Flight paramedics care for some of medicine’s sickest patients in a cramped, loud, moving cabin thousands of feet above the ground. The Certified Flight Paramedic (FP-C)® credential from the International Board of Specialty Certification (IBSC) shows your knowledge matches that responsibility. Because the exam spans everything from gas laws and crash survival to balloon pumps and neonatal resuscitation, it’s normal to wonder where to begin. The good news is that IBSC publishes exactly what it tests. With a study plan built around that content outline, you can pass on your first try.

In this guide, we’ll walk you through the exam format, the nine content domains, the official resources worth downloading, and the questions candidates ask most often.

What Is the IBSC FP-C Exam?

The FP-C is IBSC’s specialty certification for flight paramedics. According to the IBSC flight paramedic page, the exam is meant for experienced, master-level paramedics who work with a flight or critical care transport team. It measures specialty knowledge, not entry-level paramedic knowledge.

IBSC also says the exam tests the transport environment as a whole, not the way any one program operates. Think about the full range of mission profiles (rotor-wing, fixed-wing, and ground) and understand basic accreditation standards, even if your program isn’t accredited by the Commission on Accreditation of Medical Transport Systems (CAMTS).

What Is the FP-C Exam Format?

Here is the exam at a glance, based on the IBSC flight paramedic page and the IBSC Exam FAQs:

  • Questions: 135 multiple-choice questions.
  • Scored vs. unscored: 110 scored questions and 25 unscored pilot questions. You can’t tell which are which, so treat every question as if it counts.
  • Time: 2.5 hours (150 minutes).
  • Delivery: Computer-based testing at Prometric test centers, Live Remote Proctor (LRP) testing, or IBSC onsite options such as paper-and-pencil and Mobile Exam Delivery sessions.
  • Calculator: A simple on-screen calculator is provided. Personal calculators aren’t allowed.
  • Passing score: 73 correct answers out of 110 scored questions, or about 66%.
  • Results: Computer-based results are available within about an hour. Paper-and-pencil results take 4 to 6 weeks.

With 150 minutes for 135 questions, you have about 67 seconds per question. Recall items go quickly, but drip rates, burn fluid formulas, and oxygen-at-altitude questions take longer, so bank time where you can.

What Content Outline Does the FP-C Exam Use?

The exam is based on the FP-C® Detailed Content Outline, and the FP-C Candidate Handbook (April 2026) covers testing policies. Pocket Prep’s FP-C exam prep content is aligned to this exam version.

The outline divides the exam into nine domains and lists how many questions come from each:

  1. Safety/Transport Fundamentals and Post-Incident Survival: 10 questions (8%)
  2. Flight Physiology: 9 questions (about 7%)
  3. Advanced Airway and Ventilation Management: 15 questions (12%)
  4. Trauma and Burn Emergencies: 19 questions (about 15%)
  5. Neurological Emergencies: 9 questions (about 7%)
  6. Cardiopulmonary Emergencies: 25 questions (20%)
  7. Toxic and Environmental Exposures: 9 questions (about 7%)
  8. Perinatal and Pediatric Emergencies: 19 questions (about 15%)
  9. General Medical Patient: 10 questions (8%)

Domain 1: Safety/Transport Fundamentals and Post-Incident Survival (10 Questions)

This domain covers keeping the aircraft, crew, and passengers safe, and what to do if something goes wrong.

  • Scene safety, preflight aircraft and equipment checks, sterile cockpit, and safe approach to the aircraft.
  • Securing the patient, human factors, and go/no-go and abort decisions.
  • In-flight emergencies such as fire, emergency egress, emergency landing, adverse weather, and depressurization.
  • Crash-site duties, survival shelters, and emergency survival procedures.
  • Passenger safety, weather, safety management systems, and Just Culture.

Study tip: Survival and egress topics rarely come up on shift, so give them deliberate review.

Domain 2: Flight Physiology (9 Questions)

Here you apply the physics of altitude to patients and crew.

  • Causes and stages of hypoxia and how to correct altitude hypoxia.
  • Gas laws and their effects, plus signs of barometric trauma.
  • Stressors of transport (thermal, humidity, noise, vibration, and fatigue) and corrective actions.
  • Altitude-related conditions in patients and crew, and how to prevent them.

What questions look like: A patient with a pneumothorax, a bowel obstruction, or an air-filled ETT cuff is about to climb. What happens, and what do you do first?

Domain 3: Advanced Airway and Ventilation Management (15 Questions)

This domain tests your full airway plan, from deciding to intervene through managing the ventilator.

  • Indications and contraindications for basic, advanced, and alternative airways.
  • Airway medications, airway algorithms, and intubation complications.
  • Monitoring in transport, including capnography, and adjusting ventilator settings to the patient’s condition.

Domain 4: Trauma and Burn Emergencies (19 Questions)

  • Triage (including mass casualty and weapons of mass destruction incidents), injury patterns, and trauma center criteria.
  • Revised Trauma Score, TRISS, and the Glasgow Coma Scale.
  • Head, spinal cord, thoracic, abdominal, and orthopedic injuries and trauma medications.
  • Burn assessment, body surface area estimation, fluid replacement calculations, inhalation injury, and escharotomy.

