RACGP vs ACRRM: Which GP Training Pathway Should You Pick?

Why this comparison matters

Choosing between RACGP and ACRRM is one of the most significant career decisions you will make as an aspiring GP. Both colleges lead to independent general practice, but they differ meaningfully in training structure, geographic focus, scope of practice, and fellowship examinations. Making an informed choice now can save you years of frustration and help you build a career that genuinely fits your professional aspirations and lifestyle preferences.

The skills the Casper test looks for are the same whichever college you prefer, so your preparation carries over. The bigger differences come after you get an offer. For assessment dates, see our AGPT key dates guide.

How GP training works in Australia

GP training in Australia runs through the Australian General Practice Training (AGPT) program, run by the RACGP and ACRRM. For the RACGP pathway, the eligibility rules are short. You need current Australian or New Zealand medical registration, general registration by the time training starts, and an eligible citizenship, residency or visa status. Once in, you train under supervision in accredited practices until you pass your fellowship exams. For selection, the RACGP uses the National Entry Assessment, an online situational judgement test also known as the Casper test.

Training is funded by the Commonwealth, so registrar salaries are paid through your Regional Training Organisation (RTO) or rural training pipeline. For the 2027 intake, there are up to 1,694 places through the RACGP and up to 374 Rural Generalist places through ACRRM. For how places are allocated, see our guide to GP training selection criteria.

Becoming a GP in Australia

Here's the usual path to becoming a GP in Australia. You finish your medical degree and internship, then apply to AGPT and sit the National Entry Assessment. Next come several years as a GP registrar, a fellowship exam (FRACGP or FACRRM) and independent practice. The RACGP's eligibility page sets out exactly when you can apply.

Whether you train through RACGP or ACRRM, the title at the end is the same: a fully qualified Australian GP eligible for Medicare provider numbers and independent practice. The differences below are about the journey, not the destination.

The headline comparison

RACGP pathway: what to expect

The Royal Australian College of General Practitioners (RACGP) is the larger of the two colleges and trains the majority of Australian GPs. RACGP AGPT training is delivered through Regional Training Organisations (RTOs) across the country, with posts available in metropolitan, outer metropolitan, regional, and some rural locations.

Training structure

RACGP training typically spans 3–4 years full-time equivalent. The program begins with a community-based general practice placement (GPT1), followed by a hospital term and further GP placements. You will rotate through different practice settings and gradually build towards independent practice. Supervision is provided by experienced GP supervisors within accredited training practices.

The training curriculum covers the full breadth of general practice, including chronic disease management, mental health, paediatrics, aged care, women's health, and preventive medicine. You will complete workplace-based assessments, educational activities, and your fellowship exams during the training period.

RACGP examinations

RACGP fellowship requires passing two major examinations:

• AKT (Applied Knowledge Test): a computer-based multiple-choice exam testing clinical knowledge applied to general practice scenarios. Covers the breadth of GP medicine
• KFP (Key Feature Problem): a written exam presenting clinical scenarios where you identify and respond to key decision points. Tests clinical reasoning and prioritisation rather than factual recall

Both exams can be attempted during training, and most registrars sit the AKT in their second year and the KFP in their third year. The pass rates vary by cohort but generally sit around 70–80% for first attempts.

ACRRM pathway: what to expect

The Australian College of Rural and Remote Medicine (ACRRM) trains GPs specifically for rural and remote practice. ACRRM-trained doctors typically develop a broader scope of clinical skills than their metropolitan counterparts, reflecting the demands of practising where specialist referral may be hours or days away.

Training structure

ACRRM training is 4 years full-time equivalent. The program requires a minimum of 2 years in a rural or remote location (Modified Monash Model 3–7). Training includes core general practice terms, hospital terms, and the option to complete Advanced Specialised Training (AST) in areas like emergency medicine, obstetrics and gynaecology, anaesthetics, Aboriginal and Torres Strait Islander health, mental health, or surgery.

The AST component is a distinctive feature of ACRRM training. It allows you to develop procedural and specialised skills that are essential in settings where you may be the only doctor available. This breadth of training produces versatile rural generalists who can manage a wider range of clinical presentations independently.

ACRRM examinations

ACRRM fellowship requires passing two core assessments:

• StAMPS (Structured Assessment using Multiple Patient Scenarios): an oral examination using standardised patient scenarios. You demonstrate clinical reasoning, communication skills, and management plans in real-time with an examiner
• MCQ (Multiple Choice Questions): a written exam covering the breadth of rural and remote general practice medicine, including emergency, procedural, and Aboriginal health content

Dual fellowship: training with both colleges

It is possible to pursue both FRACGP and FACRRM simultaneously. Dual fellowship registrars complete the requirements of both colleges during their training period, which typically extends the total training duration to 4–5 years. Both colleges have formal agreements recognising overlapping training activities.

Dual fellowship is particularly attractive for doctors who want to work rurally but also want the flexibility to move to metropolitan practice later, or who value the broader scope of ACRRM training alongside the RACGP's widely recognised fellowship. The workload is significant, you sit four fellowship exams instead of two, but many registrars find the career flexibility worth the investment.

Making your decision: key questions to ask yourself

There is no universally better pathway, the right choice depends on your personal and professional circumstances. Consider these questions honestly:

• Where do you want to live and work? ACRRM training requires significant time in rural/remote areas. If you are committed to metropolitan practice, RACGP is the clearer fit. If you are drawn to rural medicine, ACRRM's training is purpose-built for that context
• What scope of practice excites you? If you want to perform procedures, manage emergencies independently, and develop advanced skills, ACRRM's AST pathway offers structured training that RACGP does not match
• How do you perform under exam pressure? RACGP's exams are written; ACRRM's StAMPS is oral. Consider which format plays to your strengths
• What are your family and lifestyle considerations? Rural placements can be professionally rewarding but socially isolating. Be honest about your support needs and personal commitments
• What does the job market look like? Both FRACGP and FACRRM allow you to practise anywhere in Australia. However, FACRRM is particularly valued in rural areas and can provide access to additional rural incentive payments and bonuses
• Are you interested in dual fellowship? If you want maximum flexibility, starting with ACRRM and adding RACGP (or vice versa) is achievable and increasingly common

Selection and competition: how they compare

The skills you prepare are the same, but the competition differs. For the 2027 intake, there are up to 1,694 places through the RACGP and up to 374 Rural Generalist places through ACRRM. The RACGP serves a larger applicant pool. In practice, ACRRM places can be less competitive, because fewer people choose the rural pathway, especially for remote posts.

Some people apply to both colleges, with one as a backup. If you do, check what each one asks for, because the RACGP uses the National Entry Assessment and ACRRM sets its own requirements. For how places are allocated, read our guide to GP training selection criteria.