Essential Reading for "Decision Making" in the CICM exam

The "Decision Making" section represents annotations and footnotes to the similarly named Section 2.1.2 from the CICM Second Part General Exam Syllabus (First Edition). For each of the syllabus topics, the expected knowledge domains are supposed to be "principles and practice / implementation""relevant guidelines and evidence" and "controversies and risks".  

L1 topics

Clinical assessment of the critically ill patient

  • CICM have asked a lot of weird questions in the past, for example about the non-cardiorespiratory causes of cyanosis, or how to tell the difference between a kidney and a spleen using nothing but the crude sensitivity of your fingers (like you'd make a surgical referral on the basis of those findings). Most of these questions appear to have come from the pre-2010 exam, which helps delineate the year in which the examiner who insisted on them had retired. A system of checks and balances in exam design has since replaced the lawlessness of those earlier papers, but just in case, it would not hurt to be familiar with the content of Talley & O'Connor's Clinical Examination of whatever second-hand edition, as this is likely to have the highest yield in terms of mark density per gram of printed paper. Those morally above resorting to online piracy may be able to score a cheap copy from a final-year medical student about to embark on a career in pathology.

Severity scoring

Outcome prediction

Treatment limitation / end of life care

Principles of medical ethics and application of ethical principles to clinical practice

L2 topics

Principles of critical thinking/clinical reasoning


Young, Paul, et al. "End points for phase II trials in intensive care: recommendations from the Australian and New Zealand Clinical Trials Group consensus panel meeting." Critical Care and Resuscitation 14.3 (2012): 211.

Myburgh, John, et al. "End-of-life care in the intensive care unit: Report from the Task Force of World Federation of Societies of Intensive and Critical Care Medicine.Journal of critical care 34 (2016): 125-130.

Varkey, Basil. "Principles of clinical ethics and their application to practice." Medical Principles and Practice 30.1 (2021): 17-28.

Rapsang, Amy Grace, and Devajit C. Shyam. "Scoring systems in the intensive care unit: a compendium." Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine 18.4 (2014): 220.

Desai, N., and J. Gross. "Scoring systems in the critically ill: uses, cautions, and future directions." BJA education 19.7 (2019): 212.

Seidlein, Anna-Henrikje, et al. "Ethical aspects of time in intensive care decision making." Journal of medical ethics 47.12 (2021): e24-e24.

Kazuša, Irina. "Didactic model based on principles of critical thinking." SOCIETY. INTEGRATION. EDUCATION. Proceedings of the International Scientific Conference. Vol. 1. 2020.

Richards, Jeremy B., Margaret M. Hayes, and Richard M. Schwartzstein. "Teaching clinical reasoning and critical thinking: from cognitive theory to practical application." Chest 158.4 (2020): 1617-1628.

Richards, Jeremy B., and Richard M. Schwartzstein. "Promoting critical thinking in your intensive care unit team." Critical care clinics 38.1 (2022): 113-127.