Wessex ICS Blog

Expanded Case Summaries

Facilitators: Keith Ritchie & Steve Mathieu
Venue: Queen Alexandra Hospital, Portsmouth
Date: 19th August 2015

Introduction: Steve Mathieu
Follow @stevemathieu75

Whether you love them or hate them, the Expanded Case Summaries (ECS) remain an integral part of the ICM Curriculum. They are formative assessments and a useful opportunity to focus your learning on some specific topics within the ICM curriculum. They don’t have to be rare cases, in fact more common day material with lessons may be better than once in a lifetime occurrences.

Screen Shot 2015-08-04 at 15.07.16

How many do I need to do? 10
Over what period? 2 a year
4 stage in 1 (ST3/4); 4 in stage 2 (ST5/6) and 2 in stage 3 (ST7)
How long should they be? Between 750-1500 words (excluding references)
What are they marked out of?
There are 6 domains (each scoring 1-5). A maximum of 30 points can be awarded. 18 is the minimum score to pass. In addition 4 of the 6 domains must score at least a 3
What do scores of 1-5 represent?
5 - outstanding
4 - Good
3 - Pass
2 - Needs improvement
1 - Poor and needs complete revision

And what else?

  • Case summaries should be marked with reference to the marking scheme for ECSs
  • It is intended that the ECSs will be reviewed and scored locally by Faculty Tutors. Over the course of a training programme each trainee should have ECSs marked and scored by several tutors
  • Feedback on the quality of each ECS should be provided to the trainee by the Faculty tutor marking the report
  • The case summaries will be evaluated locally as part of the ARCP programme and it is expected that an assessor from outside the region will be part of this process. In addition, a random number (up to 10%) of these summaries will be assessed centrally
  • The purpose of the case summaries is to allow the candidate to demonstrate critical thinking, knowledge of recent literature in the field of Intensive Care Medicine, critical appraisal and a sound approach to evidence-based medicine
  • It is envisaged that the standard of these case summaries will reflect the stage of training – please refer to the relevant CCT in Intensive Care Medicine curriculum manual for further discussion on ECS content.

extract from FICM guidance March 2013)

More information is available in this document and on the FICM website

Are there more examples of ECS?
Yes. We now have a WICS prize awarded each year for the best ECS. Do remember to submit your best one! Previous winners

2016 - Organ Donation - James Keegan
2015 -
Neurological Prognostication after cardiac arrest: When and how should it be done? Dr Ben Harris

Are there more?
There is now a repository of ECS at

The CCT in Intensive Care Medicine (v2.12015) - Part II. Assessment System


Preparing for the FFICM MCQ

Author: Dave Slessor (ST6 ICM & EM)
Follow @davidslessor

Even though there have now been a few sittings of the FFICM exam there is very little written about the MCQ/SBA part, and consequently I found it difficult to know how to prepare. My base specialty is Emergency Medicine and I was concerned that FFICM was going to be a variation of an anaesthetic exam.

Thankfully I managed to pass the MCQ/SBA exam and have written my thoughts below so that hopefully others will have more idea of what is expected of them.

The MCQ/SBA is very much a clinical exam and an exam on Intensive Care Medicine. Approximately one third of the questions were based on cardiology, respiratory and neurological aspects of intensive care medicine. The majority of the other questions were on other clinical topics including toxicology, renal medicine, infectious diseases, endocrinology and blood gas interpretation.

A number of questions asked about expected mortalities for certain conditions. A little knowledge of the major clinical trials was expected with questions such as treatment X is associated with improved neurological outcomes at 6 months, and Trial Y showed decreased mortality with treatment ‘B.’ All the trials that I got asked about have been covered by
The Bottom Line. I would also recommend subscribing to the newsletter from Critical Care Reviews as this will inform you about all the latest trials.

I based the majority of my revision around the Oxford Desk Reference textbook. It provided a quick way of covering most topics related to intensive care medicine. I augmented this with guidelines from amongst others, the
Intensive Care Society, NICE, BTS, Toxbase, and Public Health England (previously Health Protection Agency). I then did MCQ questions to find my knowledge gaps and then used the CEACCP articles to fill gaps on specific topics.

I used both the
Steve Bennington Multiple Choice Questions in Intensive Care Medicine and Emma Bellchambers Multiple True False Questions for the Final FFICM. I found them both useful, and representative of the exam questions, as were the MCQs on Critical Care reviews. The advantage of the Critical Care Reviews MCQs are they are free and they provide a link to a free review article on the topic. A colleague used the MCQs on Crit-IQ and also found these representative of the questions in the exam.

Having said it was a clinical exam there was still a few questions related to basic sciences but this was by far the minority. I did minimal basic science revision and would recommend others to do the same.

Overall I think it is a fair exam and an exam that I felt was very relevant to my day-to day clinical practice.

Good luck!

(conflict of interest: DS is a senior editor for The Bottom Line)