2019 Divisional Written Examination - Instructions to Candidates - RACP

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2019 Divisional Written Examination - Instructions to Candidates - RACP
2019 Divisional
Written Examination

Instructions to Candidates

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2019 Divisional Written Examination - Instructions to Candidates - RACP
2
Table of Contents

Important examination information ..................................................................................... 4
  Key dates ............................................................................................................................................................. 4
  Locations .............................................................................................................................................................. 4
  Fees .................................................................................................................................................................... 5
Applying for the exam ........................................................................................................... 6
  1.         Eligibility ...................................................................................................................................................... 6
       1.1         Examination attempts .......................................................................................................................... 6
       1.2         Notification to apply.............................................................................................................................. 6
  2.         Application period ....................................................................................................................................... 6
  3.         Application confirmation .............................................................................................................................. 7
  4.         Submission of PREP tools .......................................................................................................................... 7
  5.         Final confirmation ........................................................................................................................................ 7
  6.         Withdrawal of application ............................................................................................................................ 7
  7.         Special consideration .................................................................................................................................. 8
       7.1.        Grounds for special consideration ....................................................................................................... 8
       7.2.        How to apply for special consideration ................................................................................................ 8
Examination format ............................................................................................................... 9
  8.         Structure of the Divisional Written Examination ......................................................................................... 9
       8.1.        Visual material ..................................................................................................................................... 9
       8.2.        Multiple choice questions (MCQs) ....................................................................................................... 9
       8.3.        Extended matching questions (EMQs) .............................................................................................. 10
  9.         Examination resources ............................................................................................................................. 11
  10.        Reading preparation ................................................................................................................................. 11
  11.        Sample questions ..................................................................................................................................... 11
Examination day ...................................................................................................................12
  12.        Examination day timetable ........................................................................................................................ 12
  13.        Items to bring to your examination ............................................................................................................ 12
  14.        Items not permitted in the examination area............................................................................................. 12
  15.        Seating arrangements............................................................................................................................... 13
  16.        Completing the examination ..................................................................................................................... 13
       16.1.       Completing the question booklets and answer sheets ...................................................................... 13
       16.2.       Leaving the examination room ........................................................................................................... 14
After the examination ...........................................................................................................15
  17.        Marking ..................................................................................................................................................... 15
  18.        Results ...................................................................................................................................................... 15
  19.        Divisional Clinical examination ................................................................................................................. 15
Important examination information

Key dates

 Written examination date                                                Monday, 18 February 2019

 Examination applications open                                             Friday, 2 November 2018
                                                                             (9am AEDT/9am NZDT)

 Examination applications close                                         Monday, 26 November 2018
                                                                         (12pm AEDT/12pm NZDT)

 Submission of PREP requirements                            Australia: Thursday, 31 January 2019
                                                       New Zealand: Thursday, 20 December 2018

 Pre-examination special consideration requests         Monday, 4 February 2019 (5pm AEDT/5pm
 close                                                                                  NZDT)
 • Provisions for examination day
 • Change of venue

 Examination day special consideration requests      Friday, 8 March 2019 (5pm AEDT/5pm NZDT)
 close
 • Technical and procedural issues

 Results released (via email)                                              Thursday, 14 March 2019
                                                                            (3pm AEDT/3pm NZDT)

Locations
The 2019 Divisional Written Examination will be held in the following locations:

Australia
Adelaide                        Melbourne
Brisbane                        Newcastle
Cairns                          Perth
Canberra                        Sydney
Darwin                          Townsville
Geelong                         Wollongong
Gold Coast
Hobart

New Zealand
Auckland
Christchurch
Dunedin
Hamilton
Wellington

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Details of the venues for the Divisional Written Examination will be emailed to candidates 4 weeks
prior to the exam date.

Fees

                                                                      Amount

 Australia                                                          A$1930.00

 New Zealand                                                      NZ$2219.50

For more information about paying your RACP examination fees, please refer to the Terms and
Conditions of College fees.

