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CICM Hot Case Practice

The hot case is the bedside section of the CICM Second Part exams, and the part no question bank prepares you for. PRIMEX runs the full station: a written stem, a timed bedside phase where findings are revealed only when you ask for them, a timed discussion with an AI examiner, and an examiner-style debrief at the end. It covers the adult FCICM Second Part and the paediatric SPPE.

What is a CICM hot case?

In a hot case you examine a real ICU patient you have never met, then defend your findings and your plan in front of two examiners. The format is fixed: two minutes outside the bedspace reading a short written stem, ten minutes at the bedside performing a focused examination, then ten minutes presenting and discussing the case. The adult FCICM Second Part includes two hot cases, together worth forty per cent of the final mark; in the CICM Second Part Paediatric Examination (SPPE) the hot cases are a core component of the oral section.

Each examiner marks the case out of ten on a supervision-anchored scale: the pass standard reflects an examiner being comfortable leaving you to run the ICU with minimal supervision. Component pass rates move around by sitting; CICM publishes them per component (for example, May 2024: vivas 82%, hot cases 72%, written 59%). A weak hot case can sink an otherwise strong attempt, which is why it deserves dedicated practice rather than leftover time after the written papers.

How the PRIMEX hot case simulator works

The simulator runs the station in the same two phases as the exam, against the same clock.

Phase 0 · 2 min
The stem

Two minutes outside the bedspace with the written stem, exactly the brief the examiners would hand you.

Phase 1 · 10 min
Bedside findings

The AI plays the patient. Documented findings are revealed only when you ask for the specific manoeuvre, observation or data: the latest ABG, the current ventilator settings, the chest X-ray.

Phase 2 · 10 min
Presentation and discussion

The AI switches to examiner. You open with your uninterrupted case presentation, then the questioning moves through interpretation, management and complications.

There is no spoon-feeding in the bedside phase. If you never ask to see the ventilator, you never learn the settings, exactly as at the real bedside. In the discussion the examiner pushes past vague answers and demands specifics: which dose, what target MAP, what tidal volume per kilogram. Cases are written against the college curricula and current guidelines, and every case belongs to a curriculum domain, so the library maps onto the same sections as your tracker, notes and SAQ practice.

Voice mode

You can run the entire station out loud. Voice mode uses medical speech recognition, so you ask for findings and deliver your presentation the way you will on the day, and the AI answers back: it voices the patient during the bedside phase and the examiner during the discussion. If you would rather type, the same station runs fully in text.

The examiner-style debrief

Every case ends with a structured debrief modelled on how the college marks the station: supervision-anchored criteria across the same marking domains, with a mark out of ten. The anchor mirrors the real scale:

Five out of ten reflects an examiner comfortable leaving the candidate to run the ICU with minimal supervision.

The debrief tells you what you failed to elicit at the bedside, where your presentation lost structure, and which management answers needed numbers instead of intentions. From there you can jump straight into the matching study note and close the gap before the next case.

Adult FCICM and paediatric SPPE coverage

Hot cases are one component of the Second Part alongside the written SAQs and the structured vivas. The rest of the PRIMEX CICM track covers those too, with AI-graded SAQ practice, an oral viva simulator with voice, spaced-repetition flashcards, sourced study notes and a curriculum tracker.

Frequently asked questions

What is a CICM hot case?
A hot case is the bedside clinical component of the CICM Second Part exams. You get two minutes outside the bedspace to read a short written stem, ten minutes at the bedside examining a real ICU patient you have never met, then ten minutes presenting and discussing the case with two examiners. In the adult FCICM Second Part the hot cases are worth forty per cent of the final mark; in the paediatric SPPE they are a core component of the oral examination.
How does the PRIMEX hot case simulator work?
It runs the same two-phase structure as the exam. In the bedside phase the AI plays the patient: the case has documented findings, but each one is revealed only when you ask for the specific manoeuvre, observation or piece of data, for example the latest ABG, the current ventilator settings or the chest X-ray. In the discussion phase the AI switches to the examiner role: you give your uninterrupted case presentation first, then the questioning moves through interpretation, management and complications against the clock.
Can I practise hot cases in voice mode?
Yes. Voice mode uses medical speech recognition, so you ask for findings and present the case out loud exactly as you would in the exam. The AI voices the patient during the bedside phase and the examiner during the discussion. You can also run the whole station in text if you prefer to type.
How is a practice hot case marked?
After the discussion you get an examiner-style debrief marked against supervision-anchored criteria across the same domains the college examiners use, with a mark out of ten. The anchor mirrors the real scale, where a pass reflects an examiner being comfortable leaving the candidate to run the ICU with minimal supervision. The debrief tells you what you missed at the bedside, what your presentation lacked, and where the management answers needed specifics such as doses and targets.
Does it cover the paediatric SPPE as well as the adult FCICM exam?
Yes. There is a dedicated paediatric bank of PICU hot cases for the CICM Second Part Paediatric Examination (SPPE), spanning domains from neonatal to trauma, alongside the adult FCICM bank. Both use the same two-phase format with exam-correct framing for the unit you are running.
Is there a free trial?
Yes, every new PRIMEX account starts with a 7-day free trial and you can cancel anytime. The hot case simulator is included in the Specialist plan along with AI-graded SAQs, the oral viva simulator, flashcards, study notes and the curriculum tracker.

Run your first hot case today. The bedside section rewards reps, and reps are exactly what the simulator is for.

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7-day free trial · Cancel anytime