FFICM Examination Regulations

The Fellowship of the Faculty of Intensive Care Medicine (FFICM) examination will initially consist of a Final part only.  Following the introduction of ICM Core Training posts, date to be announced, the FFICM will consist of two parts: Primary and Final.

There are three sections to the FFICM Final Examination:

(1)       Multiple Choice Question (MCQ)

The MCQ examination will comprise Single Best Answer (SBA) questions only. There will be 80 short-stemmed (short SBA) questions and 50 longer-stemmed (long SBA) questions which will be selected to cover as wide an area of the curriculum as possible. The paper is taken in one three hour sitting.

(2)       Objective Structured Clinical Examination (OSCE)

Up to 13 stations in approximately 1 hour 45 minutes (the OSCE will include one or more test stations, only the live stations will count towards the result). The stations will be selected to cover as wide an area of the curriculum as possible.  One or more of the stations may involve the use of a medium fidelity simulator.

(3)       Structured Oral Examination (SOE)

Four stations, two question in each station, in approximately 1 hour and 15 minutes. The questions will be selected to cover as wide an area of the curriculum as possible.

All sections have to be passed to pass the whole examination.

In all sections of the examination, the performance of borderline candidates is reviewed by the examiners before final marks are awarded.

If, in the opinion of the examiners, a candidate’s answers in the SOEs have been dangerous then the candidate’s performance is reviewed by all the examiners before the marks are confirmed.

(1)        MCQ

Each SBA question will have five answer-options. 1 mark is awarded for each correctly answered short SBA and 2 marks for each correctly answered long SBA. The maximum mark obtainable is 180 (80x1 + 50x2). Marks are not deducted for wrong answers. The pass mark is set by the examiners using Angoff referencing and SEM adjustment. 

 (2)       OSCE

Each station is marked out of 20 with the pass mark for each station being determined by the examiners before the examination, using Angoff Referencing.  The pass marks for each of the live stations are summed to obtain the pass mark for the whole examination.

(3)        SOE

Two examiners are present for each part of the SOE.  Each examiner marks every question independently.  There are eight questions; Pass = 2, Borderline performance = 1, Fail = 0, giving a maximum total of 32 marks (8 x 2 x 2). The pass mark is determined using assessment methods approved by the GMC.

The FFICM Prize may, at the discretion of the Board of the Faculty of Intensive Care Medicine, be awarded annually, to the Candidate(s) who perform at the highest level of distinction in all parts of the FFICM Final Examination at their first attempt.

A level of distinction is defined as follows:

• FFICM MCQ:    The top 10% of examination candidates
• FFICM OSCE:   The top 10% of examination candidates
• FFICM SOE:      A maximum score of 32 marks.

All candidates who meet the levels of distinction at their first attempt in all parts of the FFICM Final, during the current academic year, will be discussed at the FFICM Examinations Committee Subgroup following the Spring sitting of the OSCE/SOE.  The candidate who achieves the highest level of distinction in all parts of the FFICM Final Examination at their first attempt, will be recommended to the Faculty Board for the award of the Prize.

Candidates are not informed that their exam scores meet any of the above definitions of levels of distinction unless they are awarded the prize.

The Faculty endorse the key recommendations of the Guidance on Dress Codes for postgraduate medical recruitment, training, and assessment from the Conference of Postgraduate Medical Deans (COPMeD) 2011. 

In particular, candidates are reminded that the same dress code should apply for professional examinations as it does for day-to-day clinical practice/contact with patients. This means that forms of dress should not constrain the Candidate’s ability to demonstrate recognised skills including effective communication with simulated patients or examiners, nor hinder easy verification of the Candidate’s identity.

Hence Candidates are requested not to wear forms of dress that cover the face while attending any of the FICM examinations. Candidates are also advised that there is no requirement to wear clinical/theatre clothing during any of the examinations.

In response to the increased potential for cheating and the disturbance of other candidates, the Faculty will follow the strict appliance of the following rules regarding the use of electronic devices and mobile phones during examinations:

1.       Mobile phones, smart watches and other electronic devices have no place at examinations and should be left at home wherever possible.  Mobile phones, smart watches or electronic devices (see list of examples at paragraph 2), brought to examinations must be switched off and fully deactivated for the duration of the examination. 