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Applying for the exam

1. Eligibility
      To be eligible to sit the Divisional Written Examination, you must:
      •   be registered with the College by the due date

      •   have a minimum of 24 months full-time equivalent (FTE) of certified Basic Training
         by 31 January 2019 for Australia or 20 December 2018 for New Zealand.
     •   be in an accredited training position or an approved interruption of training
      •   have completed all Physician Readiness for Expert Practice (PREP) requirements

      •   comply with the limit on the number of examination attempts and other requirements
          for progression through training, which are detailed in the RACP Progression
          through Training Policy

      •   be fully current with all College training fees. Trainees with outstanding training fees
          will not be eligible to sit the Divisional Written Examination unless they have made
          an application in writing to the Honorary Treasurer requesting special consideration.

1.1       Examination attempts
          Limits on the total training time allowed and the number of examination attempts are specified
          by the Progression through Training Policy. The revised policy was implemented on 1 January
          2017. Transition arrangements are in place that may be relevant to trainees sitting the
          Divisional Written Examination in 2019. You can view your examination attempts to date on
          the Basic Training Portal.

          For more details, please see the Progression through Training Policy.

1.2       Notification to apply
          Notifications to apply to sit the examination will be sent out via email in early November 2018.
          These will be sent to all trainees who may be eligible for the examination. However, receipt
          of a notification does not guarantee your eligibility.
          If you are expecting to be eligible to sit in 2019 and have not received a notification by
          1 November 2018, you should contact prep_bt@racp.edu as soon as possible. You should
          ensure that the College has your current email address and that you have checked your
          junk/spam email folder in case your notification is there.
          Notifications to apply are sent as a courtesy to alert you that applications to sit the examination
          are opening. You will not be granted an extension to apply if you fail to receive a notification
          and do not contact the College in sufficient time to complete an application.

2. Application period
      Applications must be submitted via the College’s online registration form. The form will be
      accessible to all eligible trainees to register. If you believe you are eligible for the examination but
      are unable to commence the registration process, you should contact prep_bt@racp.edu.au or
      Basic.Training@racp.org.nz as soon as possible.

      At the time of application, you will be able to select the city in which you wish to sit the examination.
      You must also pay the examination fee to finalise your application.

      You must contact examinations@racp.edu.au as soon as possible if you experience or anticipate
      any difficulties with submitting your application. It will not be possible to assist you if you experience
      technical or other issues and do not contact the College until after the application deadline.
      Extensions to the application deadline will not be granted.

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3. Application confirmation
   You will receive an onscreen confirmation of the successful submission of your application at the
   end of the process. After your payment has been processed, your receipt will be available by
   logging in to my.racp.edu.au Within an hour of submitting the application, you also will receive a
   confirmation email. If you do not receive a confirmation email, then your application may not have
   been submitted successfully and you must contact examinations@racp.edu.au immediately. You
   also should make sure you have checked your junk/spam email folders in case your confirmation
   email is there.

4. Submission of PREP tools
   In order for your registration for the examination to be finalised, you must ensure that you submit
   all PREP requirements by the due date of Thursday, 31 January 2019 for Australia or Thursday,
   20 December 2018 for New Zealand. This includes the submission of your Annual Progress Report
   (APR). If you do not complete all your PREP requirements satisfactorily, your training will not be
   certified. This means that you will not be eligible for the examination and your application will be
   withdrawn.

5. Final confirmation
   Once your eligibility for the examination has been finalised, you will be sent an examination
   allocation letter by email. This letter will confirm your registration for the examination and provide
   details of your examination venue.

6. Withdrawal of application
   If you wish to withdraw from the Divisional Written Examination, you must advise the College by
   email to examinations@racp.edu.au. Withdrawals are not counted as examination attempts. You
   may withdraw up until the commencement of the examination.

   Refunds of application fees will be provided according to the following rules:

            Date of withdrawal                                  Refund
            For withdrawal before 12pm AEDT/2pm NZDT on
            26 November 2018 (close of applications)            100% of application fee

            For withdrawal after 12pm AEDT/12pm NZDT on
            26 November 2018 up until 5pm AEDT/5pm NZDT
            on 30 January 2019
                                                                50% of application fee

            31 January 2019 onwards                             No refund available

   To request a refund outside of these rules on medical or compassionate grounds, you must submit
   an application under the Special Consideration for Assessments Policy (see item 7 below).

   If you withdraw from the Divisional Written Examination, you may re-apply to sit for the
   examination the following year provided you meet the eligibility criteria as listed. Note that
   application fees will not be rolled over from one year to another.

