ICM FAQs

From August 2021, the Faculty of Intensive Care Medicine (FICM) has also introduced the new FICM Curriculum 2021 and transitioned to a new online portfolio platform.

The new FICM Lifelong Learning Platform (LLP) utilises the system currently adopted by the RCOA and will be familiar to most current dual anaesthesia trainees but will be new to ICM trainees not paired with anaesthesia.

For trainees in intensive care medicine, these changes signify a major shift in their current learning. We hope by summarising these changes, addressing some frequently asked questions and linking some useful resources, that we can facilitate this transition for ICM trainees.

What is different about the new curriculum?

Broadly, it is similar to the old curriculum.

Unchanged:

Content: Whilst the new curriculum appears less specific, the content of what should be covered remains the same but with an anticipated reduced assessment burden
Stages: there remain three stages to ICM training
Exam: FFICM expected to be achieved by the end of stage 2
Multiple points of entry into the specialty
Special skills year

New updates:

Removal of top 30 cases
Assessments are formative and are to be used to guide educational supervisors to make a summative judgement using Learning Outcome Forms
Assessments are used to achieve outcomes rather than competencies

What are the fundamental key changes to the ICM 2021 Curriculum?

The new 2021 ICM Curriculum is split into 14 HiLLOs (Higher Level Learning Outcomes) – 10 speciality specific and 4 generic professional HiLLOs. Under each HiLLO, several Key Capabilities are described which guide the individual towards achievement of the HiLLO for that domain.
These HiLLOs consolidate multiple areas of professional capability within a single domain, reducing the numbers of individual assessments needed to prove competence while offering greater flexibility and a more holistic view of clinical practice.

There is a greater focus on non-clinical aspects of training, including research and quality improvement

Now the two curricula are both in “stages” – do we need to be in the same stage for both curricula throughout our training?

Ideally progression will occur together but you can progress into a higher stage in one curriculum if you meet the requirements. This is most apparent between stage 2 and stage 3 where a trainee who has completed the Final FRCA may progress into Stage 3 Anaesthesia whilst still remaining in Stage 2 ICM to complete the FFICM.

Has the entry point for ICM training changed?

Entry into ICM training remains at ST3 level, with the option of applying for dual specialty training up to ST5 level.

Note the entry point into anaesthesia specialty training is now ST4, and if trainees opt to apply and accept training in ICM at ST3 without completion of core anaesthesia training, they may encounter difficulty when attempting to apply for anaesthesia training as they will not be eligible. It may be wise to discuss career aspirations with the relevant TPDs for anaesthesia and ICM if an anaesthesia trainee wishes to apply for ICM at ST3.

At which stages do we need to complete FFICM examinations?

FFICM is to be completed by the end of ICM stage 2.
If you are a dual trainee, the parent college will have guidance on when completion of examinations is required.

Will everyone transition to the new curricula at the same time?

FICM have already transitioned all Stage 1 and 2 trainees to the new curriculum and portfolio on the 4th August 2021. Any ICM trainee who is in Stage 3 and due to CCT before the 31^st August 2022 will stay on the old portfolio and curriculum

Do I have to transition to the new ICM curriculum?

Any ICM trainee who is in Stage 3 and due to CCT before the 31^st August 2022 will have the option to remain on the old portfolio and curriculum. Everyone else will have transitioned to the new portfolio and curriculum on 4^th August 2021.

Am I able to duplicate assessments for both the parent specialty and ICM portfolios?

For anaesthesia trainees, both “Personal Activities” and “Personal Reflections” can be cross linked to both portfolios at the time of submission. Supervised learning events are speciality-specific and hence cannot be linked at the time of submission. Trainees are advised to upload evidence as a “personal activity” rather than directly into the document store if they want it to be used for ARCP. The ESSR will not pull in unlinked documents in the document store, and these will not be viewable by the ES or ARCP panel

For medical/emergency medicine trainees, there is no communication between the two different portfolio platforms, and so evidence will still need to be linked to both portfolio platforms as before.

