DipIMC: question practice and revision.

Choose a topic for focused revision and check your plan against the official specification.

• Major trauma — primary and secondary survey, packaging, damage control resuscitation
• Airway management — capnography, difficult airway indicators, Cormack-Lehane, PHEA principles
• Adult resuscitation — Resus Council UK 2021 ALS, post-arrest care, refractory VF/VT
• Paediatric pre-hospital care — APLS 7th edition, paediatric trauma, recognising deterioration
• Obstetric emergencies — APH, PPH, eclampsia, breech, shoulder dystocia, neonatal resuscitation
• Cardiac emergencies — ACS, peri-arrest arrhythmias, cardiac arrest in special situations
• Specific injuries — head, spinal, chest (tension pneumothorax), abdominal, pelvic, burns
• Toxicology and environmental — drowning, hypothermia, hyperthermia, electrocution, smoke inhalation
• Command and control — JESIP, METHANE, MERIT, scene safety, mass casualty triage (TWELVE/SIEVE)
• Communication and pre-alert — ATMIST handover, request for backup, conflict resolution
• Ethics, end-of-life, capacity in the pre-hospital setting — DNACPR, ReSPECT, advance decisions
• FPHC Consensus Statements — current statements (TXA, pelvic binders, traumatic cardiac arrest)
• Equipment and pharmacology — IO access, infusion devices, common pre-hospital drugs

Drawn from the FPHC syllabus, current FPHC Consensus Statements, Resus Council UK 2021 algorithms and item density in iatroX.

• Resus Council UK 2021 adult ALS — adrenaline 1 mg IV/IO every 3-5 minutes, amiodarone 300 mg after 3rd shock, thrombolysis for suspected PE arrest, mechanical CPR devices, eCPR criteria. Older revision sources teach 2015 algorithms — use the current standard.
• Major trauma — Major Haemorrhage Protocol activation criteria, 1:1:1 ratio (RBC : FFP : platelets), tranexamic acid within 3 hours of injury (CRASH-2 / MATTERs), pelvic binder placement, recognising tension pneumothorax clinically (decompression at 4th-5th ICS mid-axillary, not classical 2nd ICS MCL)
• Traumatic cardiac arrest (TCA) — distinguishing from medical arrest, "HOTT" reversible causes (Hypoxia, Hypovolaemia, Tension pneumothorax, Tamponade), the role of resuscitative thoracotomy and intra-arrest blood
• Paediatric resuscitation — APLS 7th edition. Adrenaline 10 mcg/kg IV/IO, fluid 10 mL/kg in trauma vs 20 mL/kg in sepsis, weight estimation formulas (age × 2 + 8 for 1-10 years), uncuffed vs cuffed ETT debate
• Pre-hospital emergency anaesthesia (PHEA) — recognising indications, drug choices (ketamine + rocuronium most common in UK), C-spine immobilisation considerations, RSI checklist, recognition of failed intubation
• Obstetric pre-hospital emergencies — PPH 4 T's (Tone, Trauma, Tissue, Thrombin), bimanual uterine compression, postpartum eclampsia (magnesium sulphate 4 g IV loading), shoulder dystocia HELPERR mnemonic
• Command and control — JESIP principles, METHANE major incident report (Major incident declared, Exact location, Type, Hazards, Access, Number of casualties, Emergency services required), TWELVE/SIEVE triage
• FPHC Consensus Statements — keep up with the latest. Recent topics: TXA in trauma, pelvic fracture binders, traumatic cardiac arrest, extrication, traumatic brain injury, helicopter operations. These are examined directly.

Observations from UK pre-hospital trainees and recent DipIMC candidates. Verify against current FPHC Consensus Statements and Resus Council UK guidance.

Candidate-reported observations — not official guidance.

