CICM First Part Examination Format Explained

Overall structure

Two written papers (MCQ + SAQ), then cross-table vivas.

Components and structure

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

• Written Paper 1 (mixed-format) — 60 questions, 150 min. 50 MCQ + 10 SAQ. Achieve Angoff pass in BOTH MCQ and SAQ sections (MCQ is a hard gate).
• Written Paper 2 (mixed-format) — 60 questions, 150 min. 50 MCQ + 10 SAQ. Achieve Angoff pass in BOTH MCQ and SAQ sections.
• Oral (cross-table vivas) (viva) — 8 stations, 12 min. 8 x 10-minute vivas (12-min encounter incl. 2 min reading).

Written totals 100 MCQs + 20 SAQs across two papers; pass both written sections (MCQ hard gate) to progress to orals.

Structure per the official examination materials: CICM source.

Exam format glossary

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

Multiple Choice Question (MCQ)

A written item that presents a clinical or factual stem with several answer options, of which one or more are correct, marked automatically against a key.

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.

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:

• Insufficient physiology depth - the CICM First Part demands mechanistic understanding, not memorised definitions.
• Neglecting the pharmacology component, which is highly weighted and requires systematic study.
• Limited SAQ practice - candidates who only read theory consistently underperform those who write practice answers under timed conditions.
• Underestimating the breadth of content: equipment, measurement, and data interpretation appear regularly.

How PRIMEX maps to the format

• SAQ practice bank mapped to the CICM First Part curriculum, with AI feedback on answer structure and content.
• MCQ question bank with spaced repetition to reinforce the physiology and pharmacology domains.
• Weak-area targeting so you spend revision time where your personal gaps are largest.

Frequently asked questions