Multiple Choic e Q uestion Exa mination

Sp e cific ations

A ustr a li a n M e di c a l C o u n c il Limit e d - J a n u a ry 2022

“The purpose of the Australian Medical Council is

to ensure that standards of education, training and
assessment of the medical profession promote and
protect the health of the Australian Community.”

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Table of Contents
1. General introduction .................................................................................................. 4

1.1. Purpose of the document....................................................................................................... 4

1.2. Privacy ................................................................................................................................... 4

1.3. Aims and objectives of the AMC examination process ......................................................... 4

1.4. Eligibility ................................................................................................................................. 4

1.5. Standard of the AMC examination ......................................................................................... 4

1.6. Standard of performance required ......................................................................................... 5

2. Structure and content of the MCQ examination ...................................................... 6

2.1. Structure of the MCQ examination ........................................................................................ 6

2.2. Content of the examination .................................................................................................... 6

2.3. Scoring of the MCQ Examination ........................................................................................ 10

3. Enrolment for the MCQ Examination ...................................................................... 11

3.1. Registration for MCQ examination ...................................................................................... 11

3.2. Venue and scheduling ......................................................................................................... 11

4. Fees .......................................................................................................................... 12

4.1. Examination fees ................................................................................................................. 12

5. Preparing for the MCQ and the process of the examination................................. 12

5.1. Before the Examination ....................................................................................................... 12

5.1.1. Planning for the examination ...................................................................................... 12

5.2 At the examination ............................................................................................................... 12

5.1.2. AMC Procedure........................................................................................................... 12

6. Results...................................................................................................................... 14
7. Candidate conduct................................................................................................... 14

7.1. General conduct of candidates ............................................................................................ 14

7.2. Unsatisfactory Results ......................................................................................................... 14

7.3. Irregular Behaviour .............................................................................................................. 15

8. Other general information ....................................................................................... 16

8.1. Change of address .............................................................................................................. 16

8.2. Further information .............................................................................................................. 16

Appendix A: The AMC graduate outcome statements ................................................... 18

Appendix B: Sample MCQ’s ............................................................................................. 21

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 SAMPLE QUESTIONS..................................................................................................................... 21

IMAGE QUESTIONS ........................................................................................................................ 21

SAMPLE MCQ EXAMINATION ....................................................................................................... 21

Appendix C: Suitable resources ...................................................................................... 28

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1. G eneral introduction
1.1. Purpose of the document
These guidelines and specifications have been prepared to assist candidates for the
Australian Medical Council (AMC) multiple choice question examination (MCQ). Candidates
should make themselves fully aware of the information provided.

1.2. Privacy
The AMC observes the provisions of the Privacy Act which sets out the requirements for the
collection and use of personal information collected.
The AMC’s full Privacy Policy may be found on the AMC web site at
http://www.amc.org.au/about/privacy-policy.
Application Forms required by the AMC may include a statement relating to the AMC’s privacy
procedures and may require specific consent from the applicant.
Please note: if this consent is not provided the AMC will not be able to process the application.

1.3. Aims and objectives of the AMC examination process

The AMC examination process assesses, for registration purposes, the medical knowledge
and clinical skills of international medical graduates whose basic medical qualifications are not
recognised by the Medical Board of Australia.
The process is designed as a comprehensive test of medical knowledge and clinical
competence. There are two stages, the MCQ examination and the clinical examination. Both
the MCQ and clinical examination are multidisciplinary and integrated.
The MCQ examination focuses on basic and applied medical knowledge across a wide range
of topics and disciplines, involving understanding of disease process, clinical examination,
diagnosis, investigation, therapy and management, as well as on the candidate’s ability to
exercise discrimination, judgment and reasoning in distinguishing between the correct answer
and plausible alternatives. The MCQ is a computer-administered examination.

The clinical examination assesses the candidate’s capacity in such areas as history taking,
physical examination, diagnosis, ordering and interpreting investigations, clinical management
and communication with patients, their families and other healthcare workers. For more
information on the clinical examination, please refer to the Clinical Examination Specifications
booklet on the AMC website www.amc.org.au.

1.4. Eligibility
International Medical Graduates (IMGs) who have a primary qualification in medicine and
surgery awarded by a training institution recognised by the AMC are eligible to apply for
assessment under the Pathway. For more information on how to apply, please visit the AMC
website – www.amc.org.au.

1.5. Standard of the AMC examination

The standard of the AMC examination is defined as the level of attainment of medical
knowledge, clinical skills and professional behaviours that is required of newly qualified

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graduates of Australian medical schools who are about to commence intern training. These
are described in the AMC graduate outcome statements listed in Appendix A.

The graduate outcomes form the basis of medical education in Australia and are used to
accredit medical schools. They are expressed in terms of four overarching domains:
1) Science and Scholarship: the medical graduate as scientist and scholar
2) Clinical Practice: the medical graduate as practitioner
3) Health and Society: the medical graduate as a health advocate
4) Professionalism and Leadership: the medical graduate as a professional and leader

1.6. Standard of performance required

The MCQ examination requires the candidate to demonstrate, to the satisfaction of the
examiners, knowledge, understanding, analysis and judgement at the level of a graduating
final year medical student about to commence the (pre-registration) intern year, across a broad
range of required clinical disciplines.
The MCQ examination is a test of the principles and practice of medicine in the fields of Adult
Health - Medicine, Adult Health - Surgery, Women’s Health - Obstetrics & Gynaecology, Child
Health, Mental Health and Population Health & Ethics. The majority of the multiple-choice
questions reflect common clinical conditions in the Australian community. In order to achieve
a satisfactory level of performance, a candidate will require a knowledge of:

• Pathogenesis
• Clinical features
• Investigative findings
• Differential diagnosis
• Management and treatment.
Some questions in the MCQ examination will test basic or essential knowledge and
understanding of topics covered by the examination. Other questions will require more higher-
level cognitive skills and will test the candidate’s ability to interpret clinical data and make
diagnostic, investigative or management decisions. Questions may contain images of X-rays,
electrocardiograms (ECGs), scans, clinical photographs and other visual material.
In general, the MCQ examination will test a candidate’s capacity for reasoning rather than rote
learning. The MCQ examination includes questions which are regarded as critical to the safety
or clinical outcome for the patient, or are based upon important common conditions and one
of:

• Related to life threatening illness; or

• Critical to safe practice (includes professionalism); or
• Successful clinical outcome; or
• Important aspects of public health

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2. Structure and c ontent of the M C Q
exa mination
2.1. Structure of the MCQ examination
The MCQ examination is a computer administered examination comprising 150 multiple-
choice questions administered over 3.5 hours.

