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EHRA Invasive Cardiac Electrophysiology Certification

Organised by the European Heart Rhythm Association (EHRA)

NEW: EHRA EP exams will be delivered in Spanish and Portuguese (in collaboration with LAHRS). 

The next EP online exams in Spanish and Portuguese will be held on 6 November 2021.

Individual registrations are open until 21 October.

The EHRA exam in electrophysiology tests knowledge, experience, clinical expertise and proficiency of physicians specialising in the treatment of patients suffering from cardiac arrhythmias. Together with the EHRA logbook of interventional procedures/operations performed under the supervision of senior colleagues, it provides the basis for the EHRA certification exam in electrophysiology.

To encourage a high standard of knowledge and clinical expertise and to enable physicians to provide their patients with the best and most advanced standard of treatment, we envisage a successful EHRA certification process to serve as a sign of excellence for the physician. To achieve and maintain the quality level of the exam we are focusing our efforts on improving the number, content, layout, and statistical power of the questions.

We strongly recommend that physicians who wish to go through the EHRA certification process acquire knowledge and clinical experience before attending the exam

A short questionnaire asking for details of the candidates’ clinical background will be part of the registration process for the exam.

EHRA Online EP Exam

certification-woman.jpg

No need to travel anymore.

Take the exam online, from your computer, at your home.

 

 

 

Schedule

The examination is designed to be completed in two parts of three hours each, with a 60-minute lunch break between the two parts.

You will be able to start the first part of your exam any time between 09:00 to 11:00 CET. 

EHRA online EP exam: what you need to know

EHRA offers the possibility of taking the exam online. Here is everything you need know to about the ESC Online Proctoring Examinations policies and rules, in order to participate!

What is this online format?

EHRA wants to provide you with the safety and convenience of an online platform, while retaining the integrity and quality of an on-site supervised exam. 

The exam is:

  • accessible everywhere in the world
  • identical in content, format and on-screen experience to previous on-site exams delivered on tablets
  • taken on your own device (computer) and monitored by a human proctor online through ProctorU®

What equipment do I need?

You must verify that your computer meets the requirements before you register for the EHRA online EP exam. If this is not the case, you will not be able to take the exam. 

You will need:

  • a strong and stable internet connection
  • a webcam, speaker and microphone

We highly recommend that you check all of the system requirements available here 

We also recommend that you test your equipment while you are on that page to verify you have the necessary equipment to take the exam. 

How can I register for this exam?

It is a two-step registration process

  • start your registration with EHRA
  • complete your registration with ProctorU®
Start your registration with EHRA

After having verified that your equipment meet the requirements, you can start your registration with EHRA. You will need to complete a pre-exam questionnaire and pay the exam registration fee. When you finish, you'll receive an email from the ESC with your invoice to confirm your payment.

Complete your registration with ProctorU®

Once you have registered with EHRA and paid your exam fee, you'll get an email with a link to complete your registration with ProctorU®.

You'll need to create a ProctorU® account. Then at the pre-defined exam date, you'll be able to choose the time slot you would like to take the exam. When you finish, you'll receive a confirmation email. 

What can I expect on the exam day?

You can find more information about what to expect on the examination day below and also on ProctorU® website.

Before the exam session begins
  • Fix any issues you may encounter on your computer. All issues must be resolved before your appointment time.
  • Close all browsers and applications not needed for the exam. 
  • Gather the documents you will need to identify you (passport, ID document with photo).
  • Make sure your exam environment meets the requirements:
    • your room is quiet and well lit
    • your are alone in the room
    • your workspace is clear from all materials and unauthorised supports
    • there are no sounds from music or television around
  • Make sure you are dressed appropriately, with your face visible to the proctor
Check-in and identification process
  • Log in to your ProctorU® account at your appointment time
  • Complete the authentication steps, which include showing your ID to the proctor. The name on your ID must match the name provided during the registration process
  • Follow the proctor instructions. You will have to:
    • Give access permission to your computer screen for monitoring purposes
    • Use your camera to show a 360-degree view of your room
  • If everything goes well, the proctor will let you start your exam

The check-in and identification process can take approximately 5 to 10 minutes. 

During the exam

Your entire exam will be recorded by ProctorU® and monitored by a human proctor. 

  • During the exam, the proctor will monitor you (via the camera) and your computer screen to ensure you follow all exam procedures
  • You must be visible to the proctor at anytime of the exam session. No breaks are allowed
  • You can interact with the proctor by speaking to him/her or using the chat option
  • You are not allowed to take notes on paper during the examination

The exam policies are:

  • Don't use any unauthorised materials, including mobile devices, prewritten notes or books
  • The use of any recording equipment is strictly prohibited
  • Don't communicate with anyone other than the proctor
  • Speaking aloud during the exam is strictly prohibited
  • You cannot be out of camera view. No breaks are allowed during the whole duration of the exam
  • Taking pictures, screenshots or trying to copy/paste any element of the exam content is strictly prohibited
  • You must behave in an appropriate manner. Any conduct that the proctor may deem vulgar, offensive, pornographic, obscene, abusive or criminal are strictly prohibited

Suspicious actions are flagged in the online proctoring system and will be reported to the ESC.  

If the proctor detects any suspicious activities or movements, he/she could terminate your exam session at any time and your exam will be invalidated and your fee won't be refunded. 

Any irregularity in relation to the ESC Online proctoring Examinations policies and rules mentioned above can lead to sanctions as described in the Online proctoring Examination Terms & Conditions

What if I have technical issues?
  • If you experience a technical problem during the test, notify the proctor by speaking to him/her or via the chat. 
  • If you get disconnected or if you lose your internet connection momentarily, you will automatically be reconnected. 
  • If you are unable to reconnect or speak to the proctor, you can call ProctorU for assistance. 

