Wessex Intensive Care Society (WICS)

Nigel Chee's Guide to the FFICM exam - what to expect

Author: Dr Nigel Chee
Follow @nigelchee


What can I add to Dr Wong’s guide?

Having navigated the second sitting of the exam (Sept 2013) I can offer some insight into the consistency of the exam and anything I learnt from the Adrian from the first.

Make sure you budget enough time for the exam. Despite being told it’s aimed at ‘intermediate level’ training, that’s not to say it’s a simple exam. Final FRCA was intermediate level too. Don’t take the exam lightly.

Did I follow Adrian’s approach? In parts - I too did not read Oh’s Intensive Care Manual nor the Oxford Desktop Reference. If you have either of them or the time and want to use if for some core knowledge then I think it would be useful- but not necessary. I read the last two years of relevant
BJA CEACCP journals and the JICS articles as well. The ICS website has some guidelines which are ripe for questions.

In addition to the resources already mentioned,
Crit-IQ was quite helpful as they had a bank of MCQ questions marketed at the FFICM audience and reasonably up to date journal club and podcasts, although you have to pay now for access.


MCQs

Practise, practise, practise…
The Final FRCA RCOA book was helpful, Bennington (the green one) and also the online resources mentioned. Doing them a couple times over seemed to help me. I didn’t notice it being overly anaesthetically orientated, but then they’re both intertwined.

OSCE

The OSCE consists of 13, seven minute stations with a one minute reading time between stations. All stations must be attempted, there are no ‘killer stations’ and the negative marking is not used. There are 12 ‘live’ stations (marks counting towards the final mark) and one station used for validating new questions (the test station). Neither the examiners nor the candidate will be made aware of the test station, therefore all 13 stations must be approached equally. The examination draws questions from four different areas, Data, Equipment, Professionalism and Resuscitation.

After the first sitting of the OSCE Crit Eye wrote in the Aug 2013 edition,

‘Examiners found that the weakest examination stations were those involving ECG and X-ray interpretation. It would be our intention to continue including such stations in future examinations in an attempt to improve standards in these areas.’

Pay heed to this - in my OSCE about half the stations were ECG or radiology related (including trying to identify the compartments of the calf). The imaging quality has improved and there weren’t any grumbles about poor quality radiology.

My only other advice is to remember the basics - e.g. for a procedure related station -
‘Introduce yourself, get consent from patient/ full monitoring/ staff/ resuscitation equipment available etc..’ they are all ticks on the mark scheme. Also try to keep talking (bullet point answers sometimes required) - once the examiner has moved on, you can’t go back to get marks. Don’t waffle prose in the OSCE, there simply isn’t time for you to mention the latest article or esoteric origins of the disorder/ case.

Structured Oral Exam (i.e. the Viva)
You should all have experience in these exams by this sitting. My advice (which I wish I’d taken) would be to get into small groups and practice viva-ing each other or get a consultant to do this. Skype/ FaceTime vivas work too. The essence of which is to get practised at talking and structuring your answers again. Depending on your department, organising practise session may not be so easy so definitely start early.

Courses

I did not attend any MCQ courses for this exam, for the 2nd part I did attend the PINCER course held in Portsmouth - which I found invaluable. Highly recommended.

On the day

So what’s my recollection of the OSCE/Viva?
Well, it began in a hotel room just off Bloomsbury Square. Suited and booted it was a quick walk to the college where I signed in, picked up my candidate number and then fumbled for a £1 coin to use in the locker rooms downstairs. Back in the foyer, now wearing a classy ‘wristwatch locker key’ I nervously acknowledged the presence of the other warriors. There were 8 of us in total; some looking relaxed and chatting whilst others were a little more pallid. Fifteen minutes before the Viva, we were greeted and had the rules of the day read out to us. We were then ushered up to the second floor where we sat with plastic cups of water awaiting further instruction - this is your last time to go to the bathroom before the start.

The exam room has two parallel sets of stations lettered A-D. Starting at your designated station, you have two vivas (7 minutes each) per station before the bell rings and you move on. The stations are partitioned off from one another and pinned to the outside of each station is a sheet of paper with the heading of each viva topic. This may give you some valuable organising time in your head or stress you out even more. Either way forewarned is forearmed. At the bell, you enter the cubicle with a desk and two examiners +/- an observer. After a brief meet and greet you sit down and wait for the fun to begin. Remember to smile.

The examiners are usually quite friendly and will not set out to trip you up. If you have a disaster station you should block it out; I’m not sure how exactly - but like being dumped for the first time, it hurts but move on. You can score a zero for a question scrape a 1 in another and still pass, so don’t give up whatever they throw at you.

Before the OSCE we were again taken to a room where we were briefed and given our starting station number. Each station is numbered and you rotate around. There maybe reading material before you enter, so have a look around. The afternoon was a little tiring and it’s difficult to gauge how you’re doing. In some stations you’ll be pushed to finish whilst others they’ll be time for small talk afterwards. After a gruelling afternoon, you may customarily find yourself at the Square Pig across the road.

For any further information please email me:


Good Luck!

Nigel


Declaration of interest from webmaster: Steve Mathieu who edits the WICS website is also a co-director for the non-profit PINCER course and is an ICM consultant in Portsmouth (Wessex). He has not contributed to or influenced this guide. There is also (amongst other) courses, the ICS national revision course and details for this can be found on the ICS website
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