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Episode 15

Changes to Fellowship exams

Show notes

Welcome to Generally Speaking, the conversation for all GPs.

Join GPs Dr Gill Singleton and Dr Billy Stoupas as they discuss some of the most pressing topics and issues surrounding the operations of a general practice.

This time, Dr Stoupas and Dr Singleton get the inside track on the recent changes to the Fellowship exams. They are joined by Dr Tess van Duuren, Acting RACGP Censor-in-Chief, and Dr Krystyna de Lange, Chair of the RACGP National Faculty for GPs in Training. Both played a key role in the development of the new exams and supported the process which was led by GP and General Manager of Education, Dr Genevieve Yates.

23 September 2020 - 02:30 PM | 26 min 53 sec

(00:21) Dr Singleton and Dr Stoupas set the scene in relation to the previous exam framework and the kind of questions that have surrounded the news that they would be changing format.

Introduction of Dr Krystyna de Lange and Dr Tess van Duuren

(002:13) Dr de Lange outlines her position and experience with regard to her own training journey and her interest in the support and advocacy of GPs in the training space.

(03:35) Dr van Duuren also reflects on her personal journey and how ensuring that the Fellowship ultimately stands for high quality practitioners and the safety of all patients.

(05:18) Dr Stoupas queries the motivation to change the exams now while there seem to be so many other obstacles. Dr van Duuren explains that the Objective Structured Clinical Examination (OSCE) is probably the biggest clinical exam in the southern hemisphere and a huge undertaking for the RACGP, so there was a lot of work being done in the background as the intention was that it was time for a renewal. Given the current state of affairs with COVID-19, a remote clinical exam became absolutely necessary and the work was expedited. There were a number of big drivers for the change and the pandemic was just one of them. 

(06:55) Dr Stoupas asks Dr de Lange if previous preparation for the OSCE is wasted in relation to the new exams. She makes the emphatic point that the answer is no. The Remote Clinical Exam (RCE) is still a clinical exam and is still testing the same competencies – it’s really just that it’s changed ­.

(08:46) Dr Singleton asks about the capacity for this format to measure good patient-centred communication and competency. Dr van Duuren reiterates that patient-centric communication, patient-centred management, patient-centred consultations are still very much in the forefront of the examiner’s mind and will be assessed that way in the RCE.

(09:53) Dr de Lange explains some of the resources in place for GPs in training alongside the mock exam. They have expanded the mock trial and now candidates will be able to do this individually –they will actually receive individualised feedback as opposed to the previous group feedback. There are also a number of webinar series that are running to try and help to go through some more of the detail, more examples and more of the marking.

(12:58) Dr de Lange at the request of Dr Stoupas offers up some tips. First is to practice, practice, practice, and ensure that your communication skills are fine-tuned and you’re aware of your timing. Making sure that you know that you’ve got the practice behind you so that you sound polished and to get your point across in the right way. She also recommends getting familiar with the Zoom platform or whatever tools will be used for the actual exam. Finally, Dr de Lange encourages getting together in study groups.

(17:15) Dr van Duuren responds to Dr Stoupas about leniency in this new format. She emphasises that they expect the same standard of performance. The exam is there to make sure that a GP is safe for unsupervised practice in Australia. The exam gives GPs in training the opportunity to demonstrate that, and there is no leniency in terms of lowering pass marks or pass rates planned at all. They are very confident that this is an excellent exam and it has been approved by the AMC.

(19:05) Dr van Duuren and Dr de Lange clear up the extra exam cycle that’s available. Essentially, anyone who’s sitting the RCE or the Clinical Competency Exam (CCE) in 2020 or 2021 will have an increase of one cycle in their exam attempt cap. So, instead of having six attempts over three years, they’ll be eligible for seven over three-and-a-half years.

(19:41) Dr Singleton asks about the physical examination in this remote test and whether there are any concerns. There will still be physical examination components to the exam but obviously without the actual demonstration of a physical examination skill. They are interested in how people approach physical examination as part of their clinical reasoning or their information gathering. But far more emphasis will be put on the reasoning behind it, as opposed to the actual skill of examination.

(21:17) Dr de Lange responds to Dr Singleton with regard to the establishment of the National Faculty for GPs in Training. She’s passionate about ensuring that there’s appropriate representation of GPs in training within education and training governance at the college, and that the facilitation of appropriate consultation with GPs in training around policies and decisions that are going to affect them is available. She appreciates that there’s going to be a lot of policy changes at the RACGP and she wants to make sure trainees are involved in that conversation.

(24:54) Dr Stoupas and Dr Singleton reflect on what they have heard and go through some of the advantages of the new RCE format.

‘We expect the same standard of performance. We’re looking that someone is safe for unsupervised practice in Australia – we’re giving them the opportunity to demonstrate that, and there isn’t any leniency in terms of lowering pass marks or pass rates planned at all. We are very confident that this is an excellent exam that has been approved by the AMC.’
– Dr Tess van Duuren

‘This [the remote exam] is still a clinical exam, it’s still testing the same competency. It’s really just that it’s changed the format. Yes, there are some changes in terms of the types of cases – realistically, the types of cases are still what they would have been for an OSCE, but probably a little bit adapted to make them able to run in a remote format.’

– Dr Krystyna de Lange

  • If you would like to learn more about Dr Tess van Duuren’s experience check out the Council member profile.
  • If you would like to learn more about Dr Krystyna de Lange’s experience and insights, or would like to connect, visit her LinkedIn.
  • If you would like to learn more about Dr Gill Singleton’s achievements and insights, or would like to connect, please visit her LinkedIn.
  • If you would like to learn more about Dr Billy Stoupas’ achievements and insights, or would like to connect, please visit his website.

Resources referred to in the Generally Speaking podcast and on the website are views of the hosts and not necessarily endorsed by RACGP.

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