on a paper bubble sheet. This format will be familiar to all candidates as it is similar to that used in the Applied Knowledge Test (AKT). 

For further details, expand the FAQ sections below.

Both the AKT and KFP will be delivered on paper. You will complete a multiple-choice answer sheet for both exams by shading the corresponding bubbles on computer-readable answer sheets. We’ll provide you with pens. You’re not permitted to use pencils or provide your own pens as these may not be visible to the scanning software.

There’s no negative marking for incorrect answers, therefore it's in your best interest to select the requested number of responses for each question.

Due to the difference in the number of responses requested per question, KFP questions contain variable marks that contribute equally to the final mark. Making each question worth 1.43% or 1/70 of your overall score.

However, it's important you read how many answers are requested. If you shade more options on the bubble sheet than you were asked for, each response will be marked, but a 0.35% penalty will be deducted from the overall mark of your paper, per additional bubble shaded.

Further information on marking and examples of questions and scoring can be found in the AKT and KFP Guide.

Paul Holt, aged 56 years, has noticed mild pain gradually increasing in his left scrotum over the last two weeks. He has increased pain when sitting. He has not had any penile discharge but has noticed mild stinging at the end of urination. He married his wife Michelle four months ago. He has never had sex with men.

Examination findings: 

  • Temperature is 37.6oC 
  • Heart rate 83/min regular 
  • Blood pressure 135/90 mmHg 
  • Scrotal examination; normal position of the testes with tenderness at the superior pole of the left testis. Normal cremasteric reflex

You commence Paul on appropriate dosages of paracetamol and ibuprofen. What are the MOST appropriate next steps? Select four (4) from the following list. 

  1. Ceftriaxone 500mg in 2ml of 1% lignocaine intramuscularly
  2. Doppler ultrasound of the scrotum
  3. Doxycycline 100 mg twice daily for 14 days
  4. First void urine for chlamydia and gonorrhoea PCR
  5. Indometacin 100mg rectally as a single dose
  6. Manually externally rotate the left testis
  7. Prostate specific antigen
  8. Reassure that symptoms are likely to settle without treatment
  9. Refer to urologist for scrotal exploration
  10. Refer urgently to the Emergency Department
  11. Tapentadol controlled-release 50mg twice daily
  12. Trimethoprim 300 mg daily for 14 days
  13. Urethral swab for herpes simplex virus PCR
  14. Urethral swab microscopy, culture and sensitivity
  15. Urine microscopy, culture and sensitivity

A. Ceftriaxone 500mg in 2ml of 1% lignocaine intramuscularly (Score: 1) 

C. Doxycycline 100 mg twice daily for 14 days (Score: 1) 

D. First void urine for chlamydia and gonorrhoea PCR (Score: 1)

O. Urine microscopy, culture and sensitivity (Score: 1)

This is a four answer multiple selection question with a mixture of investigations and management options. This patient presents with two weeks of worsening scrotal pain , low grade fever, superior pole tenderness of one testis and mild dysuria, in the setting of a heterosexual relationship. The most likely presenting complaint in this setting is epididymo-orchitis. In sexually active men of any age, Chlamydia trachomatis and Neisseria gonorrhoea are the most likely causative organisms. It is appropriate to commence empirical treatment whilst awaiting the results of investigations. A urine microscopy and culture is appropriate to determine if the cause is non-sexually transmitted. The stem describes his pain as mild and he is unlikely to need analgesia other than paracetamol and ibuprofen.

He has had this pain for more than 48 hours making acute torsion unlikely. His degree of pain is also not severe. He has a low-grade fever and dysuria which makes appendix torsion also less likely.  

Urgent steps such as a doppler ultrasound, surgical input, or emergency department review is not required at this stage. Reassurance that symptoms will settle, which may be appropriate in testicular appendix torsion, would not be appropriate here.

Clare Parker, aged 4 years, presents for her routine scheduled immunisations with her mother Heather. Clare has had a persistent cough for ten days. She also had a runny nose and fever when the cough started, however these symptoms have now settled. Clare has vomited several times after episodes of coughing but is eating and drinking normally.

Clare last had her routine childhood immunisations at age 18 months. She attends daycare two days a week.

