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European Diploma of Intensive Care guide

Todd Fraser on 27-01-2014

I had an enquiry from a chap who is planning to sit the EDIC, so I thought I'd start a blog on the topic.

 

For those of you who have sat the exam, what resources did you use?  What tips and tricks can you share with those that follow you?



17 Comments


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Faraz Mansoor from Pakistan wrote 01-29-2014 01:47:54 am
Well, i passed my EDIC theory a couple of years back. I studied Oh's Manual, SCCM mcq's--- self assessment in critical care and at the end practiced some mcq's from the ESICM modules.



Ahmed elmaghraby from Saudi Arabia wrote 04-07-2014 08:54:18 am
are u entering the 2nd part



NAGESH from AUSTRALIA wrote 12-22-2014 06:09:59 pm
I have passed both steps of EDIC,and at the exams in part 1, its all about PACT module and need to read them at-least 3 times to be confident to pass.
At clinicals, it's about 3 cases and 3 stations viva, and for this you just need to have worked in a big academic tertiary unit like Westmead, RPA, Liverpool etc and need to be up-to-date with your journals to rationalize your answer in with current evidence based patient management.



Rahul from India wrote 06-06-2015 01:56:18 am
Helo sir,,i m a md anaesthesia from india,,,,cleared the european diploma naesthesia,,,how can i write FFICM exam,,plz guide me



Lawrence from United Kingdom wrote 11-30-2015 05:12:57 am
EDIC II
How to prepare (2015)


I have just sat EDIC II and have attended the new preparation course. I found that there is not a lot information available online about how to prepare for this exam, and decided to write about my experience.


#Top tips
- Do not read a textbook.
- The computer based scenarios are probably the most challenging. Spend most of your study time preparing for these.
- For the clinical scenarios read PACT. it shows you the depth of knowledge required and the types of questions you can expect.
- Don’t worry about digging deep into subtopics, physiology or current evidence. You do need to know the basics about everything though.
- Read the official exam guidebook about the exam format and scoring.

#How to prepare in advance? What background is needed?
Have about 2 yrs of ITU experience including rotations to subspecialities (neuro, cardiothoracic, etc)
The knowledge you acquire during this should be enough, you probably do not need to read a textbook again to prepare for the exam
A couple of months before the exam identify your weak areas (eg. not had cardiothoracic rotation yet) and concentrate on those topics
Use every possibility to analyse ECGs, X-rays, USs and CTs, might be worth asking your radiologist friend to help
Experience in a western european ICU (Aus/NZ probably counts) is highly helpful. I come from Eastern Europe and I found that 6 months in a UK ICU saved my life.
English is very important because there is time pressure throughout the exam and you need to be able to understand and answer the question quickly.

#Clinical Case Scenarios (CCS)
There will be 3 CCSs. Before starting the CCS you will be given an information leaflet about all 3 cases and have 30 minutes to prepare. Then you will have 20 minutes for each CCS and about 5 mins to go the next station. One of the CCSs will be surgical, the other medical and one from a subspeciality (neuro, cardiac etc...).
When preparing, think about the questions they might asks. Some common questions you might want to prepare for:
Summarize the case: there is maximum 4 answers for each questions that are worth points so be brief and to the point. They most likely to want to hear about organ dysfunctions and history is almost always not important to mention for this question.
What’s your differential?
What’s your immediate management?
What further investigations would you want?
What can be the cause of the patient’s …….. eg. agitation?
Later on the case will evolve, don’t be surprised if a cardiothoracic case evolves to a neurosurgical one. You will be given new investigation results, CTs, X-rays to interpret.
Further questions to expect
Questions regarding physiology
Questions regarding evidence: do not be alarmed. Mentioning actual trial names never worth more than 1 point. Explain how we do it and why, maybe some physiology if applicable
There may be questions regarding what would you tell to the relatives or how you would handle if an error occurred. Just some keywords like M+M meetings and common sense will get you through this.

