2016 RACP Clinical Examination
Instructions to Candidates
2016 RACP Clinical Examination – Instructions to Candidates
Contents
1. Key Dates.......................................................................................................................................... 4
Paediatrics & Child Health .............................................................................................................. 4
Adult Medicine .................................................................................................................................. 4
2. Preamble ........................................................................................................................................... 4
3. Examination Fees ............................................................................................................................ 5
4. Examination Locations .................................................................................................................... 5
5. Applications....................................................................................................................................... 5
6. Examination Timetable ................................................................................................................... 6
7. Eligibility and Examination Attempts ............................................................................................. 7
8. Format and Content of the Exam .................................................................................................. 8
9. Examiners ....................................................................................................................................... 10
9.1 Examiner Review of Patients ................................................................................................. 10
9.2 Number of Examiners ............................................................................................................. 10
10. Standard Required ...................................................................................................................... 10
11. Conduct of the Clinical Examination ......................................................................................... 10
11.1 Quality and Safety Standards .............................................................................................. 10
11.2 Case Selection ....................................................................................................................... 11
12. Method of Marking ....................................................................................................................... 11
13. Examination Preparation ............................................................................................................ 11
13.1 Pre-Examination Contact at Examination Sites ................................................................ 11
14. Instructions for Candidates ........................................................................................................ 12
14.1 Items to Bring ......................................................................................................................... 12
15. Examination Assistants............................................................................................................... 13
16. Overseas Trained Physicians (OTPs) ...................................................................................... 13
17. Withdrawal of Application ........................................................................................................... 14
17.1 Withdrawal Timeline .............................................................................................................. 14
18. Special Consideration ................................................................................................................. 14
18.1 Permanent and or Chronic ................................................................................................... 17
18.2 Temporary Impairment ......................................................................................................... 17
18.3 Technical Issues .................................................................................................................... 18
18.4 Procedural Problems ............................................................................................................ 18
18.5 Religious grounds, financial hardship, cultural or other circumstances ........................ 19
19. Results .......................................................................................................................................... 19
20. Feedback ...................................................................................................................................... 20
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2016 RACP Clinical Examination – Instructions to Candidates
21. FAQs.............................................................................................................................................. 20
21.1 General ................................................................................................................................... 20
21.2 Eligibility .................................................................................................................................. 21
21.3 Applications ............................................................................................................................ 21
21.4 Withdrawal of Application ..................................................................................................... 23
21.5 Exam Day ............................................................................................................................... 24
21.6 Post Exam .............................................................................................................................. 25
21.7 Contact Information ............................................................................................................... 27
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2016 RACP Clinical Examination – Instructions to Candidates
1. Key Dates
To ensure fairness to all candidates and to assist in the logistics of the Clinical Examination,
the Royal Australasian College of Physicians (“RACP”, “The College”) will strictly enforce all
application deadlines and eligibility criteria.
Please note that in 2016, due to the Examinations being held separately, different deadlines
apply for the Paediatrics & Child Health and Adult Medicine Clinical Examinations. Pay
careful attention to the deadlines that affect you.
Paediatrics & Child Health
The RACP Clinical Examination will be held Friday 20 May – Sunday 29 May 2016.
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Applications open – Friday 11 March 2016 (from 9am AEDT)
Applications close – Friday 25 March 2016 (5pm AEDT)
Cut off for OTP temporary registration confirmation – Friday 25 March 2016 (5pm
AEDT)
Closing date for Special Consideration requests for provisions on Examination Day –
Friday 22 April 2016 (5pm AEST)
Closing date for post-examination Special Consideration requests (illness,
misadventure or procedural issues) – Thursday 02 June 2016 (5pm AEST)
Results released – Wednesday 08 June 2016 (from 3pm AEST)
Adult Medicine
The RACP Clinical Examination will be held Friday 22 July – Sunday 31 July 2016.
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Applications open – Friday 11 March 2016 (from 9am AEDT)
Applications close – Friday 01 April 2016 (5pm AEDT)
Closing date for Special Consideration requests for provisions on Examination Day –
Friday 29 April 2016 (5pm AEST)
OTP temporary registration cut off – Friday 27 May 2016 (5pm AEST)
Closing date for post-examination Special Consideration requests (illness,
misadventure or procedural issues) – Thursday 4 August 2016 (5pm AEST)
Results released – Wednesday 10 August 2016 (from 3pm AEST)
It is the responsibility of the Trainee to adhere to the above deadlines.
Late applications will not be accepted.
2. Preamble
The Clinical Examination is designed to test clinical skills, attitudes, and interpersonal
relationships. The clinical skills include history taking, physical examination, interpretation of
findings, construction of a diagnosis or differential diagnosis, method of investigation and
general management of patients.
Success in the Written Examination is a pre-requisite for entry to the Clinical Examination.
Detailed discussion in the Clinical Examination will be directed at testing clinical skills.
Questions testing your factual knowledge will be at a level appropriate to making adequate
management decisions in the case being discussed.
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2016 RACP Clinical Examination – Instructions to Candidates
3. Examination Fees
Clinical Examination Fee:
$2677.00
4. Examination Locations
There are approximately 95 hospital sites throughout Australia hosting the 2016 Clinical
Examination.
Candidates will not be examined in their own hospitals. All candidates will need to travel
interstate to undertake the Clinical Examination. Candidates will be advised of their allocated
venue by late April 2016 (Paediatrics & Child Health) or late June 2016 (Adult Medicine).
In the event you are allocated a hospital where you work, or have worked at in the past, you
must advise the RACP Examinations Unit as soon as possible via email at:
examinations@racp.edu.au.
5. Applications
Eligible applicants will be invited via email to apply for the 2016 Clinical Examination.
To ensure fairness to all candidates and to assist in the logistics of the examination, The
College will strictly enforce all application deadlines and eligibility criteria.
It is the responsibility of the trainee to adhere to application closing date deadlines and all
other Clinical Examination associated deadlines.
Applications for the 2016 RACP Clinical Examination open on Friday 11 March 2016.
Applications close 5pm (AEDT) Friday 25 March 2016 for Paediatrics & Child Health and
5pm (AEDT) 01 April 2016 for Adult Medicine.
Late applications to sit the Clinical Examination will not be accepted.
Online applications must be completed, including successful payment of fees, by 5pm
(AEDT) on the relevant date above. Applications that were not completed by 5pm will not be
accepted by the College, regardless of whether they have been submitted or are still in
progress. Applications submitted or still in progress after 5pm will be cancelled and
any payment made refunded.
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2016 RACP Clinical Examination – Instructions to Candidates
6. Examination Timetable
Candidates are expected to allocate the entire day for their Examination. The expected
arrival times are listed as follows:
Adult Internal Medicine Candidates
Arrival: 8.15am
Paediatrics & Child Health Candidates
Arrival: 8.45am
On reporting to their Examination site, Candidates will be asked to present their ID and sign
an attendance record. All candidates must bring current identification which clearly shows all
of the following:
• Name (as registered with the College)
• Photograph
• Signature
Examples of such ID include driver’s licence and passport.