Examination findings: 

  • Appears well although has frequent spasms of coughing 
  • Temperature 36.9oC 
  • Heart rate 90/min regular 
  • Respiratory rate 20/min 
  • Oxygen saturation 99% on room air 
  • Respiratory examination; chest auscultation is unremarkable 

You arrange appropriate investigation of Clare’s cough which confirms the most likely diagnosis.

What is the MOST appropriate management for Clare? Select three (3) from the following list.

  1. Advise Clare can return to daycare after 5 days of treatment
  2. Advise Clare can return to daycare tomorrow
  3. Advise Clare must not return to daycare until her symptoms are resolved
  4. Advise Clare should delay her routine immunisations for two weeks
  5. Advise Clare’s mother should contact the relevant public health unit
  6. Advise to avoid lactose for four weeks
  7. Advise to proceed with routine immunisations
  8. Amoxicillin-clavulanate 22.5mg/3.2mg/kg/dose 12 hourly for 14 days
  9. Clarithromycin liquid 7.5mg/kg/dose 12 hourly for 7 days
  10. Oral rehydration solution 10mL/kg/hour
  11. Prednisolone 1mg/kg/dose once daily for 5 days
  12. Salbutamol 100mcg/dose 6 puffs via spacer and mask 4 hourly as required

A. Advise Clare can return to daycare after 5 days of treatment (Score: 1)

G. Advise to proceed with routine immunisations (Score: 1)

I. Clarithromycin liquid 7.5mg/kg/dose 12 hourly for 7 days (Score: 1)

This is a three answer multiple selection question with a mixture of pharmacological and non-pharmacological management options. Candidates need to first identify that the most likely diagnosis is whooping cough (pertussis). As the cough has been present for less than 14 days, appropriate antibiotic treatment is indicated to reduce the risk of transmission to others. Exclusion from daycare is required until 5 days of therapy has been received, or if coughing has been ongoing for more than 21 days. Children should still complete the pertussis immunisation schedule if they contract whooping cough.

The child in this case is still eating and drinking normally, therefore oral rehydration is not required. As pertussis is a notifiable disease it is the GP’s responsibility to notify the Public Health unit. Other distractors relate to incorrect diagnoses (such as asthma, gastroenteritis or protracted bacterial bronchitis).

Sharon Edge, aged 47 years, presents to your clinic in tears. Her husband of 23 years passed away last month from multiple myeloma. While his death was not unexpected, she is having difficulty coming to terms with this.  

Since her husband’s death, Sharon has felt flat and sad, and has had difficulties sleeping. She often lies awake for an hour or two at night before being able to sleep through until morning. Her sister and mother live nearby and are a good support for Sharon. She has been able to talk to them about her concerns and does not think she needs other people to talk to. She has not had any thoughts of self-harm. 

Sharon experienced mild anxiety many years ago, however, is usually happy and settled. She continues to work as an accountant at her long-term workplace but is finding it difficult to concentrate and she is worried about making mistakes at work. 

You provide brief counselling and support today.  

What are the MOST appropriate next steps? Select two (2) from the following list.   

  1. Amitriptyline 25 mg at night 
  2. Escitalopram 10 mg daily 
  3. Mental health care plan 
  4. Offer a GP follow up appointment in one week
  5. Provide Centrelink medical certificate 
  6. Provide medical certificate for bereavement leave
  7. Refer to psychologist for cognitive behavioural therapy 
  8. Refer to psychiatrist  
  9. Temazepam 10 mg at night for 2 weeks 

D. Offer a GP follow up appointment in one week (Score: 1) 

F. Provide medical certificate for bereavement leave (Score: 1) 

This is a two answer multiple selection question with pharmacological and non-pharmacological management options. This question is designed to explore a candidate’s competency with managing a patient presenting during a normal grieving process. Normal grief is not a mental health disorder and does not necessarily require medication or formal psychological care. Sharon would benefit from some time away from work given her concern about making mistakes however is unlikely to require a prolonged period of leave and Centrelink support. It is appropriate to offer ongoing GP support however she does not require intensive psychological therapy at this stage. 