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7. Special consideration

7.1.   Grounds for special consideration
       The College will take the            following   circumstances     into   consideration   for   the
       Divisional Written Examination.

       Circumstances occurring prior to the examination, which include:
       •    permanent and longstanding impairment
       •     temporary impairment – medical grounds
       •     non-medical compassionate grounds or serious disruption
       •     essential commitments (religious, cultural, societal or legal obligations).

       Circumstances occurring after you have commenced the examination, which include:
       •    technical or other problems during the assessment.

       The College will not adjust your examination mark or your examination result due to any of the
       circumstances above.

7.2.   How to apply for special consideration
       1.   Read the Special Consideration for Assessments Policy.

       2.   Confirm the grounds for your request and the outcome you are seeking.

       3.   Collect the appropriate supporting documentation for your category.

       4.   Submit you request in writing to: examinations@racp.edu.au.

       Closing dates are listed in the ‘Important examination information’ section above in this
       document.

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Examination format

    8. Structure of the Divisional Written Examination
       The Divisional Written Examination for both Adult Medicine and Paediatrics & Child Health is
       made up of two papers:
         •    Clinical Applications – which examines your understanding of the practice of medicine and
              therapeutics

         •    Medical Sciences – which examines your understanding of the principles of medicine and
              the basic sciences applicable to clinical medicine.

       Each paper consists of a combination of multiple choice questions (MCQs) and extended
       matching questions (EMQs):

               Paper                         Questions      MCQs          EMQs           Time
               Clinical Applications             100         92             8            3 hours
               Medical Sciences                  70          66             4        2 hours

       Candidates are given five minutes of reading time at the beginning of each paper. They may
       not write on or otherwise mark the question booklet or scoresheet during this time.

8.1.     Visual material
         There will be questions that require candidates to interpret visual material. Questions that
         require interpretation of an image will be confined to:
                    •   plain x-rays                  •   radioisotope scans
                    •   CT scans                      •   respiratory function tests
                    •   MRI scans                     •   sleep study patterns
                    •    ECGs

         Other visual materials may be included in the Divisional Written Examination papers, but you
         will not be required to interpret them to answer the question. Generally, they will be
         accompanied by the type of report that you would be accustomed to receiving from the
         laboratory.

         These may include:
                    •   blood films                   •   electromyograms
                    •   bone marrow films             •   electroencephalograms
                    •   echocardiograms               •   histology sections
                                                      
8.2.     Multiple choice questions (MCQs)
         The MCQs cover a range of subspecialties. All questions are in an ‘A-TYPE’ format (single
         best alternative from the available options). Each question consists of four options. You should
         choose only one option and then fill in the corresponding bubble on the answer sheet provided.

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Example of an MCQ:
             In infectious mononucleosis, which one of the following cell types, in the peripheral blood, would be
             most likely to contain the virus?

                 A.          B cells.
                 B.          Monocytes.
                 C.          Neutrophils.
                 D.          T cells.

             Answer: B

8.3.     Extended matching questions (EMQs)
         A small number of EMQs will be included in the Divisional Written Examination. The format of
         EMQs is different to single-best-answer MCQs. EMQs, which were developed in 1993,1 are a
         form of MCQ used extensively in written assessments. EMQs have a similar reliability and
         validity to traditional MCQs, but are more effective at assessing problem solving and clinical
         reasoning.

         The following example of an EMQ consists of:
                 1.   an option list
                 2.   a lead-in statement
                 3.   two stems, or clinical scenarios.

         For each stem/clinical scenario, you would choose the most appropriate option, which will be
         listed from A to H on the answer sheet.

         Example of an EMQ:

             Options list
               A.         Ankylosing spondylitis.
               B.         Aortic dissection.
               C.         Prolapsed intervertebral disc.
               D.         Lumbar spondylosis.
               E.         Vertebral fracture.
               F.         Intervertebral disc infection.
               G.         Pars interarticularis defect.
               H.         Metastatic malignancy.

             Lead-in statement
             For each patient with back pain, select the most likely diagnosis.