The following table represents the typical Examination day schedule for Adult Internal
Medicine and Paediatrics & Child Health candidates. While all hospitals try to adhere to the
schedule, individual variation may occur.
Adult Internal Medicine
Morning
Afternoon
One Half of Candidates
One long case followed
8.55am to
by two short cases
11.20am
Two short cases
followed by one long
case
1.50pm to
4.30pm
Other Half of Candidates
Two short cases
9.10am to
followed by one long
11.50am
case
One long case followed
1.35pm to
by two short cases
4.00pm
Paediatrics & Child Health
Morning
Afternoon
One Half of Candidates
One long case followed
9.25am to
by two short cases
11.50am
Two short cases
followed by one long
case
2.20pm to
5.00pm
Other Half of Candidates
Two short cases
9.40am to
followed by one long
12.20pm
case
One long case followed
2.05pm to
by two short cases
4.30pm
Candidates will have a 10 minute break between their two short cases in both the morning
and afternoon sessions.
Candidates are responsible for providing their own food and beverages on Examination Day.
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2016 RACP Clinical Examination – Instructions to Candidates
7. Eligibility and Examination Attempts
All candidates sitting the Clinical Examination, including Overseas Trained Physicians
(OTPs), must have current medical registration with the Australian Health Practitioner
Regulation Agency (AHPRA).
Basic Training Program Trainees
A pass mark in the Written Examination is a pre-requisite for entry to the Clinical
Examination.
Additionally, candidates must:
• be registered with the College by the due date;
• have a minimum of 24 months of certified training by 31 January 2016;
• be in an accredited training position or an approved interruption in training;
• have completed all PREP requirements;
• comply with the limit on the number of examination attempts and other requirements
for progression through training, which are detailed in the Progression through
Training Policy;
• be fully current with all College training fees;
• have General or Limited (Postgraduate Training or Supervised Practice) AHPRA
registration;
• have completed and submitted their application to the College by the due date.
As per the College’s Progression through Training Policy, Trainees must pass the Clinical
Examination within five attempts. Refer to the RACP website for further information on the
policy: http://www.racp.edu.au/trainees/education-policies-and-governance/education-policy.
Trainees who are unsuccessful after five attempts at the Clinical Examination will neither be
eligible to continue training, nor to apply for entry into Advanced Training.
For enquiries on the Progression through Training Policy or enquiries about Examination
eligibility please contact the Basic Training Unit before the relevant Clinical Examination
application closing deadline. The College cannot guarantee any enquiries submitted
after the appropriate application closing deadline will result in acceptance of an
application to sit, regardless of the eligibility outcome.
prep_bt@racp.edu.au
Australia – 1300 MY RACP (1300 69 7227)
Overseas – (+61) 2 9256 5444
Overseas Trained Physicians
Overseas Trained Physicians (OTPs) eligible to sit the Clinical Examination will be notified of
their eligibility by the College’s OTP Unit before applications open. OTPs may be able to
obtain a temporary medical registration with AHPRA for the purpose of the Examination (see
Section 16 for further details). For OTP enquiries about Examination eligibility please
contact the Overseas Trained Physicians Unit as soon as possible. The College cannot
guarantee any enquiries submitted after the appropriate application closing deadline
will result in acceptance of an application to sit, regardless of the eligibility outcome.
otp@racp.edu.au
Australia – 1300 MY RACP (1300 69 7227)
Overseas – (+61) 2 9256 5444
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2016 RACP Clinical Examination – Instructions to Candidates
8. Format and Content of the Exam
Overview
Candidates will be examined on two long cases and four short cases. The structure of the
Examination will allow this to be done within two Examination cycles (morning and
afternoon) on the one day. In each cycle, each candidate will be examined on one long case
patient and two short case patients. In one cycle the long case will be seen before the short
cases, while in the other cycle the long case will follow the short cases. Each candidate will
be examined during these two cycles by at least four pairs of examiners. Each case will be
scored independently, and the candidate’s final result in each case will be determined by the
consensus mark.
Long Case Assessment
The purpose of the long case is to test Clinical Examination skills with an emphasis on
accuracy of the history and findings on Examination, attitudes to clinical problems, possible
diagnosis, investigations required and their appropriateness, overall interpretation, and
approaches to management.
Each candidate will be allotted 60 minutes to take a history, examine, and develop a
management plan for the patient.
Aids for physical examination may be taken into the patient's room (refer to Section 14.1)
but printed material (including textbooks, notes, MIMS, or other drug compendia), pro-forma
sheets, and electronic devices are not permitted. The aim of the restrictions is to make the
Examination as fair as possible for all candidates.
Medication lists, and results of urinalysis/rectal examination will be provided to candidates
when relevant.
Candidates will have 10 minutes to prepare their discussion and move to the Examiners’
room following their history-taking with the patient. The candidate will then spend 25 minutes
discussing the patient with one team of Examiners.
The Examiners are instructed to place emphasis on the accuracy of the history and findings
on examination, attitudes to clinical problems, possible diagnosis, investigations required
and their appropriateness, overall interpretation, and approaches to management. A
candidate’s assessment should be directed accordingly. It should be noted that excessively
lengthy case presentations are inadvisable and may be interrupted.
Short Case Assessment
The purpose of the short case is to test Clinical Examination skills with emphasis placed on
the method of physical examination, ability to elicit physical signs, and place appropriate
significance upon physical findings.
Each of the short case examinations will last for 15 minutes.
This part of the Examination is designed to assess a candidate’s physical examination
technique, their ability to elicit physical signs, and their ability to interpret and place
appropriate significance upon their findings. As part of a candidate’s assessment of the
findings they may be asked to comment on relevant diagnostic tests (e.g. x-rays, ECGs)
and/or nominate appropriate investigations.
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2016 RACP Clinical Examination – Instructions to Candidates
Candidates will be given two minutes to read a written introduction to the short case before
entering the Examination room. The introduction will be attached to the door of the short
case room. This introduction, written by the Examiners, will contain the patient’s name, the
relevant body system and sometimes the dominant clinical problem or symptom. It will have
been standardised beforehand and has been designed to be accurate, short, and directive.
There will be 10 minutes between the two short cases in each cycle.
NB: Candidates are reminded that all patient records, including their own notes about
patients, are confidential patient information and/or considered confidential examination
material. Candidates are not permitted to reproduce or distribute this information at any time
or in any way. Following the Examination, candidates must ensure that their notes regarding
patients are destroyed appropriately, or left with the organisers at the Examination for
destruction. Please refer to www.racp.edu.au for information on academic honesty and
conduct.
Pass Mark
The pass mark for Candidates is 120 marks out of 210. Candidates must pass at least one
short case and long case to pass overall.
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2016 RACP Clinical Examination – Instructions to Candidates
9. Examiners
9.1 Examiner Review of Patients
Prior to each cycle of the Examination, Examiners will take a history, examine and identify
relevant issues for discussion for each long case patient. This is done without the aid of
patient notes or prepared histories to enable a more accurate appraisal of the patient's ability
to give an appropriate history and of the accuracy of signs.
Short cases are also assessed ‘blind’ by the Examiners.
