General practitioners exam: more than half the candidates fail

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"We do have to make sure that the processes are robust": Dr Mukesh Haikerwal.

“We do have to make sure that the processes are robust”: Dr Mukesh Haikerwal. Photo: Michael Copp

 The peak body for general practitioners has defended the examination that qualifies junior doctors to work unsupervised, after more than half the candidates failed its most recent test.

General practitioners have attacked one of the components of the Royal Australian College of General Practitioners fellowship exam for being ambiguous and subjective following the low pass rate.

Only 44.6 per cent of the 1000 candidates passed one of three examinations that qualify candidates for fellowship, known as the Key Feature Problem.

Qualified GPs said the high fail rate indicated there was either a problem with the examination or a problem with the training.

Former Australian Medical Association president Mukesh Haikerwal? said the RACGP risked ceding control of training its junior workforce to private companies or universities if the federal government thought it was inadequate to the task.

“In the manufacturing industry, the rule is that you expect 80 per cent of your product to be fit for market,” Dr Haikerwal said. “It’s exactly the same here. If you’re spending that much money into your training you’d want at least an 80 per cent pass rate.

“We do have to make sure that the processes are robust and there’s transparency because there’s a danger that what is a good system will be taken away from the colleges, which would be a disaster,” he said.

The federal government increased its training places by 1200 to 1500 in the 2014 budget to respond to a shortage of GPs in some parts of Australia.

Melbourne GP Zeeshan Arain, who passed the exam in 2011, said that unlike the other examinations – a multiple choice test and a simulated consultation – the Key Feature Problem was notoriously ambiguous.

It involved an initial scenario – such as a patient presenting with chest bruising – and a series of questions that assumed the candidate’s initial diagnosis was accurate.

“In a real consultation you get all the information from a patient before giving your diagnosis,” Dr Arain said.

“It doesn’t test the clinicians’ competency and safety, it tests how well they can get inside the examiner’s head.”

The RACGP declined to say what the pass rate was for the examination in previous years.

“Pass rates for the exam fluctuate every exam and a range of factors – many of which are beyond the control of the RACGP – influence pass rates,” a spokeswoman said in an emailed statement.

“As is the case for every exam, a rigorous process is in place to develop the exam content and ensure its integrity.”

Former examiner and current medical educator Gerard Ingham said the RACGP examination processes were fair, but the Key Feature Problem exam could be improved.

“It’s a test of your exam technique, rather than your competence,” Dr Ingham said.