Do I need to copy over existing evidence from the old NHS ICM portfolio?

No. It is advised that all trainees (especially those mid-stage), could meet with their Educational Supervisors and complete a LOC form for each individual HiLLO, based on the current level of evidence they have available on their NHS ICM portfolio. This can help map your current evidence to the new HiLLOs and highlight areas which require further work prior to achieving the desired capability level. These “interim” LOC forms can then be uploaded to the ICM LLP.
Alternatively, you could create a summary document along with your ES, detailing exactly which HiLLOs you have already reached the desired capability level for and which require further work. This could then be uploaded as a supporting document to your Initial ES Meeting.
It would be appropriate to copy across evidence of exams, stage certificates and some courses, which are likely to be relevant throughout your training.
Currently the faculty have suggested that access to the old NHS E-portfolio will be lost in December 2021. You should download the portfolio in its entirety before access is lost.

How can I create a LOC form on the new portfolio if all my evidence is on the old portfolio platform?

You need to have at least one SLE, Personal Activity or Personal Reflection linked to a HiLLO in order to be able to release a LOC form to be completed by your Educational Supervisor. If you choose to use an interim paper/electronic version LOC form sent out earlier in the year or a summary document, then this can be linked to the HiLLO using a Personal Activity form (see below), and then a LOC form can be generated on the new portfolio.

What are HiLLOs?

HiLLO stands for higher level learning outcomes. These are new units of training that form what used to be the domains in the old curriculum. They are broad categories that ICM doctors are expected to achieve.

Each HiLLO has a different level of attainment expected for each stage. For some HiLLOs, expert level is met earlier in training than stage 3. In others, expert level is not expected by the end of training.

How much evidence is expected for each HiLLO?

Trainees can draw on a broad range of evidence including Supervised Learning Events (SLEs), personal activities, and personal reflections to demonstrate attainment of the Key Capabilities within each of the HiLLOs. Such activities may provide evidence of the attainment of more than one of the Key Capabilities across more than one of the HiLLOs
Depending on the stage of training, a different target capability level is expected for each HiLLO.(https://www.ficm.ac.uk/sites/default/files/target_capability_levels_for_the_icm_hillos_in_each_stage_of_training.pdf).
The faculty have provided no “target” number of assessments required for each HiLLO. The FICM Assessment Blueprint (see link) provides some guidance to which forms of assessment are most appropriate for each HiLLO.

Are there any new ICM workplace based assessments (WPBAs)?

WPBA forms are being replaced by “Supervised Learning Events” (SLEs). Trainees should already be familiar with these forms:

- ICM Acute Care Assessment Tool (ACAT)

- ICM Case Based Discussion (CBD)

- ICM Direct Observation of Procedural Skill (DOPs)

- ICM Mini Clinical Evaluation Exercise (Mini CEX)

“Learning Outcome Completion” (LOC) forms are completed and sent to you ES when a trainee feels they can provide the appropriate level of evidence to achieve the desired capability level for that particular HiLLO. These are similar to the previous CUT forms used in anaesthesia training.

What are Learning Outcome Completion (LOC) forms?

LOC forms are the tools used to demonstrate attainment of a certain level of training for each HiLLO. When sent, all evidence linked to the selected HiLLO will be available to view by the recipient, in order to assess whether the level of attainment for that stage has been achieved.

Who can sign off Learning Outcome Completion (LOC) forms?

Your Educational Supervisor (ES) will be responsible for signing off each individual LOC form and ensuring you have met the required capability level for that specific stage of training.

Will evidence gathered be stage specific or can it be used across multiple stages of training?

One assessment may be used to evidence multiple capabilities. However, it must be clear to anyone reviewing such evidence that all capabilities linked were assessed and commented upon during the assessment.
Some personal activities may be appropriate to be linked across multiple stages; dependent on whether they fit the required capability level.

I can’t have simultaneous ICM and anaesthesia placements on the new portfolio; how will this work for placements applicable to both, eg. Neuro/Paeds/Cardiac?