9.2 Number of Examiners
Candidates are examined by a team of Examiners on each short and long case. Each team
is made up of at least two Examiners, and each candidate sees at least four different pairs of
Examiners. Candidates may expect one Examiner to lead in the discussion, usually followed
by the second; although variations to this may occur.
On occasion, a third examiner may be present, but will act only as an ‘observer’ during the
examination. Only two Examiners will actively examine the candidate and determine their
score.
10. Standard Required
To pass the Clinical Examination, candidates will need to demonstrate the standard
required. This includes the breadth of knowledge, aptitude and skills necessary for the
management of general medical patients.
The criteria used for assessment of performance in the long and short cases is set out in
Appendices 1 and 2.
The College recognises that candidates have their own way of taking a history, performing
an examination, and preparing for the Clinical Examination. These reference tables are
provided to assist candidates to understand the criteria used by the Examiners in judging
their performance, and should not be interpreted as support for a particular method of
history-taking and examination. It should also be noted that not all of the assessment
domains will be applicable in every case.
11. Conduct of the Clinical Examination
11.1 Quality and Safety Standards
In order to maintain appropriate health and safety standards during the conduct of the
Examination, candidates must ensure that they wash their hands before and after carrying
out any physical examination. Alcoholic hand gel may be provided outside of the patient
rooms. Many candidates choose to bring their own supply. Using the gel before entering the
room can save time during the Examination segment. Candidates should advise the
Examiners if they have washed their hands prior to entering the room.
Clean disposable pins should be used for neurological examinations (for both the long cases
and the short cases). Please ensure that pins are disposed of appropriately.
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2016 RACP Clinical Examination – Instructions to Candidates
11.2 Case Selection
A broad range of cases are selected for the Examination however candidates may be asked
to examine similar systems on patients selected for their examination.
12. Method of Marking
The Clinical Examination has a total possible score of 210. Examiners will give a consensus
mark between 1 and 7 for each segment. Positives and negatives are incorporated in the
scoring system. The long case mark is weighted 3 times more than the short, so the long
case mark is multiplied by 9 and the short case by 3. Each candidate’s overall score for the
Examination will be determined by adding the marks of the individual segments.
13. Examination Preparation
Regular clinical activities in a candidate’s hospital should be the best preparation for the
Clinical Examination. In most hospitals, the Director of Physician Education (DPE) and
members of other College training committees will often assist candidates by discussing the
Clinical Examination and arranging ‘long’ and ‘short’ case practice sessions.
13.1 Pre-Examination Contact at Examination Sites
In the past, there have been occurrences of candidates approaching their Examination sites
after receipt of their allocation letter to obtain information regarding Examination case
selection or the types of cases in which a hospital specialises.
Candidates should be aware that the following actions may be perceived as attempting to
gain an advantage in the examination, and may lead to disqualification from the examination
and/or may affect the candidate’s progress through training:
•
Any attempt to gain information pertaining to possible cases from staff organising the
Examination at their allocated hospital;
•
Attendance at practice cases or Examinations at their allocated hospital, after
notification of allocation, is not permitted;
•
Any attempt to gain knowledge of who is Examining at their allocated hospital;
•
Any attempt to contact potential examiners seeking guidance on how to improve their
performance in the examination;
•
Any attempt to contact the Examiners they have encountered during the Clinical
Examination day apart from through the standard feedback procedures for failed
candidates, and then only if one of those Examiners is from their own training centre.
All enquiries after the Examination must be made through the Examinations Unit.
Please refer to www.racp.edu.au for information on academic honesty and conduct.
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2016 RACP Clinical Examination – Instructions to Candidates
14. Instructions for Candidates
14.1 Items to Bring
Candidates must bring their own stationery for use during the Examination e.g. blank manila
folders, blank cards or paper and pens/pencils. Pre-printed/written templates or reminders
are not allowed.
Candidates are required to bring their own equipment to the Clinical Examination. The
rationale for standardisation of acceptable equipment includes fairness to all candidates and
to ensure, as much as possible, that the clinical signs a candidate may elicit will match those
obtained by Examiners, who will likewise use standard equipment.
Candidates must bring the following equipment:
1. Blank paper/cards and pencils/pens
2. Stethoscope (these must not be electronically augmented unless the candidate has
obtained specific permission for medical reasons)
3. Standard hand-held ophthalmoscope (not a pan-ophthalmoscope)
4. Red topped hat pin or equivalent for visual field testing
5. Standard auroscope
6. Pocket torch
7. Tape-measure and/or ruler
8. Tendon hammer
9. Single-use spatulas
10. Tuning forks (128 and 256 Hz)
11. Hand-held visual acuity chart(s)
12. Cotton wool
13. Single-use neurological examination pins for testing sensation
14. Pre-printed picture for higher centres testing (*)
15. A blank form for undertaking a screening mini-mental test (*)
16. Props such as a jar, key and shirt-sleeve with button for hand function testing (*)
17. Toys for distraction and testing of development (*)
18. Standard Growth Charts (*)
(*) Some items are more relevant to either the Adult Medicine or Paediatrics & Child Health
Examination.
Candidates are not allowed to bring in references, PDAs, mobile phones, or other data
storing/sharing/recording devices, whether written or electronic.
If a candidate inadvertently brings any of these, or any other equipment not considered
acceptable to the Examination, they must declare this to an Examination Coordinator who
will take the item(s) for safe keeping until the Examination is finished.
A candidate who takes in unauthorised material may be disqualified from the Examination.
A candidate found with a recording device, including a mobile phone, will be automatically
failed.
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2016 RACP Clinical Examination – Instructions to Candidates
15. Examination Assistants
Examination Assistants will be present on the day.
The Assistants will escort candidates between rooms during the Examination. They will sit in
during presentation of the long case and during short case segments.
Assistants will assist the candidate or the patient during practical tasks, e.g. gait or hearing
examinations.
Examination Assistants cannot communicate with candidates during the period candidates
are with the Examiners. They cannot assist candidates with timekeeping during segments
(e.g. giving a five-minute warning). Candidates must not ask them to do so.
Examination Assistants are not expert Examiners. Candidates must not ask
Examination Assistants for feedback on their Examination performance.
16. Overseas Trained Physicians (OTPs)
All candidates sitting the Clinical Examination, including OTPs, must have current medical
registration with the Australian Health Practitioner Regulation Agency (AHPRA). OTPs may
be able to obtain a temporary registration for the purpose of sitting the Examination. All
queries about the registration process should be directed to AHPRA (www.ahpra.gov.au).
All OTPs who are required to complete the RACP Clinical Examination as part of their
assessment requirements for specialist recognition will sit the same Examination format as
Basic Trainees.
OTP candidates for the Clinical Examination will be examined on two long cases and four
short cases over the course of one day in the Clinical Examination cycle. The pass standard
will be that expected of a candidate who has completed the Basic Training Program of the
College. The Examination will be in general internal medicine.
The College strongly recommends that the OTP should contact his/her local Director of
Physician Education (DPE) to participate with local Trainees in preparation activities for the
Examination.
All OTPs must apply by the application deadlines of 5pm AEDT Friday 25 March 2016
(Paediatrics & Child Health) or 5pm AEDT Friday 01 April 2016 (Adult Medicine). Late
applications will not be accepted.