Anti-depressant medications are not appropriate as she does not display features of major depressive disorder. She is not suitable for a mental health care plan as she does not have a formal mental health diagnosis at this stage. There may be benefit to her seeing a psychologist in the future, however she states that she has enough support at this time, so this is not currently required.  

While she has some difficulties getting to sleep, she can sleep through the night and does not require hypnotic medication.

Danielle Martin, aged 24 years, presents with three days of bloody vaginal discharge and pelvic pain. She reports one new male partner with whom she has had penetrative sex in the past two months. She has also noticed intermenstrual vaginal bleeding but thought this was due to her etonogestrel 68 mg implant which was inserted five months ago. She did a home pregnancy test last night which was negative. 

Past medical history: 

  • Nil 

Medications:

  • Etonogestrel 68mg implant 

Examination findings: 

  • Temperature 36.9oC 
  • Heart rate 89/min regular 
  • Respiratory rate 16/min 
  • Blood pressure 122/79 mmHg 
  • Abdominal examination; lower abdominal tenderness, no guarding or rigidity 
  • Speculum examination; bloody mucopurulent discharge from the external cervical os 
  • Bimanual examination; cervical motion tenderness 

What is the MOST appropriate pharmacological management? Select three (3) from the following list. 

  1. Amoxicillin-Clavulanate 875 mg/125 mg twice daily   
  2. Benzathine benzylpenicillin 2.4 million units intramuscularly as a single dose  
  3. Cefotaxime 2 g intravenously as a single dose  
  4. Ceftriaxone 500 mg intramuscularly as a single dose
  5. Ciprofloxacin 500 mg twice daily  
  6. Clindamycin 2% vaginal cream 1 applicatorful intravaginally at night  
  7. Doxycycline 100 mg twice daily
  8. Imiquimod 5% cream topically three times weekly 
  9. Metronidazole 400 mg daily
  10. Probenecid 1 g as a single dose  
  11. Trimethoprim-Sulfamethoxazole 160 mg/800 mg twice daily  
  12. Ulipristal 30 mg as a single dose  

D. Ceftriaxone 500 mg intramuscularly as a single dose (Score: 1) 

G. Doxycycline 100 mg twice daily (Score: 1) 

I. Metronidazole 400 mg daily (Score: 1) 

This is a three answer multiple selection question with pharmacological management options. This question presents a patient with non-severe pelvic inflammatory disease (PID), which is usually caused by either sexually transmitted infections or vaginal flora.  Answers relate to pharmacological management and require knowledge of best practice guidelines. It is recommended to begin treatment immediately once the provisional diagnosis is made, without waiting for investigation results. Intramuscular ceftriaxone, metronidazole and doxycycline are first line treatment options for non-severe pelvic inflammatory disease. Intravenous cefotaxime is used for treatment of severe pelvic inflammatory disease. 

Amoxicillin-clavulanate is used for postprocedural pelvic infection or pyelonephritis.  

Trimethoprim-sulfamethoxazole is used for postprocedural pelvic infection for those who have hypersensitivity to penicillins. Ciprofloxacin is used for pyelonephritis in adults with penicillin hypersensitivity. Intramuscular benzathine benzylpenicillin is used for treatment of early syphilis. Imiquimod cream is used for treatment of genital warts. Probenecid forms part of the treatment for gonococcal urethritis in areas where penicillin-resistant gonorrhoeae is less common, such as remote areas of northern and central Australia. 

It is unlikely that Danielle is pregnant so ulipristal as emergency contraception is less appropriate. 

Molly Larson, aged 59 years, presents with three months of dry and red hands. She has been applying hydrocortisone acetate 0.5% cream topically daily for the past three months. She thinks the cream has stopped working as her hands always feel itchy and dry. She washes her hands any chance she gets with soap and water because they feel dirty all the time. She always takes gloves and hand sanitiser with her when she goes out, fearing that she will not be able to wash her hands. She tells you that she developed this habit during the COVID-19 pandemic. 

Examination findings: 

  • Both hands; dry rash with erythema, scaling and fissuring, worse on the dorsal surfaces and between the fingers 

You provide appropriate advice regarding reducing hand washing frequency and avoiding soap. 

