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2026 Statistics

Key Facts: Facharzt FMH Intensivmedizin Exam

EDIC + SGI

Exam Format

SIWF / SGI Examination Regulations

100

Written EDIC MCQs

ESICM / SGI Examination Committee

6 Years

Postgraduate Training

SIWF Weiterbildungsprogramm

180 min

Written Exam Duration

EDIC Part 1 Standard

Lifetime

FMH Title Validity

Swiss Medical Association (FMH)

100

Practice Questions

OpenExamPrep

The Facharzt FMH Intensivmedizin credential certifies specialist intensivists in Switzerland through SIWF and SGI/SSMI. Assessment comprises the written European EDIC Part 1 examination (100 MCQs in English) and the SGI structured oral clinical board, covering hemodynamics, ARDS ventilation, neurotrauma, CRRT, sepsis resuscitation, and Swiss medical ethics.

Sample Facharzt FMH Intensivmedizin Practice Questions

Try these sample questions to test your Facharzt FMH Intensivmedizin exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 68-year-old man is admitted to the ICU with septic shock secondary to acute ascending cholangitis. After receiving 30 mL/kg of balanced crystalloids, his mean arterial pressure (MAP) is 52 mmHg, heart rate is 118 bpm, and central venous lactate is 4.2 mmol/L. Bedside echocardiography demonstrates a hyperdynamic left ventricle without pericardial effusion. According to the Surviving Sepsis Campaign (SSC) guidelines, what is the initial vasopressor strategy of choice?

A.Initiate norepinephrine as the first-line vasopressor to target a MAP ≥ 65 mmHg, and add vasopressin (0.03 units/min) if norepinephrine dosage escalates

B.Initiate dopamine monotherapy at 10-20 mcg/kg/min to increase both systemic vascular resistance and renal blood flow

C.Start phenylephrine infusion as the first-line agent to avoid worsening tachycardia while achieving vasoconstriction

D.Administer epinephrine monotherapy as the first-line vasopressor before attempting any other catecholamine

Explanation: Norepinephrine is the recommended first-line vasopressor in septic shock, acting primarily as a potent alpha-1 agonist with modest beta-1 adrenergic effects. If the MAP remains inadequate despite moderate-to-high doses of norepinephrine (typically >0.25 mcg/kg/min), vasopressin at a fixed dose of 0.03 units/min should be added to raise blood pressure and reduce norepinephrine requirements.

2A 58-year-old intubated woman with severe bilateral pulmonary infiltrates and refractory hypoxemia undergoes transpulmonary thermodilution monitoring (PiCCO). The device reports an Extravascular Lung Water Index (EVLWI) of 16 mL/kg (normal 3-7 mL/kg), a Pulmonary Vascular Permeability Index (PVPI) of 3.8 (normal 1.0-3.0), and a Global End-Diastolic Volume Index (GEDVI) of 680 mL/m² (normal 680-800 mL/m²). How should these hemodynamic findings be interpreted?

A.Cardiogenic pulmonary edema due to left ventricular volume overload and elevated hydrostatic pressures

B.Non-cardiogenic pulmonary edema characteristic of Acute Respiratory Distress Syndrome (ARDS) with increased capillary permeability

C.Severe intravascular hypovolemia without true pulmonary parenchymal fluid accumulation

D.Isolated right ventricular failure with pulmonary arterial hypertension and normal alveolar permeability

Explanation: Extravascular Lung Water Index (EVLWI) > 10 mL/kg confirms pulmonary edema. The Pulmonary Vascular Permeability Index (PVPI), which reflects the ratio of EVLW to pulmonary blood volume, distinguishes permeability edema (PVPI > 3.0, indicative of ARDS/alveolar-capillary barrier breakdown) from hydrostatic/cardiogenic edema (PVPI < 3.0 with elevated GEDVI). Here, elevated EVLWI with elevated PVPI and normal GEDVI is diagnostic of ARDS.