All OTP candidates must have their AHPRA registration finalised by Friday 25 March 2016
(Paediatrics & Child Health) or Friday 27 May 2016 (Adult Medicine). Any OTPs who do not
have their registration finalised by these dates will not be able to sit. The College will
cancel their application and refund any payment made.
For enquiries about Examination eligibility please contact the Overseas Trained Physicians
Unit as soon as possible. The College cannot guarantee any enquiries submitted after
the appropriate application closing deadline will result in acceptance of an application
to sit, regardless of the eligibility outcome.
otp@racp.edu.au
Australia – 1300 MY RACP (1300 69 7227)
Overseas – (+61) 2 9256 5444
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2016 RACP Clinical Examination – Instructions to Candidates
17. Withdrawal of Application
Any candidate may withdraw up to the time the candidate’s Clinical Examination
commences. Once the Examination has commenced it is not possible to withdraw.
Any candidate who wishes to withdraw from the Clinical Examination must notify the College
in writing. Correspondence should be addressed to:
Examinations Unit
The Royal Australasian College of Physicians
145 Macquarie Street
SYDNEY NSW 2000
OR
Email: examinations@racp.edu.au
17.1 Withdrawal Timeline
Date of Withdrawal – Paediatrics & Child Health
Friday 11 March 2016 – Friday 25 March 2016
(up until 5pm AEDT)
Saturday 26 March 2016 − Friday 22 April 2016
(up until 5pm AEST)
Refund
From 5pm AEST, Friday 22 April 2016 onwards
No refund available
Date of Withdrawal
Friday 11 March 2016 – Friday 01 April 2016
(up until 5pm AEDT)
Saturday 02 April 2016 − Friday 24 June 2016
(up until 5pm AEST)
Refund
From 5pm AEST, Friday 24 June 2016 onwards
No refund available
100% of application fee
50% of application fee
100% of application fee
50% of application fee
18. Special Consideration
Paediatrics & Child Health
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•
Closing date for Special Consideration requests for provisions on Examination Day –
Friday 22 April 2016 (5pm AEST)
Closing date for post-examination Special Consideration requests (illness,
misadventure or procedural issues) – Thursday 02 June 2016 (5pm AEST)
Adult Medicine
•
•
Closing date for Special Consideration requests for provisions on Examination Day –
Friday 29 April 2016 (5pm AEST)
Closing date for post-examination Special Consideration requests (illness,
misadventure or procedural issues) – Thursday 4 August 2016 (5pm AEST)
If you consider you have circumstances that may affect your Examination performance, you
may make a Special Consideration request. Approval is at the discretion of the College and
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2016 RACP Clinical Examination – Instructions to Candidates
is not guaranteed. Candidates requesting Special Consideration should ensure they have
read the College’s Special Consideration for Assessment Policy available on the RACP
website at:
http://www.racp.edu.au/trainees/education-policies-and-governance/education-policy
Requests regarding pre-existing special consideration issues should be made with the
application to sit the Clinical Examination. The College will not adjust Clinical Examination
marks, offer a Supplementary Examination, or allow extra time to complete the Examination
for these requests, regardless of the nature of the special consideration circumstances.
If an issue arises after the application deadline and prior to the Examination day, or for
issues that arise on the Examination day, please contact the College as soon as possible at:
examinations@racp.edu.au
Candidates should only present for the Examination if they consider themselves to be
well enough and adequately prepared to sit. If you are unwell on the day of the
Examination and have commenced the Examination, the ‘attempt’ will be counted.
A summary of possible Special Consideration outcomes can be found in the table below.
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2016 RACP Clinical Examination – Instructions to Candidates
Reason for request
Timing of application
Documentation
required
Possible outcomes of
special consideration
Permanent and/or
chronic impairment or
disability.
At time of application.
Medical certificate
Independent assessor.
Aids during assessment:
special equipment, no
additional time will be
granted.
Temporary impairment
− acute illness or injury
during the course of the
exam day.
Notify Examiners before or
during the assessment.
Submit application in writing
to Examinations Unit as
soon as possible but no later
than 5pm (AEST) Thursday
02 June 2016 (Paediatrics &
Child Health) or 5pm (AEST)
Thursday 04 August 2016
(Adult Medicine).
Medical certificate.
Permission to withdraw
without financial penalty.
Temporary impairment −
compassionate grounds
and other serious
disruptive events.
Notify Examiners before or
during the assessment.
Submit application in writing
to Examinations Unit as
soon as possible but no later
than 5pm (AEST) Thursday
02 June 2016 (Paediatrics &
Child Health) or 5pm (AEST)
Thursday 04 August 2016
(Adult Medicine).
Relevant documentary
evidence.
Permission to withdraw
without financial penalty.
Religious grounds.
At time of application for
assessment.
Explanation of religious
requirement. The College
may seek advice from
religious authority.
Provisions on examination
day to facilitate religious
observance.
Cultural or other
circumstances.
At time of application for
assessment.
Explanation of
circumstances supported
by documentation from a
relevant and recognised
official or community
leader.
Permission to change
examination venue to other
than listed at time of
application.
Technical problems
during the assessment.
Notify the Examiners during
the assessment.
Examiners will notify the
Examinations Unit of a
technical problem.
Compensation, where
possible, during course of
assessment.
Financial hardship.
By two weeks prior to the
closing date of application
for assessment.
Letter of support from the
Candidate’s supervisor.
Deferred payment of fees
during the application period.
Fees must still be paid in full
no later than Friday 25 March
2016 (Paediatrics & Child
Health) or Friday 01 April
2016 (Adult Medicine), or the
trainee’s application to sit the
Examination will be
cancelled.
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2016 RACP Clinical Examination – Instructions to Candidates
18.1 Permanent and or Chronic
Candidates with a permanent and/or chronic impairment or disability may be eligible for
special aids during assessment. Candidates with special requests in regards to specific
medical requirements must submit a formal request at the time of application. This request
must clearly specify the type of assistance sought.
Please be aware that while efforts are made to accommodate special requests, there are
Examination rules and regulations in place. Requests that impact the performance of other
Candidates will not be granted. No additional time will be granted.
Requests must be received at the time of application. If an impairment or disability develops
between the time of application and the assessment date, applications for special requests
will be considered until 5pm (AEST) Friday 22 April 2016 (Paediatrics & Child Health) or
5pm (AEST) Friday 29 April 2016 (Adult Medicine).
No requests will be considered after this time as the Examination sites require sufficient
notice to prepare for these requests.
In the case of permanent and/or chronic impairment or disability, applicants must attach a
detailed medical certificate showing:
• a description of the medical problem or disability
• the period of the medical problem or disability
• the medical practitioner’s professional opinion about the effect of the medical
problem or disability on the candidate’s ability to perform in the assessment.
The medical practitioner supplying the evidence should have a professional doctor-patient
relationship with the candidate and should not be a family member, relative, supervisor,
employer or colleague.
18.2 Temporary Impairment
The Clinical Examination Committee and the Examination coordinators aim to provide
candidates with optimal examination conditions in which they can perform to the best of their
ability.