Placements can now be “replicated” across both the Anaesthesia and ICM sections of the LLP by clicking on the “View and add placements” button on the front page. There is then an option to “Replicate for RCOA”. There is a similar process that can be performed from the LLP front end to “Replicate for FICM

I can’t have simultaneous ICM and anaesthesia supervisors on the new portfolio platform. Which should I select?

This has been updated on the LLP and different supervisors are now possible using the “Replicate” feature detailed above

I can’t find assessors who are non-intensivists on the new ICM platform - will I be able to add anaesthetists, medical specialty doctors and emergency medicine doctors as assessors

Assessors can be sent Supervised Learning Event forms via the “Guest Assessor” option.

I can’t find my Clinical Supervisor on the new platform. What should I do?

Trainees can email Rohini Makwana at FICM with the full name of the CS, GMC number, email address and trust they are working at and she can add them to the list (her email address is rmakwana@ficm.ac.uk)
FICM might compile a full list of all ICM ES/CS’s in the region in due course, but for now the above plan should work

Do I need to create an Educational Supervisor Summary Report for both ICM and my parent specialty?

This will be required most years (as there will be an overlap over both specialties). When there is an entirely single specialty year (eg. year in EM for a dual EM trainee; medicine year for a dual anaesthesia trainee, an ESSR in that relevant specialty would suffice)
For dual anaesthesia trainees on the LLP platform for both portfolios, a placement can be replicated on both sides of the platform. StRs will be able to assign different ESs to the same placement so that their respective ICM and Anaes ESs will now be able to access their account in the LLP and monitor their progress. These dual placements will then appear in both their Anaes and ICM ESSRs (they are duplicated) should their ES question why the same placement appears twice but with differing ES details. Therefore, an StR can generate ESSRs on their RCoA and FICM sides and if they have replicated their placements then these will be pulled through too and fed into the ARCP date.

Does the new ICM portfolio have an option to send reminders to assessors to complete the Supervised Learning Event?

There is currently no “reminder” option available. There is no deadline for completion of forms and they will remain open until completed. You can return SLE forms to “draft” and then resend, which will generate a new email asking the assessor to complete the form.

How do you link uploaded documents to HiLLOs to provide evidence for LOC forms?

The document store is shared between both the ICM and the RCOA platform. Any documents uploaded to the document store will not be automatically pulled into an ESSR for either specialty or be automatically linked to a HiLLO. You will need to create a Personal Activity in order to link documents to appropriate HiLLOs. This can either be created by:
Create a Personal Activity on the main dashboard and add a supporting document to this activity
Add a document to the document store, and then there will be an option to link this to a Personal Activity by creating a new one

How do I link reflections?

Reflections can be completed using the Personal Reflection option on the main dashboard. These can be linked to HiLLOs and can be duplicated onto the anaesthesia LLLP platform.

Alternatively, reflections can be uploaded as a document, and then converted to a Personal Activity as above

Are we still required to keep a logbook of cases and procedures?

A logbook of cases and procedures is advisable in order to support attainment of outcomes. Further advice will be released from the regional School regarding the number of specific procedures required (i.e. intubations) will follow in due course.

The new anaesthesia curriculum suggests I only need to spend one rotation in neuroanaesthesia and cardiothoracic anaesthesia. How will this affect achieving these outcomes in stage 2 for anaesthesia trainees

The new dual curriculum expects the neuroanaesthesia/NICM and cardiac anaesthesia/CICM placements to be done in stage 2 of the dual programme (ST4 onwards with Stage 1 ICM requirements complete). During the present transition phase there will be allowance for cardiac/CICM or neuro/NICM placements during the intermediate/ST3 period to be accepted provided the required capability level for stage 2 sign off has been achieved. This will need to be endorsed by the StR’s ES when they sign off the respective HiLLOs for stage 2 completion and reviewed at ARCP.

Have the requirements for our Annual Review of Competency Progression changed with the introduction of the new curriculum

An updated ARCP information document should be available in the coming months, along with an updated ARCP checklist