The following information is based on my experience of sitting the DipIMC in January 2020. I have no affiliation with the RCSEd or FoPHC and as such the process may be different in the future. I hope the following information is useful but please conduct your own research into the exam as well!
The examination for the Diploma in Immediate Medical Care (DipIMC) is a bi-annual exam from the Royal College of Surgeons of Edinburgh. It is designed to test the “knowledge, skills and behaviours of pre-hospital emergency care practitioners” commensurate with level 5 on the Skills for Health Career Framework. It is not specific to profession and as such is open to Nurses, Paramedics, and Doctors working in pre-hospital care. Neither is it specific to speciality, and test subjects may range from critical care (i.e. the management of life-threatening asthma) to urgent care (i.e. the assessment of a minor eye injury).
As mentioned, diets (noun: “period of formal examination”) are bi-annual, in January and June/July, and consist of two examinations: a written exam (part A) and a practical exam (part B). Historically, there have been a variety of other examination methods (e.g. ‘projected material’) however these are no longer used.
For more information, visit the ‘Exam Regulations’ page on the FPHC website.
Application and cost
Each diet has a limited number of places available which are allocated to Pre-Hospital Emergency Medicine (PHEM) trainees first, and then all other applicants in chronological order. The exams are marked individually and a pass is required in both parts to achieve the DipIMC. If you fail either part, you do not have to resit the entire exam but can resit that individual part (subject to the same booking procedure as the original exam).
In January 2020, the costs were:
Written exam (resit): £310
Practical exam (resit): £415 For more information and to apply, visit the ‘Our Exams’ page on the FPHC website.
The DipIMC is based on the PHEM curriculum which relates to the “emergency response, primary scene transfer and secondary emergency transfer” of patients in the pre-hospital environment. Pivotal guidelines to be aware of include those produced by the Joint Royal Colleges Ambulance Liaison Committee (JRCALC), British Thoracic Society (BTS), the National Ambulance Resilience Unit (NARU), and the European Resuscitation Council (ERC).
Initially, I would recommend reading some of the literature relating to the history, design and experience of the DipIMC [1, 2, 3, 4] as well as watching the information videos available on the Faculty of Prehospital Care website. After this it is probably beneficial to work out how much time you have until your diet and plan your revision accordingly. Due to the breadth of knowledge in pre-hospital care, the list of potential reading material is endless and as such it can be daunting to try and begin preparation without structuring it beforehand.
Most people who sit the DipIMC have experience in pre-hospital care and therefore should already have the basic knowledge and skills required. A good strategy therefore is to identify areas of weakness in your practice and prioritise these in your revision. After all, the ultimate aim is to be well-rounded and competent in all aspects of immediate medical care.
The amount of preparation required will clearly be dependent on a number of individual factors (i.e. experience, baseline knowledge, current role) but as a newly-qualified, specialist paramedic (critical care) with five years’ experience as a paramedic, I found three months to be sufficient.
To get started, I highly recommend this blog piece by Dr Iain Beardsell for St. Emlyn's which contains loads of really useful learning resources.
Travel and accommodation
The exams take place at the Royal College of Surgeons of Edinburgh in the city centre. Edinburgh Airport (EDI) is about 8 miles away and the tram into town is regular, cheap, and takes about 30 minutes. I stayed in a budget hotel nearby, while others stayed in Airbnb properties. Overall, for return flights from South East England, transfers, accommodation, and general expenditure for three days, the trip cost me about £250.
Part A: the written exam (3 hours)
The written exam contains 180 single best answer (SBA) or multiple choice questions and lasts for 3 hours (1 minute per question). These questions cover the breadth of the PHEM curriculum and are random. There are no negative marks. You are given a booklet containing the questions and a separate answer sheet to document your answers.
In my experience of SBA exams, technique is important. Here is mine:
When answering, circle the answers on the question booklet and fill out the answer document last (this saves a lot of time!)
Go through the entire question booklet three times:
Answer all ‘easy’ questions and highlight any you’re unsure about
Answer all questions you’re unsure about (this will be most time-consuming)
Make logical guesses for the remaining questions (no negative marks)
Finally, copy your answers from the question booklet onto the answer document
Part B: the practical exam (~2 hours)
The practical exam is comprised of 12 x 8-minute objective structured practical exams (OSPE) on any subject and 2 x 16-minute OSPEs on basic and advanced life support and trauma care. They take place in a large hall which is separated into cubicles, one for each OSPE. Outside each cubicle is an information sheet detailing the scenario and what is expected of you. Candidates have 1 minute to read this information sheet, and the remaining time (7 or 15 minutes) to complete the OSPE.
Again, exam technique is important. Here are my ‘top tips’:
Read the information carefully. If (for example) it says you have conducted a primary survey, identified an isolated mid-shaft femur fracture, and need to apply a traction device, this is all you are being examined on. You will not get marks for re-doing a primary survey, or anything else that isn’t directly relevant to that task and will just waste time.
If you forget the instructions or need to take a breather, you can go back outside the cubicle and re-read the information sheet. However, the timer will continue to run during regardless.
Some OSPEs are easier than others and as such you may find you complete some quickly. To ensure a fair examination, the examiners and actors are unlikely to speak to you after you complete the task so if you finish it quickly this can lead to an awkward few minutes of silence. Take this time to ensure you have done everything required and if you recognise you made a mistake, highlight this to the examiner. Otherwise don’t feel like the silence is because you have done something wrong!
No one is perfect and everyone has strengths and weaknesses. As such you can expect some OSPEs to go really well and others to feel like a disaster. Although easier said than done, it is important to try and forget the previous OSPE the second you walk out to ensure you approach the next one with fresh confidence.
For more information, visit the ‘DIMC Objective Structured Practical Examinations’ page on the FPHC website.
Silas Houghton Budd DipIMC
Specialist Paramedic (Critical Care)
 Rutherford, G and Inglis, D (2010). 'Outlining the Diploma in Immediate Medical Care'. [Online].
 Kendellen, K. and O’Reilly, S. (2016). 'Dip(ping) into Foreign Waters…Irish Paramedics’ Royal College Experience'. [Online].