RACP Adult Medicine preparation has two connected but different tasks: demonstrating broad knowledge in the Divisional Written Examination and demonstrating clinical performance in the Divisional Clinical Examination. A question bank can expose missing knowledge; it cannot establish that you can elicit a physical sign, assess a patient or explain a defensible plan under observation.
Examination information was checked on 3 October 2026. The immediate written examination is 20 October 2026 in Australia and Aotearoa New Zealand. Do not plan around an older February-only description. The RACP October DWE page provides the sitting-specific arrangements.
The pathway from Basic Training to FRACP
The standard Adult Internal Medicine pathway combines Basic Training, its required assessments and examinations, and subsequent Advanced Training in the relevant specialty. Basic Training is ordinarily a three-year programme after internship; many Advanced Training programmes are also three years, but the requirements depend on the selected programme. Passing the DWE and DCE is not, by itself, the award of FRACP. Use the RACP training information for your curriculum and progression requirements.
Advanced Training routes include cardiology, gastroenterology, nephrology, endocrinology, respiratory medicine, infectious diseases, haematology, oncology, rheumatology, geriatric medicine, general and acute care medicine, palliative medicine and clinical immunology, among others. Joint, dual and other pathways have their own conditions. A general revision timetable should not be mistaken for a guaranteed sequence of appointments or automatic entry into a chosen training position.
For the October 2026 DWE, eligibility does not simply mean that every component of Basic Training must already be complete. RACP specifies the relevant certified training or curriculum-phase requirement, registration, completed required assessments, fees and attempt rules. Its published PREP requirement includes 24 months of full-time-equivalent certified Basic Training before 31 August for the October sitting; new-curriculum candidates have a corresponding Consolidation-phase requirement. Revised first-attempt eligibility from 2027 should not be silently applied to a 2026 candidate.
Written examination dates and the application window
The October 2026 DWE is scheduled for 20 October. Applications opened on 27 May and closed on 17 June 2026. The College publishes a proposed results date of 19 November 2026. These details, checked on 3 October, are not an indication that registration remains open or that a candidate can change sittings without meeting the applicable rules.
The DWE has February and October examination windows, so a statement that it is normally available only once a year in February is unsuitable for this cohort. For clinical examination planning, use the separate DCE arrangements and your individual allocation. A written-exam date does not establish the date of the clinical component.
DWE format: two different papers, not two equal question blocks
The October 2026 format, checked on 3 October 2026, specifies a paper-based examination with Clinical Applications and Medical Sciences sections. The former has 100 questions, comprising 92 multiple-choice items and eight extended-matching items. Medical Sciences has 70 questions, comprising 66 multiple-choice items and four extended-matching items. That is 170 questions, not approximately 200.
Clinical Applications has three hours of answering time and ten minutes of reading time. Medical Sciences has two hours of answering time and ten minutes of reading time. The full day also includes registration, instructions and a break, so an undifferentiated description of six hours should not be used as the answering-time specification. Check your region's actual start time.
For preparation, distinguish an explanation of a clinical decision from an explanation of the underlying science. A trainee may recognise the usual management approach while remaining uncertain about its physiological basis. Conversely, knowing the mechanism does not automatically identify the action required in the clinical context supplied.
DCE format: observed clinical work needs observed practice
The Adult Medicine DCE page, checked on 3 October 2026, describes two long cases and four short cases. Each long-case sequence comprises 60 minutes reviewing the patient, ten minutes preparing discussion points and 25 minutes discussing the patient with examiners. Each short case includes two minutes to read the stem and 15 minutes with the patient under observation.
The older shorthand of 60 minutes with the patient followed by 15 minutes of discussion does not match those current published timings. Nor should a variable ten-to-fifteen-minute practice session be presented as the complete official short-case sequence. Rehearse the relevant task while preserving time for feedback, then use the exact current timing when conducting a format rehearsal.
Clinical examination technique, synthesis, the impact of illness and the proposed plan all deserve attention. Do not impose identical weighting on every domain in every case: the College's criteria recognise that their importance depends on the case. A fluent presentation cannot compensate for a finding that was not actually elicited.
Examination fees and the distinction from study costs
The RACP fee schedule, checked on 3 October 2026, lists the written examination at AUD 2,329.00 or NZD 2,678.35. The Basic Training Clinical Examination is listed at AUD 3,484.00 or NZD 4,006.60. These are the College's separate examination charges, not iatroX subscription prices and not currency conversions.
