Are you ready to start the FFICM?

by Dr. Ed Hughes


Do you even need to? Maybe you’ve got the feeling you should have started already but life keeps getting in the way? Where do you even begin?

We've all been there. Through this article you'll hopefully find some answers that will point you in the right direction.

Should you start the FFICM?

The answer to the question “Are you ready to start the FFICM?” is actually quite easy, you’re eligible if you’re at the end of Stage One or within Stage Two of your training. The answer to “Should you start the FFICM?” is more personal and nuanced.

The FFICM has a sitting every six months meaning you can have four attempts whilst in Stage Two without delaying your progression into Stage Three. You’ve a total of six attempts to work with.

At the start of Stage 2 you have the luxury of choice and you can fit the exam around you. Luxury will slowly ebb into a pressing need to complete the FFICM.

I’m going to be honest with you, embarking on the FFICM is not something to be done half-heartedly. It’s a tough (and maybe not always fair) exam that deserves your respect.

Passing the FFICM is an endeavour that goes together with personal sacrifice. You need to be at a place in your life where you can make that sacrifice. It's a temporary and unsustainable tip in your work-life balance that you hopefully only need to do once.

If you’re about to move house, get married, or have a baby, maybe now isn’t the right time to start unless you absolutely must.

Of course, you can’t plan for all of life’s eventualities and there is never an ideal time to do an exam. How you cope with that risk of the unknown will also be a factor that will influence which sitting you attempt.

In short, it’s a tough exam and in choosing a sitting you need to balance your ability to commit to the work against the number of sittings you have left, bearing in mind that your personal circumstances might change unexpectedly.

How much time do you need?

Some people are naturally good at exams, some people need to work harder. Everyone’s personal circumstances are different.

As a ballpark figure three to four months of preparation is not unusual for most. Some particularly talented trainees have done the work in 6 weeks.

Your ability to find revision time in and around work will influence your lead in time to the exam.

Personally, I was able to commit about 6 to 10 hours per week to revise. I had a one-year-old child at home and felt I needed to protect my time with him, so I revised before he got up, during my lunch in work, and after he’d gone to bed with a glass of wine.

SPA time was only occasionally useful.

Your circumstances will be different but it’s important to remain realistic with the time you have.

Don’t over-estimate the time you have available or be over-ambitious with what you can achieve in it. There will be a constant tension between what you want to do and what you can do. It’s a recipe for burn-out and a tightrope you walk.

You can only do what you can do.

How understanding and forgiving any Significant Others are will play a big factor in your ability to revise outside of work. You should talk and come to an understanding before you commit to the exam.

Most importantly, make sure you allocate time to not revise and do the things that actually bring you a bit of happiness. You’ll need it.

How should you start?

The first step is the hardest.

When you first start you might feel overwhelmed with the breadth and depth of content you’re expected to know, that's normal.

The syllabus published by the college is vague and does not accurately reflect the detail you are expected to know, particularly regarding the more esoteric areas of exam material. The syllabus can be used as a blueprint, but it should not form the foundation of your revision if you value your sanity.

There are several avenues into the work and each has different benefits and drawbacks.

In my humble opinion, your revision should be directed almost exclusively towards passing the OSCE and the VIVA. The knowledge you accrue in preparation for the oral parts of the FFICM will be enough to see you through the SBA paper.

Your time is precious and cannot be wasted going over subjects you already know or doing unfocussed reading.

Picking up an FFICM MCQ or SBA book is an excellent way to facilitate focussed revision. Past questions are a great way of exploring your understanding and knowledge gaps. When you perform poorly on a question, revise that subject to an OSCE/VIVA level. You’ll experience an exponential growth in your knowledge whilst covering a breadth of exam focussed subjects. Past questions can be easily slotted into 20 minutes of downtime you find here or there.

If past questions are not for you, there are multiple topics that represent low hanging fruit for targeted revision. A comprehensive list will follow, but feel free to look at the following to get you started:

Making it Stick

How you keep your notes preparing for this exam is up to you but worth some thought before you start.

Use the method of preparation that is most complementary to your style of learning.

Some people have found great success with flash cards, keeping paper-based notes, mind maps etc.

I have to write things down. The setup that got me through the FRCA and FFICM was an iPad pro and the Microsoft OneNote app to keep electronic but handwritten and searchable notes. Keeping everything electronic meant I always had my textbooks and could work flexibly

The Next Steps

In the coming weeks a group of post-FFICM trainees and I will publish articles regarding how to be successful in the exam with a young family, what resoures are available, how to prepare for the OSCE, how to prepare for the VIVA, and what to do on the day of the exam.

Good luck.

The FFICM is not an insurmountable task and you can do it, just like the thousands of trainees who’ve gone before you and the thousands that will come after you.