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AFOEM Stage A Written Examination

AFOEM Stage A Written Examination

The Stage A Written Examination tests your knowledge in occupational and environmental medicine to determine your readiness to progress to Stage B training.

Overview
Apply
Prepare
Exam day
Resources

Overview

Key dates

Description	Date
Applications open	9am AEST, Monday 15 June 2026
Applications close	5pm AEST, Monday 29 June 2026
Exam date	Saturday 5 September 2026
Special Consideration
Pre-exam applications close (for provisions on exam day)	5pm AEST, Monday 29 June 2026 Refer to Appendix A of the Special Consideration for Assessment Policy (PDF) Special Consideration for Assessment Application form (PDF)
Exam day/post-exam applications close (for technical and procedural issues)	5pm AEDT, Thursday 10 September 2026 Refer to Appendix A of the Special Consideration for Assessment Policy (PDF) Special Consideration for Assessment Application form (PDF)
Results released	From 3pm AEDT, Thursday 8 October 2026

Information is correct as of 15 June 2026.

Location

Venues are located in Australian and Aotearoa New Zealand capital cities and major regional centres, selected at our discretion.

Exam locations will be confirmed after applications close.

Risk management and contingency planning

In addition to quality assurance, a comprehensive risk management framework safeguards exam integrity and minimises disruptions. Lessons from the COVID-19 pandemic have strengthened this framework, enhancing the ability to respond to unforeseen challenges.

Risk management plans outline strategies for mitigating potential disruptions and ensuring coordinated responses to unexpected events. Crisis communications support timely updates, and contingency plans outline alternative exam delivery methods if required.

These plans are reviewed before each exam cycle and published on our website for transparency. Through proactive risk management and rigorous quality assurance, we remain committed to upholding the highest assessment standards, providing candidates and stakeholders with confidence in the exam process.

Additionally, recommendations from the Review of Paediatric Clinical Examination in Australia and Aotearoa New Zealand are being implemented to enhance exam safety for candidates, examiners, patients, and their families/whānau/carers.

To find out more, read the Review of Paediatric Clinical Examination in Australia and Aotearoa New Zealand.

Plan A: The paper-based exam will be delivered at exam venues across Australia and Aotearoa New Zealand on 5 September 2026.

Plan B: If one or more exam locations are unable to deliver the exam on Saturday 5 September due to unforeseen circumstances, the exam will proceed at all other locations.  
If September is not feasible in an exam centre, the exam will take place a minimum of 3 months later at impacted exam locations.

Exam format overview

Multiple Choice Question (MCQ) – 120 MCQ questions

The Prepare and Exam Day tabs provide detailed information on the content and processes for each paper.

Exam development

The exam content is developed through a structured, multi-stage process designed to ensure that questions accurately and reliably assess the targeted knowledge and skills. Exam content is developed in alignment with approved exam blueprints, which define the intended coverage across relevant domains and skill areas.

Questions are written and reviewed by AFOEM subject matter experts. Each question undergoes collective review to evaluate clinical accuracy, clarity, relevance and alignment with the intended assessment outcomes. No question is written or approved by a single individual and only those that meet the required standards progress through quality assurance processes for potential inclusion in the exam.Papers are constructed from a bank of MCQs covering a wide selection of topics across basic and general medicine important to the practice of occupational and environmental medicine and aligned to the exam blueprint.

A proportion of previously used questions is included to monitor exam difficulty across different assessment forms (sittings) and to support post hoc analysis of exam performance. All questions count towards candidates’ total score on the exam.

Final exam papers are assembled through collaboration between the working party leads, relevant committees and RACP staff. Once submitted to the RACP, questions undergo technical editing and further review to confirm internal consistency, alignment with assessment standards, and overall suitability for inclusion in the exam. Final proofreading, approval and standard-setting processes ensure that each question meets the required performance expectations before materials are prepared for exam delivery.

Performance standard criteria

Standard-setting processes ensure that all candidates are assessed fairly and consistently. The exam uses a criterion-referenced standard-setting approach, the standard required to pass the exam is determined by the difficulty of the questions for the ‘minimally competent’ practitioner for defined expectations of occupational and environmental medicine practice rather than compared with the performance of other candidates. This approach ensures that all candidates who demonstrate the required standard are able to pass. There are no predermined quotas set for the number of candidates to pass or fail the exam.

