FFICM Final Examination Format Explained

Overall structure

Three separately marked components: an all-SBA written MCQ, then a 13-station OSCE and a four-station Structured Oral (SOE) taken together.

Components and structure

The FFICM Final Examination is assessed across the following components:

• MCQ (written) (MCQ) - 130 questions, 180 min. All single best answer since June 2022: 80 short SBAs worth 1 mark and 50 long, scenario-based SBAs worth 2 marks (maximum 180). Five options per question, no negative marking, Angoff-set pass mark. Delivered online via TestReach.. Must be passed before applying for the OSCE/SOE; a pass is valid for three years.
• OSCE (OSCE) - 13 stations, 7 min. Each station marked out of 20 with an Angoff-set station pass mark; no negative marking and no killer stations. Stations draw from Data, Equipment, Professionalism and Resuscitation.. 13 stations of 7 minutes with 1 minute reading between: 12 live stations count, 1 is an unmarked test station.
• SOE (structured oral) (viva) - 8 questions, 4 stations, 14 min. Two examiners independently mark each question: pass 2, borderline 1, fail 0 (32 marks total). Pass mark set by borderline regression.. Four 14-minute stations with two questions each, focused on clinical problems across the curriculum.

Pass the MCQ first (valid three years), then the OSCE and SOE, which must be booked together at the first attempt. A candidate who fails one of OSCE/SOE retakes only the failed component; failing both means retaking both together. All three components must be passed for the award of FFICM.

Structure per the official examination materials: FICM source.

Exam format glossary

Key assessment formats used in the FFICM Final 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.

Single Best Answer (SBA)

A multiple-choice format in which several options are plausible but the candidate must choose the single best answer for the scenario.

Objective Structured Clinical Examination (OSCE)

A circuit of timed stations, using real or simulated patients, that assesses clinical, procedural and communication skills against a standardised marking scheme.

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

Examiner reports and feedback consistently flag these preparation pitfalls:

• Applied basic science gaps - the Faculty's own reports repeatedly flag pharmacology (mechanisms, interactions, adverse effects) and physiology (ventilation, cardiac tamponade, maternal physiology, renal failure) as weak areas.
• Data interpretation under time pressure: blood results, microscopy and biochemistry of body fluids recur across the written and clinical components.
• Treating the OSCE and SOE as an afterthought - the clinical phase consistently passes a markedly smaller share of candidates than the written paper.
• Paediatric stabilisation and practical procedures (venous access, renal replacement therapy, chest drains, cardiac pacing) - recurring weak areas in the examiner reports.

How PRIMEX maps to the format

• Five-option single best answer bank modelled on the all-SBA FFICM written paper, with grounded per-option explanations.
• Structured Oral (SOE) simulator with voice mode: clinical openings, prioritised management probing and UK guidance expectations.
• UK study notes across 310 syllabus-mapped learning objectives, with spaced-repetition flashcards.

Frequently asked questions