At least half of the questions are taken from a pool of previously calibrated questions. The
remainder of the questions are new questions – that is questions that have not previously been
used in an AMC MCQ examination. These new questions and candidate responses are
inspected and calibrated before being used for scoring.
The examination is delivered as a Computer Adaptive Test (CAT). A CAT format of MCQ is a
form of computer- based test administration in which each candidate takes a unique,
customised examination. Research has confirmed the comparability between CATs and fixed
length tests, but with CATs requiring less than half the number of questions to obtain more
precise results.
Each CAT MCQ examination is automatically equated to any other test drawn from the AMC
pools. In the CAT MCQ format examination, for each candidate the first question is randomly
selected from the item pool. If the answer to the question is incorrect, the next question chosen
is a less difficult question; if correct, the next question is a more difficult question. This process
is continued as the examination delivers questions based on the previous responses until the
last question is reached. After each response, the computer calculates the ability estimate
(“score”) based on all the information available and obtained to that point. The precision of the
ability estimate improves as the process is continued because the questions are targeted to
the latest ability estimate of each candidate.
A pass/fail point (cut score or standard) is defined for the whole examination, and each
candidate is measured against this point regardless of the group of candidates with whom they
are examined, or the particular set of CAT questions they are administered as part of the
examination, or when they take the test.

2.2. Content of the examination

The 150 MCQ questions are selected or blueprinted in the following way.

PATIENT GROUPS

AMC CAT MCQ Adult Adult Womens Child Mental population ITEM
BLUEPRINT health health health health health health TOTALS
[Medicine] [Surgery] [Obs]
[Gyn]
ITEM TOTALS
(30%) (20%) (12.5%) (12.5%) (12.5%) (12.5%) 150

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Adult health - Medicine and Adult health - Surgery

These patient groups cover a broad spectrum of adult health and aged care, and involve a
sound foundation knowledge of the medical sciences (physiology, biochemistry, anatomy,
pharmacology) and an understanding of pathobiology and pathophysiology. They include
developed and practiced clinical skills (communication, history taking, physical examination,
counselling) an appropriate understanding of principles of treatment and familiarity with current
management strategies (investigations, procedural interventions, drug and non-drug
therapies).
Women’s health
Gynaecology covers a broad spectrum of women’s healthcare, and involves all principles of
adult health as above. Obstetrics also embodies these principles with the addition of the
understanding of the basic sciences as they apply to reproduction and the effects of
pathobiology and pathophysiology on the reproductive process (pregnancy, labour, birth and
the post-natal period).
Child health

Child health includes developmental dimensions of children’s health from fetal development
and transition to extra-uterine life to the end of adolescence, including growth, physical
development, puberty and intellectual development in normal and abnormal situations. Clinical
features and natural history of important conditions are covered including basic
pathophysiology of medical and surgical conditions including recognition and management of
developmental disability. Core clinical skills and management of common and important
conditions in a range of settings (emergency, ambulatory, inpatient, convalescent) are
included covering medical, surgical and psychosocial interventions.
Mental health

The assessment, diagnosis and management of psychological, behavioural and mental

disorders and illnesses and addictions across all age groups, based on bio-psychosocial and
cognitive principles. This includes history, mental state features, investigations and co-
morbidities, with management to include the use of psychological/behavioural, physical,
pharmacological and psychotherapeutic interventions, with their risks and benefits.
Population health and Ethics

Population health strategies are to improve the health of targeted populations, and include
screening activities, surveillance, vaccination programs, population-level education,
epidemiology and legislation or disease management measures. Population health concepts
may arise in a range of health care settings and across all patient groups, and will include
health promotion and disease prevention strategies. Ethical issues cover professional
behaviour including boundary issues, patient confidentiality, informed consent and impairment
of doctors. Legal issues embrace regulations covering the Australian health care system and
the delivery of best practice medicine.
Examination questions within the CAT MCQ examination are classified in terms of both
Clinician Tasks and Patient Groups, as follows:

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CLINICIAN TASKS
Data Gathering

History taking, mental status examination, physical examination, laboratory testing, imaging,
other investigations, and clinical reasoning.
Data Interpretation and Synthesis

Interpretation and synthesis of gathered data. Clinical reasoning, problem identification,

setting priorities and risk stratification. Formulation of differential and specific diagnosis,
causes and associations with presenting conditions.
Management
Education and health promotion, counselling, psychotherapy, drug and non- drug therapy
(including fluid and electrolyte therapy), surgical interventions, radiological interventions, drug
interactions and complications, cessation of therapy, rehabilitation, palliative care,
interdisciplinary management, family and community care.
MCQ QUESTION PREPARATION

The MCQ examination is a comprehensive examination of medical knowledge and practice.

The AMC recommends that candidates undertake a thorough review of the major topics
covered in the examination.

Candidates should familiarise themselves with the MCQ format. Examples of the MCQ
examination questions are set out in Appendix B.
In order for the candidates to familiarise themselves with the computer administered
examination, an online MCQ Trial examination, consisting of 50 questions, is available on the
AMC website – www.amc.org.au.
A wide range of general texts is readily available on this form of examination and its associated
techniques. The AMC publication Annotated Multiple Choice Questions also covers these
aspects.
REVIEW OF TOPICS

To assist candidates, the AMC has prepared a list of suitable resources, which is set out in
Appendix C.
Please note that some of the listed suitable resources in Appendix C are intended to provide
background reading on key topics and contain a great deal of reference material. The
questions in the MCQ examination are oriented towards the more common clinical
applications, differential diagnosis and therapeutics. Accordingly, care should be taken when
using major reference type textbooks for revision. Many candidates find it more useful to
undertake a comprehensive review of medical journals, such as Australian Family Physician,
Current Therapeutics, Australian Prescriber or any of the other journals in general practice
medicine. These journals contain useful review articles and summaries of the identification,
treatment and management of the more common clinical conditions in the Australian
community.