The required standard is established using a recognised standard-setting approach: the Modified Angoff method. A panel of diverse subject matter experts who are familiar with the training environment review every question on the exam to estimate the probability that a minimally competent candidate would answer them correctly. The standard to pass the exam is the aggregate average of these judgements. This approach is used to determine the overall pass mark. As a result of this process, the pass mark may vary across years according to the paper difficulty.

Marking

For each question answered correctly, 1 mark is awarded. Marks are not deducted for incorrect answers. To pass, you must get a score equal to or higher than the pass mark. The answer sheets are computer-marked.

After the exam, psychometric analysis identifies item performance (e.g. level of difficulty) and items that require qualitative review due to unexpected performance on psychometric criteria. From time to time, one or more items may be removed from scoring of candidates’ final results. No candidate is disadvantaged by this process.

Quality assurance

A robust quality assurance framework governs the exams to ensure fairness, accuracy and consistency across all assessments. Each stage of the exam process follows detailed business rules tailored to the exam’s purpose, format and potential risks.

From planning and development with relevant committees through to scenario and question selection, item creation, marker recruitment and training, stringent measures uphold rigorous assessment standards.

Data integrity is prioritised through comprehensive quality checks before results are finalised, while results meetings and ratification procedures provide additional oversight, particularly for candidate results close to the minimum expected standard and for any unforeseen circumstances that may impact outcomes.

Clear and timely communication ensures transparency for candidates and stakeholders, and structured feedback mechanisms support continuous improvement of future assessments.

Results

You’ll receive your exam result by email. Your Advanced Training Supervisor and Director of Training are copied on the email. Ensure your contact details are up to date in MyRACP, including your current email address and phone number. If you do not receive your result email, contact us for assistance.

To ensure fairness, accuracy, and integrity, results undergo the following quality assurance process:

Responsive Table

Post-exam day steps	Description
Answer sheet data collection	Scanning and processing of answer sheets by an external company.
Paper marking	The answer sheets are computer-marked.
Data collection	Processing of consensus score sheets.
Data verification	Checking for anomalies and data comparison.
RACP item analysis	Review of item statistics by internal experts.
Item review by SMEs	Subject Matter Experts (SMEs) review flagged items.
Item analysis meeting	Discussion and finalisation of item decisions.
Cut-score determination	Establishing the final pass threshold.
Results meeting	Discussion of candidate exam results and decision on incidents and post-exam special consideration applications. All candidate details are de-identified.
Results confirmation	Confirmation of results for release.
Results administration	Final preparation of results for release
Results release	Results are typically released mid-week and before the end of the day to ensure candidates can access support within business hours.

To protect the integrity of scoresheets, robust security and quality assurance processes are in place. All scoresheets are photocopied before leaving the exam venue and are securely transported via person-to-person courier from each site. Upon arrival, the exam management supplier conducts thorough checks to confirm that all scoresheets have been received and reconciled against trainee attendance records. While every effort is made to work efficiently, these steps are critical to ensuring the fairness, accuracy, and reliability of results.

See previous exam pass rates.

Candidate feedback

All candidates receive a summary of the number of correct responses within each question topic addressed in the paper.

We understand that you may be seeking more detailed individualised feedback; however, further personalised feedback can't be provided. You're encouraged to discuss your results with your Advanced Training Supervisor or mentor, who can help you reflect on your performance, recognise your strengths and identify areas for continued development.

To support equitable access and consistency for all candidates, the AFOEM Annual Trainees Meeting (ATM) includes sessions on the exam, preparation strategies and related processes, with opportunities for questions.

Next steps

To progress to Stage B training, you must pass this exam and complete all other requirements in the Occupational and Environmental Medicine Advanced Training Program handbook.

Refer to the eligibility criteria and exam attempts set out in the Progression through Training Policy and the Occupational and Environmental Medicine Training Program handbook.

Note: The Reconsideration Review and Appeals By-law (PDF) applies exclusively to decisions made by College bodies and doesn't apply to exam results, as these reflect outcomes of assessments against established criteria rather than discretionary decisions.

Apply

Eligibility

To be eligible to sit the exam, you must be an AFOEM trainee in Stage A training with:

current general AMC/MCNZ medical registration
approved registration for the current training period
an Educational Supervisor
a minimum of 6 months completed and certified active Stage A training (1 training period)
your most recent training period certified with all teaching and learning activities and assessments complete
a complete Advanced Life Support course with certificate of completion provided to Faculty

You must also have:

paid all College training fees
applied by the exam due date

If you have outstanding training fees, you’re ineligible to sit the exam. See College Fees Terms and Conditions.

