This workflow is for Final FFICM candidates using BMJ OnExamination to revise the written MCQ around a full intensive-care rota. It covers one component: the single-best-answer paper. The principal limitation is that the platform does not reproduce the OSCE or structured oral, and its personalisation is a recap-and-difficulty steer rather than a documented adaptive engine, so you still drive syllabus coverage yourself.
What BMJ OnExamination offers for FFICM right now
The table is the current state as advertised, last checked 20 July 2026. Treat every figure as vendor-reported and confirm it on the product page, because bank sizes and prices move.
| Attribute | What BMJ OnExamination reports (vendor-reported, 20 July 2026) |
|---|---|
| Bank size | 1,000+ FFICM questions |
| Components covered | Written MCQ only; the page references the "FFICM MCQ exam" and does not simulate the OSCE or SOE |
| Personalisation | "Personalised revision," user-selectable difficulty, and a recap of questions you previously found hard |
| Assessment | Editorially curated mock tests |
| Feedback | Performance feedback and peer comparison |
| Social | Group Learning leaderboards |
| Access and price | From £34.99 for one month up to £149.99 for twelve months, with intermediate tiers |
| Free trial | A small set of free questions to try before subscribing |
| Not documented | No published proprietary adaptive-difficulty algorithm, predicted-score model or spaced-repetition engine on the product page |
Two honest points follow. First, this is a written-knowledge product: a reasonable option for the MCQ, but not an OSCE or viva simulator, so it will not prepare the practical or oral components. Second, as the table notes, "personalised revision" is not a documented adaptive engine but a difficulty selector plus a hard-item recap, so responsibility for covering thin syllabus areas stays with you.
The exam you are actually sitting: the FFICM Final MCQ
The Final FFICM MCQ is the gateway written component. On the FICM pages, the current paper is 130 single best answer questions in three hours: 80 short SBAs at one mark each and 50 long SBAs at two marks each, for a maximum of 180 marks. Note the change older revision guides still get wrong: the paper moved from multiple-true-false to single best answer at the GMC's request, completed in June 2022, so there is no longer an MTF component to drill. You must pass the MCQ before applying for the OSCE and SOE, and the pass is valid for three years. Calibrate against the FICM examination regulations and syllabus rather than any third-party summary, including this one.
Baseline week: measure before you personalise
Before you let the platform's recap feature shape your feed, sit a small, blueprint-stratified sample of unseen questions and mark it honestly. A baseline should sample across applied physiology, pharmacology, clinical measurement, statistics and the major clinical systems, not over-represent whichever topic you opened first. A recap feature that only re-serves what you have attempted will raise your average while leaving whole syllabus areas untouched. Your baseline is the reference line every later number is compared with, so take it before personalisation begins.
First pass: set domain floors the steer cannot hide
Set a minimum number of questions you will attempt in every syllabus area, and do not let a rising overall percentage substitute for those floors. The intensive-care blueprint is broad: ventilation, shock, sepsis, renal replacement, neurocritical care including brainstem death and organ donation, obstetric critical care, trauma, toxicology, transfusion, nutrition, sedation and analgesia, end-of-life care and ethics, and the underpinning physics, physiology, pharmacology and statistics. A domain floor of, say, forty attempted items per area forces low-frequency topics onto the screen even when the steer would keep serving familiar respiratory questions.
An error taxonomy for intensive-care questions
Reviewing a miss as simply "wrong" tells you nothing about what to do next. Classify every error into one of six types: a knowledge gap (you did not know the fact, so take a short source read); a misread stem (you missed a qualifier such as "least likely" or a units cue); premature closure (you locked onto a diagnosis before reading the whole vignette); a guideline error (your practice is out of date); a calculation error (the numerate items that recur in critical care, such as the A-a gradient, osmolar and anion gaps, corrected calcium, drug-infusion rates and ventilator maths); and a time-pressure error (right with more seconds). The corrective action differs for each type, and lumping them together is why revision stalls.
Review intervals: not everything deserves a repeat
Immediately re-answering the question you just missed teaches recognition of that item, not mastery of the principle, so route by error type instead. Knowledge gaps get a short, sourced read and a spaced review a few days later. Misread stems and premature closure get a deliberate re-read of the technique, not a content repeat. Guideline errors get a note against the current standard, and calculation errors a fresh worked item with different numbers. Only genuine, isolated slips justify an immediate repeat; a transfer question testing the same rule is almost always more valuable than re-serving the original.
When to follow the steer, and when to override it
Follow the recap-and-difficulty steer when it surfaces genuine weak areas and stretches difficulty as your accuracy climbs. Override it in three situations: when a high-stakes but low-volume topic, such as brainstem-death testing or a specific toxidrome, is not appearing often enough; when the feed drifts toward comfortable topics and your domain floors are not being met; and whenever your overall percentage rises while a whole blueprint area sits unattempted. Because the mechanism is not a published adaptive algorithm, treat "follow the algorithm" as shorthand for following the steer when it agrees with your coverage map and forcing the feed manually when it does not.
