The 2005 Experience

My thanks to two successful candidates for their accounts and advice from 2005, and their permission to publish these.

© James Austin 2005

Before the exam:

Dissertation: Pick a topic you are interested in and have a good general knowledge of. The abstract submitted in advance is given careful consideration by the examiners, so it is worth taking time to get it right. Try to pick a smallish topic, in particular one which has a small number of references ie less than 60. I was hammered on my methods of selection of articles for review in the viva! Less controversial is probably best - even if you know your subject well. Make sure you have a supervisor who will give you a lot of input. A previous DICM candidate would be ideal. I could easily have failed because of this.

Case summaries: Any glitches in your case summaries WILL get noticed and you WILL be asked to explain them. This doesn't mean the summaries must be perfect but try to anticipate criticisms and have an answer. I was lucky in that there was a lot of overlap between my summaries and the general viva topics so pick these carefully too eg ARDS is a good idea!

General reading: Intensive Care Monitor was great for knowing the papers, whilst Oh’s Intensive Care Manual was good for general reading. Current Opinion in Critical Care was interesting, albeit in far more detail than you need for this exam. Classic Papers is a good book but of little relevance to this exam.

The Exam:

Dissertation (1 hour): Questions will extend well beyond those papers you discussed. Your method of literature search will be looked at closely!

ETR viva (30 mins): I got asked about things I hadn't ticked, including ethics and recent cases in the media re withdrawal etc. Anything can come up.

Case reports (30 mins): Spend months preparing for this then get asked about the one thing you didn't read up on! Only four or five of my cases were discussed. I don't think the summaries have to be of publication standard or the cases well managed but know the topics well.

General Vivas (2 x 30 mins): All structured questions with a model answer. Sepsis guidelines (name the grade A recommendations), burns, hypothermia, pulmonary hypertension, steroids (sepsis and meningitis), ARDS pathophysiology and ARDSNet trial (strengths, weaknesses and controversies) and several more topics besides. I expected to be asked in detail on a range of recent trials and although several came up I knew them in more detail than there was time to give in the exam. For example the single most detailed question was the size of the mortality reduction in the ARDSNet trial. With hindsight more general preparation in particular for the ETR viva would have been time well spent.

The results turned up in the post about ten days later. I think the format may change next year as more people sit the exam (see below - Ed.). It is well worth finding an examiner to keep you updated on this.

Good luck!

------------------

Thanks for the help which your web site provided - just sat the exam on the 26th. Must say it was quite fair (except the dissertation viva - where they seemed to wander off the topic completely, but I passed, so I suppose I can not complain!). Very much asked about the domain questions, in fact we were given the paper found on the web site for the board (Appendix 2 in the DICM Regulations - Ed.) and carried it around with us from viva to viva. The questions for the general vivas were pre written and fair enough. Although everyone got some very bizarre questions (like who first described the rule of 9's for burns - I developed the blank look at this point), I think they were simply to test the depth of knowledge and were not of the pass/fail variety.

Papers asked about were really only the major ones which they asked in some depth ie what were the 3 class A evidence suggestions on the surviving sepsis paper. I knew 2 but had to guess the third! Tim Evans questioned me about ARDS! We got into some depth on the problems with the ARDSnet paper but again it was near the end of the viva. I felt that the questions were really quite general otherwise and the exam tested more general ITU knowledge than I expected.

I have heard rumours that the exam is changing format in the future to more of an OSCE type. Not sure how true this is (From 2006 the two ETR vivas will be replaced by a single viva, covering your case reports, clinical scenarios and general data interpretation - Ed.).

Thanks again for your web site - it was very useful.