The AMC has prepared two major publications for candidates preparing for the MCQ and
clinical examinations.

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Anthology of Medical Conditions
The AMC publication Anthology of Medical Conditions has been produced not only to assist
International Medical Graduates (IMGs) to prepare for the AMC Examinations but also as an
essential tool for clinical practice. The publication lists over 130 Clinical Presentations of
clinical conditions and classifies them to assist in a problem-solving approach to diagnosis
and management.
It is essential for all doctors to be familiar with the laws of the society in which they practise
medicine and the ethics that underpin medical practice. It is also important to understand the
organisational aspects of medicine in the Australian context. The Anthology of Medical
Conditions contains a separate section dealing with these important issues, entitled Legal,
Ethical and Organisational Aspects of the Practice of Medicine (LEO). The publication is
enhanced throughout with medical illustrations. The publication is recommended for use in
preparing for the AMC Multiple Choice Question (MCQ) and Clinical Examinations.
To purchase the Anthology of Medical Conditions, go to the AMC’s online store at
https://store.amc.org.au/
The Anthology of Medical Conditions is currently under review and will be replaced by a new
publication. Candidates will be advised when this is due to occur to assist with examination
preparation.
Handbook Of Multiple Choice Questions
The AMC Handbook of Multiple Choice Questions is about to be superseded by an App with
items representative of the style, topics and content of the AMC MCQ Examination.
Candidates will be advised when this is due to occur to assist with examination preparation.

RECONSTRUCTED AMC PAPERS

The AMC is aware that MCQ examination papers which are circulated or available via the
internet are claimed to be accurate reproductions of AMC MCQ examination papers.
Candidates should exercise care when using these reconstructed papers. The AMC has been
provided with copies of these papers and has found many of the question stems and
responses to be incorrect. Candidates who base their preparation on such reconstructed
papers may have a distorted impression of the format and content of the actual multiple choice
questions used in the AMC examination.

STRATEGIES FOR ANSWERING MULTIPLE CHOICE QUESTIONS

A-TYPE QUESTIONS (ONE OUT OF FIVE CORRECT)

Each question consists of a stem followed by five suggested answers or completions. The
candidate is required to select the best answer to the question or the best response to the
statement. A-type questions aim to determine whether the candidate can differentiate the
correct item of information, procedure, treatment or so on, from the plausible alternative.
Answers or responses other than the single best answer may be partially correct, but there is
only one best answer or response to this type of question.
The candidate should:

• read each question or statement carefully to understand what is being asked

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• read each option carefully and eliminate those which appear to be only partially correct
• select the option that they consider to be the most appropriate answer.
IMAGE OR DATA INTERPRETATION QUESTIONS
In this type of question, an image, diagram, graph, X-ray, ECG or scan is followed by a
question or statement and five responses. The candidate is required to decide which is the
best answer or response. The aim of this type of question is to test appropriate clinical material
in the MCQ examination.
In image and data interpretation questions, candidates may find it easier to read the question
or statement first in order to determine what is being asked and then study the image or
diagram. It is easier to find the specific information in the image or diagram to answer the
question or complete the response if you know what is required
NO REVIEW OF ITEMS
In the MCQ computer administered examination candidates should complete, in the 3.5 hour
examination session, all 150 questions. Each question must be answered before a further
question will be administered – that is a candidate is not permitted to not answer a question
and progress to the next question, and so may not go back to an unanswered question.
Similarly, once a question has been answered, a candidate cannot go back to a previous
question and change a response.
Candidates who have previously attempted the MCQ should note this change to remove
the ability to review answers. This change brings the AMC MCQ into line with many other
MCQ CAT examinations, nationally and internationally, and has been introduced to improve
examination question security.
OTHER IMPORTANT INFORMATION

• Marks will not be deducted for incorrect answers.

• Items are randomised across the blueprint.
• Candidates are advised to pace themselves to balance the need to complete all
questions while taking appropriate time to answer each question.
• A timer-clock is included in the examination platform for each individual candidate.

2.3. Scoring of the MCQ Examination

As stated, candidates are expected to answer all 150 MCQ questions in the examination.

It is important to note that the determination of a candidate’s ability is not based simply on the
number of correct answers given by the candidate. Because of the CAT component of the
examination some candidates would have been administered difficult questions whilst others
would have been administered easier questions – depending on the correct or incorrect
answers to previous questions. Therefore, if candidates have the same number of correct
answers, the ability of the candidate that answered the difficult questions will be higher than
the ability of the candidate that answered the easier questions.
The AMC score is based on measurement of the candidate ability level and (for convenience)
represented on a scale of 0 to 500. A passing score is represented on the scale at 250.

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Failure to complete all 150 items in the AMC CAT MCQ examination may lead to insufficient
information for a reliable ability to be determined and therefore a result on the AMC adaptive
scale. The examination result may be recorded as Fail – insufficient data to obtain result.
Each candidate receives a computer-generated transcript of their results and feedback on
their performance in the MCQ examination.

3. Enrolm ent for the M C Q

Exa mination
3.1. Registration for MCQ examination
The specified dates and times of MCQ examinations are available upon log in to the candidate
portal, which can be accessed via the AMC website at www.amc.org.au.
Candidates may only apply for one examination at a time. Therefore, candidates who have
been scheduled for a MCQ examination may not lodge an application for another examination
before they have received the results of the scheduled examination.

3.2. Venue and scheduling

The AMC conducts the MCQ examinations throughout the year, in centres within Australia
and overseas. To view a list of examination venues, please visit www.vue.com/amc.
Pearson VUE provides the venues for the AMC MCQ Examination and controls the online
scheduling for AMC candidates to obtain an examination event appointment.
The 12-month authorisation allows you to select the most suitable MCQ examination event.
You can change examination events and venues without penalty before the closing date for
the event, but no changes will be allowed after the closing date.
Once you have received an email from Pearson VUE confirming your authorisation, you may
schedule for an AMC MCQ examination event by selecting one of the following options:

• Pearson VUE online candidate scheduling system

• Pearson VUE Contact Centres.

You can schedule into only one of the MCQ examination events covered in your authorisation.
Some examination venues have very limited seat capacity, so places are allocated on a first
come, first served basis. It is vital that you schedule immediately after you have received your
authorisation notification.
Once you have scheduled your examination event with Pearson VUE, the AMC will email you
an official AMC placement letter.

