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Predicting general practice trainee summative fellowship exam performance using commencement-of-training formative
Alison Fielding1,2, Irena Patsan1,2, Elizabeth Holliday1
1School of Medicine & Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW, 2308, Australia.
BMC Medical Education
|May 27, 2026
Summary
Formative pre-general practice assessments (PGAs) predict future success in fellowship examinations. Early identification of general practice trainees needing remediation can be achieved through these initial assessments.
Area of Science:
- Medical Education
- General Practice Training
- Vocational Training Assessment
Background:
- Fellowship examinations assess general practice trainee competency for unsupervised practice.
- Early identification of at-risk trainees facilitates proactive remediation.
- This study explored the predictive utility of early formative assessments for summative examination performance.
Purpose of the Study:
- To determine if formative pre-general practice assessments (PGAs) predict performance on summative fellowship examinations.
- To assess the utility of early-stage assessments for identifying general practice trainees requiring remediation.
Main Methods:
- Retrospective cohort study analyzing data from Australian general practice training.
- Formative assessments included a written Key Feature Problems test (PGA-KFP) and an Objective Structured Clinical Examination (PGA-OSCE).
- Multivariable regression examined the association between PGAs and first-attempt scores on fellowship examinations (Applied Knowledge Test, KFP, OSCE).
Main Results:
- Higher scores on both PGA-KFP and PGA-OSCE were associated with higher scores on fellowship examinations (Fellowship-AKT, Fellowship-KFP).
- PGA-KFP and PGA-OSCE scores significantly predicted Fellowship-AKT and Fellowship-KFP performance.
- Higher PGA-KFP scores were predictive of passing all three fellowship examinations on the first attempt.
Conclusions:
- Intensive formative assessments at the start of training predict final fellowship examination performance in general practice.
- These assessments are valuable for the early identification of trainees needing remediation.
- Further research should investigate the predictive value of less resource-intensive formative assessments.