Candidates should ensure the following action is taken regarding mobile phones/smart watches/electronic devices:

Written examinations (before sitting at exam desk):

• Powered off and stored in bag, which should be placed in designated area defined by Invigilator. Or,
• If no bag then mobile phone/smart watch/electronic device should be powered off and handed to invigilator.  Invigilator will place in envelope and mark with candidate No. Returned in exchange for exam papers.

SOE/OSCE examinations (on arrival at main reception area):

• Powered off in front of the faculty officer at reception. 
• Store in secure locker/luggage for duration of time in Faculty. Or;

• Hand to Faculty officer.  Faculty officer will place in envelope and mark with candidate No. Returned in exchange for candidate badge on leaving the Faculty.

2.       The following are some examples of ‘electronic devices’, it is not intended to be complete, if in doubt then candidates should ask the Faculty Officer/Invigilator in attendance:

Calculator, laptops, electronic tablet, recording devices, MP3 players, Bleepers, smart watches and any timing device that make audible beeps.

3.       If any type of electronic device is required as part of an examination test then it will be supplied by the Faculty.  Regular time checks are given by invigilators and therefore candidates will not need to use additional timing devices.  Watches that do not emit sound may be used.

4.       Non-compliance

Failure to comply with these requirements may lead to disqualification from the examination. 

a.    The following constitutes non-compliance of the above rules:

• A mobile phone, smart watch or electronic device found in the possession of a candidate during an examination.
• The ringing, vibrating or any audible ‘beep’ heard from a mobile phone, smart watch or electronic device whilst an examination is taking place, which is deemed by the Faculty officer/invigilator to have disrupted other candidates.

b.    In all cases of non-compliance an incident report form will be submitted to the Examinations Sub-Committee for their consideration. Candidates cited for non-compliance will be required to sign the incident report form before leaving the examination room and may be required to attend the Faculty to give further information/evidence regarding the incident.

c.     Where the Examinations Sub-Committee agree that non-compliance is proven they will consider the following, before a penalty is agreed:

• The need to preserve the integrity of the examination.
• The disturbance caused to others.
• Consistency with previous penalties.

d.    The Examinations Sub-Committee may consider awarding one of the following standard penalties or may give a more specific penalty where felt appropriate:

• No further action.
• A written warning.
• Result for an examination or part of an examination under investigation, to be declared void.
• Candidate barred from applying for an exam for a specified period.
• Where cheating is proved act in accordance with sub-paragraph 14.2.

e.    Examination results of candidates cited for non-compliance will be withheld until a decision has been reached by the Examination Committee.  Investigations will be completed as quickly and efficiently as possible and candidates will be kept informed of progress. Candidates will be informed of the outcome in writing by the Director of Training and Examinations on behalf of the Examinations Committee.

The Integrity of FFICM examinations is fundamental to the values promoted by the Faculty.  It is important that all candidates are judged on their ability, and no candidate be allowed to gain an advantage unfairly over others.  By virtue of entering to sit an examination, candidates are deemed to have understood and agreed to abide and respect all examination regulations and policies. Any aspect of misconduct at FFICM examinations will be investigated and acted upon in accordance with the following Misconduct policy.  With the exception that, where non-compliance of Faculty regulations is cited due to the use of electronic devices or mobile phones, then these matters will proceed in accordance with the policy set out at Appendix 9 of the these regulations.

1.         Misconduct includes, but is not restricted to:

• Failure to abide by the reasonable instructions of an invigilator or Faculty Officer.
• The introduction or/and use of any materials or documents other than those specifically permitted for the examination.
• Any attempt to gain access to or read the work of another candidate.
• Any attempt to communicate with another candidate.
• Unacceptable or disruptive behaviour during the examination.
• Removal by a candidate, of material or content from an examination, other than those documents specifically permitted.
• The release of content from an examination to a third party without the expressed permission of a Faculty Officer.
• Falsification or alteration of eligibility or identification documents.
• Impersonation of a candidate.
• Any other form of cheating, deception, fraud or conduct that is likely to give an unfair advantage to a candidate or candidates.