The mixed-block switch: objective criteria
Move from topic-filtered practice toward timed random blocks when three things are true: your domain floors are met, your first-attempt accuracy on new items has been stable across a couple of sessions, and you can hold roughly 80 seconds per item without rushing. Topic filters are for building; mixed random blocks test whether the knowledge survives when the next question could be anything. Leaving the switch too late is a common failure: a topic-sorted bank flatters you by removing the hardest step, deciding what kind of problem you face.
Exit criteria that are not "I finished the bank"
Completing every question in a bank is a consumption metric, not a readiness metric. The exit criteria that matter: you have met your coverage floors; your first-attempt performance on unseen, mixed, timed blocks is stable at or above target; your pacing is comfortable; your retention holds when a topic returns after a gap; and you have calibrated against official FICM sample material, not only third-party questions. If those five hold, it does not matter that some bank items remain unopened.
A seven-day plan around a full rota
Here is a realistic week for a trainee working clinically. Days one and two: use BMJ OnExamination for one job, a topic-filtered block in a weak domain each day, every item reviewed and error-coded. Day three: convert the two worst misses into transfer practice on fresh items in iatroX, testing whether the rule survived rather than re-recognising the stem. Day four: a short spaced review of the earlier misses. Day five: a timed mixed block in iatroX for unseen measurement, marked against your baseline. Day six: override the steer to force a low-volume topic. Day seven: rest. BMJ OnExamination does the building; iatroX supplies the unseen transfer check, with no claim about a proprietary algorithm on either side.
Decision checklist: continue, supplement, switch or stop
Continue if your unseen mixed accuracy is trending up and your coverage floors are being met. Supplement with a second unseen bank and the official FICM material if your accuracy has plateaued, or you cannot trust your coverage because the recap feed keeps recycling familiar items. Switch only if the content is materially out of date or you have effectively memorised the bank. Stop topic-filtered practice and move to timed mixed mocks once your exit criteria are met. Base each decision on a measurable gap, never on novelty or sunk cost.
The bottom line
BMJ OnExamination is a credible learning bank for the FFICM written MCQ: a large question pool, mock tests and a recap steer that helps as long as you do not mistake it for guaranteed coverage. Its honest limits are that it addresses the MCQ, not the OSCE or SOE, and that its personalisation is a difficulty-and-recap tool, not a documented adaptive engine. Use it to build, set your own coverage floors, and measure readiness on unseen, timed, mixed blocks elsewhere.
Frequently asked questions
Is BMJ OnExamination enough for FFICM on its own? It is a strong single bank for the written MCQ, but not a complete FFICM programme on its own. It targets the MCQ rather than the OSCE or SOE, and no single bank guarantees full blueprint coverage, so the calibrated approach is to pair it with the official FICM syllabus and sample material and a second source of unseen questions for measurement.
Which FFICM component does BMJ OnExamination not reproduce well? The OSCE and the structured oral examination. The OSCE tests data interpretation, equipment, resuscitation and communication at practical stations, and the SOE is an examiner-led viva; a single-best-answer bank cannot rehearse either. Those need simulation, practice vivas and supervised clinical exposure, which BMJ OnExamination does not claim to provide.
How many BMJ OnExamination questions should I complete per day for FFICM? There is no official daily number, and this is guidance rather than a vendor claim. Around 20 to 40 mixed questions a day, fully reviewed and error-coded around clinical work, is more useful than a rushed hundred you never analyse. The quality of your review matters more than raw volume.
When should I stop using BMJ OnExamination and move to mixed mocks? Move when your domain floors are met, your first-attempt accuracy on unseen mixed blocks is stable at or above target, and you can hold roughly 80 seconds per item comfortably. That is a performance signal, not a completion signal, so do not wait until the bank reads one hundred per cent.
How should I combine BMJ OnExamination with iatroX without duplicating practice? Apply the two-Q-bank rule: keep BMJ OnExamination as your learning bank and use iatroX as your measurement bank for unseen, timed, mixed blocks. The discipline is not to re-answer the same items in both; you learn on one and test transfer on the other, so the second bank stays genuinely unseen.
Editorial notes and references
Written by Dr Kolawole Tytler, NHS GP and founder of iatroX. Last checked 20 July 2026. All BMJ OnExamination figures, features and prices are vendor-reported and may change; confirm them on the product page before purchase, and treat the FFICM MCQ format as accurate to the FICM pages checked on this date. Disclosure: iatroX operates a competing UK question bank, so its role here is confined to a job BMJ OnExamination does not claim, namely unseen, timed transfer measurement for the written MCQ; iatroX does not replace the OSCE or SOE. Corrections are welcome through the feedback route on iatrox.com.
References: FICM Final MCQ format and examination regulations (ficm.ac.uk/fficm-final-mcq and the FFICM examination regulations); BMJ OnExamination FFICM product page (onexamination.com); iatroX, "Your Q-Bank Percentage Is Not Your Exam Score" (iatrox.com/blog/qbank-percentage-not-your-exam-score); the two-Q-bank rule and the blueprint-coverage-matrix pillars on iatrox.com; and the iatroX comparison hub (iatrox.com/compare).