A guide to completing the PEP Specialist Stream Comparability Assessment

Policy notice

From 22 November 2023 an exemption will apply to the following Continuing Professional Development (CPD) requirements for Comparability Assessments:

  • Any 50 hours of CPD in the 12 months prior to applying for your comparability assessment will be eligible to be assessed – the requirements for demonstrating breadth and a limit on the maximum hours per day will be removed. (clause 3.3.4.a.a – 3.3.4.a.b). 
  • Ten Clinical Case Analyses will no longer be required to be submitted or assessed (clause 3.3.4.c)

This will apply to all pending and new applications. You do not need to contact the RACGP to confirm this change if you have an application pending, the exemption to the requirement will be automatically applied.

1. Introduction

Specialist international medical graduates (SIMGs) seeking to enter the PEP Specialist Stream must complete the Comparability Assessment to be assessed for comparability to an Australian-trained specialist general medical practitioner.

2. Definitions

  1. Applicant means a medical practitioner who is applying for entry onto the PEP Specialist Stream.
  2. Comparability means the extent to which an SIMG’s recency, continuity of practice, continual professional development, assessment methods, training, qualifications and clinical experience is assessed as equivalent to an Australian-trained specialist general practitioner at the point of Fellowship.
  3. PEP means the Practice Experience Program.
  4. RACGP means the Royal Australian College of General Practitioners
  5. SIMG means Specialist international medical graduate.
  6. Recency means clinical recency in general practice, and is not the same as continuity of employment. Recency is assessed under the RACGP’s Practice Experience Program – Specialist Stream Assessment of Recency Policy. Please note the RACGP’s assessment of recency differs from the Medical Board of Australia’s recency of practice standards.

3. Guidance

3.1 Check your eligibility

The RACGP has assessed a number of specialist general practice qualifications as listed here.

If you hold a recognised specialist general practice qualification, you may be eligible to apply to the PEP Specialist Stream.

If your specialist qualification is not listed, your curriculum must be assessed before you can apply for a comparability assessment.

To have your qualification assessed please contact educationsupport@racgp.org.au.

If you do not meet the eligibility criteria for the PEP Specialist Stream, you may consider the Fellowship Support Program to support your journey to Fellowship.

3.2 Accessing the Application

To apply for a comparability assessment you must have an RACGP ID number. If you do not already have one you can sign up for free.

To apply for a comparability assessment, please go to ‘Apply for the PEP Specialist Stream’.

Your application will include details on how to pay your assessment fee online. You must pay the fee before you can submit your application.

RACGP accepts Visa, MasterCard and American Express and PayPal.

3.3 Completing the application

Your application will be accessible for six months from the day of payment. It may take up to 90 minutes to complete. You can save your answers at any time and complete the application in any order. You may also nominate an agency or other third-party to complete the application on your behalf.

You will need to provide information regarding your personal details, your qualifications and work experience. You will also need to upload documentary evidence of your identity, qualifications and current registrations. All information will be handled as per the RACGP’s Privacy Policy.

Personal details

Complete the online form with your personal details.

You need to provide proof of identity by uploading a scan of the photo identification page of your passport. If you have changed your name, through marriage or otherwise, you must provide official evidence of your name change such as marriage certificate. Evidence of name change documentation must include your previous name and new name.

You are required to submit a comprehensive CV that lists all clinical experience from graduation to current. The CV must be signed and dated within the last three months and include an explanation for any gaps in clinical practice greater than three months.

Documentary evidence is required for gaps greater than 12 months. You must complete your CV within the application form online. Uploaded or emailed CVs will not be accepted.

3.3.1 Academic qualifications

You must provide:

  1. Your primary medical degree certificate
  2. Your specialist general practice qualification certificate
  3. A confirmation letter from the body which issued your specialist qualification which states the pathway followed and summative assessments undertaken to gain the specialist qualification (sometimes referred to as a Letter of Good Standing)
  4. A description of the theoretical and practical summative examinations undertaken as part of your specialist general practice qualification (100-300 words each). These descriptions can be drawn from official resources of the awarding institution, or can be written in your own words.

