Critical
CriticalIntensive care judgement
Prioritise evolving critical illness and justify your investigations, treatment and escalation decisions.
CICM Second Part Viva practice
Defend your decisions in the Second Part Viva.
Practise intensive care decisions and conversations with an AI examiner or role-player, under exam timing.
Original exam-specific content On your schedule.
All pathwaysAdditional initial result Opening question
Viva 01Candidate instructions
Hyperglycaemia with circulatory collapse
2 minutes reading · 10 minutes viva
You are the ICU consultant receiving a 72-year-old woman with type 2 diabetes who has had three days of dysuria, vomiting and increasing confusion. She is drowsy but rousable, with dry mucous membranes, cool peripheries and right loin tenderness.
Temperature is 39.1°C, heart rate 128/min, blood pressure 76/42 mmHg, respiratory rate 30/min and SpO2 96% on 4 L/min oxygen.
- Blood beta-hydroxybutyrate 5.8 mmol/L
Interpret the initial arterial blood gas, ECG and clinical information, and describe your immediate management priorities.
E
Examiner
Interpret the initial arterial blood gas, ECG and clinical information, and describe your immediate management priorities.
You
This is mixed DKA and hyperosmolar crisis with septic shock and acute kidney injury. The ECG shows hyperkalaemic T-wave peaking. I would give IV calcium, begin reassessed crystalloid, antibiotics and norepinephrine, arrange urgent urological source control, then start insulin with close potassium and osmolality monitoring.
E
Examiner
Explain how you will prescribe and adjust fluid while managing the sodium and osmolality.
100+published stations per pathway
1,720+stations completed
195+hours practised
CICM Second Part Viva
Built for your examination.
Clinical data and procedures
Interpret clinical images and results, and talk through the practical decisions behind ICU procedures.
Communication under pressure
Rehearse discussions with families and colleagues through role-player conversations written for each case.
Explore the other exams
Inside a CICM Second Part Viva
Prioritise and defend your clinical decisions.
Work through clinical questions or conversations with families and colleagues, depending on the station.
“Explain how you will prescribe and adjust fluid while managing the sodium and osmolality.”
01Read
Review the stem, available clinical information and opening question.
02Respond
Answer aloud as the examiner probes your judgement or a role-player responds to your communication.
03Review
Review your feedback alongside the marking criteria and transcript.
Your practice
From station to feedback.
01Choose a stationDASHBOARD
CICM station libraryChoose what to practise next
- 01GeneralHyperglycaemia with circulatory collapse
- 02CommunicationFamily concern about transfer from intensive care
- 03RadiologyICU chest radiology and acute complications
- 04ProcedureFlexible bronchoscopy in a ventilated patient
02Give your answerSTATION RUNNER
E
Examiner
Interpret the initial arterial blood gas, ECG and clinical information, and describe your immediate management priorities.
You
This is mixed DKA and hyperosmolar crisis with septic shock and acute kidney injury. The ECG shows hyperkalaemic T-wave peaking. I would give IV calcium, begin reassessed crystalloid, antibiotics and norepinephrine, arrange urgent urological source control, then start insulin with close potassium and osmolality monitoring.
E
Examiner
Explain how you will prescribe and adjust fluid while managing the sodium and osmolality.
Type your response...
03Understand the resultFEEDBACK
Practice ratingAt Standard
You integrated the mixed hyperglycaemic crisis, septic shock and immediately dangerous hyperkalaemia. Next, make the fluid plan explicit by linking the prescription to perfusion, sodium and the rate of osmolality change.
Next focus: Control fluid and tonicity with explicit targets.
AI feedback can help you gauge your readiness, but cannot guarantee exam success.
Support between stations
Build on every attempt.
Your learning journey brings together recurring strengths and difficulties across your attempts.
Work through them with your AI coach using short spoken exercises, saved reminders and suggestions for your next station.
Included coaching minutes and unlock requirements vary by plan.
AI coach
“Your feedback across several stations mentions long answers that lose focus. Do you find it difficult to decide what matters, or do you know what matters but worry about leaving something out?”
You
“I worry that anything I leave out could cost me marks.”
AI coach
“Then working on shorter answers alone won’t address that worry. Let’s look at one of your attempts alongside its marking criteria and separate the detail that supported your answer from the detail that distracted from it.”
Why CriticalExam?
Alongside your usual preparation.
Use CriticalExam for additional spoken rehearsal between practice with colleagues and supervisors, alongside your reading and clinical experience.
Exam-specific stations
Written for your examination.
Original cases follow the relevant format, curriculum and marking criteria.
Feedback you can revisit
See the basis for your feedback.
Keep the station’s marking criteria, your transcript and feedback together for review.
Ready to get started?