MFOM Part 2 – Regulations & Guidance
INTRODUCTION
Membership of the Faculty of Occupational Medicine (MFOM) is intended for registered medical practitioners who are committed to the full-time or part-time practice of occupational medicine, and confers formal recognition of competence. It is the highest level of Specialist professional qualification in Occupational Medicine recognised by assessment by the FOM and further information can be found at the general regulation & guidance page.
It is a normal requirement for those who aspire to being on the Specialist Register as Accredited Specialists in Occupational Medicine in the UK and will be awarded to those who have completed the requisite Higher Professional Training, together with MFOM Part 1 and MFOM Part 2 examinations, and demonstrated the achievement of eleven Learning Outcomes.
Membership may also be available to medical practitioners outwith UK Specialist Training. Successful candidates will normally have completed satisfactorily a prescribed period of supervised training in one or more approved posts and have met the requirements of the curriculum, completed the appropriate Faculty Examinations and met any requirements of the General Medical Council.
These regulations and guidance give further detail related solely to the MFOM Part 2 examination.
ELIGIBILITY
| P1. Regulation |
Normally, before applying to sit the Part 2 examination a candidate must fulfil the eligibility requirements M34 to M37: |
| M34. Regulation |
Before applying to sit the MFOM Part 2 examination a candidate must have passed their MFOM Part 1 examination. See Regulation M9 (MFOM Part 1 Regulations) for conditional exemptions. Doctors who enter the GMC Specialist Register under the European Union (Recognition of Professional Qualifications) Regulations 2015, as amended by the Recognition of Professional Qualifications (Amendment etc.) (EU Exit) Regulations 2019 are exempt from the MFOM Part 1 examination. |
| M35. Regulation |
If enrolled in an approved post or programme recognised for higher specialist training in occupational medicine in the UK, the candidate must also provide evidence, following Annual Review of Competency Progression (ARCP) panel review, of having achieved the end Learning Outcomes/Professional Capabilities of ST4 training. Trainees who wish to sit the MFOM Part 2 examination before entering ST5 are able to do so provided they have the written support of their educational supervisor and NSOH. Candidates must also have paid all relevant subscription fees. |
| M35. Guidance |
The Learning Outcomes/Professional Capabilities referred to are those defined in the approved OMST 2022 Curriculum, and elaborated with guidance in the Specialty Training Handbook. Candidates must normally submit the evidence referred to in Regulation M6 (MFOM Part 1 Regulations) with their examination application. Exceptionally, and at its own discretion, the Faculty may accept later submission of this evidence; but in all circumstances it must be received before the date of the examination. |
| M36. Regulation |
If not enrolled in an approved post or programme of specialist training in the UK, the candidate must also provide evidence of at least 4 years of full-time practical experience or training in occupational medicine (or the equivalent pro-rata) in a post or posts acceptable to the Faculty. |
| M36. Guidance |
Among other things, the Faculty’s Specialty Advisory Committee (SAC) will normally seek evidence of:
(i) a sufficient breadth, as well as a sufficient duration of experience in occupational medicine (across a range of settings and covering a range of occupational health problems of a kind encountered in specialist training or practice); and (ii) structured employment involving the support and, ideally, the formal supervision of a senior occupational physician of consultant status. Normally the applicant will need to hold such a post for at least 6 months within the 12 months prior to their application to be eligible to sit the MFOM Part 2 examination; the practice of occupational medicine must be a substantial component of their work. (iii) proof of equivalent practical experience and/or training outwith UK specialist training (M37) must be received at least 4 months before the Part 2 examination date, so that the SAC has an adequate period in which to assess eligibility under M37. |
EXEMPTIONS
| M37. Regulation |
Candidates who have passed the AFOM examination in its entirety will be exempted both the MFOM Part 1 and MFOM Part 2 examinations, provided that the date on which they sat and passed the AFOM is not more than seven years before (a) their enrolment (or re-entry) into an approved post or programme recognised for higher specialist training in occupational medicine in the UK (b) if not enrolled in higher specialist training, their application for Membership. |
View regulations and guidance M38 – M39
COMPONENTS OF ASSESSMENT
| P2. Regulation |
The Part 2 MFOM examination is comprised of:
1. A Single Best Answer Paper (SBA) 2. An Objective Structured Clinical Examination (OSCE) A pass in both the SBA and OSCE are required to pass the MFOM Part 2 examination. |
| P3. Regulation |
The MFOM Part 2 SBA paper is normally held before the OSCE. The OSCE will be held on another day, normally about a month later, and may be at one or more centres. |
THE EXAMINATION SYLLABUS
| P4. Regulation |
The syllabus for the MFOM Part 2 examination will be based on the requirements for higher specialist training in Occupational Medicine in the United Kingdom (UK), as defined in the latest version of the Faculty’s GMC-approved specialist training curriculum. |
| P5. Regulation |
Questions may be asked on any part of the syllabus. Collectively, the sections of assessment (SBA and OSCE) will aim to sample systematically from the curriculum across examination sittings. |
THE PASS STANDARD
| P6. Regulation |
A candidate’s performance in each section will be assessed relative to an external standard set by the examiners. Raw marks may be adjusted to preserve a common standard between examinations. |
| P7. Regulation |
Candidates must achieve a pass in both the SBA and the OSCE to pass the MFOM Part 2 examination. On a candidate’s first attempt, they must take both the SBA and OSCE.
A pass in either the SBA or the OSCE can be banked up to a maximum of six exam attempts. |
| P8. Regulation |
Candidates are normally allowed up to a maximum of six attempts at the MFOM Part 2. However, Regulation F3 makes provision for the Faculty’s Specialist Advisory Committee (SAC) to consider a candidate’s eligibility to make a further attempt or attempts, subject to acceptable evidence of additional education experience.
