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100+ Free FFICM Final Practice Questions

Pass your Fellowship of the Faculty of Intensive Care Medicine Final Examination exam on the first try — instant access, no signup required.

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Which complication should be considered immediately after difficult internal jugular central line insertion with new hypoxaemia?

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Key Facts: FFICM Final Exam

130

MCQ SBA questions

FICM regulations appendices

3 hours

MCQ sitting length

FICM regulations appendices

Up to 13

OSCE stations

FICM regulations appendices and OSCE page

2027

Start of FCICM AKT/ACRE transition for most candidates

FICM candidate FAQs

The current 2026-27 FFICM Final examination has three components: MCQ, OSCE and SOE. The MCQ uses 130 single-best-answer questions in one 3-hour sitting: 80 short-stemmed and 50 longer-stemmed questions. Candidates must pass the MCQ before applying for OSCE/SOE. The OSCE has up to 13 stations of seven minutes with one minute reading time, and the SOE has four stations with two questions per station. The 2026-27 calendar lists the next MCQ on 25 June 2026 with a GBP 595 fee and OSCE/SOE on 5-8 October 2026 with a GBP 755 fee. July 2026 to June 2027 is the final year of current legacy formats before the FCICM AKT/ACRE transition begins from July 2027.

Sample FFICM Final Practice Questions

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

1A patient with ARDS is ventilated with high plateau pressures. Which strategy has the strongest evidence for reducing ventilator-induced lung injury?
A.Low tidal volume ventilation based on predicted body weight
B.Large tidal volumes to normalise PaCO2 rapidly
C.Routine zero PEEP in all ARDS patients
D.Prolonged high FiO2 without attention to pressure limits
Explanation: ARDS ventilation prioritises lung protection: low tidal volume based on predicted body weight, plateau pressure limitation and appropriate PEEP, accepting permissive hypercapnia when safe.
2In volume-controlled ventilation for ARDS, which pressure best reflects alveolar distending pressure when measured during an inspiratory hold?
A.Peak inspiratory pressure
B.Plateau pressure
C.Mean arterial pressure
D.Central venous pressure
Explanation: Plateau pressure measured during an inspiratory pause estimates static alveolar pressure. Peak pressure also includes airway resistance and flow effects.
3A ventilated patient has severe ARDS with persistent hypoxaemia despite lung-protective ventilation and adequate PEEP. Which adjunct should be considered early?
A.Routine high-frequency chest percussion as definitive treatment
B.Immediate extubation to room air
C.Prone positioning for prolonged sessions
D.Withholding neuromuscular blockade if severe ventilator dyssynchrony persists
Explanation: Prone positioning improves oxygenation and outcomes in selected severe ARDS when applied early and for prolonged sessions by trained teams.
4A ventilated COPD patient becomes hypotensive with high airway pressures and incomplete expiratory flow before the next breath. What ventilator problem is most likely?
A.Complete circuit disconnection with no delivered breaths
B.Pure metabolic alkalosis as the only cause
C.Tension-free normal ventilation
D.Dynamic hyperinflation with intrinsic PEEP
Explanation: Airflow obstruction with insufficient expiratory time causes air trapping, intrinsic PEEP, raised intrathoracic pressure and hypotension.
5During transfer, a ventilated patient suddenly loses the capnography trace and oxygen saturation falls. What should be checked immediately?
A.Airway displacement, obstruction or circuit disconnection
B.Serum albumin as the first priority
C.Routine daily chest physiotherapy schedule
D.Long-term outpatient spirometry
Explanation: Sudden loss of end-tidal CO2 in an intubated patient is an airway and circuit emergency until proven otherwise.
6Which feature is a relative or absolute reason to avoid or stop non-invasive ventilation and proceed to urgent airway review?
A.Alert cooperative patient with COPD acidosis improving on NIV
B.Inability to protect the airway with vomiting and worsening consciousness
C.Mild mask discomfort that improves after adjustment
D.Stable oxygenation with falling PaCO2
Explanation: NIV requires airway protection, cooperation and close monitoring. Vomiting, deteriorating consciousness or failure to improve should prompt escalation.
7Which finding supports readiness for a spontaneous breathing trial?
A.Escalating vasopressor dose and severe hypoxaemia
B.Ongoing deep coma with no respiratory effort
C.Improving underlying cause with acceptable oxygenation and haemodynamic stability
D.Uncontrolled metabolic acidosis with shock
Explanation: Weaning readiness requires improvement in the original problem, adequate oxygenation, manageable secretions, respiratory drive and haemodynamic stability.
8Which bundle element reduces ventilator-associated pneumonia risk?
A.Routine supine flat positioning
B.Avoiding oral care in all ventilated patients
C.Never reviewing readiness to extubate
D.Head-up positioning and regular sedation assessment
Explanation: VAP prevention uses multimodal care such as head-up positioning, oral care, cuff pressure attention, sedation review and early liberation from ventilation.
9A ventilated patient needs high FiO2 for hypoxaemia. What is the safest general approach once oxygenation stabilises?
A.Titrate FiO2 down to the lowest level that achieves an appropriate target saturation
B.Maintain FiO2 1.0 indefinitely regardless of PaO2
C.Stop PEEP before reducing FiO2 in every patient
D.Ignore oxygen targets because oxygen is harmless
Explanation: High FiO2 can contribute to oxygen toxicity and absorption atelectasis. ICU oxygen should be titrated to appropriate targets while maintaining adequate oxygen delivery.
10A tracheostomy patient deteriorates with suspected tube obstruction. What is a key early action?
A.Remove all oxygen while waiting for ENT review
B.Call for expert help, give oxygen to face and stoma, and assess tube patency
C.Assume all tracheostomies are impossible to ventilate from above
D.Flush large volumes blindly through the tube
Explanation: Tracheostomy emergencies require simultaneous oxygenation, help, airway patency assessment and knowledge of whether the upper airway is patent.