Plan for travel, approved leave and any necessary accommodation separately. A cheaper revision subscription does not reduce the examination fee, while a more expensive course should be judged by the actual teaching or observation it supplies. Keep the financial decision tied to a defined learning need rather than the anxiety associated with the overall training pathway.
Curriculum coverage: a thirteen-theme revision map
The following table retains the iatroX hub's published study allocation, checked on 3 October 2026, to show the breadth of the learning content. Its 200-question total is an illustrative revision set, not the official 170-question DWE blueprint. Do not present these percentages as verified paper weights.
| Revision theme and examples | Illustrative questions | Share of study set |
|---|---|---|
| Cardiology: ischaemic disease, heart failure, arrhythmias, valves, pulmonary hypertension | 24 | 12% |
| Respiratory: asthma, COPD, interstitial disease, cancer, sleep medicine, pulmonary embolism | 18 | 9% |
| Gastroenterology and hepatology: inflammatory bowel disease, hepatitis, cirrhosis, bleeding, pancreas | 18 | 9% |
| Nephrology: kidney injury, chronic disease, glomerular disorders, electrolytes, dialysis, transplantation | 18 | 9% |
| Endocrinology and diabetes: diabetes, thyroid, adrenal, calcium, bone, pituitary | 16 | 8% |
| Rheumatology: rheumatoid arthritis, lupus, vasculitis, spondyloarthritis, biological therapies | 14 | 7% |
| Haematology: anaemia, leukaemia, lymphoma, coagulation, monoclonal disorders | 14 | 7% |
| Oncology: solid tumours, immunotherapy principles and emergencies | 12 | 6% |
| Infectious diseases: HIV, hepatitis, resistance and returning travellers | 16 | 8% |
| Neurology: stroke, seizures, multiple sclerosis, degeneration and neuropathy | 12 | 6% |
| Geriatrics: frailty, delirium, dementia, falls, medicines and end-of-life care | 12 | 6% |
| Critical care, ethics, statistics, evidence-based medicine and communication | 16 | 8% |
| Aboriginal, Torres Strait Islander and Maori health, including cultural safety | 10 | 5% |
Use the current RACP curriculum and knowledge guides to establish the actual assessed scope. This table can organise your review, but it should not displace the College's framework or justify neglecting a domain because its illustrative allocation looks small.
High-value learning themes and an Australasian source hierarchy
Use Australasian guidance to resolve a source-dependent management question. For cardiovascular topics, the relevant organisation is the Cardiac Society of Australia and New Zealand, not a differently named society inferred from the initials CSANZ. Its guidance can support revision of heart failure, atrial fibrillation and secondary prevention. The CSANZ site is a route to the appropriate current documents, rather than permission to apply a remembered US recommendation unchanged.
When reviewing heart-failure therapies, compare the roles of renin-angiotensin-system treatments, beta-blockers, mineralocorticoid-receptor antagonists and SGLT2 inhibitors within the relevant source. For diabetes, distinguish Australian Diabetes Society recommendations from ADA or UK material. Questions about individualised glycaemic goals, sick-day advice, cardiovascular or renal benefit, insulin pumps and continuous glucose monitoring need the relevant population and current local arrangements.
Therapeutic Guidelines provides an Australian prescribing-reference route. In a revision session, use it to resolve a specific uncertainty about antimicrobial stewardship, an intravenous-to-oral transition or a locally relevant treatment choice. A reference subscription and a question bank perform different jobs; neither should be judged only by how many questions it contains.
For long-case preparation, multimorbidity, frailty, complex therapeutics, palliative decisions and difficult explanations are useful practice themes. For short cases, plan appropriate observed opportunities across cardiovascular, respiratory, abdominal, neurological and endocrine examination. Hearing a description of a murmur or seeing a written diagnosis does not establish that you can examine accurately or explain the significance of what you found.
Cultural safety, evidence interpretation and legal context
The RACP's Indigenous equity and cultural safety framework provides a source for understanding the profession's responsibilities in Australia and Aotearoa New Zealand. Prepare for Aboriginal and Torres Strait Islander health and Maori health in their actual contexts, including communication, historical context and collaboration with relevant liaison and support services. Do not reduce cultural safety to a memorised script or assume that one community's preferences describe another's.