Candidates must arrive promptly and report to the administrative staff in attendance. Once
candidates have reported, they will be required to remain, under the direction of the
administrative staff, until the examination session concludes.
Candidates arriving late may be excluded from commencing the examination.

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4. Fe es
4.1. Examination fees
Payment of the examination fee will confirm the placement in the relevant MCQ examination
session.
Candidates who withdraw after accepting a MCQ place will incur a withdrawal fee, the amount
of which will depend on the date of the withdrawal.
The fees for the AMC examination are reviewed from time to time and are subject to variation.
The examination fees for the MCQ examination (based on current examination costs) are
shown on the AMC website (www.amc.org.au). Information regarding withdrawal fees
currently applying to the examination are also available on the AMC website.

5. Pre p aring for the M C Q and the

pro c ess of the exa mination
5.1. Before the Examination
The following points are suggested to assist candidates in planning for and sitting the MCQ
examination.

5.1.1. Planning for the examination

Candidates should:

• Get a good night’s rest before presenting for the examination

• Avoid the use of stimulants or other drugs that may impair your performance
• Read their placement letter carefully and note the times and exact location of their
examination
• Ensure they arrive on time for each MCQ examination session and give themselves time
to settle down before the examination commences
• If travelling from interstate, ensure that they check any interstate time differences and allow
extra time in case of delayed flights or travel time between the airport and the city.

5.2 At the examination

5.1.2. AMC Procedure

Candidates reporting for the MCQ examination are required to present two forms of
Identification (ID):

• One primary ID (government-issued with name, photo, and signature) – e.g. passport;
and
• One secondary ID (name and signature) – e.g. bank card or driver’s licence.

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Conditions:

• ID documentation presented must be original (no photo copies) and valid (unexpired),
with the first name and last name on AMC records to match exactly the first name
and last name on the IDs presented on the test day.
• Expired forms of ID will not be accepted unless accompanied by valid renewal papers.
• Any government-issued ID that is missing a visible signature or containing an
embedded signature can be supplemented with an original, valid ID that shows a
matching name and signature. An additional, secondary ID will still be required.

All candidates must comply with the instructions of MCQ examination supervisors during
examinations. Failure to do so will constitute a breach of examination procedures and may
result in action being taken against the candidate concerned. Candidates are expected to
conduct themselves courteously in examinations, correspondence and personal contact with
examiners, employees or agents of the AMC. A candidate who does not comply with the
instructions of an MCQ examination supervisor, or whose conduct is disruptive or is
considered by the AMC to have been outside the bounds of reasonable and decent behaviour,
may be debarred from continuing with the examination.

No books or examination material may be used in the AMC MCQ examination. Candidates
found to be giving, receiving or recording information during examinations will not be permitted
to continue in the examination and may forfeit their eligibility to sit future AMC examinations.
As the AMC MCQ examination is computer administered, the AMC and the computer vendor
will make every effort to ensure a smooth and orderly examination administration. However,
in extraordinary circumstances beyond the control of the AMC, such as a significant power
outage, computer malfunctions or network difficulty, the AMC will take such circumstances
into account.
In instances where technical issues prevent a candidate from completing the AMC MCQ
examination under standard conditions, the AMC MCQ Panel may review the results of the
quality assurance procedures and the statistical analyses of candidate responses, to
determine whether the results obtained by a candidate reliably reflect their true level of ability.
The MCQ Panel may also order a new examination to be undertaken. No additional
examination fee will be charged.
The AMC will NOT be responsible for any other costs associated with the examination,
including travel costs.
Whilst the AMC provides examination venues to AMC candidates undertaking the examination
process, the AMC does not provide ‘prayer rooms’ for candidates on the day of the
examination. Candidates are required to make their own arrangement if a quiet place is
required. It should also be noted the timing schedule of the examination cannot be delayed
due to observance of religious requirements.
Candidates are in breach of the examination process if remaining in the examination venue
when directed to leave.
Family and friends accompanying candidates to an examination are NOT permitted to enter
the examination venue.

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6. Results
Candidate results will be available to download from their candidate portal at 9.00am on the
Thursday, four weeks following their AMC CAT MCQ examination. This is in accordance with
the process notified on the AMC website - https://www.amc.org.au/assessment/mcq/mcq-
results/
Please note: Under no circumstances will results be given over the telephone.

7. C andid ate c onduct

7.1. General conduct of candidates
Candidates are expected to conduct themselves courteously in examinations,
correspondence and in personal contact with examination centre staff, employees or agents
of the AMC and other candidates. Candidates whose conduct is disruptive, or is considered
by the AMC to have been outside the bounds of reasonable and decent behaviour, may be
excluded from the examination and/or refused the opportunity to sit future AMC examinations.
All candidates must comply with the instructions of MCQ examination staff during
examinations. Failure to do so will constitute a breach of examination procedures and may
result in the candidate being excluded from the examination or refused the opportunity to sit
future examinations.
A doctor who crosses professional boundaries while undertaking the AMC MCQ examination
may be guilty of professional misconduct and may be investigated and subjected to
disciplinary action by regulatory authorities.

7.2. Unsatisfactory Results

A feature of the MCQ examination is that because it enables statistical analysis of a
candidate’s performance, the AMC can form a reliable opinion as to whether the candidate’s
performance in the examination can be confidently accepted as a fair reflection of the
candidate’s ability.
Under the Health Practitioner Regulation National Law, which regulates registration of doctors
in Australia, a fundamental principle is to provide for the protection of the public.
Accordingly, if on analysis the AMC becomes concerned that the candidate’s performance
may not be confidently accepted as a fair reflection of the candidate’s ability, the AMC may
identify this concern to the candidate and seek an explanation. The CEO of the AMC will
consider the issue, including any explanation from the candidate, and determine whether to
withhold a result from the candidate because the CEO decides that the candidate’s result
cannot be confidently accepted as a fair reflection of the candidate’s ability. (This may come
about because, for example, analysis indicates that a candidate’s results have been materially
affected by pre-knowledge of questions or rote learning or regurgitation of pre-learned
answers.)
In this circumstance the candidate will be invited to attempt the MCQ examination again.