3A patient with a pulmonary artery catheter (PAC) in place exhibits the following hemodynamic profile: Mean Arterial Pressure (MAP) 55 mmHg, Central Venous Pressure (CVP) 18 mmHg, Pulmonary Artery Occlusion Pressure (PAOP) 22 mmHg, Cardiac Index (CI) 1.6 L/min/m², Systemic Vascular Resistance Index (SVRI) 2600 dyn·s·cm⁻⁵·m², and Mixed Venous Oxygen Saturation (SvO2) 48%. Which clinical condition is most consistent with these measurements?

A.Early hyperdynamic septic shock

B.Severe unresuscitated hemorrhagic hypovolemic shock

C.Acute cardiogenic shock secondary to extensive anterior myocardial infarction

D.Massive acute pulmonary embolism with acute cor pulmonale

Explanation: Cardiogenic shock is characterized by severe pump failure resulting in elevated biventricular filling pressures (high CVP and high PAOP > 18 mmHg), severely depressed cardiac index (<2.2 L/min/m²), compensatory vasoconstriction (elevated SVRI), and marked tissue oxygen extraction resulting in low SvO2 (<65-70%).

4An intensivist assesses fluid responsiveness in a 64-year-old mechanically ventilated patient with septic shock who has spontaneous respiratory efforts and sinus tachycardia. Which diagnostic maneuver provides the highest diagnostic accuracy to predict an increase in cardiac output with volume administration?

A.Measurement of Central Venous Pressure (CVP) target of 12 mmHg

B.Calculation of Inferior Vena Cava (IVC) respiratory collapsibility index on M-mode ultrasound

C.Pulse Pressure Variation (PPV) calculation during spontaneous breathing

D.Passive Leg Raising (PLR) test coupled with continuous real-time stroke volume monitoring

Explanation: Passive Leg Raising (PLR) acts as an endogenous reversible fluid challenge of approximately 300 mL of blood from the lower limbs and splanchnic circulation. When paired with real-time continuous cardiac output or stroke volume monitoring (e.g., via echocardiography, pulse contour analysis, or bioreactance), an increase in stroke volume ≥ 10-15% reliably predicts fluid responsiveness regardless of cardiac rhythm or spontaneous respiratory efforts.

5On day 4 following an extensive anterior STEMI, a 71-year-old man abruptly develops severe dyspnea, hypotension (BP 78/44 mmHg), and a new harsh holosystolic murmur with a palpable thrill at the lower left sternal border. Pulmonary artery catheterization reveals a right atrial oxygen saturation of 58% and a pulmonary artery oxygen saturation of 82%. What is the definitive diagnosis?

A.Post-infarction Ventricular Septal Rupture (VSR)

B.Acute papillary muscle rupture with severe mitral regurgitation

C.Left ventricular free wall rupture with acute cardiac tamponade

D.Acute pulmonary embolism complicating myocardial infarction

Explanation: A significant oxygen saturation step-up (≥7-10%) between the right atrium (58%) and the pulmonary artery / right ventricle (82%) indicates an abnormal left-to-right intracardiac shunt. In the setting of a recent STEMI and a new harsh holosystolic murmur with a thrill at the lower left sternal border, this confirms an acute ventricular septal rupture (VSR).

6A 52-year-old woman with severe pulmonary arterial hypertension is admitted to the ICU with acute right ventricular (RV) failure. She is hypotensive (MAP 58 mmHg) with a central venous pressure of 20 mmHg. Systemic arterial pressure is supported with norepinephrine. Which inotropic agent is most advantageous for augmenting RV contractility while reducing pulmonary vascular resistance without increasing myocardial oxygen consumption excessively?

A.High-dose dopamine infusion (15 mcg/kg/min)

B.Inhaled iloprost combined with an intravenous phosphodiesterase-3 inhibitor (Milrinone) or Levosimendan

C.Phenylephrine infusion titrated to a mean arterial pressure of 85 mmHg

D.High-dose epinephrine infusion (0.5 mcg/kg/min)

Explanation: Phosphodiesterase-3 (PDE-3) inhibitors (such as milrinone) and calcium sensitizers (levosimendan) provide positive inotropy ('inodilators') combined with both systemic and pulmonary vasodilation. In acute right ventricular decompensation with elevated pulmonary vascular resistance, milrinone or levosimendan enhances RV systolic performance while reducing RV afterload. Inhaled prostacyclins (iloprost/epoprostenol) provide selective pulmonary vasodilation without causing systemic hypotension.