Under no circumstance is the College able to make an adjustment to a final result as
compensation for a candidate who is ill or suffers misadventure either before or during the
Clinical Examination. A candidate seeking Special Consideration due to temporary
impairment must notify the Examiners at the venue of the circumstance on the day of the
Examination.
Following the Examination, candidates are to make a formal application to the Examination
Unit. Written requests, together with relevant documentation, must be received by 5pm
(AEST) Thursday 02 June 2016 (Paediatrics & Child Health) or 5pm (AEST) Thursday 04
August 2016 (Adult Medicine). Any requests received after this date will not be considered.
All requests for Special Consideration must clearly describe the reason for the request and
must be accompanied by the relevant documentation outlined below.
Documentation required in the case of acute illness or injury during the course of the
exam day:
A detailed medical certificate showing:
17
2016 RACP Clinical Examination – Instructions to Candidates
•
•
•
•
the date(s) on which the candidate sought medical treatment or advice
a description of the medical problem
the period of the medical problem
the medical practitioner’s professional opinion about the effect of the medical
problem on the Candidate’s ability to perform in the assessment.
The medical practitioner supplying the evidence should have a professional doctor-patient
relationship with the Candidate and should not be a family member, relative, supervisor,
employer or colleague.
Documentation required in the case of compassionate grounds or other serious
disruptive events:
•
•
documentary evidence of serious illness of a family member or significant other
person
other relevant documentary evidence.
18.3 Technical Issues
Technical problems are defined as circumstances resulting in a significant disturbance to the
normal course of the assessment which could reasonably be expected to have hindered an
individual candidate’s performance.
If during the course of the assessment the candidate is experiencing short-term discomfort or
distraction affecting his or her performance, the candidate should alert the Examiners
during the assessment. If the Examiners are of the view that the conditions complained of
warrant action, appropriate measures to address the situation will be taken. Significant
technical issues that cannot be addressed will be reported to the Clinical Examination
Results Committee by the Examiners.
18.4 Procedural Problems
Any problems during the short case Examination (e.g. patient is out of the room for several
minutes using the toilet) will be obvious to the Examiners.
In the long case Examination, the Examiners will ask candidates at the start of the case
presentation if there were any procedural problems. If the examiners forget to ask, candidates
should bring any problems to their attention.
Where possible, Examiners will take any procedural problems into account during the conduct
of the case or in their marking. If candidates do not make them aware of any concerns with the
examination process then the Examiners will be unable to assist in this way. Significant
procedural issues that cannot be addressed will be reported to the Clinical Examination
Results Committee by the Examiners.
If candidates have concerns that were not brought to the attention of the Examiners then
they must notify the Examinations Unit in writing after their Examination by 5pm (AEST)
Thursday 02 June 2016 (Paediatrics & Child Health) or 5pm (AEST) Thursday 04
August 2016 (Adult Medicine) however candidates should be aware that such requests are
only likely to approved in extraordinary circumstances.
Procedural problems that have been documented by the Examiners or notified to the
Examinations Unit are only reviewed for candidates whose marks indicate a fail. If a candidate’s
18
2016 RACP Clinical Examination – Instructions to Candidates
marks indicate a fail result but there was a significant procedural problem that may have
negatively impacted their performance AND this was not able to be taken into account by the
Examiners on the day, there is a possibility the Clinical Examination Results Committee may
offer the candidate a Supplementary Examination.
The decision to run a Supplementary Examination solely sits with the Clinical Examination
Results Committee. Candidates will be advised personally if they are eligible to sit a
Supplementary Examination. Candidates cannot request to sit a Supplementary
Examination.
18.5 Religious grounds, financial hardship, cultural or other
circumstances
For further information please refer to the Special Consideration for Assessment Policy
available on the College website at: http://www.racp.edu.au/trainees/education-policies-andgovernance/education-policy
19. Results
The Clinical Examination results will be released via a personalised email to each candidate.
Results will be released to candidates from:
3pm AEST Wednesday 08 June 2016 (Paediatrics & Child Health)
3pm AEST Wednesday 10 August 2016 (Adult Medicine)
Candidates who do not receive their results via email by 8am AEST the following day,
please contact the Examinations Unit at examinations@racp.edu.au or 1300 MY RACP
(1300 69 7227) or (+61) 2 9256 5444.
Candidates should ensure that their email address with the College is current. Candidates
who need to update their email address or confirm that their recorded email address is
correct should contact the College via phone or email:
memberservices@racp.edu.au
Australia – 1300 MY RACP (1300 69 7227)
Overseas – (+61) 2 9256 5444
The Examinations Unit is unable to discuss Examination results with candidates over
the phone or via email. Candidates are encouraged to check all sections of their email
inboxes (such as junk mail, promotions) before contacting the Examinations Unit. It is also
advised that candidates check their emailed results via a home computer as work/hospital
computers may restrict access due to firewalls.
Candidates should note that Examination results are not appealable. Please refer to the
College’s Reconsideration, Review and Appeals Process By-law (the By-law) and the
definition of a ‘Decision’ at page 9; and the Special Consideration for Assessments Policy,
pages 1-2. Both these documents are available on the College website at:
http://www.racp.edu.au/trainees/education-policies-and-governance/education-policy
19
2016 RACP Clinical Examination – Instructions to Candidates
20. Feedback
Examiners complete a form recording each candidate’s performance, immediately after each
case in the Clinical Examination. These records are used to provide feedback to
unsuccessful candidates, delivered by meeting with a member of the National Examining
Panel (NEP). The NEP Member uses the information contained in the Examiners’ report
forms and his/her experience with the Examination to assist unsuccessful candidates with
improving their performance in a subsequent examination.
Candidates who are unsuccessful in the Examination will be informed, in the formal letter
containing their results, of the name and telephone number of the NEP Member with whom
they may discuss their performance. It is the responsibility of the candidate to arrange this
feedback meeting. Candidates may also wish to invite their Director of Physician Education
(DPE) to attend this meeting. The feedback meeting for unsuccessful candidates is purely to
assist them in recognising areas of relative strength or weakness and may be useful in planning
for improving areas of weakness. Unsuccessful candidates should contact their assigned NEP
Member shortly after receipt of their formal results letter, as candidate feedback is not retained
indefinitely.
Candidates can expect to receive their formal results letter within four weeks of receiving
their Clinical Examination results outcome email. In order to maintain the privacy of patients,
all specific personal patient information will be removed from feedback sheets. Feedback
sheets will be provided to unsuccessful candidates in their feedback session with their assigned
NEP and to successful candidates with their results letter. In the interests of patient
confidentiality, case summaries will not be provided to candidates under any circumstances.
Candidates should note that feedback sheets are considered confidential examination
material and/or confidential patient information. Candidates should not reproduce or
distribute such material at any time or in any format, nor discuss this information outside of
their feedback meeting. Please refer to http://www.racp.edu.au/trainees/education-policiesand-governance/education-policy for information on academic honesty and conduct.
21. FAQs
21.1 General
When is the Clinical Examination held?
Paediatrics & Child Health, Friday 20 May – Sunday 29 May 2016.
Adult Medicine, Friday 22 July – Sunday 31 July 2016.
A candidate will be allocated one day during this period to sit the Examination.
Where is the Clinical Examination held?