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 7.3. Irregular Behaviour
Any attempt to circumvent the objectives or processes of the examination (as described in
these Specifications or in other material made available to candidates), the reliability of
candidate assessment, or the security of the examination or examination content, may:
a. produce exam results which cannot be confidently accepted as reflecting a candidate’s true
ability,

b. compromise the integrity and security of the MCQ examination and MCQ examination
content, and/or
c. detract from or impede the AMC purpose of protecting the health of Australian patients and
communities.
Accordingly, any candidate:
• found with recording equipment, or recording any aspect of the examination during the
examination; or
• who discloses or attempts to disclose or compromise the examination content or
procedures (including but not limited to, supplying, offering to supply, selling, or offering
for sale materials or details purporting to be AMC examination content); or
• who acts in any way that is in breach of the AMC’s intellectual property rights in the
examination content or procedures, or inconsistent with those rights; or
• who cheats, or receives or seeks inappropriate outside assistance in their performance
in any examination; or
• who otherwise behaves in any inappropriate manner such that the AMC cannot have
confidence that the assessment of the candidate is an accurate reflection of the
candidate’s ability; or
• who provides inappropriate assistance to another candidate, such that the AMC cannot
have confidence that the assessment is an accurate reflection of that other candidate’s
ability; or
• who participates in an examination for a purpose other than a genuine desire to pass
that examination, or whose performance in the examination is particularly poor such that
it appears that the candidate’s purpose in attempting the examination is other than a
genuine desire to pass that examination;
may be subject to the following disciplinary processes:
• Any concern identified by the MCQ Results Panel will be reported by the MCQ Results
Panel to the CEO for review. The MCQ Results Panel may withhold awarding a result
for the examination.
• The candidate will be informed of the concern in writing and provided with an
opportunity to respond.

• The AMC CEO will consider all the material, including any response from the candidate,
and will determine a final decision regarding the candidate examination result.
• The AMC CEO may also decide that the candidate may not be permitted to continue
with any AMC assessment, may be refused the opportunity to sit future examinations,
may have their results in the examination withdrawn, may be refused a result for the

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 examination, may be refused the award of the AMC certificate, may have their AMC
certificate withdrawn, and/or be reported to the appropriate authorities including the
Medical Board of Australia/Australian Health Practitioner Regulation Agency
(MBA/Ahpra) or law enforcement authorities.
• Where a concern is identified during the course of an MCQ examination and reported
to the AMC CEO, the same person may direct that the candidate be immediately
excluded from the examination, and the matter be referred to the MCQ Results Panel
for further investigation in accordance with these specifications.

All AMC candidates should be aware that, under Australian law, copyright of all examination
materials rests with the Australian Medical Council. No part of any examination may be
reproduced, stored or transmitted by any means.

8. Other g eneral inform ation

8.1. Change of address
It is important that candidates advise the AMC secretariat promptly of each change of address,
email address and/or telephone number. This will ensure that contact can be made as quickly
as possible with candidates to notify them of examination venue changes, rule or eligibility
changes, or to confirm information provided by the candidate on his or her application forms.
Change of address can be made via the telephone or by using the Change of address form
which can be obtained by contacting the AMC Secretariat. The change of address form is also
available on the AMC website (www.amc.org.au).
When advising of a change of address in writing, candidates should include the following
details:

• Candidate number
• Full name
• Previous address
• New address
• Candidate signature
• Date of birth
Under the provisions of the Commonwealth Privacy Act the AMC is unable to accept changes
of address or other candidate details submitted by email, unless provided on the Change of
address form.

8.2. Further information

If a candidate is in doubt about any aspect of the AMC examination, he/she should contact
the AMC secretariat:
Australian Medical Council
PO Box 4810
Kingston ACT 2604 Australia

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Telephone: (02) 6270 9777
Facsimile: (02) 6270 9799

Email: [email protected]
Website: www.amc.org.au

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A p p endix A: The AM C gra duate
outc om e state m ents
The goal of medical education is to develop junior doctors who possess attributes that will
ensure they are initially competent to practice safely and effectively as interns in Australia or
New Zealand, and that they have an appropriate foundation for further training in any branch
of medicine and for lifelong learning. Attributes should be developed to an appropriate level
for the graduates’ stage of training.
Included below is the list of graduate outcome statements. These statements, divided into four
domains, reflect the skills, knowledge and attitudes that Australian medical students are
required to demonstrate upon graduation. Graduate outcome statements can also be found in
the AMC’s Standards for assessment and accreditation of primary medical programs.

Domain 1
Science and Scholarship: the medical graduate as scientist and scholar

On entry to professional practice, Australian and New Zealand graduates are able to:

• Demonstrate an understanding of established and evolving biological, Clinical,

epidemiological, social, and behavioural sciences.
• Apply core medical and scientific knowledge to individual patients, populations and health
systems.
• Describe the aetiology, pathology, Clinical features, natural history and prognosis of
common and important presentations at all stages of life.
• Access, critically appraise, interpret and apply evidence from the medical and scientific
literature.
• Apply knowledge of common scientific methods to formulate relevant research questions
and select applicable study designs.
• Demonstrate a commitment to excellence, evidence based practice and the generation of
new scientific knowledge.

Domain 2
Clinical Practice: the medical graduate as practitioner

On entry to professional practice, Australian and New Zealand graduates are able to:

• Demonstrate by listening, sharing and responding, the ability to communicate clearly,

sensitively and effectively with patients, their family/carers, doctors and other health
professionals.
• Elicit an accurate, organised and problem-focussed medical history, including family and
social occupational and lifestyle features, from the patient, and other sources.
• Perform a full and accurate physical examination, including a mental state examination, or
a problem-focused examination as indicated.
• Integrate and interpret findings from the history and examination, to arrive at an initial
assessment including a relevant differential diagnosis. Discriminate between possible