#Computer based scenarios (CBS)
There are 3 stations. CBS 1 covers ECGs and other curves. CBS 2 covers radiology and CBS 3 ABGs and Biochemistry.
You have approximately 10 minutes for about 8-12 cases. These stations are probably the most difficult because of the time pressure and because it’s tricky to prepare for them.
All cases come with a brief clinical information. This is very important. Many times the key is in there rather than on the image itself, read this first. Usually there are questions regarding management as well. Again all this and you barely have more than 1 min per case.

#Curves
Expect ECGs, Ventillator curves, CVP curves (tamponade, regurg, stenosis, etc…), IABP (early/late inflation/deflation), ICP, simple CRRT pressure trends
The biggest problem is that there is not a lot of resource online for vent, cvp, icp curves. Do your google and try to practice at work.
For ECGs there are lots of resources. I really liked ECG Rounds (Metkus, 2014, McGraw-Hill).

#Radiology
The list below is not extensive. They say all cases are emergencies which we should be able to recognize before official radiological opinion. Not sure this is true for all cases though.
CT head (stroke, bleeds, intracranial hypertension, hydrocephalus)
CT abdo (free fluid, gas, pancreatitis, aneurysm, bleed, etc...)
CT chest (contusion, infiltrate, collapse, aspiration, aneurysm, haematoma, empyema, abscess, ribs etc)
CXR (the list is quite extensive, but its probably not sarcoidosis and tumours you should expect)
AXR (ileus, perforation)
US (pleural effusion, consolidation, ptx in lung, free fluid, hydronephrosis in the abdomen)
Echo (IVC, reduced systolic function, tamponade are things to r/w)

Quite a range of topics to be covered, I am not sure you really need it in all real life, but at least it’s reasonably easy to prepare for it. Look at images in PACT. Check out Radiopaedia.org (eg. http://radiopaedia.org/playlists/4401) you will find plenty of images and of course practice at work/radiologist friend.

#Biochemistry
This is supposed to test you pattern recognition. Think of these as clinical briefs.
For each case you will likely have clinical details, biochemistry, urinalysis and ABGs. Its easy to see that 1 min is barely enough to even read it all even if the abnormal ones are highlighted. The best approach is to read the clinical details and think about what could it be and then look at the relevant results.
Some things to expect:
Acids base disorders are likely to be complex so be systematic and practice calculating anion gap, delta gap, strong ion difference or whatever your preferred technique is. Here are some good examples: http://fitsweb.uchc.edu/student/selectives/TimurGraham/Case_4.html
Na, K abnormalities like DI, SIADH, CSW
Others: unfortunately it seemed to me that anything can come up here. Things I’d seen: endocrine, refeeding sy, obstetric emergencies, tumour lysis

#My Exam
unfortunately can’t remember too much
CCS1: Young girl with toxic shock syndrome, interpretation of a CT head, LP results. Later an unfortunate central line caused aortic aneurysm. What to tell to the family/trainee who did it.
CCS2: Young girl with severe asthma, ended up on ECMO. Questions regarding medical management, ventilation strategy, indications of ECMO. Nothing too scary.
CCS3: laparotomy, major haemorrhage from a ruptured spleen, DIC, ARDS, filter. Had a TEG curve to interpret (normal value there), other questions were all reasonable about the above topics.
Curves: monomorph VT, strange CVP trace, bronchospasm on vent, 2 Art line traces from the same Pt, inferior AMI
Radiology: lobe collapse on CT, chest US with pleural effusion, embolic stroke with haemorrhagic transformation, AXR with large bowel obstruction, some CXRs
CCS3: refeeding sy, CSW, antiphospholipid sy, a couple of complex ABGs

Is it worth attending the preparation course?
When I was preparing for the exam there were no online resources at all. I am sure I would have failed if not for the prep course.
The current pass rate is about 55%, down from 75% since the new exam structure was introduced. I think this is mainly because of the lack of information especially regarding the CBSs.
If you have e.g. the FFICM or FRCA you will probably be fine without the course if you brush up on your curves/radiology.
I think with adequate preparation you should be able to pass the exam without any preparation course (i.e. it’s not extremely hard), however since resources/information is still scarce out there about what to expect it is definitely helpful to attend the course.
The main benefits of the course:
mock exam
you will have a detailed list of what you need to know eg. what kind pathology you are expected to recognize on CT (similar to what I wrote above, but way more extensive)
lots of sample questions - I had one of them come up in biochemistry

#My background
Trained in Eastern Europe for 3 yrs (anaesthesia+ICM), currently in the UK for a year. No other exams done.

