Yorkshire and the Humber FFICM Viva (SOE) Practice Course CANDIDATE APPLICATION

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This course aims to give opportunities for FFICM candidates to practice the viva and OSCE components of the exam in similar conditions to the actual exam, as well as providing a set of evening tutorials on common OSCE topics. ALL ASPECTS OF THE FIVA COURSE ARE APPLIED FOR THROUGH THIS FORM.

Our aim is to accommodate all ICM trainees in the region who are preparing for the exams. The course will run in the weeks preceding the SOE exam itself and are timed to avoid National courses.

We are anticipating very high demand therefore PLEASE let us know if your situation changes and you cannot attend, so that your place can be offered to another. If you have been offered a place but are unsuccessful in the MCQ you may be asked to relinquish your place if there are candidates on the waiting list who are sitting the SOE.

**email address** fficmprepyorks@gmail.com

Details about how your data is used and additional details are provided at the bottom of this form

Email *

Name *

Please provide your First Name and Surname

Mobile phone number (optional)

If you would like to be added to the course "Whatsapp" group then please leave your mobile number. THIS IS ESSENTIAL IF YOU WANT TO JOIN THE EVENING TUTORIALS.

Are you planning to sit the FFICM Viva at the next sitting? *

YES - and I have already passed the MCQ

YES - but I am awaiting my MCQ result

NO - I am planning to sit it at a later date

Is this your first attempt at the Viva? *

YES

Current training position: *

Yorkshire and the Humber ICM Trainee

Yorkshire and the Humber Trainee outside of ICM training programme

MTI or Clinical Fellow with an ICM interest in the Yorkshire and the Humber region

Candidate from outside the Yorkshire and the Humber region

Other:

Required

Which of the FIVA courses will you be attending? (You can tick many or only one) *

OSCE on Friday 24+th February 2023 (0830-1300)

SOE / Viva on Wed 1st March 2023 (0830-1230)

SOE / Viva on Friday 10th March 2023 (0830-1230)

OSCE Evening Tutorials (TBC)

Other:

Required

DECLARATION

I understand that my email address (and mobile phone number if given) will be used to co-ordinate my involvement in the Fiva course. I understand that the course involves contribution and organisation by other trainees who will have access to this information.

In addition, I understand that this is a Yorkshire and the Humber ICM Programme initiative with limited available places. Therefore, priority will be given to current trainees on the Programme who are undertaking the exam at the next sitting.

By applying I agree to adhere to the rules of the FIVA Course:
- I will apply in good time and cooperate with my department's study leave policy to maximise my attendance
- I will confirm my attendance in good time and answer all FIVA communications
- I will inform the organisers if I wish to cancel
- I will behave in a professional manner
- I will complete all mandatory feedback
- I will join sessions adequately prepared with a device capable of delivering a reliable SOE experience (e.g. PC or laptop with Microphone, speakers and webcam, IPad or Tablet)
- I will ensure I have access to the host platform (provisionally ZOOM)

In addition, once I have been successful in the FFICM exam I will:
- Attend a minimum of one future FIVA session as faculty
- Provide details of my viva questions
- Write at least one viva question and marking scheme, or OSCE Station to be used in future courses

I have read and agree with the DECLARATION *

YES

Required

Send me a copy of my responses.

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