What is the MOST appropriate further management? Select four (4) from the following list. 

  1. Agomelatine 25 mg daily 
  2. Ceramide based cream as required  
  3. Cognitive behavioural therapy  
  4. Diazepam 5 mg daily as required 
  5. Eye movement desensitisation and reprocessing therapy 
  6. Fluoxetine 20 mg daily  
  7. Imiquimod 5% cream topically once daily for six weeks  
  8. Mometasone furoate 0.1% ointment topically once daily until skin is clear 
  9. Mupirocin 2% ointment topically twice daily for five days  
  10. Prednisolone 25mg daily for five days 
  11. Pregabalin 25 mg twice daily  
  12. Promethazine 25 mg at night 
  13. Single session psychological debriefing regarding the COVID-19 pandemic 
  14. Sorbolene lotion as required 
  15. Suvorexant 15 mg daily   
  16. Terbinafine 1% cream topically twice daily for 14 days 

B. Ceramide based cream as required (Score: 1) 

C. Cognitive behavioural therapy (Score: 1) 

F. Fluoxetine 20 mg daily (Score: 1) 

H. Mometasone furoate 0.1% ointment topically once daily until skin is clear (Score: 1) 

This is a four answer multiple selection question with pharmacological and non-pharmacological management options. This question presents a woman with a provisional diagnosis of obsessive-compulsive disorder, with compulsive hand washing resulting in hand dermatitis. Management options address both aspects of the diagnosis and include pharmacological and non-pharmacological options.  

First line treatment of obsessive-compulsive disorder includes cognitive behavioural therapy and exposure and response prevention, and selective serotonin reuptake inhibitors. Treatment of her hand washing dermatitis includes use of emollients and short courses of topical corticosteroids. Ceramide-based emollients are likely to be more effective than sorbolene cream given the provided history. Molly has already tried hydrocortisone acetate 0.5% topically, so a more potent topical corticosteroid is indicated. Oral corticosteroids may be needed in severe cases however in the given scenario it is reasonable to trial a more potent topical corticosteroid first. 

There are no strong features of depression or neuropathic pain, and Molly has not described difficulty sleeping, therefore agomelatine, pregabalin, promethazine and suvorexant are not indicated. Diazepam is not recommended first-line in obsessive compulsive disorder. Eye movement desensitisation and reprocessing therapy is used in post-traumatic stress disorder, which is a less likely diagnosis given the key features. Single session psychological debriefing is not appropriate in this case. 

Imiquimod cream is used in treatment of warts and solar keratoses. Mupirocin is used in bacterial skin infections. Terbinafine is used in fungal skin infections.  

Exam preparation materials are being updated, with more to be released ahead of the 2025.2 exams.

  • Exam Support Online (ESO) modules, Exam Support Program (ESP) modules and Self-Assessment Progress Testing (SAPT) are available on gplearning using your RACGP member login details, and you can access them multiple times. Once logged in to gplearning, go to the LMS Dashboard and either:
    • click on the 9-squares icon (also known as the ‘waffle’) at the top of the screen. If enrolled, ‘Exam Support Online – ESO' will appear in the dropdown list, or
    • click on ‘Exams’ in the Topic links, under the Content Quick Search panel, to enrol.

The ESO modules explain the AKT and KFP exams and walk you through examples. They advise how to approach and answer the exam questions, how to avoid common pitfalls and how to optimise your answers. Note: if you have previously undertaken this course, it will still appear as “completed”, however the modules have been updated.

No. There will be no change to your candidacy or existing exam results.

You will receive a note paper booklet in your exam kit.

You may underline, circle or flag key information and may make notes in the question booklet if you wish to do so. However, other than shading in the selected bubbles, it is critical that you do not make any notes or other marks in the answer booklet (bubble sheet).

