Examination Structure

There are two formal examinations which trainees must pass during their training period - the written and the practical.  These exams are usually held approximately two months apart on a weekend in September and November each year.

Written Exam

This exam comprises two papers – Paper A and Paper B.  Each paper is of three hours duration with candidates given an extra 15 minutes reading time for each paper. There will be five questions on each paper with each question worth 20 marks. Each question is broken into several sections.

Venues are selected when the residence of applicants is known.  Applicants will be required to travel if there are not sufficient candidates to justify setting up a centre in their state.  Each venue is overseen by an Invigilator who is co-opted by the Assessment Subcommittee. 

Paper A comprises the following topics:

Paper B: The topics for this paper are drawn from competencies not tested in Paper A.  These may include:

The questions are set by a pair of examiners and marked independently by each of these examiners using a marking guide.

Candidates are required to demonstrate competence in all questions of the written papers and a very good result in one question will not offset a very poor result in another question.

Practical Exam

This examination is held in one capital city in Australia.  The examination comprises the following six stations, through which each candidate rotates:

Two Exhibit Based Assessments (20 minutes each)
Two occupational history-taking exercises (two simulated patients, 30 minutes each).
Two Short Case Clinical Examination stations (15 minutes each)

Further details about each of these stations are outlined below.

Exhibit Based Assessment

This examination will comprise a series of exhibits which may include x-rays, spirometry results, blood tests, audiograms, pathology specimens or the results of biological monitoring tests, occupational hygiene equipment, toxicological or occupational hygiene data, photographs of safety or ergonomic problems or some safety statistics.

Two examiners will be present, one to score on a set marking guide, the other to pose questions relating to the exhibits.  For example an x-ray of a case of pneumoconiosis may be presented along with some air monitoring sampling heads, or respirators.  The candidate may be asked to diagnose the medical condition and select the most appropriate sampling head to use in a workplace air monitoring survey or the most appropriate respirator.

Occupational History Taking Exercises


The occupational history taking exercises are based on the principles of Objective Structured Clinical Assessments (OSCAs), which have been shown to be a reproducible and standardised method of assessing problem-solving skills. 

At each of these stations, candidates are required to take an occupational history from a simulated patient, who plays a role consistent with an occupational medical problem.  The scripts for these roles comprise a standardised history which includes such factors as clinical symptoms, relationship with work, past occupational history, relevant exposure information, relevant past medical history and other important lifestyle factors. 

The histories, along with pre-set, standardised marking guides, are developed by members of the Assessment Subcommittee and co-opted examiners.  Clinical scenarios may include the identification of occupational causes of a medical problem, assessment of impairment for return to work, a pre-employment medical or a rehabilitation problem.

Thirty minutes is allocated to each station.  Before seeing the patient, the candidate is handed a brief referral letter about the patient.  The candidate has a period of two minutes to read the letter and consider it before being called into the examination room to interview the simulated patient.  This two minutes is part of the 30 minutes allocated for the station.

The period allowed for interview is 18 minutes.  During the interview, an examiner allocates marks according to a pre-set marking guide for those relevant points raised by the candidate.  The marking guide provides quite limited discretion on the part of the examiner.  At the end of eighteen minutes, the interview is brought to a close by the examiner, who then asks the candidate two or three predetermined questions during the remaining period.  Extra clinical material, such as an x-ray, test result or photograph may be presented to the candidate as part of these additional questions.  Examples of possible questions are "What is the most likely cause of this patient’s condition?" or "What investigations would you wish to order for this patient?" or "What further worksite assessment would you conduct?" or ‘What advice would you give?”

The candidate is not required to physically examine the simulated patient.

The total marks for a candidate awarded at each station (20 marks) are made up of:

Short Case Clinical Examinations

The examination format will require candidates to be examined on two short cases.  Each case will be scored independently by two examiners.  Short cases are designed to assess the technique of physical examination, the ability to elicit physical signs and the ability to interpret and place appropriate significance to these findings.  As part of the candidate’s assessment of the findings they may be asked to comment on relevant diagnostic tests, eg. x-rays, spirometry and/or nominate appropriate investigations.

There will be one short case per 15 minute session.  There will be two such cases in the examination. 

In the 15 minute short case the candidate will usually be asked to physically examine the short case.  These will be real patients and not actors.

The candidate will be asked to:

There will be two examiners.  On occasion a third person may be present but will act only as an observer during the examination.