The RACP held information sessions from Wednesday, 15 January to Wednesday, 22 January 2025. A total of 27 trainees and 58 fellows attended across the 12 sessions, providing invaluable insights into their experience with RACP exams.

Attendees offered suggestions to drive meaningful change in this important and complex space.

Insights from the sessions

General

• Attendees received an overview of the background, report findings and recommendations, and the RACP’s next steps.


• Attendees provided invaluable insights into their experience with RACP exams and offered suggestions to drive meaningful change.


• Members were eager to hear about the RACP’s action plan and implementation timeframes.


• Attendees expressed appreciation for transparency in releasing the Report and the College’s clear commitment to addressing the findings. Transparency should continue through implementation.


• It is generally accepted that bias and racism are present in the health system and, therefore, in the Divisional Clinical Examination (DCE). It was acknowledged that the Report findings apply to all RACP examinations, providing an opportunity to address a long-standing systemic issue.


• Aotearoa New Zealand Examiners expressed concern about the Review process, key stakeholder involvement and the factual accuracy of the report.


• A number of groups questioned the composition of the Taskforce and stressed the importance of member involvement.

Report recommendations

• Examiners noted the logistical challenges, risks, and patient safety concerns associated with implementing recommendations at short notice. Recommendations such as case complexity and video/audio recording were highlighted as key areas of concern.


• Trainees strongly support video/audio recording and posed the example of the Australasian College of Emergency Medicine (ACEM) clinical examinations. It was later noted that ACEM clinical examinations use simulated patients/actors in non-clinical examination locations.


• Questions were raised about the effectiveness and impact of recommended Unconscious Bias Training and Cultural Awareness Training. It was agreed that any training must be meaningful, accessible and embedded in a suite of resources for all examiners across both countries.


• Fellows noted that conflicts of interest (COI) are avoided wherever possible, however an attempt to eliminate all potential COIs may present logistical challenges that jeopardise the delivery of clinical exams. The recommendation provides an opportunity to improve the management of COIs and reduce risks associated with perceived or actual COI.


• It was noted that several recommendations link to work already in progress through Curricula Renewal, the Cross-College Examinations Review (CCRE) and the Education Governance Review (EGR).


• Trainees support the implementation of Exam Moderators.

Divisional Clinical Examination structure

• Attendees raised concern about settings and trainees already in preparation mode for the 2025 DCE. There was shared concern about the negative impact on trainees if the exam structure and format is to change ahead of this year’s DCE.


• The role of exams and their contribution to RACP Programs of Assessment is in work underway through Cross-College Examinations Review.


• Some stakeholder groups questioned if the DCE was an appropriate way to assess clinical and professional skills:
  • Trainees raised that the current short case format does not reflect current clinical practice. Trainees’ appetite for change is clear.
  • The Report confirms that ‘The long and short case examination is no longer regarded as the gold standard as it has been in the past, though it is still considered valid and reliable’.
  • It was highlighted that any change to the exam structure would be carefully considered to maintain a valid assessment with appropriate notice of change. The stress on the health system in both countries, especially Aotearoa New Zealand, is a key consideration.

Back to Review of Paediatric Clinical Examination in Australia and Aotearoa New Zealand.