FFICM: question practice and revision.

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

• Respiratory and ventilation — ARDS, NIV, proning, tracheostomy, weaning
• Cardiovascular and haemodynamics — shock states, vasopressors, ECMO, PE
• Sepsis and infection — Surviving Sepsis 2021, source control, VAP
• Renal and fluid management — AKI, RRT modalities, fluid responsiveness
• Neurology and sedation — brain injury, ICP, delirium, status epilepticus
• Cardiac arrest and resuscitation — ALS 2021, post-ROSC, TTM
• Pharmacology — renal dose adjustment, interactions, poisoning
• Ethics and end of life — DNACPR, withdrawal, capacity, organ donation
• Paediatric and obstetric critical care

Recurring themes from FICM Board of Examiners reports across 2024–25 diets.

• Acid-base balance — described in examiner reports as "mainstream content but not well answered". Know all four primary disorders, all compensatory responses, and clinical interpretation in context.
• Sepsis bundle — Surviving Sepsis 2021 timing requirements, fluid responsiveness assessment, vasopressor selection thresholds.
• ARDS management — Berlin criteria, low tidal volume ventilation, proning evidence (PROSEVA), driving pressure targets.
• Cardiac arrest post-ROSC — targeted temperature management, neuroprognostication timing, coronary angiography indications.
• Microbiology and stewardship — antimicrobial de-escalation, source control, MDR organism management.
• OSCE and SOE structured answers — using a systematic approach to ECG, radiology and clinical data scores higher than ad-hoc interpretation.

Observations from FICM Chair of Examiners reports published after recent diets. Verify against current curriculum materials.

Candidate-reported and examiner-reported observations — not official guidance.

1. OSCE simulation: candidates over-escalate. Calling for senior help or treating every scenario as cardiac arrest when physiology is normal or near-normal loses marks. The expected level is Stage 2 ICM trainee who can manage the situation.
2. Examining the mannequin: candidates ask the examiner for information rather than examining the mannequin, which can display real signs. Examine before asking.
3. ECG and radiology stations: scores rise sharply with a structured approach (rate, rhythm, axis, intervals, waveform) versus ad-hoc interpretation.
4. SOE answer structuring: when asked for lists, listing items clearly scores higher than narrative descriptions of the same content.
5. Acid-base questions are reliably underperformed despite being core content.
6. Microbiology questions assess antimicrobial stewardship and de-escalation, not just empirical selection.

A suggested sequence; adapt the written and clinical work to your actual examination route and observed learning needs.

1. Weeks 1–4

   MCQ science foundations — physiology (cardiovascular, respiratory, renal, neurological), pharmacology (vasopressors, sedation, antimicrobials, anticoagulants, NMBs), microbiology. 30–40 iatroX questions daily.

2. Weeks 5–8

   Clinical ICM domains — sepsis, ARDS, shock states, organ support, RRT modalities, neurological emergencies, metabolic emergencies. Read Oh's Manual sections in parallel.

3. Weeks 9–12

   Mixed adaptive MCQ sessions. Target weak domains from the iatroX performance dashboard. Sit at least two timed full-length 130-SBA mocks.

4. Weeks 13–16

   Prepare for the clinical route that applies to your sitting: legacy OSCE/SOE or ACRE. Practise data interpretation, equipment explanations and communication with appropriate observation and feedback.

Dedicated FFICM 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.

Use the dedicated FFICM bank for question practice and answer explanations. Choose a practice set to see its available count and timing, then use the official specification to plan your wider preparation.

Per the FICM 2024–25 Annual Report, the FFICM Final MCQ pass rate was 84.23% across 336 candidates. The OSCE/SOE combined pass rate was 62.19% across 402 candidates. Both vary slightly between March and October diets.

The legacy route has a 130-question, 3-hour MCQ plus OSCE and SOE. From the 2027 transition, AKT uses 130 questions with revised scoring and ACRE replaces the separate clinical components. The first AKT is listed for December 2027. Check the College calendar and any valid partial-pass provisions for your own route.

A valid legacy partial clinical pass can affect the transition route. Check the College candidate guidance for the remaining component, pass validity and eligible legacy sittings through the transition year to June 2028. Candidates without an applicable partial pass should plan for the new clinical route from July 2027.

Full FFICM 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.