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 differential diagnoses, justify the decisions taken and describe the processes for
evaluating these.
• Select and justify common investigations, with regard to the pathological basis of disease,
utility, safety and cost effectiveness, and interpret their results.
• Select and perform safely a range of common procedural skills
• Make Clinical judgements and decisions based on the available evidence. Identify and
justify relevant management options alone or in conjunction with colleagues, according
• to level of training and experience.
• Elicit patients’ questions and their views, concerns and preferences, promote rapport,
• and ensure patients’ full understanding of their problem(s). Involve patients in decision
making and planning their treatment, including communicating risk and benefits of
management options.
• Provide information to patients, and family/carers where relevant, to enable them to make
a fully informed choice among various diagnostic, therapeutic and management options.
• Integrate prevention, early detection, health maintenance and chronic condition
management where relevant into Clinical practice.
• Prescribe medications safely, effectively and economically using objective evidence.
Safely administer other therapeutic agents including fluid, electrolytes, blood products and
selected inhalational agents.
• Recognise and assess deteriorating and critically unwell patients who require immediate
care. Perform common emergency and life support procedures, including caring for the
unconscious patient and performing CPR.
• Describe the principles of care for patients at the end of their lives, avoiding unnecessary
investigations or treatment, and ensuring physical comfort including pain relief,
psychosocial support and other components of palliative care.
• Place the needs and safety of patients at the centre of the care process. Demonstrate
safety skills including infection control, graded assertiveness, adverse event reporting and
effective Clinical handover.
• Retrieve, interpret and record information effectively in Clinical data systems (both paper
and electronic).

Domain 3
Health and Society: the medical graduate as a health advocate

On entry to professional practice, Australian and New Zealand graduates are able to:

• Accept responsibility to protect and advance the health and wellbeing of individuals,
communities and populations.
• Explain factors that contribute to the health, illness, disease and success of treatment of
populations, including issues relating to health inequities and inequalities, diversity of
cultural, spiritual and community values, and socio-economic and physical environment
factors.
• Communicate effectively in wider roles including health advocacy, teaching, assessing and
appraising.
• Understand and describe the factors that contribute to the health and wellbeing of
Aboriginal and Torres Strait Islander peoples and/or Māori, including history, spirituality
and relationship to land, diversity of cultures and communities, epidemiology, social and
political determinants of health and health experiences. Demonstrate effective and
culturally competent communication and care for Aboriginal and Torres Strait Islander
peoples and/or Māori.
• Explain and evaluate common population health screening and prevention approaches,
including the use of technology for surveillance and monitoring of the health status of

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 populations. Explain environmental and lifestyle health risks and advocate for healthy
lifestyle choices.
• Describe a systems approach to improving the quality and safety of health care.
• Understand and describe the roles and relationships between health agencies and
services, and explain the principles of efficient and equitable allocation of finite resources,
to meet individual, community and national health needs.
• Describe the attributes of the national systems of health care including those that pertain
to the health care of Aboriginal and Torres Strait Islander peoples and/or Maori.
• Demonstrate an understanding of global health issues and determinants of health and
disease including their relevance to health care delivery in Australia and New Zealand and
the broader Western Pacific region.

Domain 4
Professionalism and Leadership: the medical graduate as a professional and leader
On entry to professional practice, Australian and New Zealand graduates are able to:

• Provide care to all patients according to “Good Medical Practice: A Code of Conduct for
Doctors in Australia” and “Good Medical Practice: A Guide for Doctors” in
• New Zealand.
• Demonstrate professional values including commitment to high quality Clinical standards,
compassion, empathy and respect for all patients. Demonstrate the qualities of integrity,
honesty, leadership and partnership to patients, the profession and society.
• Describe the principles and practice of professionalism and leadership in health care.
• Explain the main principles of ethical practice and apply these to learning scenarios in
Clinical practice. Communicate effectively about ethical issues with patients, family and
other health care professionals.
• Demonstrate awareness of factors that affect doctors’ health and wellbeing, including
fatigue, stress management and infection control, to mitigate health risks of
• professional practice. Recognise their own health needs, when to consult and follow
advice of a health professional and identify risks posed to patients by their own health.
• Identify the boundaries that define professional and therapeutic relationships and
demonstrate respect for these in Clinical practice.
• Demonstrate awareness of and explain the options available when personal values or
beliefs may influence patient care, including the obligation to refer to another
• practitioner.
• Describe and respect the roles and expertise of other health care professionals, and
demonstrate ability to learn and work effectively as a member of an inter-professional team
or other professional group.
• Self-evaluate their own professional practice; demonstrate lifelong learning behaviours
and fundamental skills in educating colleagues. Recognise the limits of their own expertise
and involve other professionals as needed to contribute to patient care.
• Describe and apply the fundamental legal responsibilities of health professionals
especially those relating to ability to complete relevant certificates and documents,
informed consent, duty of care to patients and colleagues, privacy, confidentiality,
mandatory reporting and notification. Demonstrate awareness of financial and other
conflicts of interest.

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A p p endix B: Sa mple M C Q’s
SAMPLE QUESTIONS
This appendix contains sample question items, which reflect the format and structure of questions
to be used in the MCQ examination. The sample questions are provided as a representative
sample only.

For the MCQ examination there will be a total of 150 questions.

IMAGE QUESTIONS
In the AMC MCQ examination, photographic questions may be included.

SAMPLE MCQ EXAMINATION

A one-year-old uncircumcised boy presents with 24 hours of fever, pain on urination and some blood
in the urine. Which one of the following is the most appropriate method of obtaining a urine sample?

A. Clean catch mid stream sample

B. Bladder pressure to obtain clean catch sample
C. Clean catch urine bag collection
D. Urinary catheter
E. Suprapubic bladder tap

A baby is born at term by ventouse delivery with light meconium staining of the liquor. At birth he is
slow to breathe and his Apgar scores are 3 at one minute, 5 at five minutes and 9 at ten minutes.
Which one of the following components is most important for successful resuscitation?

A. Mouth and nose suction

B. Guedel airway placement
C. Adequate ventilation
D. Supplemental oxygen
E. Tracheal intubation

A 20-month-old boy is with his mother in the supermarket. He puts a lollipop in the trolley and
becomes enraged when his mother puts it back. He starts to cry vigorously then suddenly stops
breathing. He becomes cyanosed, loses consciousness and has a brief tonic clonic seizure. On
examination 15 minutes later, he is alert and interactive. His BP is 95/60mmHg, pulse is 100/min,
temperature 37.6°C and neurological examination is normal. Which one of the following is the most
likely diagnosis?