7A 45-year-old man with refractory cardiogenic shock is supported on peripheral femoral Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO). Three days after cannulation, his right radial arterial line shows a PaO2 of 48 mmHg and SaO2 of 82%, while the left femoral arterial cannula delivers fully oxygenated blood (SaO2 100%). What is the underlying mechanism and the most appropriate management of this phenomenon?

A.Aortic dissection caused by the femoral arterial cannula; emergently clamp the ECMO circuit

B.Inadequate ECMO pump speed; increase RPM to maximum regardless of preload drainage

C.Harlequin syndrome (differential hypoxemia) due to native left ventricular recovery ejecting deoxygenated blood from failing lungs; convert to Veno-Arterio-Venous (VAV) ECMO or optimize ventilator settings

D.Severe oxygenator membrane failure; immediately perform an emergent circuit exchange

Explanation: Harlequin syndrome (North-South syndrome or differential hypoxemia) occurs in peripheral femoral VA-ECMO when recovering native cardiac output ejects poorly oxygenated blood (due to concomitant severe pulmonary dysfunction/edema) into the proximal aorta, perfusing the coronary arteries and cerebral vessels (right arm/carotids), while retrograde well-oxygenated ECMO blood perfuses the lower body. Management includes improving native lung gas exchange (increasing PEEP/FiO2), or converting to a hybrid configuration such as V-AV ECMO.

8A 60-year-old patient with an Impella CP microaxial flow pump placed for cardiogenic shock develops sudden recurrent 'position alarms', dark red urine, and a rise in plasma free hemoglobin to 85 mg/dL with an elevated serum lactate dehydrogenase (LDH). What is the primary underlying cause and immediate corrective action?

A.Acute renal cortical necrosis; initiate continuous veno-venous hemofiltration immediately

B.Heparin-induced thrombocytopenia; discontinue heparin purge and switch to bivalirudin

C.Aortic valve leaflet rupture; immediately initiate emergency open-heart surgery

D.Impella inlet suction and malposition causing mechanical shear hemolysis; evaluate catheter position with echocardiography and adjust depth/support level

Explanation: Impella complications frequently include mechanical hemolysis and suction alarms caused by device malposition (inlet abutting the LV wall, papillary muscle, or crossing too deep/shallow across the aortic valve) or severe intravascular hypovolemia. Plasma free hemoglobin elevation, dark hemoglobinuria, and LDH rise are hallmark signs of hemolysis. Immediate echocardiographic verification of the inlet depth (3.5-4.0 cm below the aortic valve) and adjustment of position or reducing P-level is required.

9A 55-year-old woman is admitted to the ICU comatose following resuscitation from an out-of-hospital ventricular fibrillation cardiac arrest. In accordance with current ERC/ESICM post-resuscitation care guidelines, what is the standard temperature management strategy and neuroprognostication timeline?

A.Actively prevent fever by maintaining constant normothermia (target 36.0–37.5°C) or constant hypothermia (32–36°C) for at least 72 hours, and delay formal neuroprognostication until ≥72 hours post-arrest

B.Rapidly cool the patient to 28–30°C for 48 hours and perform definitive brain death testing at 24 hours post-ROSC

C.Permit spontaneous fever up to 39°C as an adaptive inflammatory response and perform brain MRI at 12 hours

D.Maintain strict hypothermia at 32°C for 7 days followed by immediate extubation

Explanation: Current post-cardiac arrest guidelines (ERC/ESICM) recommend targeted temperature management (TTM) targeting a constant temperature between 32°C and 36°C, or strictly preventing fever (>37.7°C) for at least 72 hours. Multimodal neuroprognostication (bilateral absence of pupillary/corneal reflexes, SSEP N20 loss, high serum NSE, malignant EEG patterns) should strictly be performed at or after 72 hours post-ROSC after excluding residual sedation and neuromuscular blockade.

