The FJFICM Final Exam Structure

© James Austin 2007

From 2008, the FJFICM Final Exam will consist of:

• Two written papers, each lasting two-and-a-half hours (150 minutes) and consisting of 15 Short-Answer Questions. That's ten minutes per question folks, including reading time! Both written papers are written on the same day (writer's cramp, here we come). From 2008, the Equipment and Data Interpretation elements of the exam (formerly included in the OSCE) will be incorporated into the written papers. A pass of 50% on the written paper is required to qualify for the Oral exams.
• Two 'Hot Cases' of 20 minutes each. This involves being introduced to a real live patient on a real live ICU, given a brief outline of their history, and asked to examine them with a view to answering a specific question (e.g. "What do you think his prognosis might be?"; or "How would you manage him over the next 24 hours?"; or "What do you think the source of his fever might be?"). You might have ten minutes or so to examine the patient (you can ask questions about relevant background history, current management, observation charts etc); and then the examiners will have ten minutes or so to examine you. They will often feed in relevant investigations as the discussion develops. The emphasis is on being efficient, thorough, and accurate with your examination; and being able to put your findings together into a sensible assessment and management plan for the patient, at the level of a junior consultant. Basics such as hand hygiene and consideration for the patient are, of course, paramount.
• A set of eight vivas of ten minutes each. Most of these consist of an initial clinical scenario, with questions developing down a pre-determined structure with a pre-determined marking scheme (you're not at the mercy of the examiner's whim!). One viva will be a Communication Station, where you will have to demonstrate some (usually stressful) conversational skills with an (often very convincing!) actor. One viva will be a Skill Station typically involving a practical demonstration of either resuscitation, or use of some piece of ICU technology. Occasional vivas have focused on non-clinical scenarios, such as evidence-based medicine, or audit and quality assurance.

The total mark is derived as follows

• 30% from the Written Papers
• 40% from the Vivas
• 30% from the Hot Cases

To pass, you have to achieve a minimum of 50% overall; a minimum of 50% (15/30) in the Written Papers (to qualify for the Oral exams); a minimum of 40% (12/30) in the Hot Cases; and fail no more than one section.