A list of the recognised summative exams is available in the appendix. If you have completed assessments that are not named in the appendix you may provide evidence as part of your application outlining why these assessments should be taken into consideration as part of their comparability assessment. This could include a letter of support from the specialist college outlining the assessment’s requirements and structure. Colleges should provide as much information as possible, preferably including sample exam questions, psychometrics, and public reports when available.

If original documents are not in English, you must provide certified official and endorsed English translations of these documents in addition to the originals.

3.3.2 Medical Registration

You must provide:

  1. Evidence of current medical registration for all jurisdictions of practice since you obtained your specialist general practice qualification (with expiry dates if applicable)
  2. An official copy of and explanation of any restrictions on the registration or current complaints pending

If original documents are not in English, you must provide certified official and endorsed English translations of these documents in addition to the originals.

3.3.3 Verification of qualifications

You need to apply for primary source verification of your primary and specialist general practice qualifications from the Educational Commission for Foreign Medical Graduates (ECFMG) through EPIC. Step by step instructions are available on the AMC website.

You must supply your AMC number in order to submit your application. You may submit your application before EPIC verification has been completed, however your comparability assessment may not be finalised until EPIC verification is received.

3.3.4 Continuing Professional Development (CPD)

You must:

    1. Complete 50 hours CPD in the 12 months prior to applying for your comparability assessment (the date of signing of the statutory declaration) that demonstrates a breadth of experience across a range of areas that are relevant to clinical general practice and meets the following criteria:
        1. A maximum of 10 hours per day of CPD, and
        2. A maximum 20 hours in each CPD area.
    2. Provide documentation showing the completion of 3.3.4.a which provides detailed evidence of:
        1. the nature of each CPD activity,
        2. the date of each CPD activity, and
        3. the number of hours completed for each CPD activity.
          1. Where a certificate does not give hours for an activity, there should be a statement from the relevant international College or similar giving a conversion of credits or points to hours. The RACGP will not accept CPD points statements if they do not include the number of hours undertaken.
    3. Submit ten Clinical Case Analyses within the comparability assessment. They must meet the following criteria: 
        1. provides reflection of a minimum of ten patients that you have treated,
        2. includes a variety of cases that demonstrates the scope of your practice,
        3. is completed on the approved Clinical Case Analysis template (found in the application).

3.3.5 General Practice Experience requirements

To support your application, you must provide evidence that your experience within the last 48 calendar months meets the requirements of the Practice Experience Program – Specialist Stream Assessment of Recency Policy. The RACGP’s clinical recency requirements differ from the Medical Board of Australia’s recency of practice standards. You must meet the RACGP’s clinical recency requirements prior applying for a comparability assessment.

For each role, you must provide a letter of support. The letter must:

  1. be dated and signed by the Practice Principal (preferably) or Senior Medical Director, CEO, Director, or Practice Manager
  2. be on practice letterhead
  3. state the specific dates you were/are employed
  4. state whether you worked full time or part time
  5. state the total hours worked each week
  6. state the duration of your weekly sessions (eg Monday-Friday 9am-12:30pm & 1:30pm-5pm)
  7. state the exact nature of the work you are/were required to undertake, including a detailed description of the duties you performed

It is not sufficient simply to say "the duties are everything a general practitioner does". The letter must give a detailed summary of the patients, presentations, management you saw and duties of your role.

If you have gaps in clinical practice you must provide supporting documentation:

  • gaps of 3 - 12 months require a detailed explanation
  • gaps greater than 12 months require a detailed explanation and supporting documentation such as medical certificates, travel receipts or employment contracts.

The RACGP recency requirements refer to clinical recency, not continuity of employment. Applicants who have taken leave for any reason during the 48 calendar months must still meet these requirements.

3.3.6 Statutory declaration

In order to submit your assessment you must complete and sign the statutory declaration form verifying certain uploaded documents. You need to print copies of your documents and take them, along with the originals to be signed by an authorised witness.

