RACP Adult Medicine (DWE + DCE): question practice and revision.

Choose a topic for focused revision and check your plan against the official specification.

• Cardiology — IHD, heart failure, arrhythmias, valvular disease, pulmonary hypertension
• Respiratory — asthma, COPD, ILD, lung cancer, sleep medicine, PE
• Gastroenterology and hepatology — IBD, hepatitis, cirrhosis, GI bleeding, pancreatic
• Nephrology — AKI, CKD, glomerular disease, electrolytes, dialysis, transplant
• Endocrinology and diabetes — T1/T2 DM, thyroid, adrenal, calcium/bone, pituitary
• Rheumatology — RA, SLE, vasculitis, spondyloarthropathies, biologics
• Haematology — anemia, leukaemia, lymphoma, coagulation, MGUS, myeloma
• Oncology — common solid tumours, immunotherapy basics, oncological emergencies
• Infectious diseases — HIV, hepatitis, antimicrobial resistance, returning traveller
• Neurology — stroke, seizures, MS, neurodegenerative, peripheral neuropathy
• Geriatrics — frailty, delirium, dementia, falls, polypharmacy, end-of-life
• Critical care basics, ethics, statistics, EBM, communication
• Aboriginal/Maori health and cultural safety (binational RACP framework)

Drawn from the RACP Adult Internal Medicine Curriculum, Therapeutic Guidelines Australia (eTG), Cardiac Society of Australia and New Zealand (CSANZ) guidelines, and item density across the iatroX bank.

• CSANZ Cardiovascular Society of Australia and New Zealand — heart failure management (four-pillar GDMT: ACEi/ARB/ARNI + beta-blocker + MRA + SGLT2i), AF anticoagulation, post-MI secondary prevention. Differs slightly from US ACC/AHA.
• Diabetes management — ADS (Australian Diabetes Society) guidelines, A1C individualised targets, SGLT2i and GLP-1 for CV/renal protection, sick day rules, insulin pump and CGM emerging access
• eTG Therapeutic Guidelines — central prescribing reference across all medical subspecialties. Antibiotic stewardship, IV-to-oral switch, common Australian-specific drug choices.
• Indigenous (Aboriginal and Torres Strait Islander) and Māori health — recognised core RACP competency in the binational Australasian framework. Closing the Gap, Hauora Māori principles, cultural safety in tertiary medicine.
• Common DCE long-case themes — multi-morbidity, frailty, complex therapeutics, palliative care decisions, breaking bad news. Examiners assess clinical reasoning, communication, and management planning equally.
• DCE short-case themes — examination technique on real patients: cardiovascular (heart sounds, murmurs, signs of HF/RV failure), respiratory (clubbing, signs of consolidation), abdominal (organomegaly, ascites), neurological (cranial nerves, cerebellar signs, gait), endocrine (acromegaly, Cushing's, thyroid)
• Critical appraisal and statistics — RACP DWE has explicit statistics block. Recognising RCT methodology, NNT calculations, hazard ratios, meta-analysis interpretation. Often under-prepared.
• Voluntary Assisted Dying (VAD) framework — increasingly important in Australian medicine. Recognising VAD eligibility, state-specific frameworks (Victoria 2019, then most states by 2023-2025), physician role boundaries.

Observations from recent RACP Basic Training graduates. Verify against the current RACP Curriculum, eTG, and Australasian specialty society guidelines.

Candidate-reported observations — not official guidance.

