Most DipIMC candidates decide they are "done" with new questions using the wrong signal — a high bank percentage or a finished progress bar. This checklist replaces that with the minimum evidence you should actually verify before you stop doing new questions and switch to consolidation, simulation or rest. It is a checklist, not a study timetable: work through it, and where a box is unchecked, you have found your next study action. It covers the Part A written knowledge layer that a question bank can measure; the Part B OSPE needs separate, hands-on rehearsal and is flagged where relevant.
The minimum evidence that you have "covered" DipIMC
You can reasonably say you have covered the DipIMC written blueprint when all of the following are true at once:
- Every blueprint domain has been attempted on unseen items — not just the comfortable ones.
- Your first-attempt accuracy on unseen, timed, mixed questions is at or above your target, not just your accuracy on reviewed questions.
- You have format-specific practice for the things SBAs test indirectly: pre-hospital scenarios, image and ECG interpretation, calculations.
- Your high-confidence error rate is low — you are rarely confidently wrong, which is the dangerous failure mode.
- Your knowledge on guidance-sensitive topics is current and jurisdiction-correct.
- Your performance is calibrated against the RCSEd official sample material, not just against one vendor's style.
- Earlier misses hold up on spaced retests a week or more later.
If any of these is not yet true, keep doing new questions in that specific area. If all are true, more new questions add little, and your time is better spent on OSPE rehearsal and rest.
Current exam snapshot
DipIMC is awarded by the RCSEd Faculty of Pre-Hospital Care and has two components, both of which must be passed:
- Part A (written): 180 single-best-answer questions in 180 minutes — one minute per item.
- Part B (OSPE): 14 stations — twelve 8-minute and two 16-minute — plus rest/preparation stations.
Part A is blueprinted to the UK PHEM curriculum at Skills for Health Career Framework Level 6; the college-reported standard fee is £760 with single-component resits, and up to five attempts are permitted. The authoritative source is the RCSEd/FPHC regulations and sample material — treat any third-party claim about content or weighting as secondary to those. This checklist concerns Part A; where a domain has a strong practical element, the box is only fully ticked when you have also rehearsed it hands-on for the OSPE.
Build a blueprint coverage table
The core instrument is a coverage table you fill in from your own data. Map the rows to the current PHEM curriculum domains (verify the live domain list against the RCSEd/FPHC curriculum) and complete every column before you conclude you are done.
| Blueprint domain | Official weight (verify) | Questions attempted | First-attempt accuracy | Last reviewed | Confidence (H/M/L) |
|---|---|---|---|---|---|
| Trauma — head & spinal | verify | ||||
| Trauma — chest, abdomen, pelvis, limb | verify | ||||
| Catastrophic haemorrhage & shock | verify | ||||
| Airway, RSI & pre-hospital anaesthesia governance | verify | ||||
| Analgesia & sedation | verify | ||||
| Medical & cardiac emergencies | verify | ||||
| Paediatric pre-hospital emergencies | verify | ||||
| Obstetric & neonatal emergencies | verify | ||||
| Environmental (hypothermia, drowning, heat) | verify | ||||
| Toxicology & hazardous materials | verify | ||||
| Mental health, capacity & behaviour | verify | ||||
| Major incident, triage & command | verify | ||||
| Medico-legal, ethics & safeguarding | verify | ||||
| Equipment, packaging, transport & handover | verify |
A domain is only "covered" when it has adequate attempts, target first-attempt accuracy on unseen items, a recent review date and at least medium confidence. Empty or low-attempt rows are where self-selected practice has quietly skipped you past a weakness.
Ten domain-level blind spots self-selected practice tends to hide
When you choose your own questions, you drift toward what you already enjoy — usually trauma. These ten areas are the ones most often left thin, and each should have exam-specific clinician review before you trust your coverage:
- Paediatric pre-hospital emergencies — weight-based dosing, APLS algorithms and paediatric trauma, often under-practised by adult-focused clinicians.
- Obstetric and neonatal emergencies — eclampsia, post-partum haemorrhage, cord prolapse, pre-hospital delivery and newborn resuscitation.
- Environmental emergencies — hypothermia, drowning and heat illness, including the modified resuscitation algorithms they require.
- Toxicology and hazardous materials — common poisonings, antidotes and decontamination principles, plus scene-safety implications.
- Mental health, capacity and restraint — the Mental Health Act versus the Mental Capacity Act, and acute behavioural disturbance in the field.
- Medico-legal and ethical practice — consent, confidentiality, DNACPR/ReSPECT, recognition of life extinct, documentation and safeguarding referral routes.
- Major incident and triage doctrine — METHANE reporting, triage sieve and sort, command structures and interoperability principles.
