FFICM Examination Report March 2021

The FFICM exam forms an important part of the summative assessments within the ICM CCT programme, and hence is part of the quality assurance that doctors in training who complete the programme are equipped to provide safe and effective care to the public across the whole of the ICM curriculum. 

The pass rate for the October 2021 OSCE section of the FFICM examination was unexpectedly low. The SOE section also had a lower pass rate than previous sittings, but less marked than the change in OSCE score. Although set from the same curriculum, the two sections test different skills and test knowledge in different ways so it does not follow that the pass rates for the two components should be similar in any exam sitting.

All sections of the exam are under constant review, looking for ways to improve the content, delivery, and standard setting. This will continue and will include an external review of the FFICM and FRCA examinations in 2022. The Faculty has committed to developing more examination resources and guidance for candidates in 2022. The subgroup developing this is staring work this month.

Our exploration of all aspects of the October 2021 OSCE has been unable to find any evidence as to the cause of this low pass rate. Specifically, there is no evidence to suggest that the standard of the exam has changed between diets. 

The cohort of candidates sitting the exam may have had a substantially different training experience through the 2020 and 2021 Covid pandemic than has been appreciated. This cohort of examinees is in motivation, commitment to ICM and intelligence equivalent to previous historical cohorts, though their experiences and teaching has been different. This does not mean that they have less future potential to be equally competent intensive care physicians, but they are different in their preparation likely consequent to the pandemic. Likewise trainers have had to deliver training in a different way and examiners have moved to an online platform. The ramifications of the pandemic on working life and training experience, together with the psychological and social impact outside of the work environment cannot be overstated. The impact of the pandemic on training and experience may not be by itself an explanation for the low FFICM OSCE pass rate but may represent an additional impact on other previously unmeasured contributory factors. 

My thanks go to the college exams team, who work hard to enable the running of these exams and also to the examiners (who are all busy ICU consultants) who spend time preparing, modifying questions as well as delivering the oral exams. In particular I would like to thank Jerome Cockings (Deputy Chair) and Jeremy Bewley (MCQ subgroup lead), Anthony Bastin (OSCE subgroup lead) and Barbara Philips (SOE subgroup lead) who lead the exam sub-sections.