Good Luck



Jacob from United Arab Emirates wrote 12-02-2015 09:40:47 am
Hi Lawrence, thanks for your detailed information. Where did you appear for your exam,(your exam center), are there any difference in centers regarding cases etc or it is quite a standard throughout all exam centers.



Lawrence from United Kingdom wrote 12-04-2015 03:56:58 am
Hi Jacob,
I sat it in London. I don't know about other centres.
We were told at the prep course, that with the previous exam format (real patients) there was wide inter-centre variability which improved with the new format.
Now questions and answers are standardised throughout the exam centres so they are the same.



Deepu84in from India wrote 12-06-2015 05:48:42 pm
Gave EDIC Part 1 in Oct 15 in Bern. Cleared it.
Need to say that this exam needs proper understanding of european guidelines and practice. MCQs were tricky and lenghty. Steve Benington s mcq books, both 2009 edition and 2015 edition, are superb and covers all aspects but also has many errors. Also you need some textbook to support your knowledge. i read Oh's Manual cover to cover. About PACT modules, they are informative but essentially required for Part 2 i suppose.
It needs atleast 2 months of continous reading to clear this exam.



Zunairah from Pakistan wrote 04-09-2016 06:37:42 am
Hi Lawrance are u still in blog very nice explanation .Did that exam helped you in upgrading ur status
Zunairah Pakistan
EDIC 1 is all about module yes after taking april2016 exam i realized 3 readings of modules are needed. steve mcqs are fine but reading is far more important.MCQs were not confusing and difficult but steves were,so by doing steve dont get upset read modules again and again



Dr.adel.hamada from Saudi Arabia wrote 04-09-2016 06:43:58 pm
I have taken April 2016 exam
best of 5 questions were fair enough but multiple choice questions were not easy and the style of it is out of exam.
my advice solve questions as more as possible, read patient challenge in modules.



Dd from India wrote 05-03-2016 09:24:51 pm
when are the result of edic 1 and any idea of passing marks



Dd from India wrote 05-10-2016 08:22:42 pm
result is out



Zunairah from Pakistan wrote 05-17-2016 03:52:52 am
I have cleared EDIC part 1 exam and its all about modules and ofcource working in ICU READ MODULES AGAIN AND AGAIN



Dr. Erdbories from Germany wrote 06-03-2016 11:23:23 pm
I sat EDIC II exam in Zürich yesterday.
All I can say is that is was really tough for me especially the CSS.

For further Information or Tips here is my e-Mail Christoph.Erdbories@gmx.com
good luck for everybody!



Go The Extra Mile from Australia wrote 01-03-2018 10:44:56 am
There is a new website – www.gotheextramile.com - that offers online MCQ tests in intensive care medicine. The MCQ are organized in the form of tests, each one consisting of 30 questions. The tests may be taken online, and are marked immediately. Detailed feedback is provided upon completion of the test.
The salient features of this site are –
Name of website www.gotheextramile.com
Platform PC, Mac, IPad
Preferred browser - Chrome
Number of Question for EDIC 1800 (1200 Questions for the Primary)
Number of Tests for EDIC (30 questions/test) 70 (40 tests for the CICM Primary)
Topics Covered Cardiology and CT Surgery 270
Haematology, Transplant and Blood Tests 270
Infectious Diseases and Antimicrobials 180
Liver Disease, Nutrition and Toxicology 180
Neurology including TBI 150
Procedures and Monitoring 210
Nephrology and CRRT 270
Respiratory Medicine 180
Respiratory Physiology 180
Trauma and Surgery 210
Type of Questions MCQ
True-False
Match the columns
Duration of each test- 30 minutes
Immediate Automatic marking - Yes
Detailed Feedback - Yes
Duration of subscription - One year*
Number of attempts allowed - 3 for each test
Number of free tests - 2



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Prasad from India wrote 12-01-2018 10:40:51 pm
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