In order to verify the documentation, the witness must sight the original and the downloaded copy then list the verified documents in the space provided on the form, eg “Medical degree, medical registration”. All documents printed must be listed.

The statutory declaration is available here.

You must have the following documents verified:

  • Medical registration for all jurisdictions of practice
  • Letters of support from your practices.

For a list of authorised witnesses please visit the Australian Government Attorney-General’s Department.

3.3.7 Submit application

If there is any part of the application you have not understood, please request clarification from the RACGP by phone on 1800 472 247 or by email to educationsupport@racgp.org.au before you submit your application.

You will not be able to amend the application once you have submitted it, unless RACGP staff or Assessors request more information from you.

By submitting the application you confirm that you have given the RACGP true, accurate and complete information. Your application will be assessed based on the information you have provided, in line with the PEP Specialist Stream Comparability Assessment Policy.

If additional information or documentation is required you will be contacted via email and provided with a link to access your application again. All the information and documents you have uploaded will be accessible in the application and you can make any necessary adjustments.

3.4 Assessment Timelines & Outcome

  1. You must provide current, full and verifiable information in your application with sufficient detail to assess comparability.
    1. All documents must be in English, or be accompanied by certified official translations to English.
    2. The RACGP will take reasonable steps to verify the information provided; additional information or documentation may be requested to substantiate the assessment.
    3. Submission of plagiarised, false or misleading information will be handled as per the Academic Misconduct Policy.
  2. Your application will be reviewed by RACGP staff and then referred for assessment by the RACGP Assessors under the PEP Specialist Stream Comparability Assessment Policy. You could be asked for more information by the RACGP staff or by the assessors.
  3. You will receive a Summary of Preliminary Review (SPR) once your application has been reviewed by the assessors. You will have the opportunity to respond to requests from the assessors for additional information or clarification of information already provided.
  4. Completed applications may take up to 10 weeks to be assessed. A completed application is defined by the date at which all information is received and no further feedback is required. If the assessors require further information, this timeline may be extended.
  5. You will be advised of your comparability outcome via email. You must ensure the RACGP has your up to date email contact details. To change your email address please contact the RACGP on 1800 626 901 or email educationsupport@racgp.org.au.
  6. Components of the assessment outcome may also be used to inform your eligibility for other RACGP Fellowship pathways.
  7. Comparability Assessment outcomes are valid for 12 calendar months from the date of the outcome letter.

3.5 Reconsideration and resubmission

  1. If you believe the outcome has not fully considered any aspect of your application, you may submit a request for reconsideration within 10 business days of receiving your outcome. Reconsiderations are handled under the Dispute, Reconsiderations and Appeals Policy.
  2. If, after receiving your outcome, you believe you have additional evidence which would change that outcome, you may submit that additional evidence within 10 business days of receiving your outcome. Additional evidence which contradicts previously submitted evidence will not be considered. 
  3. If you wish to repeat the assessment at a later date, you may do so. You may complete further CPD or additional education, to improve your recency of practice, or to gain additional experience in general practice before submitting your new assessment.

4. References

Academic Misconduct Policy

Dispute, Reconsiderations and Appeals Policy

PEP Specialist Stream Comparability Assessment Policy

Specialist Stream Assessment of Recency

Appendix: Validated assessment instruments

A. Theoretical

Applicants applying to the PEP Specialist Steam must have completed a theoretical summative assessment in at least one of the following formats to be assessed as comparable under the PEP Specialist Stream comparability assessment process.

These formats are accepted as rigorously assessing a candidate’s capacity for knowledge and clinical reasoning, which can be defined as thinking through the various aspects of patient care to arrive at a reasonable decision regarding the prevention, diagnosis, or treatment of a clinical problem in a specific patient. Patient care includes history taking, conducting a physical exam, requesting laboratory tests and diagnostic procedures, designing safe and effective treatment regimens or preventive strategies, and providing patient education and counselling.