- Airway, RSI and pre-hospital anaesthesia governance — drug choices confirmed against the SmPC/eMC, monitoring standards and human factors, not just the procedure.
- Non-trauma medical and cardiac pathways — ACS, arrhythmia, stroke, sepsis, anaphylaxis and DKA as they present pre-hospital.
- Equipment, packaging and transport physiology — Sandpiper bag contents, pelvic binders and vacuum mattresses, transfer and altitude considerations, and structured handover (ATMIST/IMIST-AMBO).
Format checklist: practise the exam, not just the topic
- Deliberate practice on pre-hospital scenario stems, where the safe next action depends on scene and resource constraints, not just the diagnosis.
- Trauma and clinical images interpreted under time — you can name what you are seeing and act on it.
- Equipment recognition and correct use, including kit you rarely touch.
- Awareness that structured practical performance (the OSPE) is a separate, hands-on assessment you cannot cover with SBAs — rehearse it live.
Interpretation checklist
- Images and photographs (wounds, rashes, injury patterns) — interpreted, not just recognised.
- ECGs — rhythm and ischaemia recognition at a pre-hospital decision level.
- Radiographs where relevant to pre-hospital decisions.
- Laboratory and observation trends — reading a trajectory, not a single value.
- Calculations — drug doses (paediatric especially) and infusion rates, checked against the SmPC/eMC.
- Ethics and applied law items answered to the UK standard.
Recency checklist
- Identify guidance-sensitive topics (major trauma, major haemorrhage, cardiac arrest, sepsis, head injury) and note that guidance changes.
- Record the date and jurisdiction of each source — a resuscitation or trauma recommendation must match the current UK guidance you will be examined against.
- Cross-check against current NICE, Resuscitation Council UK, JRCALC and FPHC consensus positions; use the SmPC/eMC for medicines facts. Where a bank explanation is older than current guidance, trust the guidance.
Performance checklist
- Unseen, timed, mixed blocks at or above your target accuracy — not topic-labelled blocks.
- Speed — you finish at roughly one minute per item without a late-paper collapse.
- High-confidence errors are rare — you are seldom confidently wrong.
- Retention — earlier misses still correct on spaced retests.
- Official-material calibration — your bank scores line up with the RCSEd sample, so you are not calibrated to one vendor alone.
The stop/continue decision tree
Work top to bottom and act on the first branch that fits:
- If a domain row is empty or low-attempt → continue new questions in that domain; you have not covered it.
- If coverage is complete but unseen mixed accuracy is below target → continue, but shift to mixed, timed blocks and coded error review rather than more topic blocks.
- If accuracy is high on reviewed items but soft on fresh ones → consolidate: add a second unseen source (iatroX) to break recognition, before doing more of the same bank.
- If written performance is solid across all checks but stations are unrehearsed → simulate: stop new SBAs and rehearse the OSPE hands-on.
- If you are confidently wrong in a specific area → seek teaching, not more questions; confident errors rarely self-correct through volume.
- If every box is ticked and retention is stable → rest and maintain with light mixed blocks; more new questions will not move your readiness.
One-page checklist and a worked example
The one-page version (copy this):
- Every blueprint domain attempted on unseen items — yes/no.
- Unseen, timed, mixed accuracy at target — yes/no.
- Format practice done: scenarios, images, ECGs, calculations — yes/no.
- Guidance-sensitive topics current and UK-jurisdiction — yes/no.
- High-confidence errors rare — yes/no.
- Spaced retention holding a week later — yes/no.
- Calibrated against RCSEd official sample — yes/no.
- OSPE rehearsed hands-on (separate from SBAs) — yes/no.
Any "no" is your next action. All "yes" means stop adding new questions.
Worked example (invented data). A paramedic four weeks out has done 1,100 questions at 74% overall and feels ready. The table tells a different story: trauma rows are full at 82%, but paediatric (120 attempts, 58%), obstetric (40 attempts, 55%) and medico-legal (30 attempts, 61%) are thin and weak. Unseen mixed accuracy is 66% — well below the 74% "overall", because the overall figure was inflated by reviewed trauma items. Two high-confidence errors appear in toxicology. The decision tree is unambiguous: do not stop. Continue new questions in paediatric, obstetric and medico-legal domains; add an unseen second source to close the reviewed-versus-fresh gap; book teaching for the toxicology blind spot; and only then move toward mocks and OSPE rehearsal. The finished progress bar would have hidden every one of these gaps.