Exam attempt limit

You cannot continue Advanced Training if you exceed the examination attempt limit based on when you commenced training.

Commenced training	Before 2019	From 2019 onwards
Attempt limits	5	3

See the Progression Through Training Policy for more information about examination attempts.

Overseas trained physicians: Check eligibility requirements with your overseas trained physicians case officer before applying.

Application process

Submit your application

Applications are now closed.

Application confirmation

After submitting your application form, we email you to confirm it’s been received. If you don’t get a confirmation email, check your junk/spam folders and contact us if it’s not there.

Payment

Once applications have closed, we email you a link to pay the exam fee and any other outstanding fees.

Final confirmation

You receive a candidate allocation letter via email when your eligibility has been finalised. This confirms your exam registration and venue.

Fees

Australia | AUD $2,329.00
Aotearoa New Zealand | NZD $2,678.35

To be eligible to sit the exam, you must be up to date with all your College training fees.

See College Fees Terms and Conditions to learn more about paying your exam fees.

Exam fees support the delivery of the exam and fund the complex operational and logistical requirements involved in managing the assessment across multiple locations. 

Fees contribute to a wide range of essential costs, such as: 

venue hire and invigilation services
production and manual processing of exam materials
contracts with external companies for scanning and data verification
meetings of the Examination Committee and Exam Working Party activities
travel, accommodation, and catering for those involved in exam development and setting the standards
licensing and maintenance of secure digital platforms used for exam administration and results management

These costs ensure that each exam is conducted fairly, securely and in accordance with the RACP's high standards of quality and professionalism.

Special consideration

Throughout RACP training programs, trainees may experience exceptional circumstances that impact their assessment activities. These circumstances are not ordinarily encountered or anticipated and are beyond the trainee’s control and may affect their ability to attend or perform optimally in an exam, or complete or submit a work-based assessment requirement.

We're committed to supporting all trainees by providing reasonable adjustments where necessary to ensure equitable access to assessment activities, in a manner that is transparent, fair, respectful, responsive, accountable and people-focused.

Before the exam

Special consideration may be approved for:

permanent or long-term disability
temporary disability due to medical or other relevant conditions
pregnancy, lactation and infant-feeding needs
essential religious, cultural, social or legal commitments
compassionate grounds or other significant disruptive events occurring before the examination

Applications should be submitted as early as possible, preferably at the time of exam application, to allow sufficient time for review and implementation of any approved arrangements.

Applications submitted after the published deadline may still be considered in exceptional circumstances, at the discretion of the College, and additional supporting documentation may be required.

During the exam

Special consideration may be given for technical or procedural issues. Candidates must notify the examiner or invigilator of the issue immediately so the incident can be acknowledged, mitigated where possible and documented.

After the exam

Special consideration may be requested for:

technical or procedural issues that could not be resolved during the exam
temporary disability that occurred during the exam and prevented completion
racism, discrimination, or bias experienced during the exam

Applications must be submitted within 5 calendar days of the exam and before results are released. Temporary disability, where the candidate elected to continue the exam, isn't eligible for post-exam consideration.

Impaired preparation isn't grounds for special consideration. Candidates who believe their preparation has been significantly affected should withdraw before sitting the exam. All applications require supporting documentation and are reviewed confidentially. Special consideration may result in reasonable adjustments or alternative arrangements but will not change your marks or exam result.

For full details and application requirements, see the Special Consideration for Assessment Policy and the Special Consideration for Assessment application guide and form (PDF).

Withdrawal and refund

Withdrawals aren't counted as exam attempts. You may withdraw up to the start of the exam by contacting the College. Refund rules apply, and details are outlined in the College Fees Terms and Conditions.

Withdrawal on medical or compassionate grounds may be eligible for a refund. To request this, submit the required application form under the Special Consideration for Assessment Policy. Refund amounts depend on the timing of your withdrawal, as detailed in the College Fees Terms and Conditions.

Candidates who withdraw can apply to sit the exam the following year, provided eligibility requirements are met. Application fees are not carried over from one year to the next.

To withdraw from the exam, contact faculty.examinations@racp.edu.au

Prepare

Exam Format

15 min reading time | 3-hour exam | 120 multiple-choice questions (MCQs)

The exam is a summative assessment designed by the Faculty Assessment Committee. It covers a cross-section of required areas of competence as defined by the Occupational and Environmental Medicine Advanced Training Curriculum (PDF).

