CICM Second Part Examination Format Explained

Overall structure

Two written SAQ papers, then a clinical (hot cases) and viva oral section.

Components and structure

The CICM Second Part Examination is assessed across the following components:

• Written Paper 1 (short-answer (SAQ)) — 15 questions, 150 min. ~10 min/SAQ. Achieve Angoff cut-off in written to reach orals.
• Written Paper 2 (short-answer (SAQ)) — 15 questions, 150 min. ~10 min/SAQ. Achieve Angoff cut-off in written to reach orals.
• Clinical (Hot Cases) (long case) — 2 stations, 20 min. 30 marks. No severe fail in Clinical.
• Vivas (Cross-table) (viva) — 8 stations, 10 min. 8 x 10-minute encounters (+2 min reading each).

Written totals 30 SAQs (300 marks). To pass orals: >=50% of oral marks AND no severe fail in Clinical.

Structure per the official examination materials: CICM source.

Exam format glossary

Key assessment formats used in the CICM Second Part Examination, defined. Each definition is general and applies across colleges.

Short Answer Question (SAQ)

A written question that requires a structured free-text response, marked by examiners against a model answer or rubric rather than by machine.

Viva voce

A structured oral examination in which examiners question the candidate in real time, assessing reasoning, justification and depth of understanding under pressure.

Long case

A clinical examination in which the candidate independently assesses a real patient, then presents and defends the history, findings and management plan to examiners.

Hot case

An unseen, time-pressured bedside assessment of a real and often critically ill patient, used in intensive-care examinations to test rapid clinical assessment.

What the format means for your preparation

The single most common preparation mistake is studying as if the examination only had an MCQ component. Format-aware preparation looks like this:

• MCQ components reward high question volume and pattern recognition. Read explanations, not just answers, and revisit weak domains with spaced repetition.
• Short answer / SAQ components reward a prioritised, structured response under time pressure. Practise writing complete answers in the available time, not just outlining points.
• Viva or OSCE components reward verbalised structured reasoning. Practise aloud, ideally with feedback, rather than rehearsing silently.
• Practical or image-based components reward repeated exposure under time pressure. Build a routine that includes timed slide or image interpretation.

What separates pass from fail under this format

Across multiple sittings, these failure modes recur:

• Vague SAQ answers without clinical prioritisation - examiners want a management framework, not a list of differentials.
• Clinical station anxiety disrupting the structured thinking that scores marks in each domain.
• Gaps in less-common ICU presentations: toxicology, obstetric emergencies, and paediatric ICU are tested.
• Over-relying on clinical experience without structured examination preparation in the final months.

How PRIMEX maps to the format

• SAQ practice with AI grading benchmarked to CICM Fellowship examiner expectations.
• Viva simulation for structured clinical reasoning practice under timed conditions.
• Curriculum-mapped notes across all CICM Fellowship domains.

Frequently asked questions