Overview

Key dates

Sunday 15 November is planned as a contingency date should we receive a high number of candidate applications.  We'll notify trainees as soon as possible after applications close whether this date is required.

Location

To be confirmed.

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.

Exam format overview

The exam consists of 6 exam stations, each presenting a different scenario.

The Prepare and Exam Day tabs provide detailed information on the content and processes of the exam day.

Exam development

The exam content is developed by the Stage B Practical Working Party, a dedicated group of AFOEM Fellows who oversee the design, refinement and quality of all exam stations. The process is facilitated by the Lead Coordinator and supported by RACP staff. The working party use structured processes designed to support reliability and alignment with the Occupational and Environmental Medicine Advanced Training Curriculum. Topics are planned and mapped across relevant learning domains to ensure appropriate coverage of learning objectives and equitable assessment across candidates. This mapping supports blueprint fidelity and reduces construct under-representation.

Working party members collaboratively develop exhibit-based assessment tasks, objective structured clinical examination stations and associated marking guides, engaging in structured peer review to refine clinical relevance, clarity and scoring intent. Independent faculty review and careful selection of clinical cases and patients provide additional checks on suitability, interpretation and alignment with the required level of practice. These steps help reduce assessment bias, improve scoring consistency and strengthen content validity.

Once submitted to the RACP, exam materials undergo technical editing and further quality assurance 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 component 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 Stage B Practical uses criterion-referenced judgement, meaning performance is evaluated against 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.

Performance expectations are defined through structured assessment criteria, marking guides and examiner judgement applied across all stations. Examiners assess candidate performance independently and then determine final outcomes using agreed scoring processes. These processes support consistent interpretation of the required standard and ensure that final decisions reflect demonstrated performance across the exam.

Examiners undertake structured calibration activities before the examination to develop a shared understanding of station requirements, marking standards and acceptable responses. Together with established exam governance and quality assurance processes, this calibration supports fairness, scoring consistency and defensible pass–fail decisions.

Marking

Passing a station

For each station, a score is awarded by consensus of 2 examiners.

Clinical Stations scores are determined using the Professional Competencies Rating Scale rubric which incorporates clinical skills and professional behaviours assessment domains.  

The 5 assessment domains are:

1. Interaction with patient
2. Examination technique
3. Examination accuracy
4. Interpretation and synthesis of physical findings
5. Investigations

Professional Competencies Rating Scale (Clinical) (PDF)

To pass, candidates must:

• score 15/25 or more across all domains and,
• achieve a minimum score of 3/5 for 'interaction with patient' and at least 2 other domains.

OSCE Stations are assessed using a pre-determined marking guide.

The stations also include a professional competencies rating based on the Professional Competencies Rating Scale rubric. Professional qualities ratings contribute to 30% of the overall station score.  

Professional competencies ratings are determined using a pre-set rating scale our of 25 for:  

• interaction with patient
• history-taking technique
• accuracy of history-taking
• interpretation and synthesis of history findings and prioritisation of clinical issues
• management and discussion

Professional Competencies Rating Scale (OSCE) (PDF)

The pass marks for the questions are determined using the Modified Angoff method which is based on the assessment of the exam by subject matter experts.

The pass mark for each OSCE Station varies according to the difficulty of the station.

EBA Stations are assessed using a pre-determined marking guide. 

The pass marks for the questions are determined using the Modified Angoff method which is based on the assessment of the exam by subject matter experts.

The pass mark for each EBA Station varies according to the difficulty of the station.

Passing the exam

To pass the exam, you must pass at least 4 stations, including:

• 1 x Exhibit-Based Assessment (EBA) Station
• 1 x Clinical Station
• 1 x Objective Structured Clinical Examination (OSCE) Station

The RACP reviews the examination performance statistics prior to the release of results. The performance of the examination stations is analysed, and the pass mark reviewed to determine each candidate’s result. During this process, one or more questions may be removed from the examination and the pass mark adjusted accordingly.

See previous exam pass rates.

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.

Quality assurance processes apply across exam planning, assessment design, clinical case and exhibit selection, examiner recruitment and calibration. These structured processes support consistent standards and reliable assessment across all components of the examination.

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

Candidate Feedback 

All candidates receive general feedback that provides a cohort-level overview of performance, including key strengths and areas for improvement identified across the examination. 

Unsuccessful candidates also receive a personalised feedback report summarising their performance in stations where the required standard was not met. This feedback highlights key strengths and weaknesses across relevant assessment domains and is prepared following review of examiner comments and consensus outcomes.  

See previous years' Stage B Practical Examination feedback reports: 

• Feedback Report 2024 (PDF) 
• Feedback Report 2025 (PDF) 

We understand that you may be seeking more detailed individualised feedback; however, additional personalised feedback cannot be provided. You are encouraged to discuss your results with your Advanced Training Supervisor, Director of Training or mentor to support reflection and preparation for a future attempt. 

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

Next steps

In order to progress to Stage C Training, you must pass this exam and:

• pass the AFOEM Stage B Written Examination
• complete your year of training including all other training requirements in the Occupational and Environmental Medicine 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.

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.