About the FFICM Final Exam

The FFICM Final is the current Faculty of Intensive Care Medicine fellowship examination for UK intensive care medicine trainees. It tests pre-CCT registrar-level intensive care practice through a written MCQ paper, an Objective Structured Clinical Examination and a Structured Oral Examination. The source row used the ID uk-frca-icu, but the official examination name is FFICM Final; the Faculty has also published transition guidance for new FCICM AKT and ACRE formats from July 2027.

Assessment

Final FFICM currently consists of MCQ, OSCE and SOE components; candidates must pass MCQ before OSCE/SOE

Time Limit

MCQ one 3-hour sitting; OSCE approximately 1 hour 45 minutes; SOE approximately 1 hour 15 minutes

Passing Score

Angoff standard setting for MCQ, OSCE and SOE; component results are pass/fail

Exam Fee

2026-2027 calendar lists MCQ GBP 595 for June 2026, OSCE/SOE GBP 755 for October 2026 and MCQ GBP 610 for January/June 2027 (Faculty of Intensive Care Medicine)

FFICM Final Exam Content Outline

Broad curriculum coverage

Respiratory Failure and Ventilation

ARDS, lung-protective ventilation, PEEP, auto-PEEP, NIV, weaning, tracheostomy and difficult airway emergencies.

Broad curriculum coverage

Shock and Cardiovascular Support

Septic, cardiogenic, hypovolaemic and obstructive shock, vasoactive therapy, fluid responsiveness and echocardiography.

Broad curriculum coverage

Sepsis, Infection and Source Control

Sepsis resuscitation, antimicrobial stewardship, VAP, line infection, C difficile, candidaemia and necrotising infection.

Broad curriculum coverage

Renal, Acid-Base and Electrolytes

AKI, CRRT, hyperkalaemia, sodium disorders, rhabdomyolysis, fluid overload and acid-base interpretation.

Broad curriculum coverage

Neurocritical Care, Sedation and Analgesia

TBI, ICP, seizures, SAH, brainstem death, delirium, ICU weakness, sedation strategy and pharmacology.

OSCE/SOE professional domains

Equipment, Resuscitation and Professionalism

Ventilator alarms, vascular access, monitoring, temperature management, ethics, consent, organ donation and treatment limitation.

How to Pass the FFICM Final Exam

What You Need to Know

  • Passing score: Angoff standard setting for MCQ, OSCE and SOE; component results are pass/fail
  • Assessment: Final FFICM currently consists of MCQ, OSCE and SOE components; candidates must pass MCQ before OSCE/SOE
  • Time limit: MCQ one 3-hour sitting; OSCE approximately 1 hour 45 minutes; SOE approximately 1 hour 15 minutes
  • Exam fee: 2026-2027 calendar lists MCQ GBP 595 for June 2026, OSCE/SOE GBP 755 for October 2026 and MCQ GBP 610 for January/June 2027

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

FFICM Final Study Tips from Top Performers

1Revise physiology and clinical decision-making together; FFICM questions often test why a management step is safe.
2Practise ventilator waveforms, ABGs, haemodynamic traces and drug calculations under time pressure.
3Use a structured answer framework for SOE: diagnosis, immediate risks, physiology, management and escalation.
4For OSCE, practise data interpretation, equipment checks, professionalism and resuscitation stations aloud.
5Track errors by organ system and by failure mode: knowledge gap, prioritisation, safety or communication.

Frequently Asked Questions

Is uk-frca-icu the official exam name?

No. The source row used a FRCA-style ID, but the verified official examination is the FFICM Final, administered by the Faculty of Intensive Care Medicine.

What is the current FFICM Final format?

The current format has three components: a 130-question SBA MCQ paper, an OSCE and an SOE. Candidates must pass the MCQ before applying for OSCE/SOE.

How long is the FFICM MCQ?

The regulations appendices describe 80 short-stemmed SBA questions and 50 longer-stemmed SBA questions in one three-hour sitting.

What is changing after 2026-27?

FICM transition guidance says July 2026 to June 2027 is the final year of current legacy formats. From July 2027, written MCQ exams become FCICM AKT and OSCE/SOE becomes FCICM ACRE for most candidates.

Does this practice bank cover OSCE and SOE?

This site-wide bank contains 100 four-option practice MCQs. The topics are selected to support FFICM MCQ knowledge and the clinical reasoning expected in OSCE/SOE preparation, but it is not a substitute for viva or station practice.