Exam Details - Fellowship in Immediate Medical Care (FIMC)

Key Facts

Share this page   Print this page

Fellowship in Immediate Medical Care (FIMC)

The Fellowship in Immediate Medical Care (FIMC) is the highest level of formal qualification available for pre-hospital practitioners. The level of performance expected is that commensurate with level 8 on in the Skills for Health Key Elements of the Career Framework (http://www.skillsforhealth.org.uk)

The exam focuses on the timely recognition, diagnosis, and management of conditions and situations in a pre-hospital environment rather than on the use of facilities for investigation and treatment that may be available predominantly within a hospital. However, the level 7 practitioner would be expected to be able to undertake safe emergency transfer between hospitals and therefore be capable of interpreting the range of investigations typically found in the emergency department setting.

This examination is blueprinted against the current UK Pre-hospital Emergency Medicine (PHEM) curriculum (available on the GMC and Intercollegiate Board websites). Potential candidates are strongly advised to read and consider the content of the curriculum thoroughly before applying for the examination.

As a multi-professional examination, it can test any curriculum element and will not be limited by national or local professional scopes of practice. Success in the examination, however, should not provide the sole evidence of competence to practice in every one of these elements.

Exam Benefits

  • Highest level of formal qualification available in the UK for pre-hospital practitioners
  • Utilised by the Intercollegiate Board for Training in Pre-hospital Emergency Medicine (IBTPHEM) as the phase 2 national summative assessment for clinicians working in pre-hospital emergency medicine training programmes
  • Eligible to join the Faculty of Pre-Hospital Care as an Advanced Practitioner Fellow
  • Opportunity to demonstrate a specialist interest in pre hospital emergency medicine
  • Required for sub-specialty recognition by the GMC and FPHC Register of Consultant (Level 8) Practitioners.

Exam Format

The Fellowship in Immediate Medical Care (FIMC) exam will consist of two parts (A and B), conducted on 3 separate days as follows:

  • Part A: Written Exam of Underpinning Knowledge
    A written paper of 180 minutes duration consisting of 180 Single Best Answer (SBA) questions
  • Part B: An Objective Structured Practical Examination (OSPE)
    The OSPE will normally consist of 14 OSPE testing stations. 12 of the stations will each be of eight minutes duration and two will be of 24 minutes duration. Each 24 minute OSPE will involve simulation of a pre-hospital or an emergency interfacility transfer scenario. There may also be one or more rest stations or preparation stations

To gain a pass overall, candidates must achieve a pass in both parts. Candidates who are unsuccessful at either Part A or Part B may re-sit the relevant component alone provided it is within 3 subsequent available diets of the first attempt.

Advice to Exam Candidates

This examination has a limited number of places available which will be allocated in the order detailed below.

  • Firstly, specific exam places are allocated to PHEM trainees currently in a PHEM training post and at the pre-determined point of their training as directed by the Intercollegiate Board for Training in Pre-hospital Emergency Medicine (IBTPHEM) (including resit candidates). 
  • Secondly, exam places are allocated to all other applicants (including current PHEM trainees applying outside of their IBTPHEM allotted exam slot) in strict chronological order of application. 

Once the exam is full, applicants will be placed on a waiting list in chronological order of application. Those on the waiting list will be offered places that become available on the next available exam diet.


Exam Fee: £1130

Resit Fee: This is calculated based on the number of components the candidate is resitting.

  • £450 if applying for the written paper resit only
  • £680 if applying for the OPSE resit only

Exam Eligibility

There are two parallel sets of eligibility requirements: one for trainees completing approved subspecialty training programmes in Pre-hospital Emergency Medicine (PHEM) and one for practitioners who have undertaken alternative forms of pre-hospital care training.

All applicants must have been engaged in the practice of their profession for a minimum of five years post registration with either the UK General Medical Council, UK Nursing and Midwifery Council or the UK Health and Care Professions Council and hold the Diploma in Immediate Medical Care RCSEd.

  1. Trainees in approved PHEM sub-specialty training programmes must show documented evidence, countersigned by the Training Programme Director of a GMC approved PHEM sub-specialty Training Programme, of sufficient clinical experience (at time of application) in the area of pre-hospital emergency care.
  2. Practitioners who have undertaken alternative forms of pre-hospital care training outside of approved PHEM sub-specialty training programmes must demonstrate that their experience and training can be considered comparable to that of a sub-specialty trainee. This requires that the applicant submits a Certificate of FIMC Eligibility issued by the Faculty of Pre-Hospital Care. Detailed regulations regarding the criteria for the Certificate of FIMC Eligibility can be obtained directly from the Faculty of Pre-Hospital Care.