To construct a fair and relevant exam, we developed a bank of MCQs covering a wide selection of questions. The questions are relevant and cover a broad range of topics across basic and general medicine.

The exam uses the One-Correct (Type A) Multiple-Choice format. Each MCQ includes 4 answer options with only 1 correct answer.

Skills assessed:

clinical skills, as expected of a medical practitioner at completion of postgraduate year 2 (PGY2)
critical appraisal of general medical literature
professional qualities
knowledge of basic physics, chemistry and microbiology
knowledge of anatomy, pathophysiology and pharmacology as outlined in the curriculum
knowledge of methods of clinical investigation and treatment as outlined in the curriculum

Exam content is weighted as follows:

Domain 10: Clinical practice
Domain 20: Workplace hazard assessment – only Theme 20.1
Domain 30: Critical appraisal of information
Domain 60: Professional qualities

60 to 80%
5 to 15%
10 to 20%
10 to 15%

Preparation tips

Start your exam preparation early

Start preparing as early as possible. Most successful candidates start 6-12 months ahead of their exam.

Practice your approach

A supervisor or mentor can help you with practice questions. Go through your thought process out loud with them as you construct an answer. This approach helps you obtain valuable feedback and provides a better insight into your approach.

Organise and equip yourself

Finding a quiet, comfortable place to study is important. Study in a way that best suits your individual learning style. Develop a study plan and revision timetable. Use different learning approaches such as flashcards, mind maps, diagrams or opportunities to teach others as part of your revision.

Study with others

The shared experience of studying with others helps many trainees feel motivated, confident and on-track during the preparation period.

Many have joined or created support groups that meet regularly, share resource ideas and provide a forum for constructive feedback.

Join the RACP Trainee Facebook group (a closed group) to meet other trainees, share experiences, tips, events and ideas.

Attempting the exam again

Meet with your supervisor

If you're actively training, meet with your supervisor to talk through your previous attempts at the exam. Your supervisor is likely to have valuable insights to share about areas you need to focus on and areas to improve.

Use the Improving Performance Action Plan template and plan your study to maximise time spent on these focus areas. For example, once a week you could spend time on each area to make sure you have a thorough understanding of each topic.

You could also ask your supervisor to share trial case studies and cross-reference them with the Occupational and Environmental Medicine Advanced Training Curriculum.

Repeat what worked

What study materials did you use last time? What was helpful and what wasn't? Review your materials and look for other valuable resources.

RACP Support Program

Preparing for exams can be stressful. Reach out to the RACP Support Program for free, 24/7, completely confidential support. Make an appointment or speak with a consultant by calling 1300 687 327 (Australia) or 0800 666 367 (Aotearoa New Zealand).

The Training Support Unit is here to support your progress through your examinations. The Training Support Unit will be in contact with you to offer support and provide important information shortly after you register for the final attempt of your exam. If you're not on your final attempt of an exam and would like support from the Training Support Unit, contact us via email trainingsupport@racp.edu.au for Australian Candidates or trainingsupport@racp.org.nz for Aotearoa New Zealand candidates.

Exam day

Exam day safety

Your safety is a priority during all exam activities, as it is in your workplace. If at any time you feel unsafe, you should stop and seek assistance immediately. Doing so will not adversely affect your assessment. Support is available from examiners and College staff throughout the exam.

In line with the Review of Paediatric Clinical exam in Australia and Aotearoa New Zealand, additional measures are being introduced to further strengthen safety for candidates, examiners, patients and their families/whānau/carers. These changes aim to ensure a safe, supportive and respectful environment for everyone involved in the exam.

To learn more, refer to the Review of Paediatric Clinical exam in Australia and Aotearoa New Zealand.

Timetable

8:30 to 8:40am	Arrive and sign in
8:50am	Pre-exam announcements
9am	Reading time begins
9:15am	Exam begins
12:05pm	Announcement of 10 minutes remaining in the exam
12:15pm	Exam concludes. Exam booklets and answer sheets collected.

Personal items

Bring

Printed or digital copy of your candidate allocation letter confirming your name, candidate number and session time
Current valid photo ID with your full name and signature, for example a passport or driver's licence – a digital valid photo ID is acceptable, a picture of your ID isn't acceptable
Blue or black ballpoint pens (no pencils, gel or felt-tip pens)
1 x highlighter (optional)
1 x ruler (optional)
Basic analogue watch (optional)
Water in a clear plastic bottle (optional)

Lunch isn't provided, and many venues don't have food vendors on site. You may need to leave the venue to purchase lunch or bring your own on the day.

