The Faculty has been undertaking an analysis of the results of the October 2021 FFICM exam since these results were shared on 4 November 2021. We have also held online meetings with national and regional StR and other candidate representatives, regional trainers, and Examiners to collect information and listen to the range of questions and concerns raised. It was important for us to hear the experiences of people sitting the FFICM and to understand the impact on candidates.
The devastation, uncertainty and personal impact felt by so many was clearly articulated. We heard about the individual impact that the exams and exam outcomes have had on some of our doctors in training, valued colleagues alongside whom we work. We recognise the huge personal investment, not just financial but in terms of time, energy, and emotional wellbeing, that training in ICM requires.
We regret that we are not at present able to give a final conclusion to this issue and recognise this prolongs uncertainty. However, we wanted to honour our commitment to update you by 25 November and reassure you that we continue to work hard to resolve matters. At present, a definitive conclusion – the need for which was strongly articulated at the engagement events – is contingent on ongoing discussions with the GMC. We are not able to put forward a date of resolution on the GMC’s behalf but will write again on Thursday 9 December (two weeks from this update).
This update is also available to download as a PDF below.
- There is no clear or single cause for the OSCE/SOE disparity in the exam data.
- We are opening conversations with the GMC.
- FICM’s position is that all passes already issued for this exam will stand.
- This sitting will not count toward any candidate’s total number of examination attempts.
- We are in discussion with the Lead Dean for ICM as to what steps can be taken to safeguard the training status and progression of affected candidates.
- FICM commits to reviewing the OSCE question bank.
Disparity between OSCE and SOE results
We cannot be certain, from analysing the exam data itself, what precise factors have led to the disparity in OSCE/SOE result, or in what proportion. The cause is likely multi-factorial and a confluence of events, and indeed some factors may have impacted different candidates in different ways – we have been doing our best to review as much information, data and feedback on this examination sitting as possible to help contextualise the results. Various factors were suggested at the engagement events; some involved reviewing the question content and conduct of the examination, looking at the case-mix candidates had experienced, the impact of the pandemic on people and the exam experience itself. We hear the feedback that the Faculty and FICM Examiners need to understand and learn from this experience.
Whilst we do not draw any final conclusions from this examination, as local circumstances vary, we cannot discount the serious impact of the pandemic on our candidates, trainers, and Examiners. Case-mix and training opportunities have been affected and our workforce is very tired. The added burden on professional lives and exam preparation has been compounded by ongoing difficulties and concerns for personal health, the health of loved ones, childcare issues, and significant disruption to emotional wellbeing. This is a level of change and disruption not faced by a whole cohort in previous sittings of the examination and therefore it is difficult to draw comparisons to previous sittings. Furthermore, this may be an issue that is more acutely felt and experienced in ICM over any other medical or health profession in the UK, making it difficult to make quick comparisons to other similar groups with national examinations regulated by the GMC.
Involving the GMC
We heard a number of requests from the engagement events for FICM to seek guidance from the GMC. We have been in contact with the GMC to outline what happened and seek a way forward. This further engagement with the GMC is ongoing and will unfortunately require more time, and we are not able to put forward a date on the GMC’s behalf.
We entirely appreciate the desire for urgent resolution to this issue and are working to conclude this as quickly as we can. As stated, we will provide further update on 9 December.
Honouring existing exam passes
Some candidates who passed the exam have asked whether their pass mark might be rescinded following a review. The FICM position, which we have articulated to the GMC, is that previously issued exam passes must be unaffected; we believe that to change this would be unfair to those candidates.
Regardless of the outcome of this situation, we can confirm that the October sitting of the FFICM will not count toward any candidate’s total number of examination attempts.
Workforce and training considerations
We are in discussion with the Lead Dean as to what steps can be taken to safeguard the training status and progression of affected candidates.
As previously discussed, FICM commits to reviewing the OSCE question bank. FFICM will also be participating in the broader independent external review of RCoA examinations, which is now out for tender.
Engagement event questions
We committed to respond within a week to the issues raised in the engagement events in as full a way as possible, with immediate answers to areas we can resolve straight away or updates on progress on those areas which may need additional consideration or input before resolution.
There were questions raised verbally on the call, in the meeting chat and via email. We have considered all the feedback and questions and summarised below with our thoughts – some questions are also reflected in the update section above.
On those areas we have responded, we hope we have addressed your points and provided further background and explanation, along with assurances of the steps we are taking to make necessary improvements. We know that there are outstanding issues, and we will write to you again on 9 December to give you a further update on progress.
If you raised questions which you do not feel are covered, please contact us.
It is important that we listen and use what you have told us as the basis for change which will benefit our members, our patients, and our specialty.
We know we are not there yet, but we are committed to continual improvement and to keeping our members at the forefront of what we do, and to the degree of integrity that you expect.