An ‘attempt’ is defined as the sitting of an exam section or sections in a single examination diet. For example, a candidate sitting both sections in one diet has made one ‘attempt.’ If that candidate fails one of the sections, they will be entered for that section only when they next apply. This will count as their second attempt. |
SINGLE BEST ANSWER (SBA) PAPER
| P9. Regulation |
This 3-hour examination paper will comprise of 180 questions in the format of a statement or ‘vignette’, a lead-in question and five options. Candidates will be required to choose the most appropriate response from the options. |
| P10. Regulation |
The SBA paper is conducted as an online exam. All questions are compulsory. A negative marking scheme will not be employed. |
OBJECTIVE STRUCTURED CLINICAL EXAMINATION (OSCE)
| P11. Regulation |
The Objective Structured Clinical Examination will comprise twelve clinical stations, structured across the following four areas:
The duration of each OSCE station will be 10 minutes and all stations are compulsory. General guidance on the OSCE is provided below although the exact content of questions and administrative arrangements may vary. |
APPLICATION FOR ADMISSION; COMMUNICATION OF RESULTS
| P12. Regulation |
Applications for admission to the MFOM Part 2 must be made by the advertised closing date and submitted via The Faculty’s online application system, together with such other evidence as the form dictates to confirm eligibility under Regulation A1. All applications must be accompanied by the appropriate examination fee (see General Regulations & Guidance). Details of times and places of examinations will be available to candidates well before the due dates. |
| P13. Regulation |
Results of the examinations will be communicated to the candidates in writing as soon as is practicable. In no circumstances will results be given by telephone. |
SYLLABUS
The syllabus will be based on that defined by the GMC-approved OMST 2022 curriculum for higher specialist training in Occupational Medicine in the United Kingdom (UK) – i.e. the Specialty Registrar’s training curriculum.
Doctors in specialist training posts and those outwith such programmes may find it helpful to read the FOM’s OMST 2022 Curriculum Guidance.
By careful selection of examination questions, the examiners will aim to offer a broad coverage of this GMC-approved training curriculum across examination sittings.
COMPONENTS OF THE MFOM PART 2 EXAMINATION
Single Best Answer (SBA) Paper
The SBA paper will last for 3 hours and will be conducted online. The paper will consist of 180 questions presented in the SBA format. Each question in the paper will consist of a statement or ‘vignette’, a lead-in question and five options. All questions are compulsory.
The purpose of the SBA examination is to test the application of knowledge and higher order problem solving, rather than the recall of factual information. The examination paper will be blueprinted to the OMST 2022 Curriculum Professional Capability topics within the following Learning Outcomes:
- LO1: Professional values and behaviours
- LO3: Professional skills and knowledge – clinical practice
- LO4: Workplace risk
- LO5: Health promotion and illness prevention
- LO7: Patient safety
- LO9: Safeguarding
- LO11: Research
The marking system for the SBA examination is as follows:
- One mark (+1) is awarded for each correct answer.
- No mark is deducted for an incorrect answer (a negative marking scheme is not used).
- No mark is awarded or deducted if a question is left unanswered.
- No mark is awarded for any answer that is partially erased, smudged, or a double response to a question.
Candidates are advised that the pass mark in the SBA examination will be assessed relative to an external standard set by the examiners, and that raw marks may be adjusted (scaled) to preserve a common standard between examinations.
Objective Structured Clinical Examination (OSCE)
The OSCE comprises 12 clinical stations that will be held at either the Northern General Hospital in Sheffield or another suitable venue. In certain circumstances it may be necessary to conduct the OSCE as a live, online examination.
In each station, candidates will be observed and assessed by pairs of examiners. At times, an auditor (who assesses the performance of the examiners, not the candidate), or a trainee examiner, may be present but will take no part in the examination.
The stations are run on a circuit and candidates may commence the circuit at any of the clinical stations. Depending on the number of candidates, it may be necessary to run two circuits simultaneously. If so, to standardise the assessments as far as practicable, each station in the two circuits will have broadly similar cases with similar tasks and questions.
The clinical stations will be structured across the following four areas with all stations being linked to the OSCE blueprint to ensure they assess a broad spectrum of the curriculum content in a variety of ways:
- History taking
- Examination
- Explanation
- Procedures
The duration of each OSCE station will be 10 minutes. Candidates will also have 2 minutes reading time prior to each station. Two examiners are present at the station. The candidate is given clear written instructions prior to commencing the station. The scenarios presented are drawn from the typical spectrum that an occupational physician could reasonably expect to see in daily practice e.g. a musculoskeletal, cognitive, neurological, respiratory, cardiac, or dermatological case. Some of the stations will also involve a patient with a mental health or disability history. The examiners will ask all candidates the same or similar questions and will use a pre-designed marking scheme for each case.
Candidates are not required to pass every station or any particular station. However, they are required to reach a bare minimum pass standard in certain areas which are not directly tested elsewhere in the MFOM Part 1 and MFOM Part 2 examinations. These include: the candidate’s approach to, and communication with, the patient; their capacity to manage the patient’s concerns; and their ability to take a detailed history, conduct a suitable clinical examination, elicit clinical signs and reach an appropriate diagnosis.
Marking
The pass mark in the OSCE will be assessed relative to an external standard set by the examiners. Raw marks may be adjusted (scaled) to preserve a common standard between examinations. Candidates’ total marks across all stations, adjusted/scaled as necessary, will be compared with the overall pass mark.
Other comments
In preparing for the clinical elements of assessment, candidates for the OSCE may find it advantageous to practise their clinical skills by attending a suitable course or by a short-term attachment to a hospital unit.