2.         Reporting misconduct:

2.1       Under normal examination conditions suspected misconduct should be reported to the Faculty through the submission of ‘an Incident report form’ (available on request through a Faculty officer).  Incident report forms can be completed by examiners, invigilators, Faculty officers, examination candidates and any other such person who becomes aware of any incident that may affect the examination processes or its regulations.  Forms completed by exam candidates regarding suspected misconduct of another candidate must be countersigned by a witness such as a Faculty official. All forms must be completed as soon as possible with full details of fact, they must be signed and dated and given to the duty Faculty officer.  Full instructions for completion of Incident Report forms are set out on the back of the form. 

2.2       Any materials that are reasonably believed by an invigilator or Faculty officer not to be permitted as part of the exam will be confiscated. Electronic devices will be returned at the end of the exam with details logged on the Incident report form. The Candidate concerned will be asked to acknowledge agreement of the confiscation of other materials on the Incident report form. All such materials will be included as part of the report.

2.2       Where misconduct is suspected after an examination or outside examination conditions, such as where a candidate is suspected of passing on or unauthorised use of examination content that has not been released into the public domain, then a written report of the incident should be submitted to the Director at the Faculty address.  Such reports should give full details of the person suspected of misconduct and the person submitting the report.

2.3       Anonymous reports of misconduct will not be used to initiate a formal misconduct process.

2.4       The Faculty acknowledges that any case of misconduct can have an adverse effect on a candidate’s reputation and career.  Therefore all matters of the reporting and process of alleged misconduct will be kept strictly confidential. However, where the allegation of misconduct is proven, the Faculty reserves the right to forward details of the case to the GMC/National Medical Council and in the case of UK trainees, their local Intensive Care Educational Supervisor or Regional Adviser.

3. Review of alleged Misconduct

3.1       Incident report forms that allege misconduct and written reports received as described in paragraph 2.2 will be handed to the Director who will carry out a review of the alleged misconduct to determine if there is sufficient evidence of a prima facie case to warrant the incident being passed to the relevant Examinations Chair and/or the Misconduct Group (see paragraph 4).

3.2       Where, in the opinion of the Director, an incident is not deemed to be self-evident from the facts set out in the report or the incident is judged to be of a minor/technical issue, then the matter will not be processed and no further action will be taken. However, this will not preclude an official letter being issued to advise the candidate of the conduct of behaviour expected under examination conditions.  Cases not processed beyond the Director’s review will not be recorded on a candidate’s personal records.

3.3       Where, following the review of a report and consultation with Faculty staff/witnesses as necessary, the Director deems that there is sufficient evidence to prove a case of misconduct, the Director will inform the candidate of the allegations in writing.  The candidate concerned will be allowed 10 working days, from the date of the letter, to accept or challenge the case against them.

3.4       Examination results of candidates cited for alleged misconduct will not be processed until a decision has been reached.  Investigations will be completed as quickly and efficiently as possible and candidates will be kept informed of progress.

3.5       If, within 10 working days a candidate admits in writing to the allegations made against them, then the matter will be forwarded to the Examinations Chair and Vice Chair for their formal consideration and the award of an appropriate penalty in accordance with paragraph 6. Where allegations are accepted by the candidate, they can submit a written statement with their response that may be taken into account by the Examinations Chair/Vice Chair. A decision will be reached as soon as possible and normally within five working days of the date of the candidate letter.

3.6       If a candidate denies an allegation of misconduct in writing to the Director, either in whole or in part, then the matter will be referred to the Misconduct Group who will deal with the matter electronically.

4          Misconduct Group process

4.1       The Misconduct Group (the Group) will consist of:

• The Chair of the Examinations (Chair)
• A Chair of a FFICM examination component, not involved in the incident
• The Head of Faculty
• A nominated Patient Liaison Group (PLG) representative    

4.2       The duty of the Group will be to examine the facts of the case and to determine the strength and integrity of the evidence. Then make a decision based on the balance of probabilities, whether the allegation of misconduct is proven. Where to the satisfaction of the Group, a case is proven the Group will agree an appropriate penalty in accordance with paragraph 6. The outcome will be decided electronically/via telephone conference and therefore there will be no charge to the candidate.