             Stems
                1. A 23-year-old man has a 6-month history of low back pain. This is predominantly at
                   the thoracolumbar junction and in the right buttock. His pain is worse in the morning
                   and he has difficulty in getting out of bed. There is some improvement during the
                   day. Examination shows restriction of lumbar spinal movement, particularly lateral
                   flexion.
                 Answer: A

                 2.   A 32-year-old woman presents with acute onset of low back pain. The pain is
                      constant and is not significantly affected by posture. All spinal movements are
                      painful and difficult. Three weeks earlier, she had a urinary tract infection, which had
                      been treated with amoxicillin.
                 Answer: F

1
  Case SM, Swanson DB. Extended-matching items: a practical alternative to free-response questions. Teaching and Learning in
Medicine. 1993;5:107-115.

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9. Examination resources
    The Divisional Written Examination is blueprinted to the Basic Training and Professional Qualities
    curricula. Please access this link to refer to the relevant curricula.

    The new Knowledge Guides support trainees’ study and exam preparation by clearly, explicitly
    and logically laying out what trainees are expected to understand and cover, and the standard
    they are to achieve. These guides can also be used to support trainees’ learning and assessment.

10. Reading preparation
    Candidates are expected to be familiar with the material in current textbooks, and with relevant
    aspects of basic science, in their applicable division: Adult Medicine or Paediatrics & Child Health.

    Knowledge of topics that are covered during in-service training programs and general coverage
    of review articles, annotations and editorial comment in appropriate medical journals are an
    essential part of preparation for the Divisional Written Examination. Texts on the major
    subspecialties may be useful but are not essential.

    Candidates are also expected to be familiar with diseases that are relevant to medical practice in
    our region (South West Pacific region), and with advances in physiology and biochemistry that
    are applicable to adult medicine/paediatrics.

11. Sample questions
    The purpose of sample questions is to allow candidates to become familiar with the examination
    format and style.

    The 2018 Divisional Written Examination papers are available for reference on the RACP website
    (for both Adult Medicine and Paediatrics & Child Health).

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Examination day

12. Examination day timetable
     Candidates are advised to arrive at their allocated examination centres by 8.45am.

    Time               Task

    8.45am             Candidates enter examination area

    9.15am             Pre-examination announcements

    9.25am             Reading time commences

    9.30am             Clinical Applications paper commences

    12.30pm            Examination concludes

    12.40pm–1.40pm              LUNCH

    1.40pm             Candidates re-enter examination area

    1.45pm             Pre-examination announcements

    1.55pm             Reading time commences

    2.00pm             Medical Sciences paper commences

    4.00pm             Examination concludes

13. Items to bring to your examination
     1.    Your candidate allocation letter (hardcopy or email)
     2.    Current photographic identification that shows your full name and signature – for example,
           passport or photo driver licence
     3.    Blue or black ballpoint pens (no pencils or gel or felt-tipped pens are allowed)
     4.    One (1) ruler

     During the examination, all mobile phones/smart watches/pagers/electronic communication
     devices are to be switched off, placed on the floor under your desk and visible to the invigilators at
     the exam centre at all times. Any candidates found with their mobile phone/smart
     watch/pager/electronic communication device on their person during the examination will be
     automatically disqualified and immediately escorted out of the examination venue. Any phones or
     pagers that sound during the examination will be subject to an incident report.

     All watches are to be removed and placed on the floor under your desk.

14. Items not permitted in the examination area

     •      Written material (other than your candidate allocation letter)
     •      Calculators 
     •      Food or beverages (other than water)
      •      All other belongings – for example, bags

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You may bring bottled water in a clear plastic bottle into the examination room. If you require other
   beverages or food during the examination for medical reasons, you must submit an application for
   special consideration by Monday, 4 February 2019. No other beverages or food will be allowed into
   the examination room without pre-approval.

   Please see item 7 above in these instructions for special consideration application procedures.

15. Seating arrangements
   The examination seating is allocated. Seating lists showing candidate name and seat number will
   be displayed near the entrance of the venue.

   Any enquiries about seating on the examination day must be discussed with the Chief Invigilator
   as soon as possible.

   If you require specific seating arrangements during the examination for medical reasons, you must
   submit an application for special consideration by Monday, 4 February 2019.

   Please see item 7 above in these instructions for special consideration application procedures.

16. Completing the examination

16.1.   Completing the question booklets and answer sheets
        For each of the two examination papers, candidates will be provided with:
         •   a question booklet
          •   an answer sheet.

