Strategies for success

Luck is what happens when preparation meets opportunity.

SENECA

Timing

Candidates should begin studying for the exam sooner rather than later and ideally with a year's run up to the event. In reality, preparation starts with your first training position. This is not as onerous as it sounds, as it will help you to learn how to do your job well. It is much easier to attempt the exam while you are working in an intensive care medicine post rather than trying to do it from another rotation such as anaesthetics or medicine. Do not be pressured into sitting the exam too early. The only way to learn the tricks of the trade is to learn the trade properly. If you have not learnt enough or seen enough patients then you will not pass. It is recommended that candidates study for all parts of the exam at the same time, rather than leaving the clinical and oral sections until after the written exam. That time is for finessing and polishing your personal style, not deciding what it is.

It is easy to feel quite overwhelmed by the amount of studying required when you first begin contemplating the exam. Preparing an exam study timetable will break the process down into manageable portions so that you can avoid feeling swamped. This way you can systematically cover the material required without panicking at the extent of the task. Systematic learning in this way will raise your confidence and morale as you look back over the areas you have successfully covered in the past, knowing that you can apply the same process to the topics that lie ahead.

There is an absolute goldmine of information to be found on various websites and you would be most unwise not to be familiar with the resources available, especially those associated with the examining bodies (see Chapter 1).

Preparation courses

There are several courses available for trainees in ICM who want to progress towards becoming a specialist intensivist. There are many benefits in attending some of these as they not only contain a high level of educational content, but more importantly provide an opportunity to meet and mix with other trainees. They also provide the chance to meet and be taught by senior specialists in the field, many of whom are also examiners.

EDIC/DICM

Scientific meetings

Attending the ESICM Annual Scientific Congress is a high-yield activity. A number of education workshops are held prior to and during the Congress. The Pre-Congress Critical Care Refresher course is popular. Aside from the educational merits of attending the Congress, it is usually held in a European city where hard work may be rewarded with a break. Other useful meetings are the annual International Symposium of Intensive Care and Emergency Medicine (Belgium) and Intensive Care Society Meetings (United Kingdom). These conferences provide up-to-date information and give a guide to the current hot topics in ICM.

National Intensive Care exam revision course (Bristol/Bath, UK)

This one-day course is predominantly aimed at candidates sitting the EDIC or DICM. It provides candidates viva practice and up-to-date literature in critical care. The course consists of lectures, vivas, data interpretation and small group tutorials. Detailed information is available online at www.cardiff.ac.uk/pgmde/wimat or you can email wimat@cardiff.ac.uk.

Diploma of the Irish Board of Intensive Care Medicine preparatory course (Dublin, Ireland)

This three-day course covers topics relevant to the DICM and EDIC. Detailed information is available at www.icmed.com.

FCICM

The CICM website has a list of current courses and conferences that is regularly updated.

Scientific meetings

If you are fortunate enough to have the opportunity to attend a CICM Annual Scientific Meeting or the Australian and New Zealand Intensive Care Society (ANZICS) conference, you will be provided with up-to-date information as well as a guide to the current controversies in the specialty.

CICM Primary exam courses

Courses are evolving that are designed to assist primary exam candidates (e.g. Royal Adelaide Hospital Primary short course).

ANZICS Intensive Care Registrars course

This course is conducted in Melbourne in July every year. It does not aim to prepare participants for the FCICM exam; rather, it provides a sound theoretical basis to current practice in intensive care. Eminent leaders in the field regularly give excellent interactive lectures on core intensive care topics. The best time to attend this course is early in your advanced training (i.e. first core year). Further details are available on the ANZICS website: www.anzics.com.au/education_courses.htm.

ADAPT workshop (Australian Donor Awareness Program Training)

The aim of the Australian Donor Awareness Program is to increase awareness of organ and tissue donation and grief counselling among health professionals who care for patients and their families. It is hoped that it will provide health professionals with the knowledge and skills to support potential donor families, so that they are able to make a decision about organ donation that is right for them. The course runs for one day in centres around Australia and New Zealand. Attendance is now compulsory for all trainees in intensive care prior to being awarded Fellowship. Further details are available on the website: www.adapt.asn.au/activities.

Advanced Paediatric Life Support (APLS) course

This three-day course is run frequently all around Australia and New Zealand. The coursebook essentially covers the syllabus of paediatric knowledge required by adult intensivists, and the scenarios cover most of the practical skills. At the very least you should be familiar with the coursebook, and track down local APLS instructors to take you through some scenarios. Course information can be found at www.apls.org.au and www.resus.org.uk.

Emergency Management of Severe Trauma (EMST) course

The EMST (Advanced Trauma Life Support) course teaches a systematic practical approach to the trauma patient. Unfortunately the waiting list for courses is long and it may not be possible for candidates to complete one before their examination. However, familiarity with the course manual will provide an excellent framework on which to base the initial assessment of the severely injured patient. The course webpages can be found via the Royal College of Surgeons websites in your respective regions.

Exam courses

There are a number of excellent courses available to help prepare candidates for all of the components of the second part of the FCICM exam. Each of the courses below offers an opportunity to practise all the parts of the Fellowship exam. The experience gained by attending these courses is invaluable and you should aim to attend at least one of them before sitting the exam. A limited number of places are available so you should plan well ahead, both in terms of applying for a place on the course and in booking leave from work, especially if you are sitting the exam with several other colleagues from the same ICU. The format of the courses changes in response to feedback from participants, but currently all are offering interactive lectures and insight into exam techniques followed by real-time exam practice of clinical cases and vivas.

Australian Short Course in Intensive Care Medicine

This course is held in Adelaide, just before the FCICM exam in April/May.

The Australian Intensive Care Medicine clinical refresher course

This course is held in Brisbane, between the written and clinical parts of the examination in August/September. It is also run under the umbrella of the Australasian Academy of Critical Care Medicine, with further details available on the College website.

The Sydney Short Course in Intensive Care Medicine

This course is held in Sydney in November. Although this course is newer than the Adelaide and Brisbane courses, it has been highly recommended by past participants. A long course is also held with regular structured evenings, including moving between different units for clinical cases and practice vivas.

The Canberra ICU course

This most recent addition targets trainees commencing their approach to the Fellowship exam and includes lectures as well as mock exam practice.

Sydney Intensive Care Equipment course

This new course aims to provide trainees with an up-to-date practical refresher on ICU equipment.

Textbooks, journals and online resources

Investing in a comprehensive textbook to establish a broad basic knowledge of intensive care cannot be overemphasised. Suggestions include Oh's Intensive Care Manual; Irwin and Rippe's Intensive Care Medicine; Critical Care Secrets; Key Topics in Critical Care (less detailed); Intensive Care: A Concise Textbook (less detailed); and Core Cases in...