Friday 4 April

2025.2 AKT and KFP enrolments open

Thursday 1 May

AKT and KFP enrolments close / Deadline for AKT and KFP special arrangements applications

Tuesday 13 May

AKT and KFP National Assessment Advisor open letter emailed to candidates

Tuesday 20 May

AKT and KFP practice exam, answers and rationale emailed to candidates

Tuesday 27 May

Venue confirmed and important exam details provided

Thursday 5 June

Deadline for AKT withdrawals to receive a fee refund

Friday 6 June

Deadline for KFP withdrawals to receive a fee refund

Tuesday 24 June

Exam day reminder emailed to candidates

Friday 4 July

2025.2 AKT exam day

Saturday 5 July

2025.2 KFP exam day

Friday 22 August

2025.2 AKT and KFP results release

You can access your exam results and assessment statement by logging in to the RACGP website on the date the results are published. AKT and KFP pass marks will not be published on the RACGP website or provided to candidates. You’ll receive your results as a Pass or Fail mark, along with the score band (ranging from F4 – P4). P1 is the first band above the pass mark, and P4 is the highest band. F1 is first band below the pass mark, and F4 is the lowest band. Individual scores are not provided. This is in line with recent changes to how results are provided for the CCE.

The AKT and KFP are auto-marked. The pass mark for each AKT and KFP is determined by actively practicing Fellows who set the standard for each exam, using an internationally recognised standard setting methodology. For more information about marking and standard setting, refer to the AKT and KFP guide.

Bubble answer sheets are scanned, and your answers will be digitally recognised. Where the computer cannot confidently identify your answer, human intervention is used to recognise your intent – this is most common when you’ve had to cross out an answer.

Both the AKT and KFP will be held at 11am (local time) in each venue. There are not multiple sessions.

Both exams have a duration of four hours.

A full list of exam locations is available here. You will be asked to list your preferred location when enrolling.

All enrolled candidates will receive an exam venue confirmation email approximately six weeks prior to the exam. You are advised to wait until your venue has been confirmed before making travel arrangements.

If you have not received your venue confirmation after this week, please contact examinations@racgp.org.au.

Candidates are permitted to bring the following items into the exam room without an approved special arrangement:

      Medicine and medical devices

  • Medication – if in original pack
    • EpiPens
    • inhaler
    • simple analgesia
    • prescription medications where doses are required during the exam time
    • insulin
  • Diabetes / blood glucose monitoring devices or insulin pumps. You can bring your blood glucose monitor as well as your insulin to help maintain your blood sugar levels. If your phone is required, it must be on flight mode with all sounds disabled and must be placed on your desk in view of the invigilators.
  • Eye drops
  • Ear drops
  • Nasal spray
  • Hearing aids

      Food and water

  • A small amount of food such as a muesli bar or lollies. Please note the food must be of a type that creates minimal disruption to other candidates and minimal noise when consumed (no plastic wrappers). Hot food or food with nuts or strong odour is not permitted. Food should be in a clear zip lock bag. Chewing gum (not bubble-gum) is allowed but must be disposed of appropriately.
  • Still water (not carbonated/sparkling) in up to two (2) clear, colourless plastic bottles – the bottles can’t have any writing on them, labels must be removed, and you should place these bottles on the floor or beside your chair only (not on your desk) during the exam

      Comfort aids

  • Prescription / reading glasses (can be in case with cleaning cloth)
  • Lip balm
  • Feminine hygiene products – in plain, unlabelled packaging and placed in a clear zip lock bag
  • Tissues – a small pack in their original packaging
  • Hand towel
  • Ear plugs – non-electronic earplugs (rubber, foam, plastic etc). If you choose to use earplugs, it’s your responsibility to ensure you can hear any announcements the invigilator makes.
  • Face mask
  • Pen grip
  • Highlighters – maximum two, blue and/or yellow only
  • Cushion
  • Clear ruler
  • Small tube of hand cream

All items must be reviewed at registration and may not be allowed in the exam if they don’t meet the requirements. Ear plugs and tissues will be provided at all venues.

Candidates are not permitted to bring the following items into the exam room:

  • Pens, pencils, or other writing devices or stationery of any kind (other than those on the authorised items list). Pens will be provided in all examinations.
  • Paper including blank notepaper, notes, books or notebooks
  • Mobile phones
  • Watches of any type
  • Timing or recording devices, calculators, computers, iPads, iPods, tablets, organisers or electronic devices of any type
  • Electronic or active earplugs or headphones or ear muffs
  • Non-religious headwear, hats or hooded jackets/jumpers/tops
  • Any bags or other personal belongings. Your invigilator will advise where to place your belongings. This may be in a dedicated space or within the exam room where they are not to be accessed.