Closing the Gap and Hauora Maori can arise in contextual reading, but they require attention to the particular source, population and professional task. The aim here is accurate understanding, not an endorsement or ranking of political programmes. Where a question concerns an individual patient, their own account and preferences remain central.
For evidence-based medicine, practise study design, absolute and relative effects, number needed to treat, sensitivity, predictive value, hazard ratios and meta-analysis interpretation. These are appropriate review themes; a commercial topic label does not prove the existence of a separately timed official statistics block. Identify whether an error concerns the calculation, its setup or the interpretation before selecting another exercise.
Voluntary assisted dying requires jurisdiction-specific legal and professional reading. For example, Western Australia's health department distinguishes its 2019 Act from commencement of the service on 1 July 2021. A publication or implementation date is not interchangeable with the current eligibility rules. Resources dated 2019 or 2023 to 2025 should be checked against the applicable current state or territory material; this guide does not provide eligibility or prescribing instructions.
Common pitfalls to investigate, not assume
The first pitfall is importing a familiar UK or US answer without checking whether the scenario requires Australasian guidance. Compare CSANZ, ADS and Therapeutic Guidelines with the source you previously used, and write down the actual point of difference. Do not label every incorrect answer a jurisdiction problem when the missing element is basic physiology.
A second problem is an unfocused long-case presentation. A third is describing findings confidently without having demonstrated a reliable examination technique. Address the former through observed synthesis and discussion; address the latter through suitable bedside teaching. More multiple-choice questions alone do not resolve either problem.
Fourth, keep cultural safety within the learning plan rather than treating it as optional reading after the medical topics. Fifth, retain evidence interpretation even when a current rotation gives little exposure to research discussion. Sixth, distinguish state-specific legal requirements from a general statement about Australian practice.
Seventh, review locally relevant contexts that may be unfamiliar, including rural exposure, tropical infections and envenomation. Leptospirosis, melioidosis, snake or spider bites and marine envenomation are examples for source-led study, not predictions of the next paper. Eighth, plan progression with your training team: examination outcomes, attempt limits, curriculum requirements and access to posts all matter. Passing at a particular attempt does not guarantee a particular Advanced Training appointment.
These are proposed review checks. The original hub described candidate-reported pitfalls, but without a defined sample they should not be interpreted as measured frequencies or evidence that successful candidates all followed one approach.
An eighteen-month framework across Basic Training years two and three
During months one to six, establish breadth across the thirteen themes and begin appropriate clinical discussion on rotations. The original planning example used 30 questions daily. Treat that as one possible allocation rather than an evidence-based minimum, and protect time for reviewing why an answer was chosen. Pair deeper reading with identified gaps rather than reading every specialty guideline from beginning to end.
For months seven to twelve, increase targeted written practice while retaining older material. Include statistics, Therapeutic Guidelines-based questions and relevant cultural-safety learning. A monthly mock can provide information about unfamiliar mixed material, provided there is time to review it. It is not a requirement that every learner needs precisely that frequency.
Months thirteen to fifteen can contain a more intensive written phase. Two practice papers weekly are an optional example, not a validated route to a pass. Keep the Medical Sciences and Clinical Applications timings distinct. As the clinical examination becomes the nearer task, shift more of the available time towards observed long and short cases rather than assuming that written performance transfers automatically.
Months sixteen to eighteen can focus on observed mock cycles, presentation, examination technique and response to questioning. Arrange feedback from appropriate experienced clinicians, confirm logistics and use the actual allocated format. The framework is a proposed planning sequence, not a report of outcomes from a defined graduating cohort. It must be adapted to part-time training, interruptions, your curriculum and examination allocation.
For a candidate already booked on 20 October 2026, the useful version is much shorter: identify the remaining written gaps, review them and test unfamiliar mixed material. Do not restart an eighteen-month plan. iatroX's separate RACP Adult Medicine final-fortnight article addresses that immediate task.
Sample question: a small clone does not make organ involvement irrelevant
A fictional teaching case describes a 58-year-old man with nephrotic syndrome, macroglossia and carpal tunnel syndrome. Serum free light chains show markedly elevated lambda chains. Tissue demonstrates Congo-red-positive deposits with apple-green birefringence, and bone marrow contains 7% clonal plasma cells. The proposed options are multiple myeloma, MGUS, smouldering myeloma, Waldenstrom macroglobulinaemia and AL amyloidosis.
