On the CICM Part Two Viva Exam

On preparation
  • Preparing for the written exam prepares you for the vivas. Additional practice is still required but the bulk of the knowledge is acquired through written exam practice.  Previous written exam questions are often recycled as viva stations. Conversely, practicing vivas is a good way to practice a structured approach to answering written questions
  • Viva practice requires two people, but only one of them needs to be a CICM exam candidate. Involvement of lay persons is possible if viva answers are available in written form
  • Timing the practice is crucial. 
On talking:
  • The viva has several questions, each worth a certain number of marks. The first question may only be worth two marks or so, which means that answering this one question should not take the first five minutes.
  • If you keep talking, and they are not interrupting you, it does not mean that you are scoring points. 
  • If you are answering questions incompletely or missing marks, they are supposed to prompt you, but often they will not.
  • Don’t argue with the examiner. It looks bad.
  • If you don’t know the answer, do not waffle. Instead, move on to the next question. Say, “I’d like to come back to that later”. You want to keep scoring marks.
On dressing appropriately:
  • With regards to dress code, consider: though “look professional and feel comfortable” is the common directive from the college examiners, practically and anecdotally trainees have found themselves to be more successful if they were wearing suits. Does this mean that examiners are swayed by elegant apparel, or that the more intelligent candidates are naturally drawn to wearing suits? It is difficult to say. As in all things in medicine, one needs to consider the risks and benefits, the risks of wearing a suit and tie being relatively minor. 
On the communication viva:
  • The objective is not “get the family to agree to organ donation”. The objective is not to dominate them or assert yourself. The whole point of the exercise is to demonstrate (in ten minutes) that you are comfortable in the company of angry, bereaved, grieving people. During these ten minutes, you may not reach any sort of conclusion for your discussion.
  • These are generally done very poorly, with a pass rate which is typically under 30-40%. The pass rate for the overall exam is usually greater than 30-40%. Ergo, there are many qualified intensivists walking around out there who had failed the communication viva. They are clearly none the worse for it.
On failure:
  • Doing poorly in one viva station does not need to reflect in the following vivas. They are each worth very little in the grand scheme of things. Dwelling overmuch on the last viva is a sure recipe to underperforming in the subsequent viva. Just let it go. 
  • Performance in the vivas is often said to be quite good, when it is compared to trainee performance in the rest of the exam. However, it is still possible to fail the vivas, even in the case of trainees whose preparation is widely acknowledged as exceptional. It is not always clear what the reason for this was, and the college feedback is often uninformative ("insufficient core knowledge" and "knowledge gap" being typical examiner comments). Trainees are therefore counselled against taking such results to heart, at least no more so than an unfavourable roll of dice in a game of chance, insofar as the influence of their skills and knowledge on the outcome appears to be similar.