1. Australian/NZ vs UK/US guidelines — CSANZ vs ACC/AHA vs ESC; ADS vs ADA vs Diabetes UK. Subtle differences in drug choice and threshold. The RACP tests Australasian standards specifically.
2. DCE long-case structure — 60 minutes with the patient + 15 minutes discussion. Time pressure for comprehensive history-taking, focused examination, management plan formulation. Practise the structured presentation format.
3. DCE short-case examination technique — examiners assess the technique, not just findings. Smooth, structured, professional examination matters. Years of regular practice required.
4. Indigenous and Māori health under-preparation — examined directly across both DWE and DCE. Cultural safety in tertiary care, recognising historical context, working with Aboriginal/Māori liaison workers.
5. Critical appraisal block — DWE includes explicit statistics and EBM. Calculations under time pressure (NNT, sensitivity at low prevalence, hazard ratios). Often under-prepared.
6. Voluntary Assisted Dying — Australian VAD frameworks are state-specific. Knowing the principles, eligibility, physician role boundaries is important.
7. Australasian-specific clinical contexts — leptospirosis (NZ rural exposure), melioidosis (tropical Australia), tropical infections in northern Australia, snake/spider bites, marine envenomation. Don't neglect.
8. Time-to-Advanced-Training — passing DWE+DCE on first attempt accelerates entry into Advanced Training. Failed attempts delay subspecialty career start. Plan thorough preparation.

A pragmatic phased approach used by recent RACP Basic Training graduates.

1. Months 1–6 (foundation)

   Foundation pass across all 13 blueprint topics. 30 questions/day with the iatroX adaptive engine. Read CSANZ, ADS, Australasian specialty society guidelines paired to weak topics. Begin daily DCE-style case discussions on rotations.

2. Months 7–12 (DWE focus)

   Targeted weak-area drilling. Daily statistics and EBM block practice. eTG-aligned management plans for common presentations. Indigenous/Māori health and cultural safety dedicated reading. Mock DWE papers monthly.

3. Months 13–15 (DWE final + DCE prep)

   Two DWE mock papers per week. After DWE pass, transition to intensive DCE preparation — daily long-case examination practice with senior staff, short-case practice on real patients during rotations.

4. Months 16–18 (DCE final preparation)

   Full mock DCE assessment cycles with consultants. Refine long-case structured presentation technique. Short-case examination technique with peer feedback. Confirm DCE booking, accommodation, equipment. Sleep, hydrate before the assessment.

Dedicated RACP Adult Medicine (DWE + DCE) question practice with answer explanations, guided Tutor review and study planning.

• Focused question practice — Choose the relevant bank and use your answers to identify what to study next.
• Guided reasoning — Explore a difficult answer with Tutor, then apply the distinction independently.
• Review and timed practice — Return to important mistakes and choose a timed practice set where available.

Choose the relevant bank and use the official exam guidance to plan your preparation.

Three-phase pathway: (1) Basic Training (~3 years post-internship) culminating in DWE + DCE exams; (2) Advanced Training (~3 years) in chosen subspecialty with subspecialty-specific requirements; (3) FRACP award after successful completion. The DWE+DCE gate progression from Basic to Advanced Training.

9 February 2027; applications run from 23 November to 8 December 2026. The DWE has February and October sittings. Check RACP separately for DCE dates and your eligibility.

DWE has 170 questions: 100 Clinical Applications and 70 Medical Sciences, answered in three hours and two hours respectively, plus ten minutes reading per paper. DCE is a separate clinical assessment with long and short cases. Both must be passed.

Specialist IMG pathway is via the RACP Comparability Assessment process. Internationally qualified physicians may have RACP recognise overseas training as comparable, with conditions for supervised practice. The standard RACP Basic Training pathway is typically for graduates progressing through Australian/NZ internship → BPT.

RACP is the binational Australasian framework (Australia + New Zealand). It tests Australasian guidelines (CSANZ, ADS, eTG) and the specific cultural/social context including Aboriginal, Torres Strait Islander and Māori health. The exam structure (DWE + long/short cases) differs from MRCP UK (3-part written + PACES) and US ABIM (single MCQ exam).

Yes — examined directly across both DWE and DCE. The binational RACP framework includes Aboriginal, Torres Strait Islander and Māori health as core competencies. Closing the Gap (Australia), Hauora Māori (New Zealand), cultural safety in tertiary medicine.

Full RACP Adult Medicine (DWE + DCE) bank access is included in all-access. Up to 10 new sample questions per day are shared across exams, with no account required. A verified free account includes one guided Tutor session; continued Tutor use is included in all-access.