Study tip: Practice burn formulas and trauma scores until you can do them quickly with the on-screen calculator.

Domain 5: Neurological Emergencies (9 Questions)

  • Differential diagnosis of coma, seizures, and cerebral ischemia.
  • Focused and serial neurologic exams, motor strength, and recognizing rising intracranial pressure through level of consciousness.
  • Neurologic medications and critical interventions.

Domain 6: Cardiopulmonary Emergencies (25 Questions)

The largest domain covers cardiac and respiratory emergencies plus the devices critical care patients arrive with.

  • Acute myocardial infarction, heart failure, cardiogenic shock, primary arrhythmias, and hemodynamic instability.
  • Invasive monitoring and electrical therapies in transport.
  • Ventricular assist devices, transvenous pacemakers, and intra-aortic balloon pumps, including adjusting them.
  • ARDS, spontaneous pneumothorax, and pneumonia, monitored with pulse oximetry, capnography, blood gases, and chest radiography.

Domain 7: Toxic and Environmental Exposures (9 Questions)

  • Toxicologic exams, decontamination, antidotes, overdose, and chemical, biological, radiological, nuclear, and explosive (CBRNE) events.
  • Snake, scorpion, and spider envenomation.
  • Cold, heat, diving (decompression sickness, arterial gas embolism, drowning), and altitude emergencies.

Domain 8: Perinatal and Pediatric Emergencies (19 Questions)

This domain has 26 lettered subtopics, the most in the outline.

  • Obstetric and fetal assessment, electronic fetal monitoring, contractions, cervical status, and obstetric emergencies such as cord prolapse and placental abruption.
  • Deciding whether to transport or deliver at the referring facility, and managing precipitous delivery.
  • Neonatal resuscitation, isolette transport, temperature control, and transport on ECMO, nitric oxide, or high-frequency ventilation.
  • Pediatric respiratory, medical, cardiovascular, and traumatic emergencies, including child abuse.

Domain 9: General Medical Patient (10 Questions)

  • Medical emergencies such as abdominal aortic aneurysm, GI bleeding, bowel obstruction, and hyperosmolar hyperglycemic states.
  • Invasive monitoring, lab-guided care (blood glucose, CBC), and infection prevention.
  • Pain assessment, documentation, and management.

How Should You Use the FP-C Blueprint to Build a Study Plan?

  1. Take a baseline. Answer a mixed set of questions before you open a textbook.
  2. Map every miss. Tag each missed question to one of the nine domains and the specific subtopic.
  3. Weight your time. Cardiopulmonary, Trauma and Burn, and Perinatal and Pediatric make up half the outline. Start there if you’re weak in any of them.
  4. Close practice gaps. If your program rarely flies OB, neonatal, or balloon pump patients, study them on purpose. The exam covers every mission profile.
  5. Don’t skip the small domains. Flight Physiology and Safety are only 19 questions combined, but they’re the content unique to flight, and few other sources teach them.
  6. Finish with timed, mixed practice. Build toward about a minute per question.

What Official FP-C Resources Should You Use?

Commonly used IBSC FP-C study textbooks:

  • Patient Transport: Principles and Practice 6th Edition (ISBN 978-0443105708)
  • Critical Care Transport, 3rd Edition (ISBN 978-1284263114)
  • Flight Medical Provider: A Ground and Flight Critical Care Guide (ISBN 979-8218144173)
  • CAMTS Accreditation Standards, 12th Edition (ISBN 978-1955366284)
  • BLS Provider Manual, 2025 (ISBN 978-1684723102)
  • PALS Provider Manual, 2025 (ISBN 978-1684723393)
  • ACLS Provider Manual, 2025 (ISBN 978-1684722952)

Frequently Asked Questions About the IBSC FP-C Exam

What score do I need to pass the FP-C?
You need 73 correct answers out of the 110 scored questions. IBSC doesn’t release exact scores. If you don’t pass, your score report shows your relative strengths and weaknesses.

How soon will I get my FP-C exam results?
Computer-based candidates get results within about an hour. Paper-and-pencil results take 4 to 6 weeks.

Can I retake the FP-C if I fail?
Yes. You can take the same exam up to three times in total, waiting at least 30 calendar days between attempts. Full fees apply each time.

How much does the FP-C exam cost?
IBSC lists $285 for IBSC Affiliate Members and $385 for non-members. Rescheduling within 30 days of your test date costs $100, and fees are non-refundable. See the IBSC exam fees page for current pricing.

How long is the FP-C valid?
Four years. You can renew by retaking the exam or by submitting 100 approved continuing education credits.

Start Preparing for the IBSC FP-C Exam With Pocket Prep

Pocket Prep’s IBSC FP-C exam prep includes 1,000 practice questions with detailed explanations and a full-length mock exam to rehearse test-day pacing. Use the Weakest Subject quiz to find your gaps and the Missed Questions quiz to close them. With a consistent study plan, you can walk into exam day with confidence.