A. Febrile convulsion
B. Breath-holding spell
C. Epilepsy
D. Syncopal episode
E. Encephalitis

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A 9-year-old Aboriginal girl presents to a regional hospital with the complaint that her ankle has
become increasingly painful over the last three days. She had fallen from play equipment at school a
week earlier. Except for a recent episode of pharyngitis her previous health has been good. Her
temperature is 38.5ºC and her pulse rate is 95/min. On physical examination she has a mildly swollen
ankle with some pain on movement, but the examination is otherwise normal. The heart sounds are
normal and no murmur is heard. The lungs are clear. Which one of the following is the most
appropriate initial investigation?

A. X-ray of ankle.,
B. Full blood count and ESR
C. Ross River virus serology
D. Ankle joint aspiration
E. Rheumatoid serology

A 35-year-old woman presents following an intentional overdose. She called an ambulance and
admits to taking sertraline but refuses to give any further details. On examination she is irritable,
uncooperative and abusive. Her BP is 125/87 mmHg, pulse 112/min and temperature 37.2°C. In
addition to β-hCG, which one of the following is the most important investigation?

A. Arterial blood gas

B. Blood alcohol level
C. Urine drug screen
D. ECG
E. Paracetamol level

A 26-year-old woman has been diagnosed with schizophrenia. She lives with her parents. The history
is a gradual onset of symptoms from the age of 19. She is now stable on amisulpride 800 mg per day.
She has never worked but continues to make attempts to find employment. She complains of difficulty
concentrating and thinking clearly and of problems "feeling" her body. Which one of the following is
most likely to be associated with a poorer prognosis?

A. Use of high dose antipsychotic

B. Insidious onset of illness
C. Living with her parents
D. Somatic sensory deficits
E. Chronic thought disorder

A 14-year-old girl is brought in by her mother who is concerned about her daughter's low moods and
tearfulness. The girl describes six months of feeling sad and anxious with a decrease of energy and
loss of interest in recreational activities. Her school grades have deteriorated. She has occasional
suicidal thoughts but no plans. Which one of the following is the most appropriate next step in
management?

A. Arrange admission
B. Commence sertraline
C. Commence fluoxetine
D. Cognitive behavioural therapy
E. Encourage physical and social activities

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A 50-year-old man presents asking for a prostate cancer blood test. He says he has no obstructive or
irritative lower urinary tract symptoms. Which one of the following is the most appropriate next step?

A. Discuss the pros and cons of prostate cancer screening

B. Perform a digital rectal examination and prostate specific antigen (PSA) blood test
C. Arrange a urinary tract ultrasound to assess prostate morphology
D. Advise that screening is not necessary in the absence of symptoms
E. Arrange a prostate biopsy

A 45-year-old woman seeks information about her 18-year-old daughter during her own consultation
with the family's general practitioner. She is worried about her daughter and believes that she is
depressed and has been seeking contraceptive advice from the doctor. She seeks confirmation of
this. Which one of the following is the most appropriate action?

A. Ask that she attend with her daughter at the daughter's next appointment
B. Discuss the daughter's depression with her
C. Telephone the daughter now regarding her mother's request
D. Advise her you cannot discuss any other patients
E. Advise that you have not seen the daughter as a patient

A 27-year-old man with a history of heroin dependence presents to the Emergency Department with
abdominal pain and vomiting. He appears agitated in mood, and has tachycardia and fever and
dilated pupils. He admits recent use of cocaine and heroin. Which one of the following clinical findings
is most helpful in differentiating cocaine intoxication from heroin withdrawal?

A. Agitation
B. Abdominal pain and vomiting
C. Tachycardia
D. Dilated pupils
E. Fever

A 23-year-old woman presents to her general practitioner at 16 weeks gestation in her first pregnancy
with frequency and mild stinging when she passes urine. Her temperature is 37.3⁰C and pulse 84/min.
On abdominal palpation there is suprapubic tenderness. Which one of the following is the most
appropriate management?

A. No treatment as these symptoms are common in pregnancy.

B. Request a midstream urine specimen and await culture.
C. Prescribe a wide-spectrum antibiotic after midstream urine specimen collection.
D. Insert an indwelling catheter to ensure free drainage of urine.
E. Perform a suprapubic bladder tap to obtain an uncontaminated urine specimen

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A 37-year-old woman presents to the Emergency Department at 12 weeks gestation in her fourth
pregnancy with intermittent lower abdominal cramps and vaginal bleeding. She has a regular cycle
with five days of bleeding every 28 days, and is certain of her dates. Her previous three pregnancies
each ended in miscarriage before 10 weeks. Speculum examination confirms a moderate amount of
blood with clots in the vagina. On bimanual palpation, the uterus is anteverted with size equivalent to
8 weeks gestation. The cervix easily admits one finger. Which one of the following is the most likely
diagnosis?

A. Cervical incompetence
B. Threatened miscarriage
C. Missed miscarriage
D. Incomplete miscarriage
E. Ectopic pregnancy

A 29-year-old primigravid woman at 36 weeks gestation presents after not noticing any fetal
movements for 24 hours. The pregnancy has been uncomplicated until now, with all routine screening
tests normal. On examination the symphysiofundal height measures 34 cm. The fetus is in cephalic
presentation with the head 3/5 palpable abdominally. Which one of the following is the most
appropriate next step in management?

A. Serum estriol assay

B. Cardiotocograph (CTG)
C. Obstetric ultrasound
D. Biophysical profile
E. Induction of labour

A 19-year-old woman presents to her general practitioner with intermittent spotting from the vagina
since commencing a triphasic oral contraceptive pill one month ago. The bleeding is not associated
with sexual intercourse. She has been with the same partner for one year. A recent screen for
sexually transmitted infections was negative. On examination, the vagina and cervix appear normal.
Which one of the following is the most appropriate management?

A. Increase the estrogen dose

B. Increase the progestogen dose
C. Change to a biphasic pill
D. Recommend an etonogestrel contraceptive implant instead.
E. Continue the current medication and review in two months

A 75-year-old man presents following two episodes of blurring of vision affecting the right eye over the
past month. Each episode lasted for five minutes with complete resolution. Neurological examination
is normal. Ocular examination shows normal eye movements and pupil reactions. Which one of the
following is the most appropriate initial investigation?

A. Ocular tonometry
B. Carotid duplex Doppler studies
C. CT head
D. Holter blood pressure monitoring
E. ESR

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A 23-year-old woman complains of diarrhoea with offensive stools and loss of 5 kg weight over the
previous 3 years. She now weighs 50 kg. There is no history of abdominal pain or abdominal
operations. Physical examination shows a slightly distended abdomen, muscle wasting and glossitis.