Candidates are permitted four attempts in which to pass the exam. A re-sit of an individual component part constitutes an attempt.

Additional Information

Before applying for this exam, please ensure you have read and understood the relevant documentation.

Our Exam Policies and Procedures page will provide you with more general information about sitting an exam at the College.

Frequently Asked Questions

Who can sit this examination?

The Fellowship in Immediate Medical Care (FIMC) is open to those in the PHEM Training Programme and Medical Practitioners who have undertaken alternative forms of pre-hospital care training.

My work organisation will be paying my examination fee. Can you raise an invoice?

We will only a raise an invoice for an organisation in extreme circumstances. We ask, where possible, that candidates either pay the fee online or provide a cheque for the relevant examination fee.

When do I get to see the contents of the Sandpiper Bag?

To enable examination candidates to familiarize themselves with the Sandpiper bag, please visit the following link: Sandpiper Bags - The Faculty of Pre-Hospital Care (rcsed.ac.uk)

How can I apply for an examination?

You can apply for an examination via the RCSEd College website by completing the application form online or by downloading the paper application and submitting this to the Examination Section by post.

Where and when are the examinations held?

We hold examinations in the UK and Internationally. Please check the College website for exact dates and locations.

Where do I send my supporting documents?

Surgical Examinations

You can submit supporting documents electronically by scanning copies and emailing these to surgical.exams@rcsed.ac.uk. Alternatively, you can send it by post to the College address of FAO Examinations Department, The Royal College of Surgeons of Edinburgh, Nicolson Street, Edinburgh, EH8 9DW.

FPHC Examinations - FIMC / DIMC / DRTM / DUMC

You can submit supporting documents electronically by scanning copies and emailing these to fphc.exams@rcsed.ac.uk. Alternatively, you can send it by post to the College address of FAO FPHC OFFICE, The Royal College of Surgeons of Edinburgh, Nicolson Street, Edinburgh, EH8 9DW.

I want to postpone my examination, what do I do?

Sadly, we cannot allow candidates to postpone their examination to a later diet. You will need to withdraw from the examination and then re-apply for the examination diet you wish to sit.

I want to withdraw from an examination, how do I do that?

You must advise the Examinations Department in writing (via email) that you wish to withdraw from an examination. Depending on when you request to withdraw, you may be asked to provide supporting evidence. If you withdraw before the closing date for application, there is no requirement to submit evidence. However, following the closing date, you will be required to submit evidence which must be received by the College within 14 days of the examination commencement date.

What are suitable reasons for withdrawing from an examination?

There are a number of number of reasons for needing to withdraw from an examination; these are:

  • medical reasons (illness prior or illness on the day of an examination)
  • compassionate grounds (e.g. bereavement)
  • unable to secure time off work
Can I get a full refund following my withdrawal from an examination?

Candidates who withdraw from an examination will be subject to a 20% administrative fee. 80% of your fee will be returned via the original payment method used to pay for the examination.

When will I receive my candidate notice?

Candidate notices are usually sent 4-6 weeks prior to the examination commencement date.

Will I be quarantined?

Occasionally candidates need to be quarantined. This depends on the examination session you are allocated to. For most examinations, we quarantine candidates who sat the morning examination session until the afternoon examination session has commenced. A light lunch is normally provided for you. You will receive information about whether you need to be quarantined in your candidate notice.

Is there somewhere to store my belongings?

Yes - where possible, we will provide you with a securely locked cloakroom to store your belongings. If this is not possible, we will have a designated area in the examination hall for this.

Can I keep my mobile phone and other electronic devices on my person?

When you register for the examination on the day, you will be asked to hand over your mobile phone and any other electronic devices (e.g. tablets, smartwatches) to the RCSEd Coordinator. Your device(s) will be placed in an envelope marked with your candidate number and stored securely in the RCSEd Administration Office while you undertake your examination.

When will my results be published?

Each examination varies. Results are normally published around 6 weeks after the examination has taken place. The intended results publication date will be stated on your candidate notice, and it will also be mentioned at your examination sitting.

back to top of page

Get in touch

If you have any questions about this exam, please contact us and a member of our Examinations team will be happy to help you.

The Royal College of Surgeons of Edinburgh
Examinations Section

Phone: +44 (0)131 527 1600
Fax: +44 (0)131 557 6406

Email: fphc.exams@rcsed.ac.uk