What do I have to do to sit the FCICM?

© James Austin 2011

There are two main routes to sitting the FCICM. Most candidates are trainees from Australia, New Zealand or Hong Kong, for whom training requirements include:

• A six-year training programme, consisting of three basic training years (BTYs), and three advanced training years (ATYs). The six years must include:

1. At least 36 months of ICU (12 months in BTYs and 24 months in ATYs). At least one of the ICU 'core years' must be 12 months continuous training in an approved unit; and at least 12 months must be spent in 'C24' approved units in Australia, New Zealand or Hong Kong (there are C12 units in  England, Ireland, India, Singapore and Canada);
2. At least 12 months of anaesthetics; 
3. At least 12 months of internal medicine (or paediatric medicine for PICU trainees), of which 6 months should be at registrar level; 
4. The remaining training time may involve any combination of intensive care, anaesthesia, internal medicine, surgery, emergency medicine, research or other relevant experience. See CICM's Training Program for the full info.

• Passing the FCICM Primary, or the FRACP (Australian MRCP), or the FANZCA (Anaesthetic) Primary, or an equivalent exam, prior to commencing ATYs.
• Completion of the ADAPT course (Australasian Donor Awareness Programme).
• 'Formative assessments': Examining and presenting four ICU patients to your local supervisor in the six months prior to sitting the FCICM Final Exam (as a warm-up for the clinical 'Hot Case' exam).
• Passing the FCICM Final exam, available in either adult or paediatric flavour. Either exam involves a written component (short-answer questions), clinical exams in intensive care and general medical cases, and a viva exam (the OSCE exam was dismantled in 2008). You must have completed the basic training (BTYs) and at least one 'core year' of advanced training (ATY) before you can sit the exam.
• A 'Formal Project' - this "should preferably be a prospective scientific study, but may be an evidence-based systematic review, a retrospective study or a case series. Individual case reports will not be accepted." The formal project may be completed after the exam.

An alternative route to sitting the FCICM, for those who have already completed Intensive Care Training in another country and wish to live and work in Australia, is via assessment as an Overseas-Trained Specialist (OTS). Being granted specialist recognition does not automatically lead to being granted the FCICM - you can only become a FCICM if you sit the exam - but assessment as an OTS allows you bypass some or all of the training requirement, if you have received similar training overseas. Application is made via the Australian Medical Council (AMC), with a tremendous amount of paperwork. The AMC refers such applications to the CICM, which will compare your training and qualifications to those of Australasian trainees. For specialist recognition, the CICM will often require that you spend a year or two in 'supervised practice' in Australia, and may require you to sit their exam as well (without going through the requirements listed above - though you still have to do the 'Formative Assessments'). Once you have satisfied them that your training and qualifications are equivalent, you may be recognised as a specialist; if you want to go on to become a FJFICM, you must then still sit the exam, though you may be exempted from the written part of the exam.

A similar system for Overseas-Trained Specialists operates in New Zealand via the MCNZ. However, my impression is that it is somewhat easier to work as an intensivist without having the FCICM in New Zealand than in Australia, particularly in the district hospitals.