RACP BPT DCE Rubric Explained
What is the RACP DCE rubric?
The RACP BPT Divisional Clinical Examination rubric scores each long case across six domains: history taking, physical examination, investigations and interpretation, diagnosis and formulation, management, and communication. Short cases are scored on examination accuracy, interpretation of findings, and patient communication. The pass standard is set per sitting using a standard-setting process rather than a fixed cut-score. Source: RACP DCE handbook. Domain-by-domain breakdown below.
The Divisional Clinical Examination (DCE) is the clinical component of RACP Basic Physician Training. It sits alongside the Written Examination and consists of a long case and short cases assessed by consultant examiners. This page walks through the marking domains used in each, and how to align practice to the way examiners actually score the encounter.
Overall DCE structure
- Long case: 60 minutes alone with the patient (history and examination), a brief independent thinking period, then around 25 minutes of presentation and discussion with two consultant examiners. Most sittings include two long cases.
- Short cases: focused clinical tasks of around 15 minutes each, typically four short cases, each marked by two examiners.
- Long cases and short cases are scored independently and combined against the standard set for that sitting.
Long case marking domains
Examiners score each long case against a set of domains covering data gathering, reasoning, and management. The exact descriptors evolve, but the marking framework consistently includes the following:
History taking
- Active problem identification, including a coherent timeline.
- Screening for relevant comorbidities, medications and adverse effects.
- Functional, social and occupational context (not bolted on at the end but integrated into the formulation).
Physical examination
- Targeted examination informed by the history, not a head-to-toe ritual.
- Accurate elicitation and reporting of signs.
- Recognition of when a sign is absent versus not assessed.
Investigations and interpretation
- Selection of relevant investigations with reasoning, not a shopping list.
- Interpretation of available results in the context of the formulation.
- Acknowledgement of investigation limitations and what would change management.
Diagnosis, problem list and formulation
- A prioritised problem list ordered by clinical importance.
- Differential diagnosis with supporting and refuting features for each.
- Integration of comorbidities so the formulation reflects the whole patient.
Management
- A plan that addresses each active problem with a clear rationale.
- Risk-benefit reasoning for each proposed intervention.
- Recognition of patient priorities, goals of care and follow-up.
Communication and professionalism
- Clarity and structure of the presentation to examiners.
- Ability to defend reasoning under questioning without becoming defensive.
- Patient-centred language during the patient encounter.
What examiners weight most heavily
Successful candidates report that formulation and management discussion carry disproportionate weight. A complete history and slick examination are necessary but not sufficient. The examiners are testing whether you can integrate the data into a clinical plan that another physician would trust. Candidates who score poorly often present accurate data without an organising structure, or list management options without rationale.
Short case marking
Short cases assess focused examination technique on a specific body system or sign. Each station is run by two examiners. Scoring weights examination accuracy, interpretation of findings, and clear communication with the patient. The framework differs from the long case in that there is little formulation; the candidate is tested on technique and the ability to draw a sensible differential from what they have just examined.
Pass standard
The RACP uses a standard-setting process to set the cut-score for each sitting rather than publishing a fixed pass mark. The standard reflects the level of clinical performance expected of a physician about to enter advanced training, not a fixed percentage. Candidates are assessed against that standard, not ranked against each other.
Practice scaffolds that map to the rubric
- Practise full long cases under time, with a 60-minute patient encounter and a 25-minute presentation. Compressing one half always weakens the other.
- Rehearse the presentation aloud. Most candidates over-rehearse silently and under-rehearse out loud, which is the format examiners actually score.
- Maintain a problem-list discipline. After every patient encounter, write a prioritised list before writing anything else.
- For short cases, drill examination sequences with a partner who can interrupt with examiner-style questions.
- Get feedback from at least one consultant who has examined the DCE recently. The hardest part to self-assess is whether your formulation actually holds together.
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Start free trialFrequently asked questions
How is the RACP BPT DCE long case scored?
Two consultant examiners score each long case independently against the RACP marking domains, then their scores are combined. The domains cover history taking, physical examination, investigations, diagnosis and problem list, management planning, and communication. Each domain is rated on the college's marking scale published in the current DCE handbook.
What is the cut-score for the RACP BPT DCE?
The RACP sets the pass standard for each DCE sitting using a standard-setting process rather than publishing a fixed numeric cut-score. Candidates are assessed against the standard for that sitting, not ranked against each other. The current methodology is described in the official DCE examination handbook.
What do RACP consultant examiners weight most heavily in the DCE long case?
Case formulation tends to carry the most weight. Examiners look for a problem list that prioritises issues by clinical importance, an integrated diagnosis that accounts for comorbidities, and a management plan that addresses each active problem with a clear rationale. Strong history and examination data are necessary inputs, but candidates who pass typically demonstrate higher-order reasoning across the formulation and management domains.
How long do I have to present a DCE long case to the consultants?
Candidates spend 60 minutes with the patient (history and examination), then have a short period of independent thinking time before presenting to two consultant examiners. The presentation and discussion session runs around 25 minutes total: an uninterrupted summary followed by examiner questions on differential diagnosis, investigation choices and management priorities.
How is the DCE short case marked compared with the long case?
Short cases assess focused examination technique against a specific body system or sign. Each short case runs around 15 minutes and is scored by two examiners on physical examination accuracy, interpretation of findings, and communication with the patient. The rubric weighting differs from the long case, which is dominated by formulation and management.
Where is the official RACP BPT DCE rubric published?
The current marking criteria, domain definitions and standard-setting methodology are published in the RACP Divisional Clinical Examination handbook, available through the RACP trainee resources portal. Candidates should always check the handbook for the sitting they are preparing for, since the college updates wording and domain descriptors periodically.