MAFP/icFRACGP Part 1 common mistakes
MAFP/icFRACGP Part 1 · Understand the traps and how to avoid them.
When a KFP-style scenario asks what you would do next, you answer with the definitive management or the diagnosis instead of the single most appropriate immediate step (for example, choosing 'start antibiotics' when the correct next action is 'ask about red-flag symptoms' or 'arrange urgent same-day assessment').
Candidates read the stem as a knowledge recall question and jump to the answer they know best, ignoring the words 'next', 'first' or 'most appropriate'. The format rewards sequencing and safety, not maximal information.
What to do instead
Before answering, underline the question's action word and rank your options by 'what must happen in the next few minutes/hours to keep this patient safe'. Practise 20 stems where you write the immediate next step before considering management, and check yourself against the principle that history/safety-netting/appropriate referral usually precedes definitive treatment.
Ignoring the patient's stated ideas, concerns and expectations (ICE) in a communication station and moving straight to a biomedical explanation and plan.
Under time pressure, candidates default to checklist questioning and treat ICE as optional small talk. They also fear that exploring concerns will 'waste' consultation time.
What to do instead
Use a fixed opening: 'What were you hoping we'd cover today?' then explicitly elicit 'What worries you most about this?' and reflect it back before explaining. In practice, time three consultations and note that ICE takes under 90 seconds when asked early; build it into the first two minutes as a non-negotiable step.
Failing to safety-net or provide explicit follow-up criteria when managing an undifferentiated or self-limiting presentation (e.g. a child with fever, a woman with abdominal pain).
Candidates assume the consultation ends when the diagnosis or prescription is given, and they omit the 'if this happens, do this' component because it feels like extra content rather than core care.
What to do instead
Adopt a standard closing script: specific symptoms to watch for, a time frame, exactly who to contact and how (e.g. 'if the fever persists beyond 48 hours or she becomes drowsy, call the practice or attend the emergency department'). Write this out for your five most common presentations and rehearse saying it aloud.
Applying adult dosing, adult reference ranges or adult decision rules to children, or failing to weight-base a paediatric drug dose.
Most revision material and clinical exposure is adult-heavy, so candidates pattern-match to adult thresholds; paediatric presentations are less frequent in training and numbers are easily misremembered.
What to do instead
Build a one-page paediatric reference card (weight-based paracetamol/ibuprofen/antibiotic doses, normal heart and respiratory rates by age, fever red flags under 3 months) and test yourself weekly. In any paediatric question, first state the child's age and weight and recalculate before choosing an option.
Missing the perinatal or postpartum context in a woman's presentation - treating a mood change, hypertension or bleeding as a general adult problem rather than a pregnancy-related emergency.
Candidates compartmentalise 'women's health' as contraception and screening, so they do not screen for pregnancy status or recent birth when assessing headache, breathlessness, abdominal pain or low mood.
What to do instead
Add two automatic questions to every woman of reproductive age: 'Could you be pregnant?' and 'Have you given birth in the last 12 months?'. Memorise the postpartum red flags (pre-eclampsia up to 6 weeks, postpartum haemorrhage, sepsis, VTE, puerperal psychosis) and treat their presence as an escalation trigger.
Treating risk assessment in mental health as a tick-box question ('any thoughts of harm?') rather than a structured assessment of intent, plan, means, protective factors and immediate safety.
Candidates are anxious about asking directly and fear 'putting ideas in their head', so they use vague euphemisms and accept a 'no' at face value.
What to do instead
Learn and rehearse a direct script: 'Have you had thoughts of ending your life? Have you thought about how? Do you have access to that? What has kept you going?'. Document intent, plan, means, protective factors and the agreed safety plan, and know your local escalation pathway for same-day mental health assessment.
Failing to recognise and act on red flags in older patients - attributing weight loss, falls, confusion or functional decline to 'just ageing' rather than pursuing serious pathology.
Ageist framing and the atypical presentation of illness in older people lead candidates to accept non-specific symptoms as normal; the exam deliberately tests whether you investigate.
What to do instead
Use a structured review for any older patient with a new functional decline: medication review (including anticholinergics and polypharmacy), delirium screen, falls history, and consideration of malignancy, infection and depression. Practise writing a problem list that separates 'chronic stable' from 'new and unexplained'.
Confusing the legal and ethical frameworks - breaching confidentiality without a clear legal basis, or conversely refusing to share information when a mandatory or permitted pathway applies (e.g. child protection, notifiable diseases, fitness to drive).
Candidates conflate 'consent', 'capacity', 'confidentiality' and 'mandatory reporting', and are unsure which rule overrides which; they also forget that the public interest exception is narrow and must be proportionate.
What to do instead
Make a comparison table of the four concepts with a one-line definition and a worked example each. Learn the specific statutory notification requirements in your jurisdiction and the steps for assessing capacity (understand, retain, weigh, communicate). For any confidentiality question, state the legal basis explicitly before deciding.
Answering population-health questions at the level of the individual patient - recommending a single screening test rather than applying the principles of screening, prevention, equity or population-level intervention the question is testing.
Clinical training rewards individual management, so candidates miss cues such as 'population', 'programme', 'priority' or 'most cost-effective' and default to the consultation they know.
What to do instead
Before answering, identify whether the question is about an individual or a population, and if population, apply the screening criteria (important condition, acceptable test, effective treatment, acceptable to population, cost-effective) and consider equity and access. Review the distinction between primary, secondary and tertiary prevention with one example each.
Overlooking the professional and ethical role in day-to-day scenarios - accepting a gift or a friend request, treating a relative, or failing to recognise and manage a conflict of interest, boundary issue or own impairment.
Candidates treat professionalism as abstract theory and do not recognise it embedded in ordinary consultation vignettes; they also underestimate the expectation to disclose and manage, not simply avoid.
What to do instead
For every scenario ask 'whose interests are at stake?' and 'would I be comfortable if this were reviewed?'. Learn the standard responses (decline or declare, document, discuss with a colleague or supervisor, follow the practice policy) and rehearse how to have the awkward conversation out loud.