Crack the KFP Clinical Scenario Techniques for RACGP Success

The Key Feature Problem (KFP) is one of the most critical components of the RACGP exam, designed to assess clinical reasoning and decision-making in general practice. Unlike the AKT (Applied Knowledge Test), the KFP goes beyond knowledge recall and challenges candidates to apply clinical judgment under pressure.

If you're preparing for the RACGP examination, understanding how to approach clinical scenarios in the KFP can significantly improve your chances of passing. This article breaks down key strategies and explains how to think like a GP in the KFP exam setting.

 

 

Understanding the KFP Format

The KFP exam consists of clinical scenarios (called "stems") followed by several key questions. Each question targets critical steps in diagnosis, investigation, and management. Your goal is not to write long essays but to provide concise, specific answers, just as you would in a real consultation.

The exam lasts 3.5 hours and includes 26 cases with around 2-5 questions each. While the AKT tests broad medical knowledge, the KFP focuses on clinical reasoning, prioritization, and safe decision-making in a general practice context.

 

The Mindset for KFP Success

One of the biggest mistakes candidates make is treating the KFP like a short-answer test. It’s not. It’s a test of decision-making. Each question is carefully crafted to assess how you think, not just what you know.

Key principles:

• Think like a GP: Consider context, safety, and long-term care.
• Be specific: Vague answers like “bloods” will not score. Instead, write “FBC” or “TSH” depending on what’s clinically relevant.
• Prioritize: The KFP is not about listing every possible option, it’s about choosing what matters most for the scenario.

 

 

How to Approach a Clinical Scenario

1. Read the Stem Carefully

The clinical stem contains crucial information. Read it slowly and highlight key details: patient age, past history, symptoms, medications, and red flags. Always ask yourself:

• What is the most likely diagnosis?
• Is the patient stable?
• Are there any risk factors or urgent issues?

 

2. Identify the Key Problem

The KFP expects you to focus on the most urgent or relevant issue. This might be:

• Making a diagnosis
• Deciding on first-line investigations
• Managing acute risks
• Coordinating ongoing care

Resist the urge to cover everything, focus only on what is asked.

 

3. Answer with Precision

Each question has a marking guide with specific keywords. For example:

• Instead of “imaging,” write “non-contrast CT brain.”
• Instead of “medications,” write “start metformin 500 mg daily.”

Avoid writing full sentences. Bullet-point answers or single terms are sufficient unless the question asks for an explanation.

 

Common KFP Pitfalls to Avoid

• Being too broad or vague: Vague answers score zero, even if your idea is correct.
• Writing non-specific diagnoses: For example, “infection” instead of “otitis media.”
• Over-investigating: Choose only what is essential for the diagnosis or management.
• Overprescribing: Avoid unnecessary antibiotics or medications unless clearly indicated.
• Avoid 5 common mistakes RACGP exam cadidates make.

 

Practice Makes Perfect

Preparing for the RACGP KFP exam is not just about reading textbooks. It’s about practicing real-life clinical problems under timed conditions. Try these strategies:

• Use past papers and case banks: Practice under timed settings to simulate the exam.
• Study with a peer or group: Discussing cases improves reasoning and exposes blind spots.
• Review RACGP guidelines: Especially those related to chronic disease, mental health, and emergency care.

If you’re also preparing for the AKT, remember that both exams test different skills. The AKT is more fact-based and can help reinforce knowledge for the KFP, but don’t rely on AKT-style learning alone.

 

 

Topics Commonly Tested in the KFP

While the RACGP examination covers all of general practice, certain areas come up repeatedly:

• Mental health (depression, anxiety, suicide risk)
• Chronic disease management (diabetes, COPD, hypertension)
• Child health (immunization, fever, developmental concerns)
• Acute presentations (chest pain, abdominal pain, infections)
• Women’s health (contraception, antenatal care, menopause)
• Preventive care (screening, lifestyle counseling)

 

Read the RACGP exam reports: These offer insight into common candidate errors and examiner expectations.

Practice AKT and KFP mock exams, Prioritize safety and guidelines: Examiners love answers that reflect good, evidence-based practice.

The KFP exam is not about perfection, it’s about clinical competence. By thinking like a GP, focusing on the question, and answering with clarity, you can excel in this key part of the RACGP examination. Combine this with solid preparation for the AKT, and you’ll be well on your way to Fellowship.

Remember, every clinical scenario is an opportunity to show your reasoning and your readiness to practice independently. Stay calm, stay focused, and practice smart.