How global scoring works (and why borderline candidates fail)

Many candidates believe RACGP exams are purely checklist-based. While specific actions matter, examiners also apply a global judgment about a candidate’s overall safety and competence.

This global assessment plays a significant role in determining outcomes, particularly for borderline performances.

“Borderline candidates don’t fail on one mistake — they fail on cumulative uncertainty.” - A/Prof George Eskander

What global scoring reflects

Global scoring reflects examiner confidence in a candidate’s ability to practise safely and independently. It considers:

• consistency of reasoning
• clarity of communication
• prioritisation of risk
• organisation of management
• response to uncertainty

A single minor error rarely causes failure. Repeated small lapses create doubt.

How candidates drift into the borderline zone

Candidates often drift into borderline territory when they:

• hesitate repeatedly
• contradict themselves
• miss red flags intermittently
• provide vague safety-netting
• require excessive prompting

These patterns reduce examiner confidence, even if individual answers are correct.

How to protect your global score

Strong candidates protect their global score by:

• maintaining structure throughout
• verbalising risk consistently
• acknowledging uncertainty safely
• escalating appropriately
• remaining organised under pressure

Conclusion

Global scoring rewards consistency, safety and clarity over perfection. Candidates who demonstrate reliable clinical reasoning throughout the station are far less likely to fail borderline.

Reference
Schuwirth LWT, van der Vleuten CPM. Programmatic assessment: from assessment of learning to assessment for learning. Medical Teacher. 2011.