10A 62-year-old postoperative orthopedic patient experiences sudden hemodynamic collapse in the ICU. Bedside focused critical care echocardiography (TTE) demonstrates right ventricular dilation with an RV/LV end-diastolic area ratio of 1.2, flattening of the interventricular septum throughout the cardiac cycle ('D-shaped' left ventricle), and hyperkinesia of the RV apex with akinesia of the RV mid-free wall (McConnell's sign). What is the most likely diagnosis?

A.Acute anterior myocardial infarction with left ventricular apical aneurysm

B.Acute massive pulmonary embolism causing acute cor pulmonale

C.Constrictive pericarditis with pericardial knock

D.Severe hypertrophic obstructive cardiomyopathy

Explanation: Acute right ventricular strain (acute cor pulmonale) on bedside echocardiography is characterized by RV enlargement (RV/LV area ratio > 0.9–1.0), systolic and diastolic septal flattening ('D-shaped' LV on parasternal short-axis view), and McConnell's sign (sparing and hyperkinesia of the RV apex with severe akinesia of the RV mid-free wall). In an acutely collapsed postoperative patient, this is highly specific for massive acute pulmonary embolism.

About the Facharzt FMH Intensivmedizin Exam

The Facharzt FMH für Intensivmedizin (Specialist in Intensive Care Medicine FMH) is the Swiss Federal specialist title granting full independent practice rights as an intensivist across Switzerland. Governed by the SIWF (Swiss Institute for Postgraduate and Continuous Medical Training) and the SGI / SSMI (Swiss Society of Intensive Care Medicine), board qualification requires passing the written European Diploma in Intensive Care Medicine (EDIC Part 1) examination, followed by the SGI structured oral board examination. The syllabus covers advanced hemodynamic monitoring and shock, invasive mechanical ventilation and ARDS, neuro-critical care, acute kidney injury and continuous renal replacement therapy (CRRT), sepsis and severe infections, clinical toxicology, polytrauma resuscitation, and Swiss medical-ethical end-of-life decision-making. Note on format and language: While the official written EDIC Part 1 examination is administered in English and the SGI oral examination is conducted in Swiss national languages (German/French/Italian) or English, this question bank is an English-language multiple-choice study adaptation created by OpenExamPrep—not an official SGI or ESICM examination release—specifically designed to train high-yield clinical decision-making, physiological calculations, and guideline-based critical care protocols.

Assessment

Two-part qualifying examination: 1) The written EDIC Part 1 examination comprising 100 multiple-choice questions (3 hours, administered in English), and 2) The SGI structured oral-practical board examination consisting of interactive clinical case vignettes evaluated by a panel of Swiss critical care specialists in German, French, Italian, or English.

Time Limit

180 minutes written examination (EDIC Part 1) plus approximately 60–90 minutes structured oral board examination

Passing Score

Criterion-referenced standard passing score on the written EDIC Part 1 MCQ examination (Angoff method, typically ~60–65% raw score) and a structured passing evaluation across all clinical case stations assessed by the SGI examination committee

Exam Fee

CHF 1,700 for non-members (CHF 1,360–1,530 for SGI members) for the combined written and oral examination; SIWF FMH Title Application fee CHF 1,000–2,500 (Schweizerisches Institut für ärztliche Weiter- und Fortbildung (SIWF / FMH) and Schweizerische Gesellschaft für Intensivmedizin (SGI / SSMI) in partnership with ESICM (EDIC))

Facharzt FMH Intensivmedizin Exam Content Outline

25%

Hemodynamics, Shock & Cardiovascular Emergencies

Pathophysiology and management of distributive, cardiogenic, obstructive, and hypovolemic shock; advanced hemodynamic monitoring (transpulmonary thermodilution/PiCCO, pulmonary artery catheterization, critical care echocardiography); vasopressors, inotropes, and vasodilators; post-cardiac arrest care and targeted temperature management; and temporary mechanical circulatory support (VA-ECMO, Impella, IABP).

25%

Respiratory Failure, Mechanical Ventilation & ARDS

Diagnosis and Berlin definition of ARDS; lung-protective invasive mechanical ventilation (low tidal volume, driving pressure, plateau pressure limits, PEEP titration); rescue therapies (prone positioning, neuromuscular blockade, VV-ECMO); obstructive lung disease (severe COPD exacerbation, status asthmaticus, auto-PEEP); non-invasive ventilation and high-flow nasal cannula (ROX index); ventilator waveforms, dyssynchrony, and protocolized weaning.

