How to prepare for the FFICM
The Final FFICM SOE is four 14-minute stations, each with two seven-minute questions of five sub-questions, marked independently by two examiners. 2026-27 is the final year of the current OSCE/SOE, with the last full sitting expected in March 2027, before a single clinical exam, ACRE, replaces both from July 2027 (subject to GMC approval). Prepare from the FFICM exam syllabus, answer the Faculty's example SOE questions aloud against a seven-minute clock, and structure every answer, which is what the Faculty's examiners repeatedly ask for.
Step by step
- 1
Decide whether to sit now or wait for ACRE
The 2026-27 OSCE/SOE sittings are 5 to 8 October 2026 and 15 to 18 March 2027; the Faculty's pages now call the exam FCICM because it is becoming the College of Intensive Care Medicine. From July 2027 you sit ACRE, two circuits of seven nine-minute stations, unless you hold a partial pass. If you have failed five times, the Faculty recommends waiting for ACRE, and if you are in training you must discuss waiting with your Training Programme Director.
- 2
Know the rules for your first sitting
You must pass the MCQ first, and it is valid for three years. At your first sitting you take the OSCE and SOE together; if you then pass one, you only retake the other.
- 3
Revise from the Faculty's syllabus and blueprint
The SOE tests clinical science applied to intensive care, usually through clinical problems, with questions drawn from across all curriculum domains. The Faculty's detailed FFICM Examination Syllabus and the ICM Assessment Blueprint are the documents to revise against.
- 4
Practise the Faculty's example questions aloud
Use the Faculty's example SOE questions and its videos of good pass and borderline answers to endocrine and microbiology questions. Answer each question aloud in seven minutes with a colleague asking the sub-questions, since every question has five predetermined sub-questions.
- 5
Build a structure for common question stems
The Faculty's 2024-25 annual report advises using the FFICM Exam Glossary and creating structured response tools for stems such as 'What is the pathophysiology of?', 'What is the role of?' and 'What additional challenges should be considered?'. Candidates who did well answered systematically without significant prompting from the examiner.
- 6
Target the topics examiners flag
The annual report lists weak SOE areas: applied basic science and pathophysiology (for example inotropes, right heart failure, respiratory physiology and toxicology), organ support such as ventilator modes and settings and renal replacement therapy, common ICU procedures, and professionalism. Earlier reports flagged DNACPR, mental capacity, high-flow nasal oxygen, 12-lead ECG electrode placement and measuring compartment pressure.
- 7
Practise with seniors and read the guidance
The Faculty advises practising with peers and senior colleagues, especially those with examiner or postgraduate training experience, and reviewing published ICM professional guidelines and key research as part of your preparation.
- 8
Know the day
The SOE is run by the RCoA examinations team in the same building as the FRCA exams. Bring a passport or photo driving licence, as hospital ID is not accepted, and remember that every station must be attempted or a fail is awarded automatically.
Official resources
- FFICM Final SOE
The Faculty's SOE page: objective, structure, scoring and the rules on sitting it with the OSCE.
- Resources for Candidates
The Faculty's syllabus, glossary, example questions, SOE example videos and its list of topics that have scored poorly in past exams.
- FFICM Example SOE Questions
Example SOE questions from the Faculty; use them for timed seven-minute practice with a colleague.
- FFICM Examination Syllabus (March 2022)
The detailed syllabus the Faculty produced for exam revision, alongside the curriculum's assessment blueprint.
- FFICM Exam Glossary
Definitions of the terms and phrases used in exam questions, so you know exactly what each stem is asking.
- FFICM Examination Annual Report 2024-25
Section 4.3 gives examiners' feedback on SOE performance and how to prepare.
- The Transition Year
Who can still sit the legacy OSCE/SOE in 2027-28, and the Faculty's decision pathways after each result.
Common mistakes examiners report
- Unstructured answers. Examiners have reported SOE candidates who would have scored more easily by structuring their answers, particularly when asked for lists, and by a more structured approach to broad topics. source
- Vague or unfocused answers to professionalism questions, with no reference to guidelines, ethical principles or evidence-based medicine. source
- Talking generally rather than answering the exact question, and using vague non-medical terms, such as 'heart attack' when anterior myocardial infarction was required. source
- Deferring to another specialty, for example 'ask a microbiologist' about antibiotic choice. Examiners expect you to understand the management of all relevant ICU conditions and therapies. source
Practise with MedMock
MedMock practises the Final FFICM SOE only: four 14-minute examiner-led stations, each with two seven-minute questions of five sub-questions, followed by marked feedback. Because the Faculty publishes no station themes, the practice stations are grouped by curriculum area (anaesthesia and peri-operative care; medicine, surgery and trauma; science; professionalism), and the worked example shows one full station. The MCQ, the OSCE and the new ACRE format are not practised.
Questions candidates ask
Is 2026-27 the last year of the SOE?
Yes, unless you already hold a partial pass. The final academic year of the current OSCE/SOE runs to June 2027, and the last full sitting is expected in March 2027. In 2027-28 only candidates with a valid partial pass can take their outstanding legacy component; everyone else sits ACRE.
What does ACRE look like?
One clinical oral exam delivered in two halves on the same day: two circuits of seven nine-minute stations, with three minutes to read each station, including one communication station with an actor. The Faculty says the curriculum, standard and purpose of the assessment have not changed.
What is the SOE pass mark?
It is set by borderline regression of question scores against examiners' global scores, and the Faculty says it will be in the range of 80% to 85%. The format page explains the marking.
Do I have to sit the OSCE and SOE together?
At your first sitting, yes. If you fail one and pass the other, you only retake the failed component; if you fail both, you retake them together.
How long should I prepare for the SOE?
The Faculty does not set a preparation period. Its annual report links strong performance to thorough preparation and familiarity with the exam structure, so leave plenty of time for timed spoken practice after your reading rather than squeezing it into the last few days.
Sources
- FICM: FFICM Final SOE
- FICM: Calendar & Fees
- FICM: 2027: Launch of the New FCICM Exams
- FICM: Candidate FAQs (2027 launch of the new FCICM exams)
- FICM: The Transition Year
- FICM: Deciding whether to sit or wait - Key Considerations
- FICM: Resources for Candidates
- FICM: FFICM Examination Annual Report 2024-25
- FICM: FFICM VIVA Candidate Information (March 2022)
- FICM: FFICM Chair's Report March 2025
- FICM: FFICM Exam Glossary
Checked on 27 September 2026.
Exams and their regulations change. MedMock is not affiliated with any examining body; always check the current guidance on the official site before you book.