FFICM Examination Report March 2021

Each question is written by an examiner in the OSCE subgroup, before being reviewed and revised by a panel of OSCE examiners. The final question is then subjected to an ‘Angoffing’ process by examiners in the OSCE subgroup to establish the standard required. Only questions that have undergone this full review process and have been approved by the OSCE group of examiners are added to the live database for inclusion into the examination. 

Each OSCE question contains a number of sub-questions. Overall the OSCE question is marked out of a total of 20. A sub-question with a single factual answer is generally awarded 1 mark (occasionally 2 for particularly important items). A sub-question with a number of correct answers may be scored 1 mark per correct answer or multiple answers e.g. 1 mark per 2 items. As is normal for medical OSCE questions, a complex skill or overall performance within a question (such as communication style in a communication question or overall fluency and prioritisation in a simulation question) may be scored 0 to 5.

OSCE questions are ‘scripted’ carefully so that the questioning is standardised for all candidates, with any prompts which the examiner is allowed to use written into the question. This is done so that the questioning is as objective and reproduceable as possible. 

The first diet of the FFICM exam comprised only new questions. The OSCE question bank has expanded over time as new questions have been added. Now, exam questions are regularly reused, and new ones included as “test” stations to carefully assess their performance, allowing further editing prior to going “live” in future sittings.  

The agreed Angoff score for the question remains until such time as the question is revised. A programme of review and revision (if necessary) of all questions occurs over several years, to ensure all questions remain relevant and up to date, for example reflecting new relevant National guidelines or changes in practice.  Revised questions are then re-presented for Angoff to establish the new Angoff score. This process is done in advance of the exam itself by the examiners in the OSCE subgroup.

Each OSCE exam has 13 questions, of which one or two are new (i.e., not used in any previous exam). Over time, the number of new questions per day has reduced gradually from all new questions in the first exam to one or two plus the test question per day. In the most recent October exam previously used questions had been used between one and eight times (an average of 2.8 times).