RACP Adult Internal Medicine DWE and DCE Guide

The Royal Australasian College of Physicians (RACP) Adult Internal Medicine Basic Training examination family consists of two assessments:

• Divisional Written Examination (DWE): assesses clinical knowledge and basic science applicable to clinical medicine.
• Divisional Clinical Examination (DCE): assesses clinical acumen, clinical and interpersonal skills using real patients.

Passing both is required to fulfil the Adult Internal Medicine Basic Training examination requirements and progress to Advanced Training. The examinations do not themselves confer Fellowship; Advanced Training and the subsequent Fellowship admission process are separate steps.

This guide covers Adult Internal Medicine. Paediatrics & Child Health is a separate examination pathway. RACP administers the Adult Medicine examinations in Australia and Aotearoa New Zealand; candidates should follow the instructions for their jurisdiction and sitting.

Divisional Written Examination — October 2026 format

The paper-based DWE has two sections, each containing multiple-choice questions (MCQs) and extended matching questions (EMQs):

RACP notes that questions may involve interpreting material such as X-rays, CT or MRI scans, ECGs, respiratory function tests, and sleep-study patterns. The sitting page explains that EMQs use a shared option list and lead-in across related scenarios.

Divisional Clinical Examination

The Adult Medicine DCE is a clinical assessment with real patients and different patients for its two Long Cases and four Short Cases. At least two examiners assess each case.

The DCE uses published performance criteria. Long Case domains include history and examination accuracy, synthesis and prioritization, the effect of illness on the patient and family, and management planning. Short Case domains include patient interaction, examination technique, interpretation and synthesis of findings, and investigation or management discussion.

The October 2026 blueprint gives target numbers of MCQs by specialty. These are target counts, not percentages; they do not specify an EMQ or DCE weighting.

RACP also identifies understanding the effects of comorbidities on overall health and interactions between diseases and treatments as important. Use the ranges to organize broad revision, not to predict exact questions. The DCE is organized around its Long Case and Short Case assessment criteria rather than these DWE specialty counts.

Eligibility depends on the trainee’s curriculum pathway, cohort, previous attempts, and examination sitting. The sitting-specific RACP page and the applicable training requirements determine an individual candidate’s eligibility.

For the published October 2026 DWE pathway, RACP lists College registration, 24 months of certified Basic Training under PREP or completion of the Consolidation phase under the new curriculum by the applicable threshold, completion of required training activities, compliance with attempt and progression rules, an application by the published closing date, and no outstanding College fees. The DCE additionally requires a passed DWE and completion of the applicable training and registration requirements.

First-time candidates from applications for 2027: RACP says the revised criteria apply to trainees who have not yet attempted the DWE and DCE. For a first DWE attempt, the PREP route may qualify after 12 months of certified FTE Basic Training; under the new curriculum, successful completion of the Foundation Phase may qualify. A first DCE attempt requires a passed DWE and successful completion of the Foundation and Consolidation phases, with a minimum of 24 months certified FTE. The change is optional, not an expectation to sit earlier. Other application, progression, and fee requirements still apply. RACP directs Overseas Trained Physicians to confirm DCE eligibility with their case officer.

For the DWE

• Plan separate revision for Clinical Applications and Medical Sciences, covering applied clinical and therapeutic reasoning as well as basic science applied to medicine.
• Use the published specialty target ranges to structure broad coverage. Avoid treating the ranges as percentages or predictions of exact questions.
• Practise both MCQs and EMQs under timed conditions. For EMQs, work through the shared options and compare plausible responses across related scenarios.
• Include practice interpreting visual or report-based material of the kinds RACP lists, such as ECGs, imaging, and respiratory tests.
• Use the current sitting’s RACP preparation resources to become familiar with its format.

For the DCE

• Rehearse full Long Cases using the published review, preparation, and discussion timings; practise Short Cases with a brief stem and focused examination.
• Seek supervised practice with patients and feedback on history accuracy, examination technique, interaction, clinical synthesis, prioritization, and management discussion.
• Practise concise Long Case presentations within the discussion time. RACP notes that excessively long presentations may be interrupted.
• Use feedback from more than one source to identify specific skills for repeated practice. Written-question practice can support knowledge review, but the DCE itself is a real-patient assessment.

• Australia and Aotearoa New Zealand: These are Adult Medicine examinations within the same RACP examination family, but application arrangements, venues, and sitting instructions are published by jurisdiction and cycle. Check the relevant RACP page for current application information, dates, fees, and deadlines.
• DCE allocation and travel: RACP states that candidates must travel to a different city or state from where they reside and will not be examined at hospitals where they have had training rotations. Venue requests are not guaranteed; use the allocation information provided by RACP for planning.
• Exam-site conduct: Do not approach an allocated hospital to seek information about cases, inspect examination areas, identify examiners, or obtain performance guidance. RACP identifies such conduct as a potential academic-integrity issue.
• Withdrawal and attempts: RACP states that a withdrawal is not counted as an attempt, but attending the DCE and withdrawing after it has commenced counts as an attempt. Attempt limits and training time limits can depend on cohort and prior examination history, so check the rules that apply to your record.
• Special circumstances: Use the current RACP sitting guidance for special-consideration procedures and application requirements.