Check that you don’t have any of these items on you before you start your examYou may be asked to pat yourself down (eg along the arms, legs and waistline) to show that you are not concealing banned items.

You may also be asked to turn out your pockets so exam staff can verify that they are empty.

You need to bring photo identification (ID) to your exam. This must be a current (not expired), original document. Digital IDs (IDs on a mobile phone app), scans or copies are not accepted. Accepted forms of ID are:

  • passport
  • Australian driver’s licence
  • proof-of-age or identity card issued by an Australian state or territory
  • Australian student identity card
  • any other Australian entitlement or identity card issued by the Australian Federal Government or a state/territory government that includes a photograph.

The name on your ID must match your name in our records. If your ID doesn’t match our records, contact examinations@racgp.org.au at least 48 hours before your scheduled exam time. Middle names are not considered, only first and last names. If we can’t confirm your identity before your exam, you may not be permitted to sit.

No. You must use the black ball-point pen you are provided with on exam day to ensure your paper can be scanned by our exam vendor.

Inks from fountain pens, markers, and other types of pens are prone to smudge, bleed, or run, which could make your answers harder to read, or may not be compatible with the scanning process. We will have ample spare pens at each venue in case your pen stops working. However, you are welcome to bring your own pen grip. See “What can I bring into the exam room” for full list of permissible items.

If you make a mistake in a multiple-choice question, place a cross through the circle you want to remove and shade a new choice. To re-select a crossed-out answer, circle your choice and make sure to cross out any unwanted choices. If there is any doubt, a human examiner will review your answer.

If you need to change a response to a written question, cross it out and re-write it nearby. Ensure it is obvious which question your answer applies to.

Every venue will have a small number of spare papers available if a candidate’s original paper is damaged during the exam.

All candidates enrolled in the AKT or KFP will receive a PDF copy of the paper-based practice exam. The practice exam format is the same as the real exam format. The exam booklets on exam day are printed and bound, not loose-leaf.

The RACGP has well-established procedures for handling incidents in exam venues. If there is an interruption, please follow the instructions provided by staff at the venue.

Make sure you record the correct enrolment and exam dates in your calendar. Please refer to  Enrolment Dates for further details.

Requests for late enrolment will no longer be accepted outside the enrolment period.

Refer to Part 2: RACGP Fellowship Examinations, Section 3 Withdrawing from an examination of the Assessments and Examinations Candidate Handbook.

If you request to withdraw from the AKT or the KFP more than 20 business days before the scheduled exam, you will receive a refund of the enrolment fee, minus a $100 withdrawal fee per exam segment.

If you request to withdraw less than 20 business days before the scheduled exam date, you will not receive a fee refund. For further details, please refer to the Exam results, marking and dates section above.

Check your eligibility criteria on the policy framework.

The RACGP audits all exam enrolments to ensure candidates are eligible to sit the Fellowship examinations and provides enrolment information to all RTOs for the purposes of validating eligibility. If you are found to not meet the eligibility requirements, you will be automatically withdrawn from the exam segment and will be subject to a $100 withdrawal fee per exam segment.

Remember, you must tell us of any restrictions, conditions, suspensions and/or undertakings on your medical registration as soon as possible. This will help us support you appropriately on your journey to Fellowship.

Subject to the limitations of the Fellowship Exams Policy (AGPT, RVTS and FSP candidates) or the Fellowship Exam Attempts Policy (GPE pathway candidates), you can apply for suspension of your candidacy in any semester in which you do not sit an exam.

You cannot sit exams if you have suspended the semester.

Following the exam/s, you will have the opportunity to provide feedback about your experience via an online survey sent to your email. The evaluation findings are used to inform quality assurance and continuous improvement initiatives (guided by the RACGP Monitoring and Evaluation Framework), thereby ensuring processes for future exams are of the highest quality. All feedback gathered is confidential (see the RACGP Privacy Policy ). We would greatly appreciate you taking the time to complete the survey!

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