The 2016 Clinical Examination will be held in approximately 95 hospital locations across
Australia.
The precise location of an individual candidate’s Examination will be received via email by
mid-April (Paediatrics & Child Health) or mid-June (Adult Medicine).
20
2016 RACP Clinical Examination – Instructions to Candidates
Candidates should ensure that their email address with the College is current. Candidates
who need to update their email address or confirm that their recorded email address is
correct should contact the College via email or phone:
memberservices@racp.edu.au
Australia – 1300 MY RACP (1300 69 7227)
Overseas – (+61) 2 9256 5444
21.2 Eligibility
Am I eligible to sit the Clinical Examination in 2016?
A pass mark in the Written Examination is a pre-requisite for entry to the Clinical
Examination.
Additionally, candidates must:
• be registered with the College by the due date;
• have a minimum of 24 months of certified training by 31 January 2016;
• be in an accredited training position or an approved interruption in training;
• have completed all PREP requirements;
• comply with the limit on the number of examination attempts and other requirements
for progression through training, which are detailed in the Progression through
Training Policy;
• be fully current with all College training fees;
• have General or Limited (Postgraduate Training or Supervised Practice) AHPRA
registration;
• have completed and submitted their application to the College by the due date.
To discuss your eligibility please contact the Basic Training Unit at: PREP_bt@racp.edu.au
before the relevant application closing deadline. The College cannot guarantee any
enquiries submitted after the relevant application closing deadline will result in acceptance of
an application to sit, regardless of the eligibility outcome.
Can I sit the Examination if I am not currently in an accredited training position?
Yes, as long as your interruption of training is registered with the College and all other
eligibility criteria are met. To discuss your eligibility please contact the Basic Training Unit at:
PREP_bt@racp.edu.au before the relevant application closing deadline. The College cannot
guarantee any enquiries submitted after the relevant application closing deadline will result
in acceptance of an application to sit, regardless of the eligibility outcome.
21.3 Applications
How can I apply for the 2016 Clinical Examination?
Paediatrics & Child Health applications open on Friday 11 March 2016 (from 9am AEDT)
and close Friday 25 March 2016 (5pm AEDT).
Adult Medicine applications open on Friday 11 March 2016 (from 9am AEDT) and close
Friday 01 April 2016 (5pm AEDT).
21
2016 RACP Clinical Examination – Instructions to Candidates
Those who are eligible will be sent an email invitation to apply online.
NB: The online application will only work for eligible applicants. If you did not receive an
invitation to apply directly from the College, then you will be prevented from completing the
online application.
How do I know if my online application has been processed successfully?
When online applications are successfully processed an email will be sent with a receipt and
the Instructions to Candidates attached as a PDF.
Please check your emails including any junk mail and promotional folders.
If you have not received this email it may mean that your application has not been
processed. Please contact the Examinations Unit at: examinations@racp.edu.au to confirm
if your application has been successful.
Can I obtain a receipt for my application?
When online applications are successfully processed an email will be sent with a receipt and
the Instructions to Candidates attached as a PDF.
Please check your emails including any junk mail and promotional folders.
If you have not received this email it may mean that your application has not been
processed. Please contact the Examinations Unit at: examinations@racp.edu.au to confirm
if your application has been successful.
Why is the website not accepting my application?
The online application will only work for eligible applicants. If you did not receive the email
invitation directly from the College please contact the Basic Training Unit to discuss your
eligibility at: PREP_bt@racp.edu.au before the relevant application closing deadline. The
College cannot guarantee any enquiries submitted after the relevant application closing
deadline will result in acceptance of an application to sit, regardless of the eligibility outcome.
Some hospitals and workplaces have firewalls that will prevent the application being
processed. Smartphones and tablets may also be incompatible with the online application.
Please try the online application at home on a desktop computer or laptop. If the online
application is still not working for you please contact the Examinations Unit at:
examinations@racp.edu.au
I do not own a credit card therefore cannot apply online. How can I apply?
Please contact: examinations@racp.edu.au before the relevant application closing deadline.
I have missed the application deadline. Can I still apply for the 2016 Clinical
Examination?
No, late applications will not be accepted. The next opportunity to apply for the Clinical
Examination will be in 2017.
22
2016 RACP Clinical Examination – Instructions to Candidates
Can I change my elected Examination venue?
No, candidates will not be examined in their own hospitals. Candidates should be prepared
to travel to a different city which, in most cases, will mean a different state.
Candidates who are unable to travel due to pregnancy, illness or a specific life event must
submit a Special Consideration request to the Examinations Unit at the time of application,
including appropriate documentation. Please refer to the Special Consideration for
Assessments Policy available on the College website:
http://www.racp.edu.au/trainees/education-policies-and-governance/education-policy
A specific allocation is not guaranteed.
21.4 Withdrawal of Application
Can I withdraw my application?
Yes, it is possible to withdraw your application. To withdraw from the Examination a formal
request must be put in writing to: examinations@racp.edu.au
A withdrawal is only finalised once confirmation is received from the Examinations Unit.
Those who withdraw are able to re-apply for the Clinical Examination in 2017.
If I withdraw my application will I receive a refund of my Examination fees?
Depending on the timing of the withdrawal the following refunds will be awarded:
Date of Withdrawal – Paediatrics & Child Health
Friday 11 March 2016 – Friday 25 March 2016
(up until 5pm AEDT)
Saturday 26 March 2016 − Friday 22 April 2016
(up until 5pm AEST)
Refund
From 5pm AEST, Friday 22 April 2016 onwards
No refund available
Date of Withdrawal
Friday 11 March 2016 – Friday 01 April 2016
(up until 5pm AEDT)
Saturday 02 April 2016 − Friday 24 June 2016
(up until 5pm AEST)
Refund
From 5pm AEST, Friday 24 June 2016 onwards
No refund available
100% of application fee
50% of application fee
100% of application fee
50% of application fee
The withdrawal refund amount is in accordance with the Terms and Conditions effective from
1 January 2014, which can be found on the College website:
http://www.racp.edu.au/docs/default-source/pdfs/terms-and-conditions-for-racp-fees.pdf
If I withdraw my application will it be considered an attempt?
If the correct withdrawal procedures are followed then those who withdraw will NOT be
considered as having attempted the Examination.
23
2016 RACP Clinical Examination – Instructions to Candidates
A withdrawal is only finalised once confirmation is received from the Examinations Unit.
Is there a Supplementary Examination?
A small number of candidates may be offered an opportunity for re-examination at a
Supplementary Examination where the format will be identical to that of the earlier
Examination. The Supplementary Examination is offered rarely, and offered only where there
has been significant procedural misadventure during the course of the Examination.
Candidates will be advised personally if they are eligible to sit a Supplementary Examination.
Candidates cannot request to sit a Supplementary Examination. The decision to run a
Supplementary Examination solely sits with the Clinical Examination Results Committee.
21.5 Exam Day
What do I have to bring to the Examination?
Please refer to item 14.1 Items to Bring for a full list of equipment.
Candidates are not allowed to bring in references, PDA, calculators, mobile phones, or other
data storing/sharing/recording devices, whether written or electronic.
