The FFICM OSCE tests whether you can apply your intensive care knowledge in practical, clinical scenarios — interpreting data, handling equipment, managing resuscitation, and communicating with patients and families. It is held face-to-face at the Royal College of Anaesthetists in London and consists of 13 stations (12 live + 1 test station) at 7 minutes each with 1 minute reading time between stations.
Each station is marked out of 20, giving a total of 240 marks across the 12 live stations. The pass mark is set using the Angoff method. There are no "killer stations" — you do not fail automatically for performing badly at any single station. No negative marking.
The four examination domains are Data, Equipment, Professionalism, and Resuscitation — with some stations crossing domains (e.g., a data station may include communication elements).
Data Stations
Data stations test your ability to interpret clinical information relevant to ICU practice. This includes ECG interpretation (arrhythmias, ischaemia, pacing, electrolyte effects), radiology (chest X-ray, CT head, CT chest/abdomen — not specialist radiology but the imaging an ICU consultant must interpret), blood gas analysis and metabolic data (acid-base disturbance, lactate trends, electrolyte derangement), haemodynamic data (arterial waveforms, CVP traces, cardiac output data, echocardiography findings), and laboratory data (microbiology results, haematology, coagulation studies, organ function panels).
How to prepare: Practise interpreting data under time pressure — 7 minutes goes fast when you are reading a complex dataset. Work through ECG books, radiology resources (Defined Image for ICM), and clinical data scenarios. iatroX's FFICM Q-Bank includes data interpretation questions mapped to the ICM curriculum.
Equipment Stations
Equipment stations test your knowledge of the devices used in intensive care. You may be asked to identify equipment, explain its function, describe how to set it up or troubleshoot it, or discuss the indications and complications. Common equipment topics include ventilators (modes, settings, troubleshooting), vascular access devices (central lines, arterial lines, dialysis catheters), monitoring equipment (cardiac output monitors, ICP monitoring, BIS), airway equipment (difficult airway trolley, tracheostomy, bronchoscopy), and renal replacement therapy circuits.
How to prepare: Handle equipment during clinical shifts. Ask consultants to walk you through unfamiliar devices. The OSCE tests practical familiarity, not just theoretical knowledge. If you have not physically handled a piece of equipment, you will struggle to discuss it convincingly under exam pressure.
Professionalism Stations
Professionalism stations test communication, ethical reasoning, and the interpersonal skills essential to ICU practice. Scenarios include breaking bad news to family members (organ donation discussions, withdrawal of treatment, unexpected death), consent discussions for procedures (tracheostomy, central line, renal replacement), capacity assessment in the ICU context, communication with colleagues (handover, escalation, team disagreement), and end-of-life care discussions.
How to prepare: Practise these conversations with colleagues. Use the SPIKES framework for breaking bad news. Understand the legal framework for capacity and consent in ICU (Mental Capacity Act, best interests, advance decisions, lasting power of attorney). These stations reward genuine empathy and structured communication, not scripted responses.
Resuscitation Stations
Resuscitation stations test your ability to manage clinical emergencies in real time — typically using simulation equipment (mannequins). Scenarios include cardiac arrest management (ALS algorithms), acute airway emergencies, major haemorrhage management, anaphylaxis, and other time-critical ICU emergencies.
How to prepare: Attend simulation sessions. Practise ALS algorithms until they are automatic. Verbalise your thinking — the examiners want to hear your clinical reasoning, not just see the correct actions.
General OSCE Tips
Keep answers directed and concise — marks are awarded for specific points on the examiner's mark sheet, not for volume of speech. Structure your answers (systematic approach to ECG interpretation, systematic approach to CXR, systematic data review). Practise talking out loud while interpreting data — the examiners cannot mark what you do not say. Time management is critical — use the 1-minute reading time effectively to plan your approach.
The iatroX FFICM Q-Bank at covers the clinical knowledge underpinning every OSCE domain. Ask iatroX provides instant reference for management protocols and guidelines relevant to OSCE scenarios — useful during preparation and during clinical shifts.