18%

Neuro-Critical Care & Sedation/Analgesia/Delirium

Management of severe traumatic brain injury (ICP/CPP targets, tiered intracranial hypertension protocols); aneurysmal subarachnoid hemorrhage and delayed cerebral ischemia; refractory status epilepticus; acute stroke and intracerebral hemorrhage; brain death determination (SAMW/ASSM guidelines); and evidence-based sedation, analgesia, and delirium management (PADIS guidelines, RASS, CAM-ICU).

12%

Acute Kidney Injury, CRRT & Metabolic/Electrolyte Disorders

KDIGO staging and etiology of acute kidney injury; continuous renal replacement therapy (CVVH, CVVHD, CVVHDF, dose prescription, regional citrate anticoagulation vs systemic heparin); advanced acid-base interpretation (Stewart physicochemical approach vs Henderson-Hasselbalch, anion gap); and life-threatening electrolyte emergencies (hyperkalemia, severe hyponatremia/ODS risk, hypophosphatemia, refeeding syndrome).

10%

Sepsis, Severe Infections & Antimicrobial Stewardship

Sepsis-3 diagnostic criteria (SOFA score) and Surviving Sepsis Campaign 1-hour resuscitation bundle; pharmacokinetic/pharmacodynamic optimization of antimicrobials in critical illness (extended/continuous infusions, therapeutic drug monitoring, augmented renal clearance); ventilator-associated pneumonia, catheter-related bloodstream infections, necrotizing fasciitis, severe acute pancreatitis, and invasive fungal infections.

10%

Trauma, Toxicology, Nutrition & Ethics/End-of-Life

Severe polytrauma resuscitation (massive transfusion protocol, viscoelastic ROTEM/TEG testing, tranexamic acid, abdominal compartment syndrome); acute toxidromes and antidotes (paracetamol/NAC, toxic alcohols, carbon monoxide/cyanide, calcium channel blockers/HIET, local anesthetic systemic toxicity/lipid rescue); enteral/parenteral nutrition guidelines; and Swiss medical-ethical standards (SAMW/ASSM guidelines, advance directives, surrogate decision-making, withdrawal of life support, organ donation DBD/DCDD).

How to Pass the Facharzt FMH Intensivmedizin Exam

What You Need to Know

Passing score: Criterion-referenced standard passing score on the written EDIC Part 1 MCQ examination (Angoff method, typically ~60–65% raw score) and a structured passing evaluation across all clinical case stations assessed by the SGI examination committee
Assessment: Two-part qualifying examination: 1) The written EDIC Part 1 examination comprising 100 multiple-choice questions (3 hours, administered in English), and 2) The SGI structured oral-practical board examination consisting of interactive clinical case vignettes evaluated by a panel of Swiss critical care specialists in German, French, Italian, or English.
Time limit: 180 minutes written examination (EDIC Part 1) plus approximately 60–90 minutes structured oral board examination
Exam fee: CHF 1,700 for non-members (CHF 1,360–1,530 for SGI members) for the combined written and oral examination; SIWF FMH Title Application fee CHF 1,000–2,500

Keys to Passing

Work through all 100 available questions
Review every answer and explanation
Track weak areas and revisit them
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Facharzt FMH Intensivmedizin Study Tips from Top Performers

1Master Hemodynamic Waveforms and Profiles: Be fluent in distinguishing cardiogenic shock (high CVP/PAOP, low CI, high SVR), septic shock (low CVP/PAOP, high CI early, low SVR), and obstructive shock (elevated right heart pressures with normal/low left heart filling in PE vs equalization of diastolic pressures in cardiac tamponade).

2Calculate Respiratory Mechanics Bedside: Memorize target thresholds for ARDS protective ventilation: tidal volume 4–8 mL/kg predicted body weight (PBW), plateau pressure < 30 cmH2O, and driving pressure < 14–15 cmH2O. Know PROSEVA trial criteria for prone positioning (PaO2/FiO2 < 150 with PEEP ≥ 10 cmH2O and FiO2 ≥ 0.6 for ≥16 hours/day).