Tip: Wear additional clothing layers to adjust to the room temperature.

Not permitted during the exam

Written material (other than your candidate allocation letter)
Recording and electronic devices including digital watches, smart pens, tablets, scanners, dictionaries (that function in a similar way to a tablet)
Wearable AI devices, e.g. smart glasses, smart watches
Pagers
Laptop computers
Personal communication aids
Calculators
Ear plugs (unless special permission has been granted by RACP)
Headphones
Food and beverages (other than still water) to be consumed during the exam unless special permission has been granted by RACP
Dictionaries
Pencils or pencil cases
Frixton (erasable) pens, gel pens or felt tip pens

Carrying recording devices on your person, including mobile phones and wearable AI devices, will result in automatic disqualification. 

All mobile phones, digital watches, sport watches, smartwatches (including but not limited to Apple Watch, Garmin, Fitbit, Samsung), pagers and electronic communication devices must be:

switched off
placed on the floor under your chair
clearly visible to invigilators

Devices that sound during the exam are subject to an incident report.

Seating arrangements

Seating lists showing your allocated seat number are displayed near the venue entrance.

Desks will be labelled with your name and candidate ID number.

Discuss seating enquiries with the Chief Supervisor as early as possible on exam day.

Apply for special consideration for exceptional circumstances by the due date.

Completing the exam

At your seat, you receive:

a question booklet
a multiple-choice question answer sheet

When instructed, write your name, candidate number and exam city on all materials.

You have 15 minutes reading time, during this time you must not write on or mark the paper in any way.

To answer each question, fill in the answer bubble corresponding to the option you think is correct. Use black or blue ballpoint pen only.

To change an answer, cross through the incorrectly filled bubble and then fill in the correct one. To reselect a previously crossed-through answer, circle that answer and cross through all incorrect answers. Out of the ordinary answers will be manually reviewed.

Your chosen response should be clear.

AFOEM Stage A Written Examination

Issues on exam day

If you experience issues leading up to the exam or on exam day that prevent you from attending, contact us. This may include illness, natural disasters or personal/family issues.

If you arrive up to 30 minutes late, you can attempt the exam, but you won’t get additional time.

If you arrive more than 30 minutes late, you won’t be permitted to enter the exam.

Leaving the exam room

Don't leave the exam room without an invigilator’s approval. If you need the toilet, an invigilator will escort you. If you want to leave before the end of the exam, stay seated and raise your hand. An invigilator will check your materials and release you.

You can't leave in the first 30 minutes or last 10 minutes of the exam.

On completion of the exam, your exam booklet and answer booklets will be collected before you can leave.

Post-Exam Candidate Survey (PECS)

We'll email you a link to a survey at the end of the exam to complete before results are released.

We value your feedback on the question quality, exam arrangements and process. Responses are discussed by the College and the Committee at the post-exam meeting.

Conduct

Exam materials and content are confidential. You’re required to sign an Annual Participant Agreement (confidentiality agreement) before taking the exam. 

The following is considered academic misconduct: 

removing exam materials from the venue
reproducing or distributing the contents of exam material

For more information, see the Academic Integrity in Training Policy.

Resources

A range of resources is available to help you prepare for the Stage B Written Examination and understand the assessment requirements.

Occupational and Environmental Medicine Training handbook
AFOEM examination pass rates
Education policies
Wellbeing
Progression Through Training Policy (PDF)

Sample questions

Member login required

AFOEM Stage A Sample Questions

Exam Information Session

An exam information session will be held on Thursday, 6 August from 12.00pm – 1.00pm AEST. You’ll receive further information and instructions on how to register in mid-June.

Member login required

2026 Candidate Information Session FAQs (PDF)

RACP Online learning resources

Access a broad selection of interactive, self-paced learning resources developed with RACP Fellows, trainees, and subject matter experts to support your ongoing learning.

RACP Online Learning resources

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AFOEM Stage A Written Examination

The Stage A Written Examination tests your knowledge in occupational and environmental medicine to determine your readiness to progress to Stage B training.

Overview

Key dates

Location

Risk management and contingency planning

Exam format overview

Multiple Choice Question (MCQ) – 120 MCQ questions

Exam development

Performance standard criteria

Marking

Quality assurance

Results

Candidate feedback

Next steps