Clinical reasoning plays a major role in a doctor’s ability to make diagnoses and decisions. It can be considered as the physician’s most critical competence.



MCQ: Multiple Choice Questions.

This style of assessment requires candidates to analyse a clinical scenario, or stem, and choose the most appropriate answer from a list of possible options.

The assessment tests clinical knowledge, requiring candidates to synthesise the information provided in the clinical stem and use only the relevant clinical components to select an answer, and demonstrates a candidate’s ability to discard irrelevant clinical components and incorrect answers, or distractors.

EMQ: Extended Matching Questions (R-type MCQs)

This is a variation on the MCQ structure, but includes a series of clinical scenarios or stems rather than just a single scenario. This format allows for more in-depth assessment of clinical reasoning and problem solving skills; candidates are required to assess these thematically linked scenarios while discarding distractors and irrelevant clinical information to select the most appropriate answer from a common list of possible options.

The EMQ format comprises four parts for each question:

  1. A theme. This might be a symptom, investigation, diagnosis or treatment: for example, back pain, dyspnoea, diabetes, corticosteroids.
  2. The clinical scenario, or stem, which outlines the scenario
  3. The lead in statement, which outlines what is required of the candidate (ie provide the most likely diagnosis).
  4. A possible list of answers, or options.

SBA: Single Best Answer.

This format offers a single question with multiple alternative answers, from which the candidate must choose the single best answer; unlike other methods, the format does not offer many incorrect answers and one correct answer. Instead, it requires careful analysis of the information provided to determine which of the answers is most likely or the ‘best fit’.

AKT: Applied Knowledge Test.

This assessment may incorporate elements of the above formats; it is designed to test the application of knowledge in a clinical context, rather than knowledge alone. The questions, whether SBA or EMQ, comprise a clinical stem, a lead in statement informing the candidate of the question’s requirement, and a set of answer options.

KFP: Key Feature Problem.

This assessment is designed to test clinical reasoning and clinical decision-making by assessing how candidates analyse patients in the context of a given scenario, and how they consider the key features, or critical steps, required to resolve the clinical problem.

It is not a simple short-answer assessment, instead requiring candidates to write in their own answer (when appropriate, referring back to demographic, clinical and geographic information provided in the clinical stem).

Short notes paper

These papers require candidates to provide a written response in the format of short notes, bullet points, short paragraphs or essays on given topics or on a clinical scenario.

B. Practical

Clinical Examination, which depending on the time of sitting, is the Objective structured Clinical Exam (OSCE), Remote Clinical Exam (RCE) or the Clinical Competency Exam (CCE). This exam is designed to assess how a candidate integrates their applied knowledge and clinical reasoning when presented with clinical scenarios. It tests not only knowledge and reasoning but communication skills and professional attitudes in the context of consultations, patient exams or peer discussions. Clinical Examinations classically comprise a circuit of multiple clinical stations. Shorter stations do not focus on the entire consultation, rather focusing on certain aspects of a consultation. Longer stations require the candidate to manage entire consultations, including outcome of investigation and follow up visits.

Other multi-station clinical practical assessments may be equivalent to the RACGP Clinical Examination; see clause 3.3.1 above for information on evidence required to demonstrate equivalence.

Providing additional evidence

The RACGP recognises that international specialist colleges may run assessments that differ terminologically from the above instruments but which may, nonetheless, be equivalent or comparable in principle and structure.

Applicants who have completed assessments not named above may provide evidence as part of their application outlining why these assessments should be taken into consideration as part of their comparability assessment. This could include a letter of support from the applicant’s specialist college outlining the assessment’s requirements and structure. Colleges should provide as much information as possible, preferably including sample exam questions, psychometrics, and public reports when available.

Version Date of effect Amended by
3 04/08/2023 Education Policy and Guidance Lead
Amendment details
  • Update to clause 3.4.g
2 25/05/2023 Education Policy and Guidance Lead
Amendment details
  • Update to policy links
  • Removal of clause 3.3.4.d
1 9/9/2021 Education Policy and Guidance Lead
Amendment details