FFICM Examiners Report October 2019

There were 13 visitors to the exam over both days of the SOE and OSCE, all UK ICM consultants. The visitors’ feedback included positive comments on the fairness and equity in the way examiners treated candidates. They felt that the standard of the questions being asked met their expectations for end of stage 2 training, and that some of the questions seemed rather easier than they had expected but were badly answered by a number of candidates.

During examiner call-over, examiners noted that a number of candidates appeared to present themselves for examination with either inadequate experience or preparation; the examination standard is that of end of stage 2 training (as described in the FICM curriculum) and therefore, can include questions on cardiothoracic ICM, neurosurgical ICM and paediatric ICM topics, as well as general ICM topics and applied basic sciences as relevant to ICM. 

Particular areas where a number of candidates scored badly included ECG and radiology questions in the OSCE, with a number of candidates failing to be systematic in their approach (eg not describing heart rate on an ECG, or not commenting on the name and date, or not commenting on areas such as the visible skeleton or abdomen of a chest radiograph) so lost marks. This has been noted in previous reports.

While some candidates did very well on the ECG questions, others missed important findings such as acute myocardial infarction or atrial fibrillation. 

The use of a ‘scattergun’ approach by some candidates to questions such as, ‘what is the most likely diagnosis?’ was noted, with a large number of (unlikely) answers being given; candidates should be aware that the OSCE marking scheme does not credit one correct answer given in a string of incorrect answers in questions such as this.  

In the SOE section, both visitors and examiners noted that where a good answer contained a number of items, some candidates seemed unable to structure or classify their answers. The SOE questions on weaning from ventilation and heart-lung interactions were noted to be answered very poorly by a number of candidates and in the simulation station of the OSCE, a number of candidates appeared to be ‘task-focused’ and lost marks by not taking an overview of the situation and integrating all the information available. The communication station of the OSCE on breaking bad news was also noted to be answered badly by a number of candidates.