I have not received my Candidate Allocation Letter, what can I do?
A Candidate Allocation Letter contains information on the date and precise location of where
a candidate is required to sit the Clinical Examination. Candidates should expect to receive
their allocation letter via email by mid-April (Paediatrics & Child Health) or mid-June (Adult
Medicine).
If you have not received this information by late-April (Paediatrics & Child Health) or lateJune (Adult Medicine) please contact the Examinations Unit at: examinations@racp.edu.au.
The Candidate Allocation Letter will contain important information on assembly points at the
Examination venue. Candidates should print a copy and bring it with them on Examination
day for reference.
What form of ID do I bring to the Examination?
All candidates must bring current identification which clearly shows all of the following:
• Name (as registered with the College)
• Photograph
• Signature
Examples of such ID include driver’s licence and passport. Candidates should also bring
appropriate documents where their name as registered with the College does not match the
name on their ID, e.g. change of name documentation or marriage certificate.
When candidates report to their Examination site they will be asked to present their ID and
sign an attendance record.
24
2016 RACP Clinical Examination – Instructions to Candidates
Will there be a lunch break?
Yes, there will be a 30 minute lunch break between sessions. Candidates are advised to
bring their own lunch. Hospitals may have a cafeteria to purchase items from; however
candidates must be aware of their start time for the afternoon session.
What do I wear to the Examination?
Please dress in an appropriate and professional manner for the Examination. This is not a
day for casual clothes but neither is it necessary for candidates to invest in an expensive suit
purely for the Examination. It is important that you are comfortable and can examine your
patient easily in the clothes you are wearing.
What if I have a medical condition (e.g. diabetes or pregnant)? Can I bring in special
equipment or food?
If you require food, drinks other than water, or other special provisions during the
examination on medical grounds then an application for Special Consideration with
accompanying documentation must be submitted prior to the deadline. Please see Section
18 of this document for Special Consideration application procedures and deadlines.
What do I do if I am sick on the day of the Examination?
You must first decide if you are well enough to sit the Examination. If you sit the
Examination, this will be counted towards your total number of attempts at the Clinical
Examination. No extra time or other special provisions will be allocated under these
circumstances. For acute medical issues which occur during the Examination please see
Section 18 for Special Consideration application procedures and deadlines.
If you are too unwell to present to the Examination you must contact the Examinations Unit
before the commencement of the Examination at: examinations@racp.edu.au.
If you do not present to the Examination this will not be counted towards your total number of
attempts only if the Examination Unit is notified of your withdrawal before the
commencement of the Examination.
21.6 Post Exam
When will I receive my Examination results?
Results will be sent to all Paediatrics & Child Health candidates via email from 3pm AEST,
Wednesday 08 June 2016.
Results will be sent to all Adult Medicine candidates via email from 3pm AEST, Wednesday
10 August 2016.
The results email advises candidates if they have been successful or unsuccessful.
Please ensure that your email address with the College is current. If your email address
needs updating or you would like to check the College has your correct email address,
please contact:
memberservices@racp.edu.au
Australia – 1300 MY RACP (1300 69 7227)
25
2016 RACP Clinical Examination – Instructions to Candidates
Overseas – (+61) 2 9256 5444
Results will NOT be posted on the RACP website.
Candidates who are unsuccessful in the Examination will be informed in the letter containing
their results of the name and telephone number of the NEP member with whom they may
discuss their performance. It is the responsibility of the candidate to arrange this interview
time.
I have not received my results, what can I do?
Results will be sent to all Paediatrics & Child Health candidates via email from 3pm AEST,
Wednesday 08 June 2016.
Results will be sent to all Adult Medicine candidates via email from 3pm AEST, Wednesday
10 August 2016.
Please check all email folders including junk mail and promotions. Please check via a home
computer as work/hospital computers may restrict access due to firewalls.
If you have not received this email by 8am AEST on Thursday 09 June (Paediatrics & Child
Health) or 8am AEST Thursday 11 August 2016 please contact the Examinations Unit:
examinations@racp.edu.au
Australia – 1300 MY RACP (1300 69 7227)
Overseas – (+61) 2 9256 5444
The Examinations Unit can only advise if you have been successful or unsuccessful.
Can I have my Examination re-marked/reviewed/reconsidered? Can I appeal the
result?
No. There is no opportunity for a re-mark or any other review or reconsideration of marks
once results have been released. Candidates should note that the individual domains do not
contribute equally to the final mark. In some cases certain domains are given more weight
than others by the Examiners. For example, missing one very important physical sign in the
short case may lead to a fail mark for that case even if the candidate performed well in the
other domains of the case.
Candidates who are unsuccessful in the Clinical Examination will have a chance to calculate
their own scores with their nominated NEP during their feedback session.
Candidates should note that Examination results are not appealable. Please refer to the
College’s Reconsideration, Review and Appeals Process By-law (the By-law) and the
definition of a ‘Decision’ on page 9 as well as the Special Consideration for Assessments
Policy. Both these documents are available on the College website:
http://www.racp.edu.au/trainees/education-policies-and-governance/education-policy
Can I re-sit the Examination?
The next opportunity to sit the Examination is in 2017. Eligible applicants will be invited to
apply via email around March 2017. If you are unsure of the number of Examination
attempts you have remaining, please check the FAQ section of the Progression through
Training Policy or contact the Basic Training Unit at: PREP_bt@racp.edu.au
26
2016 RACP Clinical Examination – Instructions to Candidates
Am I eligible for Special Consideration?
See Section 18 for Special Consideration procedures and provisions.
NB: The deadline to apply for post-exam Special Consideration is 5pm (AEST) Thursday 02
June 2016 (Paediatrics & Child Health) or 5pm (AEST) Thursday 04 August 2016 (Adult
Medicine).
No applications will be considered after this time.