AL amyloidosis is the most likely answer among those options. The reasoning should connect the multisystem presentation and amyloid deposits with the light-chain abnormality, rather than dismissing a pathogenic clone because its marrow percentage appears small. The question asks for the most likely explanation, not for a complete diagnostic workup.
The qualification matters: Congo red establishes amyloid deposition, not its protein type. A monoclonal abnormality does not eliminate other forms of amyloidosis. Accurate typing is needed to confirm AL rather than an alternative subtype, as explained in the JACC: CardioOncology diagnostic review, published in 2022 and consulted on 3 October 2026. This example is not a treatment recommendation.
A useful follow-up asks what additional information would confirm the presumed type and whether the same answer would hold if the tissue were typed differently. That tests whether the learner understands the inference rather than remembers a cluster of keywords.
International graduates and examinations with similar names
An internationally qualified specialist considering recognition of overseas training should examine the RACP overseas-trained physician pathways. Comparability assessment and any required supervised practice are not the same as simply purchasing a Basic Training question bank and entering its examinations. Other international graduates may enter a local training pathway after meeting its requirements; circumstances differ.
RACP is the Australasian physician-training framework. MRCP(UK), RCPSC Internal Medicine and ABIM certification are separate assessments in different systems. Their content can overlap, but their eligibility, professional context and assessment formats should not be treated as interchangeable. MRCP(UK) includes Part 1, Part 2 Written and PACES, rather than three written examinations plus PACES.
Where iatroX fits the preparation
This guide is published by iatroX, which is one of the learning resources discussed. According to its product information checked on 3 October 2026, the Adult Medicine bank contains more than 1,500 questions, developed with Australasian physician input and organised against the relevant curriculum. Adaptive sequencing, spaced repetition, topic information and timed practice are intended to structure learning; they do not establish RACP endorsement or a validated readiness score.
The Socratic Tutor starts from an attempted question and explores the underlying misconception. For DWE preparation, the useful outcome is an independently explained distinction followed by a different application. For DCE preparation, a conversation can rehearse reasoning but must remain alongside real examination practice and appropriate observation. The separate RACP DCE simulation track is not a physical-examination assessment.
Free questions and Ask-iatroX remain free without trial expiry or a verification gate, under the product information dated 3 October 2026. The public sample offers up to 20 questions without an account; a separate limited Tutor demonstration is described for verified accounts. Ongoing Tutor access is paid.
The UK subscription is £99 paid upfront annually, equivalent to £8.25 per month billed annually, or £29 monthly, as published on 3 October 2026. It includes premium banks, Tutor, planner, simulations and CPD tools together. The regional hub also advertises US-dollar prices of $29 monthly and $99 annually; these must not be read as AUD or NZD amounts. Its published offer mentions cancellation and a seven-day annual money-back guarantee, subject to the actual purchase terms and billing channel.
For a written-knowledge gap, use questions and source-led explanation. For an examination-technique gap, prioritise suitable bedside teaching. For a spoken-synthesis gap, combine repeatable rehearsal with experienced observation. A larger list of unrelated examinations is not a reason to purchase more than the preparation task requires.
The original hub credits clinical review to Dr Kola Tytler, MBBS CertHE MBA MSt MRCGP, on 12 May 2026. The current examination and product checks are dated 3 October 2026 and do not imply a new personal clinical sign-off. Related catalogue pathways include RACP Paediatrics, AMC and MRCP(UK) Part 1; choose them only for a relevant goal.
Frequently asked questions
Is the Adult Medicine DWE held only in February?
No: RACP lists an October 2026 DWE on 20 October alongside its February examination arrangements. Check the sitting-specific page and your own eligibility rather than using a February-only assumption.
Are the written and clinical examination formats interchangeable for revision?
No: written questions assess knowledge in a different way from observed long and short cases. Use question practice for identified knowledge gaps and appropriate clinical teaching for examination and bedside performance.
Does passing the DWE and DCE automatically award FRACP?
No: the pathway also requires completion of the applicable training and specialty requirements. Confirm progression and fellowship conditions with RACP and your training programme.