3Review Neuro-Critical Care Tiered Protocols: Understand the Brain Trauma Foundation step-up management for elevated intracranial pressure (>22 mmHg) and cerebral perfusion pressure (target 60–70 mmHg), including the distinct physiological roles of 20% mannitol vs 3% hypertonic saline, mild hypocapnia (PaCO2 30–35 mmHg) as a temporizing bridge, and surgical decompressive craniectomy.

4Understand Regional Citrate Anticoagulation (RCA) in CRRT: Recognize that citrate chelates ionized calcium in the extracorporeal circuit (target circuit iCa 0.25–0.35 mmol/L), while systemic calcium chloride/gluconate infusion restores systemic iCa (target 1.1–1.3 mmol/L). Monitor for citrate toxicity ('citrate lock') marked by widening total-to-ionized calcium ratio (>2.5), refractory metabolic acidosis, and escalating systemic calcium requirements.

5Integrate Swiss SAMW/ASSM Medical Ethics: Know the Swiss legal framework (ZGB Art. 360 ff.) regarding advance directives (Patientenverfügung), surrogate decision-maker hierarchy (beiständische Person, spouse/partner, cohabiting partner, descendants, parents, siblings), criteria for withholding/withdrawing life-sustaining treatment, and protocolized palliative symptom control during terminal extubation.

Frequently Asked Questions

What is the Facharzt FMH für Intensivmedizin title?

The Facharzt FMH für Intensivmedizin is the federally recognized specialist medical title awarded by the SIWF / FMH (Swiss Medical Association) upon completion of at least 6 years of accredited postgraduate training (including a core specialty and at least 33–36 months in accredited category A/B intensive care units), passing both the written EDIC Part 1 examination and the SGI oral board examination, publishing a peer-reviewed scientific paper, and meeting all logbook requirements.

How is the Swiss Intensive Care Medicine specialist examination structured?

The qualification requires two distinct examinations: 1) The written EDIC Part 1 (European Diploma in Intensive Care Medicine) examination, consisting of 100 MCQs in English organized in collaboration with ESICM, and 2) The SGI structured oral board examination, which tests clinical reasoning, bedside hemodynamic data interpretation, critical care imaging, and ethical decision-making across real-world patient scenarios before a panel of Swiss intensivists.

What is the connection between the Swiss SGI exam and the European EDIC?

Under the cooperation between the Swiss Society of Intensive Care Medicine (SGI/SSMI) and the European Society of Intensive Care Medicine (ESICM), candidates registering for the Swiss written specialist exam are automatically registered for the EDIC Part 1 examination. Passing this component satisfies both the Swiss written exam requirement and the first half of the European Diploma in Intensive Care Medicine.

When can Swiss intensive care trainees sit the examination?

Trainees typically register for the written EDIC Part 1 examination during their 5th or 6th year of postgraduate training (after completing at least 18–24 months of accredited intensive care clinical time). The SGI oral board examination is taken after successfully passing the written part and nearing completion of all clinical training requirements.

Why is this practice question bank presented in English?

The official written EDIC Part 1 Examination is written and administered exclusively in English across Europe, including Switzerland. Critical care scientific literature, hemodynamic formulas, and international consensus guidelines (ESICM, SSC, ARDSnet) are universally formulated in English. This practice bank provides 100 high-yield English-language questions tailored to the SGI and EDIC blueprint.

What are high-yield clinical calculations tested on the ICU board?

Key calculations include driving pressure (Plateau pressure - PEEP), static compliance (Vt / [Pplat - PEEP]), ROX index ([SpO2/FiO2]/Respiratory Rate), systemic vascular resistance (SVR = 80 × [MAP - CVP] / CO), oxygen delivery (DO2 = CO × CaO2 × 10), Stewart strong ion difference (SID = [Na + K + Ca + Mg] - [Cl + Lactate]), and calcium ratio during citrate anticoagulation (total Ca / ionized Ca > 2.5 indicating citrate accumulation).

100+ Free Facharzt FMH Intensivmedizin Practice Questions

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