4.3       The examinations manager will act as the Group secretary.  The purpose of the Group secretary is to:

• Advise all parties on the deadline for submission of further evidence and the date on which the Group will announce their decision.
• Co-ordinate and prepare documentation/evidence for all parties.
• Provide secretarial support to the Group as required.
• Maintain communication with the candidate and provide advice as required.
• To produce and distribute the ‘decision document’ to all parties.

4.4       The Director will submit the case for the Board of examiners in writing to the Group, through the Group secretary.

4.5       The candidate has the right to submit written evidence for consideration by the Group up to the deadline given by the Group secretary.

4.7       The Group secretary will acknowledge receipt of all evidence submitted by the Candidate and confirm the date scheduled for the Group to make its decision. This will not be more than one calendar month following the written confirmation of denial of the allegation of misconduct, see paragraph 3.6. All documents to be used along with a copy of this policy will be sent by email attachments to the candidate and the Group members no later than 5 working days before the date set for the decision to be announced. No documents may be presented in evidence to the Group, unless circulated by the Group secretary in the manner detailed above.

4.8       The validity of the process will not be affected if the candidate fails to submit further documentary evidence on their behalf prior to the deadline given by the Group secretary.

4.9       Following referral of alleged misconduct to the Group, a candidate has the right to reverse their answer to the allegations up to 48 hours prior to the date scheduled for the Group’s decision. Where allegations are then accepted by the candidate, they can submit a written statement with their response that may be taken into account by the Group. A decision on the penalty to be awarded will be made on the date announced by the Group secretary.

4.10     Neither the Group nor the candidate will be given any information regarding the candidate’s result or performance at the examination in question.

4.11      The decision of the Group is to be confirmed in writing to the candidate (the decision document) as soon as possible following the decision date.  A copy will be provided to each member of the Group and a copy will be held on Faculty files. 

5. Appeals procedure

5.1       Appeals must be carried out in accordance with The Faculty of Intensive Care Medicine Regulations and Appeals, Paragraph 13 and an Appeal Application (Appendix 5) with the appropriate fee must be submitted within seven working days of the date of the Groups decision.  All subsequent procedures and hearings will be handled in accordance with Appendices 6 and 7 of the aforementioned regulations.

5.2       The Appeals panel will be advised that the Misconduct Group considered the case but will not be give details of the outcome. 

5.3       The Appeal panel will have the power to confirm, amend or reverse the decision made by the Misconduct Group.

6. Penalties

6.1       Where the Misconduct Group or exam chair/vice chair (paragraph 3.5), agree that the case in whole or in part, is proven whether through admission by the candidate or the outcome of the Group’s findings, then they will consider the following before a penalty is agreed:

• The need to preserve the integrity of the examination.
• The severity of the infringement proven
• Consistency with previous penalties.
• The evidence of remorse and the admission of the understanding of the seriousness of the case.

6.2       The Misconduct panel or the exam chairs (paragraph 3.5) may consider awarding one of the following standard penalties or may give a more specific penalty where appropriate:

• No further action
• A written warning (see paragraph 6.3)
• Result of an examination or part of an examination, to be declared void
• Candidate barred from applying for an exam for a specified period

6.3       Where a written warning is agreed upon, the Group/exam chair will reflect on the severity of the misconduct proven and reserve the right to forward details of the case to the GMC/National Medical Council and in the case of UK trainees, their local Intensive Care Educational Supervisor or Regional Adviser in Intensive Care.

6.4       Where a candidate’s examination result is declared void, the attempt will be recorded against the candidate’s exam history.  Exam papers will not be processed.

Please see the downloadable version of these Regulations below for the Additional Educational Training Form.

The Faculty endorse the key recommendations of the Guidance on Dress Codes for postgraduate medical recruitment, training, and assessment from the Conference of Postgraduate Medical Deans (COPMeD) 2011. 

In particular, candidates are reminded that the same dress code should apply for professional examinations as it does for day-to-day clinical practice/contact with patients. This means that forms of dress should not constrain the Candidate’s ability to demonstrate recognised skills including effective communication with simulated patients or examiners, nor hinder easy verification of the Candidate’s identity.

Hence Candidates are requested not to wear forms of dress that cover the face while attending any of the FICM examinations. Candidates are also advised that there is no requirement to wear clinical/theatre clothing during any of the examinations.