ACRRM vs RACGP Training

Australia is one of the only countries in the world to have two GP colleges; the Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM). 

The RACGP was founded in 1958 and is the larger of the two colleges with over 40,000 members.  In 1997 a group of rural doctors split from the RACGP and formed ACRRM, a college dedicated to rural and remote medicine. Today ACRRM has approximately 4,500 members.


Both the RACGP and ACRRM are accredited by the Australian Medical Council (AMC) to provide training in the specialty of general practice. Both colleges have excellent training programs and fellowship of either college allows a doctor to practice as a GP anywhere in Australia.

Australian General Practice Training (AGPT) programs are offered through both colleges and a structured education program with exam support is delivered by the Regional Training Organization’s (RTOs). The AGPT has the option of training on either the rural or the general pathway. General pathway registrars can only train with the RACGP, whereas those on the rural pathway can choose to complete their training with either college. If you are an IMG under the 19AB moratorium, you must train on the rural pathway.

RACGP’s AGPT program is three years, comprising of one year in hospital, 18 months in a general practice post and six-months in an extended skills post. There is an option to obtain an additional fellowship in Advanced Rural General Practice (FARGP), which adds an additional 12 months onto your training time. 

The ACRRM AGPT program is four years, which is made up of three years of core generalist training and one year of advanced specialist training (AST) in a speciality of the doctors’ choosing.

Additionally, both colleges have alternative pathways. The RACGP has the practice experience program (PEP) and ACRRM has the Independent Pathway (IP).


Both ACRRM and RACGP have fellowship exams which must be completed by the end of your training (extensions to training time are available in some circumstances).

The RACGP has three exams:

  • The Applied Knowledge Test (AKT) is a 150 question, 3.5 hour, multiple choice exam which tests your application of knowledge across the domains of general practice. The 2021.2 pass rate was 76.42%.
  • The Key Feature Problems (KFP) is a 26 case 3.5 hour, short written answer exam which is designed to test your clinical reasoning. The 2021.2 pass rate was 59.34%.
  • The Clinical Competency Exam (CCE), which consists of nine 15 minute clinical cases across two days and is designed to assess how you apply your knowledge and clinical reasoning skills in clinical scenarios. This is a new exam, which has replaced the OCSE and the RCE. The first cohort’s results have not yet been made public.

The total RACGP exam fees for the 2022.1 cycle was $9,430.

ACRRM assessment consists of:

  • The Multiple Choice Question (MCQ) exam, which is a 125 questions 3 hour exam designed to assess recall, reasoning and applied clinical knowledge. The pass rate for the 2021B exam was 88%.
  • The Case Based Discussion (CBD), which is an assessment of clinical reasoning and  application of knowledge in a clinical context and is an online case discussion with an examiner of six clinical cases, submitted by the candidate which takes place over three, one hour sessions. The 2020 pass rate was 82%.
  • The Structured Assessment Using Multiple Patient Scenario (stAMPS), which
    aims to assess higher order functions in a highly contextualised framework, where candidates can explain what they do and demonstrate their clinical reasoning. It is an online, oral assessment in which the candidate is presented eight rural medicine scenarios and are asked three questions over 10 minutes for each scenario. The pass rate for the 2021B exam was 51.4%.
  • The Summative AST which is dependent on what speciality your advanced speciality is in. It can consist of:
    • A project, 
    • A further stAMPS assessment (emergency medicine only), or 
    • A procedural skills logbook.

The total current ACRRM exam fees are $6,735 + an additional $3,150 if your AST requires a project or $3195 for the additional EM stAMPS exam.

Both colleges have additional on-the-job assessments such as clinical teaching visits, logbooks, competency assessments and multi-source feedback.

Which College should I choose?

Choosing which college is right for you is a personal decision. If you want to train in an inner-city or metropolitan area and are not under the 19AB exemption or rurally bonded, the RACGP is the college for you. If you would like to do some, or all of your training in a rural or remote location, both colleges offer comprehensive and well-supported training programs leading to a fellowship, which will allow you to be recognised and to work as a specialist general practitioner anywhere in Australia.

By Dr Susan Roberts

Dr Roberts is a recent Fellow, having trained on the rural pathway in Northern NSW, and a previous FGP Advisor providing ongoing support and guidance to all doctors that are interested in a career in general practice.