21.7 Contact Information
Inquiries regarding Basic Training
eligibility:
1300 MY RACP (1300 69 7227)
(+61) 2 9256 5444
prep_bt@racp.edu.au
Inquiries for Overseas Trained
Physicians:
1300 MY RACP (1300 69 7227)
(+61) 2 9256 5444
prep_bt@racp.edu.au
Inquiries regarding Training
Support:
1300 MY RACP (1300 69 7227)
(+61) 2 9256 5444
TrainingSupport@racp.edu.au
All other Examination inquiries:
1300 MY RACP (1300 69 7227)
(+61) 2 9256 5444
examinations@racp.edu.au
27
22. Appendix 1 − Criteria for Assessment of Performance in the Long Case
Assessment
Domains →
Level of
Performance ↓
History
Examination
Exceptional
Performance
• Exceptional
attention to detail
• Highly
sophisticated
interpretation
• Mature
understanding of
complex issues
• Highly mature,
systematic, wellstructured
completion of
complex
examination
Much Better
than Expected
Standard
• Sophisticated
interpretation of
the history
• Focuses on key
issues
• Shows maturity in
extracting difficult
information
• Actively seeks
subtle signs that
might enhance
diagnosis
• Superior
organisation of
difficult
examination
• Emphasis on
appropriate details
• Appreciates
subtleties
• Interprets
significant aspects
of the history
• Includes
important
relative negative
signs
• Complete and
accurate history
• Minimal need to
clarify details
• Timely and well
structured
• Some
interpretation
• Correctly
identifies all
important
physical signs
• Poorly organised
• Omission of some
key issues
• Need to clarify
important details
Better than
Expected
Standard
Expected
Standard
Short of
Expected
Standard
Well Short of
Expected
Standard
Very Poor
Performance
Synthesis and
Priorities
Management Plan
• Highly sophisticated,
well balanced and
complete
understanding of
psychological and social
aspects
• Sophisticated management
plan incorporating all
therapeutic options
• Mature anticipation of
prognosis
• Ability to adjust
management plan for
different outcomes
•
Shows mature
understanding of
subtle, difficult, or
intimate aspects of
patient’s functioning
• Demonstrates balance
when discussing issues
and sophisticated use
of external social
support
• Shows persistence in
exploring subtle
psychological issues, or
issues that impact on
the patient or family
• Superior construction of
management plan, including
long term impact
• Highly developed and
discriminating use of
investigations
• Mature recognition and
interpretation of inconsistent
results
• Identifies all key
problems
• Arranges
problems in
order of priority
• Understands patient’s
physical and
psychological
functioning in relation
to disease
• Appreciates impact of
treatment and
prognosis on patient
and family
• Proposes an appropriate
management plan for the
major issues
• Provides a sensible, balanced
approach to investigations
• Interprets investigations
appropriately
• Recognises important side
effects of proposed
treatment
• Omission of
some important
physical signs
• Problems poorly
prioritised
• Significant
problems undervalued
• Fails to recognise some
important aspects of
the disease on patient
or family
• Misses some aspect
affecting functioning or
reaction to illness
• Lacking confidence and
including some errors in
arranging a management
plan
• Erratic and nondiscriminatory use of
investigations
• Errors in the interpretation
of tests
• Lacking some appreciation of
complication of treatment
• Omission of many
key points
• Inaccuracies or lack
of detail
• Repetitive, poorly
structured
• Need to spend
substantial time in
clarifying details
• Many significant
signs not
recognised
• Poor
understanding
of significant
problems
• Requires
substantial
prompting
• Poor understanding of
the impact of disease
on patient and family
• Shows little concern
about psychological
aspects
• Inappropriate or poorly
directed management plan
• Poor understanding of useful
investigations
• Inability to interpret
investigations
• Major inability to appreciate
side effects of treatment
• No clear structure
• Focused only on
single problem
• Minimal detail
• Minimal
attention to
detail with the
examination
• Most key
management
issues
unidentified
• No attempt to
establish
priority
• Impact of disease not
explored at all, or
unable to be discussed
• Poorly directed management
plan without regard to major
issues
• Very poor ordering of
investigations without regard
to expense or potential
complications
• No attempt to interpret
investigations
• No understanding of side
effects of treatment
• Appreciates
significance of
more subtle
signs
• Very
sophisticated
and intelligent
synthesis
• Mature and
competent
arrangement of
interactive
problems
• Identifies all
major and minor
problems
• Very careful
prioritisation
which includes a
long term view
• Recognises
social impact of
disease
Impact of Illness on Patient
and Family
• Confidently
identifies
essential
problems
• Shows maturity
in recognising
lesser issues
•
Proposes appropriate
management plan with good
understanding of social
impact lifestyle and
psychological aspects of
disease
• Good use of discriminating
investigations
• Accurate interpretation of
results
23. Appendix 2 − Criteria for Assessment of Performance in the Short Case
Assessment
Domains →
Level of
Performance ↓
Examination
Technique
Examination
Accuracy
Interpretation of Physical
Findings
Discussion of
Investigations
• Meets expected
standard
• Fluent and accurate
and within time
• Makes adjustment
to routine when
appropriate
• Correctly
identifies all signs
found by
examiners
• Establishes a most
likely diagnosis on
basis of examination
and includes
discussion of difficult
signs
• Discusses alternatives
at consultant
equivalent
• Thorough
interpretation of
investigations,
including integration
with physical
examination
• Recognises areas of
doubt and discusses at
consultant equivalent
• Meets expected
standard
• Fluent and accurate
and within time
• Makes adjustment
to routine when
appropriate
• Correctly
identifies all
essential and
desirable signs
• Establishes a most
likely diagnosis on
basis of examination,
considers all likely
alternatives
• Correctly interprets
investigations,
integrates with
examination findings
without prompting, at
a mature level
• Meets expected
standard
• Fluent and accurate
and within time
• Makes adjustment
to routine when
appropriate
• Correctly
identifies all
essential and
most desirable
signs
• Correctly interprets all
major findings
• Introduces
him/herself to the
patient
• Shows respect for
patient as indicated
by preservation of
patient’s modesty,
seeking permission
for sensitive aspects
of examination e.g.
groin palpation
• Recognises and
modifies
examination when
painful
• Undertakes
systematic
examination of
required area or
system, without
unnecessary
duplication
• Demonstrates
confidence in the
examination
• Completes assigned
task in appropriate
time
• Detects all
essential signs
• Reports
significant
negative findings
• Does not find
major signs that
are not present
• Identifies most likely
diagnosis and provides
a reasonable
differential diagnosis
based on physical
findings
• Provides appropriate
interpretation of signs
• Recognises
inconsistencies in
interpretation and
findings
• Provides sensible
priorities in diagnosis
• Discusses appropriate
alternative diagnoses
• Less than expected
standard
• Unduly rough,
clumsy or causes
pain without
adjustment or
apology
• Expected
components not
completed
• May require
prompting to
proceed with
appropriate
examination
• Misses essential
signs
• Fails to look for or
mention
important
negative findings
• Does not offer
appropriate
investigations
• Misinterprets or is
unable to integrate
investigations with
examination findings
• Less than expected
standard, requiring
examiners to
intervene
• Very slow and
requires substantial
prompting and
guidance
• Misses essential
signs
• Finds
abnormalities that
are not present
• Fails to look for
important
negative findings
• Inappropriate and
insensitive approach
to patient
• Slow examination
not completed in
appropriate time
• Cannot perform
appropriate
examination of
system
• Misses all
essential signs
• Finds
abnormalities that
are not present
• Fails to look for
important
negative findings
• Not confident with a
diagnosis
• List of differential
diagnoses poorly
developed
• Unable to consider
alternative
explanations for
findings
• Requires more than
minor prompting to
reconsider options
• Unable to suggest a
reasonable diagnosis
• May advance incorrect
diagnosis inconsistent
with signs
• Requires substantial
prompting
• Unable to reconsider
additional information
which may alter
diagnosis
• Unable to suggest a
reasonable diagnosis
• Unable to interpret
the physical signs
elicited
Approach to Patient
Exceptional
Performance
Much Better
than Expected
Standard
Better than
Expected
Standard
Expected
Standard
Short of
Expected
Standard
Well Short of
Expected
Standard
Very Poor
Performance
• Accurately interprets
and recognises major
findings in
investigations
• Integrates
investigations with
examination findings
• Unable to use
investigations to assist
in diagnosis
• Inappropriate
dependence on
investigations
• Unable to suggest
reasonable
investigations
• Misinterprets
information provided