Start here: StAMPS, the format and how to prepare

StAMPS is a key assessment for ACRRM registrars. It asks you to bring together your clinical knowledge, reasoning and communication skills to demonstrate how you would assess and manage patients in rural and remote practice.

Knowing the medicine is essential, but you also need to communicate how you would apply it. The examination requires you to recognise serious illness, prioritise care, work with available resources and escalate appropriately. Your answers should also demonstrate a holistic, patient-centred approach.

This is why exam technique matters. Developing a clear structure helps you organise your thinking and explain your decisions under pressure. These skills extend beyond the examination—they can also strengthen your approach to patients in everyday practice.

In this course, I will teach you the approach that helped me prepare for StAMPS. I sat the examination in 2025 and supported friends preparing for it in 2026. Now, I want to share that experience with you.

Every practice question on this site is written or reviewed by me to reflect the kinds of scenarios and questions you may encounter in StAMPS. With help from my friends Nik and Rose (who are excellent with computers), we created this AI resource where you can speak to the computer like you would in the real exam and get detailed marking and feedback straight after each scenario. We designed the questions and marking to reflect the format and standard of the real exam as closely as we can.

Many existing resources draw on RACGP exam preparation. Although some skills overlap, StAMPS has its own format, rural context and demands. This website focuses on those differences, helping you build relevant clinical knowledge, develop reliable answer structures and practise applying them.

The aim is to help you approach the examination with a clear method, purposeful practice and greater confidence.

Understanding StAMPS and the examination format

StAMPS stands for Structured Assessment using Multiple Patient Scenarios. ACRRM describes it as a blend of an Objective Structured Clinical Assessment, or OSCE, and a traditional viva voce examination.

You discuss a scenario directly with an examiner. This gives you an opportunity to explain what you would do and why. The assessment is designed to explore higher order thinking within a clinical context, rather than simply testing whether you can list facts or recite a protocol.

The scenarios test core and general principles as well as your response to the particular patient. You may need to start treatment before you have a definitive diagnosis. Information can be revealed progressively, and your initial plan may need to change.

You also need to answer in the context of your environment. For example, identifying that a patient requires urgent imaging is only part of the answer. You also need to explain whether the imaging is available locally, how urgent it is, whether the patient is safe to travel or whether they need retrieval.

The examination format

• The examination is conducted online over approximately three hours.
• There are eight scenarios, each lasting ten minutes.
• Each scenario begins with introductory case information and contains three questions.
• Additional information may be supplied as the scenario unfolds.
• Candidates have a designated virtual examination room and rotate between examiners.
• The ten-minute interval/ reading time between scenarios is to account for any technical issues and is also your reading time.

You have ten minutes to answer per scenario. Dividing that time evenly gives approximately three minutes and twenty seconds per question, before allowing for the examiner to speak or provide additional information. So, I would be aiming to make most of your answers to be around 3 minutes per question.

What examiner prompts mean?

The handbook explains that an examiner may ask you to clarify an unclear answer or expand an answer that lacks sufficient detail. Do not rely on the examiner to guide you through the essential management. If you are asked for detail, answer that request directly.

A prompt is not automatically evidence that you have failed. It may be an opportunity to make your reasoning clearer. Equally, an absence of prompts does not prove that your answer is complete. Practise giving answers that make your priorities and reasoning easy to follow without needing repeated clarification.

Understanding scoring

Each scenario is scored in several areas, each out of 7:

The number of scored areas and the maximum total changed in 2026, so check the current ACRRM Handbook for Fellowship Assessment for the details of your sitting.

For each scenario you get a score out of 7 for each question. You need to provide a structured approach that is appropriate to the rural and remote context.

On top of this you get a score out of 7 for each of the following elements:

Systematic approach – Use a clear, structured approach for each question type. This is what I will teach you below, helping you organise your answers and cover the key points with confidence.

Communication and professionalism – Show how you would communicate sensitively and empathetically with patients. Explicitly mention maintaining confidentiality, exploring the patient’s perspective and giving them an opportunity to ask questions. It is easy to focus on the medical details and overlook these essential aspects of care. A statement such as, “I would use a sensitive and empathetic approach to explore the patient’s understanding of the diagnosis and any concerns they may have,” helps demonstrate these skills to the examiner.

Adapting to your setting (scored on its own before 2026, and still essential in every answer) – Adapt your approach to the setting in which you are working, particularly in rural practice. Consider how available resources, distance from specialist services and local support may affect patient care. Show that you can make effective use of the resources available, develop a realistic management plan and recognise when additional support or referral is needed.

The FACRRM standard and review process

In addition to the numerical scores, the examiner judges whether your performance is at the expected FACRRM standard for each scenario. These judgments can identify performances requiring review before results are submitted to the Board of Examiners for ratification.

Your result combines your total score with the number of scenarios judged to be at standard. Results close to the pass mark are reviewed before they are finalised. The exact rules, and the cut score, are set out in the ACRRM Handbook for Fellowship Assessment and can change between sittings, so always check the current handbook.

A review is where an experienced examiner who did not assess the original performance undertakes the review. Review is automatic and does not require a reconsideration application.

Know your town! StAMPSville

The StAMPS examination is set in StAMPSville, so know your town! Understanding the local context and adapting your care to a remote environment are important parts of your answers.

Use the link to the ACRRM website to find the StAMPSville profile and learn it thoroughly. Know which services are available, how many mental health clinicians work in town, and which specialists visit—and how often.

Make your answers specific to the setting. If the profile states that a paediatrician visits monthly, saying, “I would refer this child to the visiting paediatrician, who comes once a month,” demonstrates greater awareness of the local context than simply saying, “I would refer to paediatrics.”

Likewise, if a patient needs a CT scan, consider where it can be performed, how the patient will get there and any barriers to accessing it. Think through the practical details, just as you would in real life.

When I was preparing for the exam, a friend and I regularly quizzed each other on the StAMPSville profile until we knew it inside out. I encourage you to do the same. The practice scenarios on this site are set in Wattle Creek, our own fictional rural town with its own community profile, so you can practise using local knowledge in exactly the same way.

You can find the StAMPS community profiles on the ACRRM website: StAMPS Community Profiles (opens in a new tab)

The preparation period

In my experience, you should allow at least four to five months to prepare for this exam. Use the first one to two months to develop your answering style and build a clear structure for each question type. Aim to spend around an hour a day working through straight forward cases, focusing on how you organise and communicate your answers.

During the final three months, make regular case practice your priority. I aimed for three cases a day during the week and five to seven cases a day on weekends. That will not be achievable every day, but having a target helps you build consistency. Using this tool, three cases should take approximately two hours.

Alongside case practice, review the clinical content, but keep your study focused and practical. Concentrate on assessing and managing common presentations, recognising dangerous diagnoses, and taking a targeted history and examination. Aim for the breadth of knowledge needed for rural generalist practice rather than spending hours studying specialist-level management.

Clinical knowledge alone is not enough—you need to practise cases. You must be able to turn what you know into a clear, structured answer that addresses the question and demonstrates your clinical reasoning. Practising aloud helps you develop that skill, identify gaps and deliver your answers with confidence under exam conditions.