The Fellowship of the Faculty of Intensive Care Medicine (FFICM) is the exit examination for consultant-level intensive care medicine in the UK, set by the Faculty of Intensive Care Medicine. It has three sections — a multiple-choice paper (MCQ), an objective structured clinical examination (OSCE) and a structured oral examination (SOE) — each marked independently, and you must pass the MCQ before sitting the OSCE and SOE. This guide covers the current format, the fees, eligibility, how the pass mark is set, and how to prepare for an exam with a small candidate pool and few dedicated resources.
What the FFICM is and who sits it
The Final FFICM is the exit exam for the standalone intensive care medicine CCT, taken during Stage 2 of training, and a pass underpins consultant-level independent ICM practice. Roughly 400 to 500 candidates attempt it each year. It occupies a particular niche in the exam landscape: the candidate pool is far smaller than for MRCP or MRCGP, the exam tests well beyond ALS or basic ICM competence, and dedicated revision resources are scarce. That combination — a high standard, broad content spanning the basic sciences and the whole of clinical critical care, and relatively little purpose-built material — is what makes the FFICM feel harder to prepare for than its candidate numbers might suggest.
Eligibility
You must already hold a pass in the Primary examination of a complementary specialty college — FRCA Primary for anaesthetists, Primary MRCP for physicians, or an equivalent — before sitting the Final FFICM, which can be taken at any point during Stage 2 of the programme.
The three sections
The MCQ runs for three hours and has consisted entirely of single best answer questions since June 2022: 130 questions made up of 80 short SBAs worth one mark each and 50 long, scenario-based SBAs worth two marks each, for a maximum of 180 marks, with no negative marking. It is conducted remotely on the TestReach platform, and the fee is £510. The OSCE consists of 13 stations of seven minutes, with one minute of reading between them; 12 are live and one is an unidentified test station, there are no killer stations and no negative marking, and questions are drawn from Data, Equipment, Professionalism and Resuscitation. It is usually held at the Royal College of Anaesthetists, with a fee of £355. The SOE consists of four 14-minute stations with two questions each — eight questions in total, each marked independently by two examiners — testing clinical science applied to ICM, usually framed around clinical problems, with a fee of £320 (or £635 for the OSCE and SOE together). On a first attempt you must book both the OSCE and the SOE, and the OSCE/SOE pass standard sits in the 80 to 85% range, in line with other colleges. Across all three sections the examinable ground spans physiology, pharmacology and microbiology applied to critical care, alongside the clinical management of the critically ill patient — from respiratory and cardiovascular failure to sepsis, neurocritical care, renal replacement, trauma, obstetric and poisoning emergencies, and the ethical and end-of-life dimensions of intensive care.
How the pass mark is set
The MCQ pass mark is set by Angoff referencing applied to each question and then weighted for the long versus short SBAs. Each section is standard-set and marked separately, so a strong score in one section cannot rescue a weak score in another — you have to clear every component.
2026 dates and results
The MCQ runs remotely, while the OSCE and SOE run in person within defined windows. Check the FICM calendar for the current 2026 sitting and application dates. Last reviewed June 2026.
Pass rates
The FICM publishes exam reports, including candidate numbers, pass rates and common areas of difficulty, back to 2018; consult the latest report for current figures rather than relying on estimates. After a second unsuccessful attempt at the OSCE or SOE, you can request a structured guidance interview with an examiner to identify specific improvement areas. Candidates most often report the SOE and the long, scenario-based MCQ questions as the hardest elements, both of which test applied judgement rather than recall.
How to prepare
For the MCQ, drill SBAs across the four science domains — physiology, pharmacology, clinical ICM and microbiology — and review each miss back to the underlying principle, because the long, scenario-based questions reward applied reasoning rather than recall. For the OSCE, rehearse data interpretation, equipment and resuscitation under timed conditions; for the SOE, practise structured viva answers aloud, ideally in pairs. Because dedicated resources are scarce, a structured question bank and disciplined timed practice count for more here than in higher-volume exams. A realistic plan gives the MCQ several months of steady SBA practice, then a focused block of OSCE and viva rehearsal once the written paper is passed. Practising the SOE aloud with a colleague playing examiner is the single highest-value activity for that section, because the marks reward fluent, structured spoken reasoning that silent revision does not build.
Where iatroX fits
Dedicated FFICM resources are few, so a structured adaptive bank fills a real gap. iatroX offers an FFICM MCQ bank, on iatroX's subscription (£29/month or £99/year), that leads with a Socratic tutor working back through the reasoning behind a miss; questions mapped meticulously to the FFICM blueprint; spaced repetition; adaptive sequencing that shows whether physiology, pharmacology, clinical ICM or microbiology is undermining your MCQ score; and a mobile app.
A few common questions
How many sections does the FFICM have? Three — the MCQ, the OSCE and the SOE.
Do I sit them together? You must pass the MCQ first, then book the OSCE and SOE together on a first attempt.
What makes me eligible? A pass in a relevant Primary exam — FRCA Primary, Primary MRCP, or an equivalent.
Is iatroX's FFICM bank free? Not in full — the bank is on iatroX's subscription (£29/month or £99/year), with free sample questions to try first.