The FFICM MCQ is the first hurdle on the path to Fellowship of the Faculty of Intensive Care Medicine — and it must be cleared before you can sit the OSCE and SOE. With 130 SBA questions across 3 hours, covering the entire ICM curriculum from applied basic science to clinical management, it tests a breadth of knowledge that makes focused preparation essential.
The good news: the MCQ pass rate has been consistently strong (84% across 2024/25). The exam is demanding but fair, and structured preparation works.
Format
The MCQ consists of 130 single best answer questions in two formats.
80 short SBAs (1 mark each): Concise stems testing factual knowledge, pharmacology, physiology, and clinical science applied to intensive care. Each has five options. These test breadth — can you recall the key facts across the full ICM curriculum?
50 long SBAs (2 marks each): Extended clinical scenarios requiring integration of multiple pieces of information to determine the best management. These test clinical reasoning — can you apply knowledge to a critically ill patient?
Total marks available: 180 (80 + 100). No negative marking. Duration: 3 hours. Delivery: remote via the TestReach platform, invigilated. Fee: £510.
The pass mark is set using Angoff referencing — meaning each question has a pre-determined difficulty, and the pass mark reflects the collective difficulty of the specific paper rather than a fixed percentage.
High-Yield Topic Areas
Based on the ICM curriculum blueprint, the areas that generate the most MCQ questions are resuscitation and acute management (cardiac arrest algorithms, shock management, airway management, sepsis), organ support (mechanical ventilation, renal replacement therapy, vasoactive drugs, nutrition), applied pharmacology (sedation, analgesia, antimicrobials, vasopressors, inotropes, neuromuscular blockade), applied physiology (cardiovascular, respiratory, renal, neurological), specific conditions (ARDS, traumatic brain injury, status epilepticus, acute liver failure, DKA/HHS, major haemorrhage), and professionalism (consent in ICU, capacity, end-of-life care, organ donation, communication with families).
The long SBAs disproportionately test clinical management of complex ICU scenarios — the kind of multi-organ, multi-system cases where you must integrate physiology, pharmacology, and clinical judgement simultaneously.
The Preparation Strategy
Timeline: 12-16 weeks for most candidates working clinically. Allow 3-4 hours of study per weekday evening and 6-8 hours at weekends.
Question volume: Aim for 2,000-3,000+ questions across all sources. The breadth of the ICM curriculum means you need volume to ensure coverage.
Primary resource: iatroX offers an FFICM curriculum-mapped question bank with over 700 questions, accessible through a single subscription that also provides access to multiple other Q-banks. The questions are mapped to the ICM curriculum with detailed, guideline-grounded explanations. Adaptive spaced repetition ensures you retain material from week 2 through to exam day.
Supplementary resources: Crit-IQ (150 MCQ questions with ICM focus), BJA Education MCQs (requires subscription, useful for basic science), and OnExamination (uses FRCA content that overlaps with ICM). Steve Benington's "Intensive Care Medicine MCQs" remains a useful textbook resource.
Guideline reference: Ask iatroX provides instant clinical reference grounded in UK guidelines — invaluable when MCQ explanations are unclear or when you need to verify a management pathway against the current evidence.
Mock exams: Complete at least 2-3 full timed mocks under exam conditions (3 hours, no breaks, TestReach format if possible). The remote delivery format has its own rhythm — practise it before exam day.
Week-by-Week Timeline (12 Weeks)
Weeks 1-4: Systematic topic coverage — one major ICM domain per week (resuscitation/airway, cardiovascular/shock, respiratory/ventilation, renal/metabolic). 30-40 questions daily from iatroX FFICM Q-Bank.
Weeks 5-8: Remaining domains (neurology/sedation, infection/antimicrobials, specific conditions, professionalism/ethics). Increase to 40-50 questions daily.
Weeks 9-10: Full mock exam + targeted weakness revision based on results.
Weeks 11-12: Second and third mock exams. Final review of high-yield topics. Light revision in the last 2-3 days. Rest before exam day.
On Exam Day
The TestReach platform requires a computer with webcam, microphone, and stable internet. You will be remotely invigilated. Set up in a quiet, private room. Test your technology in advance. The exam is 3 hours with no scheduled breaks — manage your time (approximately 1.4 minutes per question) and use the flagging function for uncertain answers.
Trust your preparation. The 84% pass rate tells you that candidates who prepare systematically pass this exam.