FFICM Examiners Report - March 2017

Over the two days of examining 11 visitors attended the exam. There is a limit to the number

of places available to visitors and I am pleased to say on this occasion all visitors either

attended or gave the faculty notice of problems, rather than just not presenting on the day as

in previous sittings.

Most visitors attending the exam are involved in organising training and assessment

although some were merely interested as trainers themselves. The feedback during this

exam was similar to previous sittings. Many of the visitors were surprised to see the

standard expected although some thought the exam was easier than they expected and

others thought it was harder. Most were impressed with the breadth of knowledge tested in

the exam and even within each cohort of candidates. Some visitors seemed surprised to find

the wide range of imaging used in the exam and even more so that candidates were

prepared for this.

The visitors are a valuable source of feedback to the examiners as well as acting as external

auditors. Some provided specific feedback about individual questions that will be used by the

sub-groups responsible for maintaining the question banks. As before visitors considered it

was invaluable to be able to see how the exam runs and the standard that is expected to

communicate back to local trainees.

Visitors selected a few topics to highlight, they recognised that there were a number of

questions on paediatric critical care and complimented the exam on covering the issue of

‘non-accidental injury’ in one station and ‘never events’ in another. As always the subject of

ECG’s was raised and I refer the reader to previous reports for details. From the examiners

point of view there was not universal criticism of performance on ECG’s but all agreed that

the topic was generally weak.

One of the communication stations was setup to see how a candidate would handle a

relative who was using an interpreter. On this occasion the interpreter was signing for a

simulated deaf relative. This was handled with varying degrees of professionalism.

The simulation station presented a number of different scenarios to different cohorts of

candidates. In this exam the examiners commented that some candidates were struggling

because they chose not to believe what they were being told during a simulation. Examiners

stressed that the simulator is not set up to trick candidates. If the simulated assistant is

‘suitably experienced’ and indicates there are bilateral breath sound with nothing added then

it is reasonable for the candidate to believe this is accurate information at the time.

Again in this sitting of the exam some candidates’ performance was at a level that caused

special concern to the examiners and this will be fed back to local tutors in line with exam

rules. Ideally candidates will seek local advice about their preparedness for the exam and be

dissuaded from taking it if not ready.

As always it should be stressed to candidates that they will on occasion be presented with

clinical situations where the patient or patient’s findings are normal and other situations

where the abnormalities are gross. One examiner reported showing imaging to candidates

clearly showing retained swabs that regularly were not commented upon.