1. Older revision materials — Resus Council UK updated their algorithms in 2021 (drug doses, sequences, special circumstances). Materials based on the 2015 guidelines are outdated. Always check the source date.
2. Tension pneumothorax decompression site — UK practice has shifted toward the 4th-5th ICS mid-axillary line (over the classical 2nd ICS mid-clavicular line) due to better chest wall thickness data. The OSPE may expect the newer site.
3. Major haemorrhage paradigm — older materials teach crystalloid-led resuscitation; current practice is balanced blood product resuscitation (1:1:1) with early TXA. Crystalloid use is now restricted.
4. PHEA decisions — recognising the difference between "should be intubated in hospital" and "should be intubated pre-hospital" is examined. Not every patient needing definitive airway management needs it pre-hospital.
5. Command and control terminology — METHANE vs ATMIST vs MIST handovers serve different purposes (initial scene report vs casualty handover). Confusing them costs marks.
6. Specific FPHC Consensus Statements — these are the College's own evidence-based position papers and are examined directly. They include nuances not in standard ALS/ATLS courses (e.g. extrication priorities, traumatic brain injury management, pelvic binder application).
7. Paediatric weight-based dosing under time pressure — adrenaline 10 mcg/kg, atropine 20 mcg/kg, suxamethonium 1-2 mg/kg, rocuronium 1 mg/kg. Calculation speed under stress is examined directly.
8. OSPE communication and non-technical skills — examiners specifically assess situational awareness, decision-making under pressure, communication clarity, and team leadership. These are weighted alongside technical performance.

A pragmatic phased approach used by recent DipIMC passers, balancing Part A knowledge with Part B practical skill development.

1. Weeks 1–4

   Foundation pass across all 13 blueprint topics. 30 questions/day with the iatroX adaptive engine. Read the FPHC Consensus Statements alongside (all of them — they are central). Daily Resus Council UK algorithm recall.

2. Weeks 5–8

   Targeted weak-area drilling. Map current Resus Council UK 2021 algorithms (adult ALS, paediatric ALS, neonatal life support, trauma cardiac arrest), APLS 7th edition. Drug calculation practice (paediatric weight-based, infusion conversions).

3. Weeks 9–10

   Two timed Part A mock papers under exam conditions weekly. OSPE practice with peers — communication, primary survey, packaging, drug calculations. Practise structured handovers (METHANE, ATMIST).

4. Weeks 11–12

   Bookmark review only. Targeted reading on latest FPHC Consensus Statements, helicopter operations, mass casualty triage. Confirm RCSEd booking and OSPE venue logistics. Sleep, hydrate, do not learn new material.

Dedicated DipIMC question practice with answer explanations, guided Tutor review and study planning.

• Focused question practice — Choose the relevant bank and use your answers to identify what to study next.
• Guided reasoning — Explore a difficult answer with Tutor, then apply the distinction independently.
• Review and timed practice — Return to important mistakes and choose a timed practice set where available.

Choose the relevant bank and use the official exam guidance to plan your preparation.

Doctors, nurses and paramedics must meet the RCSEd registration and experience provisions. The standard routes require four years after the relevant registration, with an alternative of five months in an approved UK PHEM programme for doctors. Candidates outside those routes should obtain a decision from RCSEd about special consideration.

Use the current RCSEd examination page or contact its examination team. A previous diet or usual seasonal pattern is not confirmation that a new sitting is available to book.

Part A contains 180 SBA questions in 180 minutes. Part B is an OSPE, normally twelve eight-minute and two sixteen-minute testing stations. Both parts must be passed under the College rules.

Check the current RCSEd fee for the full examination or the component you are resitting. Read the College payment, withdrawal and refund terms before applying.

RCSEd permits five attempts. A resit of an individual component counts as an attempt; check the rules for retaining a component pass.

DipIMC (Diploma) is the entry-level pre-hospital qualification, demonstrating safe and competent pre-hospital emergency care knowledge and skills. FIMC (Fellowship in Immediate Medical Care) is the higher fellowship, demonstrating consultant-level pre-hospital expertise. Most PHEM consultant trainees progress from DipIMC to FIMC during specialty training.

FPHC Consensus Statements are evidence-based position papers produced by the Faculty on key pre-hospital topics — including TXA in trauma, pelvic binders, traumatic cardiac arrest, extrication, traumatic brain injury, and helicopter operations. They are examined directly in the DipIMC and should form a core part of your revision.

Full DipIMC bank access is included in all-access. Up to 10 new sample questions per day are shared across exams, with no account required. A verified free account includes one guided Tutor session; continued Tutor use is included in all-access.