Haemoglobin,90 g/L,(115-165)

Mean Cell Volume,110 fL,(80-100)

Which one of following is the most likely cause?

A. Multiple jejunal diverticulosis

B. Pernicious anaemia
C. Gluten-sensitive enteropathy
D. Ulcerative colitis
E. Crohn disease

A 79-year-old man presents complaining of pains in his thighs and arms. He has noticed increased
difficulty in climbing stairs for the last two weeks.

His current medications are:

Atorvastatin,80 mg daily

Sertraline,100 mg daily

Frusemide,40 mg daily

Digoxin,62.5 µg daily

Atenolol,50 mg daily

Enalapril,10 mg daily

On examination, there is some tenderness of upper arm and thigh muscles, and mild weakness of hip
flexion. Electrolytes, liver function tests and full blood examination are all normal. Creatine kinase is
8,000 U/L (70-380). Which one of the following is the most likely diagnosis?

A. Polymyalgia rheumatica
B. Atorvastatin induced myopathy
C. Stiff man syndrome
D. Sertraline-induced myositis
E. Hypokalaemic myopathy

A 27-year-old woman presents with a three week history of greenish brown discharge from the right
nipple. She first noticed this when she squeezed her nipple while washing in the shower. On
examination, she has no breast masses. The nipple appears normal. Small volumes of greenish
brown discharge can be produced from three openings in the central right nipple. Which one of the
following is the most likely diagnosis?

A. A,Mastitis
B. B,Duct ectasia
C. C,Breast cancer
D. D,Fibrocystic change
E. E,Physiological discharge

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A 23-year-old moto-cross rider is brought to the Emergency Department following an accident. There
is a 6 cm laceration over the anterior aspect of his tibia which is clearly deformed. His foot is well
perfused. Which one of the following is the most appropriate initial step in management?

A. IV antibiotics
B. Fracture reduction
C. Lavage
D. Surgical debridement
E. Tetanus toxoid administration

A 32-year-old man is brought into the Emergency Department with a six hour history of increasing
pain in his right arm. He is confused and unable to give a clear history, but it appears that two days
ago he injured his arm, sustaining abrasions when he fell off his trailbike. He is disoriented, with a
temperature of 39.2°C, BP of 108/60 mmHg, pulse 110/min and oxygen saturation 96% breathing
room air. His right arm is red and swollen, with blistering visible away from the wound site. His
haemoglobin is 146 g/L (130-180), white cell count 38 x109/L (4-11) and creatinine 155 umol/L (60-
120). Apart from the immediate administration of antibiotics, which one of the following is the most
appropriate next step in management?

A. Intubation, ventilation and dialysis

B. Wound biopsy
C. CT right arm
D. Hyperbaric therapy
E. Surgical debridement

A 50-year-old man presents with the 2 cm lesion shown (see image) on the left side of his upper
abdomen. This has been present for two months and is slowly getting larger. Which one of the
following is the most appropriate next step in management?

A. Observe and review in one month

B. Cryotherapy and curette
C. Sentinel node biopsy
D. Punch biopsy
E. Excision biopsy

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A 24-year-old woman presents to the Emergency Department with a painful swelling on the right side
of the neck, worsening over the past three days. She is now having noisy breathing, difficulty
swallowing and is feeling sweaty. On examination she looks in distress, with a temperature of 38.2°C,
BP 100/70 mmHg and pulse 110/min. She has tender, enlarged lymph nodes on the right side of her
neck. A view inside her mouth is shown in the photograph (see image). Which one of the following is
the most appropriate management?

A. Amoxycillin
B. Incision and drainage
C. CT head and neck
D. Ultrasound neck
E. Endotracheal intubation

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A p p endix C: Suita ble resourc es
Online Medicine resource; suitable resources include UpToDate, BMJ Best Practice or Medscape.

Guidelines written by professional societies, colleges, and evidence-based medicine organisations;

guidelines from the RACGP provide useful information on Australian practice.

Therapeutics Guidelines addresses current recommendations on use of medicines in

Australia https://tgldcdp.tg.org.au/etgcomplete

State, territory and federal departments of health publish resources for clinical practice including the
Australian Immunisation Handbook, 2018. http://immunise.health.gov.au/

Specific resources include:

Royal Children’s Hospital Clinical Guidelines https://www.rch.org.au

Sadock B J, Sadock V A, Ruiz P, Kaplan & Sadock’, Concise Textbook of Clinical Psychiatry, 4th ed,
2017. ISBN 9781496345257 (paperback).

American Psychiatric Association. DSM-5: Diagnostic and Statistical Manual of Mental Disorders, 5th
edn. American Psychiatric Association, Washington DC, 2013. ISBN 9780890425596 (paperback).

Online mental health resources Guidelines and resources for practice Royal Australian and New
Zealand College of Psychiatrists https://www.ranzcp.org/Publications/Guidelines-and-resources-for-
practice.

Guidelines for preventive activities in general practice (The Red Book) 9th Edition
https://www.racgp.org.au/your-practice/guidelines/redbook/

Putting Prevention Into Practice - The Green Book 3rd edition https://www.racgp.org.au/your-
practice/guidelines/greenbook/

SNAP: a population health guide to behavioural risk factors in general practice 2nd
edition https://www.racgp.org.au/your-practice/guidelines/snap/

National guide to a preventive assessment in Aboriginal and Torres Strait Islander peoples 3rd
Edn. https://www.racgp.org.au/your-practice/guidelines/national-guide/

RACGP (Silver Book) Aged Care Clinical Guide 5th edition https://www.racgp.org.au/silverbook

Refugee Health. The RACGP has resources on its website to assist GPs in providing healthcare
for refugees: http://www.racgp.org.au/support/library/subject-portals/refugee/

The Australian Immunisation Handbook, 2018. http://immunise.health.gov.au/

Breen KJ, Cordner S, Thomson CJH. Good medical practice: professionalism, ethics and law. Port
Melbourne: Cambridge University Press; 2016. ISBN 9781938182679

RANZCOG statements and guidelines https://ranzcog.edu.au/statements-guidelines

Pregnancy Care Guidelines https://www.health.gov.au/resources/pregnancy-care-guidelines

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