        For each of the two papers, candidates must write their name, candidate number and
        examination city on the question booklet and answer sheet. Candidate numbers are advised
        in the examination allocation letter (sent via email), and also may be provided to candidates
        by invigilators where needed. Candidates should ensure that they enter their candidate
        number, not their MIN or table number, on the answer sheet and that they record the number
        on both sides of the answer sheet.

        Candidates must not open the question booklet or commence filling in their details until
        instructed to do so by an invigilator.

        The front cover of the question booklet contains a declaration that requires the candidate’s
        agreement by signature.

        All the content of these documents is confidential examination material and must not be
        removed from the examination room. You are not permitted to reproduce or distribute the
        contents of examination material at any time or in any way. Reproducing or distributing
        examination material is a breach of the College’s Academic Integrity in Training Process.

        Candidates must use only black or blue ballpoint pen to mark the question booklets and answer
        sheets. To answer the questions, the candidate should fill in ONE bubble only for each question
        on the answer sheet provided, and that bubble should correspond with the option that the
        candidate considers to be the correct answer.

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To change an answer, put a cross through the incorrect answer and fill in the correct answer
        (bubble). To reselect a previously crossed-through response, circle the answer to mark the
        correct answer and ensure any incorrect answers are crossed through. Anything out of the
        ordinary will be manually reviewed.

        Candidates should ensure the chosen response is obvious. See the examples below.

16.2.   Leaving the examination room

        You must not leave the examination room without the approval of an invigilator. If you require
        a toilet break, the invigilator will escort you to the facilities. If you wish to leave the examination
        room before the end of the examination, please remain seated and raise your hand to alert an
        invigilator who will then check your materials and release you.

        When you have finished the examination, you may leave the examination room from
        30 minutes and up until 10 minutes before the end of each examination paper. You must
        ensure your question booklet and answer sheet are collected by an invigilator before leaving.
        You are not permitted to leave the examination room during the last 10 minutes of each
        examination paper.

        On completion of each paper, the question booklet and answer sheet will be collected.

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After the examination

17. Marking
    The Divisional Written Examination consists of a total of 170 questions. A correct answer
    is worth one mark. Marks are not deducted for incorrect answers. The examination papers
    are computer-marked. The pass mark is set each year using a combination of statistical
    analysis approaches, including the modified Angoff process and Rasch equating. These
    two processes ensure that the standard of the examination is valid and fair from year to
    year.

    Please access this link for more information regarding regarding this standard setting
    process.

    Twenty questions from recent Divisional Written Examinations will be re-used in the 2019
    examination as ‘marker’ questions. These questions are used to compare the standard of
    cohorts from one year to the next. The scores achieved on these questions will not count
    towards the total marks of individual candidates.

18. Results
    Results will be released on Thursday, 14 March 2019 from 3pm AEDT/3pm NZDT. You will
    be notified of your examination outcome (i.e. successful/unsuccessful) via a personalised
    email. Please ensure that the College has your current email and postal address.

    If you do not receive your result, please call 1300 69 7227 or email
    examinations@racp.edu.au.

    You will receive a results feedback letter via email within four weeks of the results
    notification email. This letter will include a feedback statement that gives:

        •    the pass mark for the 2019 examination
        •    your overall mark
        •    your mark for each paper.

    In addition, the Directors of Physician (or Paediatric) Education (DPE) at each hospital
    receive notifications listing candidates’ names and pass/fail status, and a report showing
    aggregated performance of their hospital against national averages. No report is supplied
    where there are insufficient candidate numbers at the hospital to provide de-identified
    scores.

    The College’s Reconsideration Review and Appeals Process does not apply to the
    outcome or results of the assessment of the Divisional Written Examination and Divisional
    Clinical Examination.

19. Divisional Clinical examination
    Once you have satisfied the requirements of the Divisional Written Examination, you may
    be eligible to apply for the Divisional Clinical Examination.

    Information about applying for the Divisional Clinical Examination will be included in the
    results notification email to successful candidates. Eligible candidates will be invited to
    apply for the 2019 Divisional Clinical Examination via a separate email the day following
    the 2019 Divisional Written Examination.

    Please see the College website for examination and application dates.

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