Each exam, a few topics are noted to be answered badly by a number of candidates. ECG interpretation, including basic rhythm analysis continues to be noted as an area of weakness for many candidates, as does chest x-ray interpretation. Again, many candidates seemed unable to answer questions on applied basic sciences, including abdominal anatomy and physiology of cardiac output. Knowledge of relevant microbiology and antibiotics were again an area of weakness for some candidates.
The exam standard is that of an end of Stage 2 trainee, who is one year away from a consultant post. Some examiners commented on a trend of candidates answering ‘ask another specialty’ in answer to some questions eg ‘ask microbiologist’ on antibiotic choice, ‘ask a nurse’ on set up of CPAP; while involving of the multidisciplinary team is clearly important, candidates are expected to have an understanding of the management of all relevant ICU conditions and therapies. Also ‘higher’ intellectual skills such integration of information from multiple items is expected as well as an appreciation of ethical issues in resuscitation. A few candidates lost marks by using casual, inaccurate terms and not then clarifying, such as ‘use electricity’ when ‘DC cardioversion’ was required.
A question on a critically ill obstetric patient that included recent national guidance was answered poorly, and many candidates were unable to answer a question on the practicalities of oxygen and CPAP therapy. Many candidates also did poorly on a question regarding renal replacement therapy, particularly its circuit components, and on chronic critical illness.