Two weeks on, the same candidate re-runs the table. Paediatric has climbed to 220 attempts at 71%, obstetric to 90 attempts at 68%, and medico-legal to 75 attempts at 70%; unseen mixed accuracy has risen to 72% and now sits close to the reviewed figure, which means the reviewed-versus-fresh gap has largely closed. The toxicology high-confidence errors have gone after a focused teaching session. Now — and only now — most boxes are ticked, the decision tree points to "consolidate and simulate", and the sensible move is to stop adding new written questions and spend the final days on OSPE rehearsal and light mixed maintenance. The number that changed the decision was never the completion percentage; it was unseen mixed accuracy plus the shape of the coverage table.
Three mistakes this checklist is designed to stop
Mistaking completion for coverage. A finished bank tells you that you have seen every question the vendor wrote, not that you have covered the RCSEd blueprint. Vendors weight their content toward what is easy to write and popular to revise — usually trauma — so a full progress bar can sit on top of a barely-touched obstetric or medico-legal domain. The coverage table exists precisely to make that invisible gap visible: an empty or low-attempt row is an uncovered domain no matter what the completion figure says.
Trusting a blended percentage over unseen performance. Once you have reviewed a question, re-answering it measures memory, not readiness. An overall percentage mixes those reviewed items with genuinely fresh ones and drifts upward as you cycle the bank, which is why it feels reassuring in the final fortnight even when little new is being learned. First-attempt accuracy on unseen, timed, mixed blocks is the one figure that cannot be inflated by repetition, and it usually sits several points below the headline number.
Fixing the wrong component. Candidates who feel underprepared tend to do more of what they are already good at — more written questions — when the real gap is a practical station or a confidently held misconception. More SBAs will not rehearse an OSPE skill, and volume rarely corrects a high-confidence error, which needs teaching or a corrected reference source. The decision tree routes each type of gap to its matching action so that effort lands where the deficit actually is, rather than where it is most comfortable to work.
Frequently asked questions
How do I know whether I have covered the full DipIMC blueprint? You know when your blueprint coverage table is complete — every PHEM domain attempted on unseen items, with target first-attempt accuracy, a recent review date and adequate confidence — and not before. A finished bank or a high overall percentage does not prove coverage, because self-selected practice systematically skips your weak domains; only a domain-by-domain table, checked against the current RCSEd/FPHC curriculum, shows the gaps.
Can one question bank be enough for DipIMC? For the Part A written knowledge, a single strong, DipIMC-specific bank plus the official RCSEd material can take most candidates a long way — but relying on one bank risks calibrating to its particular style, so a second, non-overlapping source of unseen items is a sensible safeguard rather than a luxury. No bank is enough for the diploma overall, because none reproduces the Part B OSPE, which requires hands-on rehearsal.
What should I measure instead of my overall Q-bank percentage for DipIMC? Measure first-attempt accuracy on unseen, timed, mixed blocks; your high-confidence error rate; retention on spaced retests; pacing at one minute per item; and calibration against the official sample. Your overall percentage blends reviewed and unseen items and flatters you — as our worked example shows, a "74% overall" can sit on top of 66% unseen mixed accuracy. The unseen, mixed figure is the one that tracks readiness.
When should I stop doing new DipIMC questions? Stop when every domain is covered on unseen items, your unseen mixed accuracy is at target, guidance-sensitive knowledge is current, high-confidence errors are rare, retention holds on spaced retests, and you are calibrated against the official sample. At that point new questions add little, and the decision tree points you to consolidation, OSPE simulation or rest. Until then, any unchecked box is a reason to keep going in that specific area.
Which DipIMC resource should I use for my weakest component? Match the resource to the gap: for thin written domains, a DipIMC-specific SBA bank plus iatroX for unseen mixed measurement; for the Part B OSPE, a live, hands-on course such as a DipIMC study day, because stations cannot be rehearsed on paper; and for calibration, the RCSEd official sample used sparingly under exam conditions. The weakest component defines the tool — do not use more written questions to fix a practical-station gap.
Editorial notes and references
Written by Dr Kolawole Tytler, NHS GP and founder of iatroX. Last checked 21 July 2026. Exam format and the £760 fee are drawn from the RCSEd/FPHC pages on the date shown and can change; blueprint domain weightings must be verified against the current FPHC PHEM curriculum before you rely on them. Any vendor figures cited in linked platform articles are vendor-reported and dated there. Disclosure: iatroX operates a question bank and is therefore a competitor to the products discussed; in this checklist its role is confined to the unseen-MCQ measurement layer, and it does not reproduce the OSPE. Corrections are welcome via the feedback route on iatrox.com.
References: RCSEd Faculty of Pre-Hospital Care — DipIMC exam details, regulations and sample material; NICE, Resuscitation Council UK, JRCALC and FPHC consensus guidance for recency checks (medicines facts via the SmPC/eMC); iatroX, "Your Q-Bank Percentage Is Not Your Exam Score"; iatroX, completion is not coverage and the two-Q-bank rule; iatroX comparison hub and question bank.