Registration fees

EHRA Exams:

  • In order to respect exam capacity, registrations will be managed on a first come first served basis.
  • We encourage you to register online as early as possible to guarantee a seat.
  • Registration for all ESC administered exams closes 15 days prior to the examination with no exceptions.
  • However, registration may close earlier when the exam capacity is reached.

 

EHRA/LAHRS EP Online Exam in Spanish:

Individual registration is open until 21 October.

Please note that healthcare companies or third-party agencies cannot use a delegate’s “MyESC account” or create a delegate “MyESC account” for registering their delegates. This is Individual Registration only.

Candidate confirms that this is a purchase 'by myself' as an individual, and the billing address is correct. Candidate understands that after payment has been made, changes in the invoice details will not be possible.

Fee Types                    Online Fees
Standard Fee €750
EHRA Member Fee €625*
LAHRS Member Fee €625*
EHRA Member and LAHRS Member €525**

*To benefit from member fees you must be a member before registering for the exam. This fee is only available for EHRA Ivory, Silver and Gold Members and to LAHRS Members.

**To benefit from member EHRA and LAHRS fees you must be an EHRA Member and a LAHRS member before registering for the exam. Both memberships are required.

Individual Registration_Register Myself

 

EHRA/LAHRS EP Online Exam in Portuguese:

Individual registration is open until 21 October

Please note that Healthcare companies or third-party agencies cannot use a delegate’s “MyESC account” or create a delegate “MyESC account” for registering their delegates. This is Individual Registration only.

Candidate confirms that this is a purchase 'by myself' as an individual, and the Billing Address is correct. Candidate understands that after payment has been made, changes in the invoice details will not be possible.

Fee Types                    Online Fees
Standard Fee €750
EHRA Member Fee €625*
LAHRS Member Fee €625*
EHRA Member and LAHRS Member €525**

*To benefit from member fees you must be a member before registering for the exam. This fee is only available for EHRA Ivory, Silver and Gold Members and to LAHRS Members.

**To benefit from member EHRA and LAHRS fees you must be an EHRA Member and a LAHRS member before registering for the exam. Both memberships are required.

Individual Registration_Register Myself

 

EHRA EP Online Exam in English:

Registration is closed.

Please note that Healthcare companies or third-party agencies cannot use a delegate’s “MyESC account” or create a delegate “MyESC account” for registering their delegates. This is Individual Registration only.

Candidate confirms that this is a purchase 'by myself' as an individual, and the Billing Address is correct. Candidate understands that after payment has been made, changes in the invoice details will not be possible.

Fee Types                    Online Fees
Standard Fee €750
Standard Resit Fee €438**
EHRA Member Fee €625*
EHRA Member Resit Fee €375**

 

*To benefit from member fees you must be a member before registering for the exam. This fee is only available for EHRA Ivory, Silver and Gold Members.

**Please note that the resit fee is reserved just for candidates who have sat and failed the exam in the past and cannot be used by candidates under any other circumstances. 

 

Cancellation policy

If you wish to cancel your registration for the certification exam, you must contact us. The EHRA cancellation policy is as detailed below:

  • Up to six weeks before the exam: 100% refund
  • From six to four weeks: 50% refund
  • Within four weeks: no refund
  • No show: no refund

In the case of unforeseen circumstances (such as a death in the family, on-call at the hospital, an accident involving the candidate), a document of proof will be required, and you will be refunded the entire registration fee.

Requirements

Those interested in taking a certification exam will be asked, during the registration process, to provide:

  • A copy of their medical diploma (MD) issued by a National Health Authority (sent as PDF document labelled with their name - i.e., MD_Name-Surname)

To achieve certification as an EHRA Certified Electrophysiology Specialist (ECES) the candidate must complete the two levels:

  1. Level 1: Pass the exam (in English) consisting of multiple choice questions. 
  2. Level 2: Pass the exam and document practical experience: Once the exam is passed a logbook must be submitted three years* after sitting the exam.

*The requirements will change for candidates sitting the exam from 2014. Please see below.

The exam

The examination is designed to be completed in two consecutive parts of three hours each. 

The questionnaire is compiled by the EHRA Certification Committee and consists of 130 multiple-choice questions. The statistical performance of each MCQ is analysed, and the 10 least discriminating MCQs are not taken into account. The candidates' final score is therefore derived from 120 MCQs only. The pass mark is pre-determined using a validated standard-setting process. 

Questions are based on the analysis of practical clinical cases and decision making (60-80%), with the remaining dedicated to theoretical questions.

Exam results are sent (to your email address registered on your My ESC account) within the two months after the exam is sat.

Upon successful completion of the exam, candidates will receive an ECES Level 1 Certificate valid for ten years.  

As skills can only be maintained by continued education and practical involvement, certification is granted for ten years. Afterwards, you are required to complete the recertification process to renew your certification. 

EHRA/LAHRS EP exams in Spanish and Portuguese:

Candidates cannot resit the exam in the same calendar year. A candidate who fails the English exam in August 2021 cannot resit in the Spanish or Portuguese exams in November 2021. 

Appealing the exam

Candidates who have comments or concerns about an Examination question should contact the ESC via the ESC Contact us webpage. The relevant certification committee will review all comments, concerns and suggestions made by Candidates.  These comments or concerns must be logged on the Examination day with the proctor or at the latest before Candidates received their Examination results.

  • After having received your results:

If you believe that an incorrect result has been awarded to you, you may lodge an appeal by sending to the ESC exam administration an official letter within 8 days of receiving your scores, via the ESC contact us form. The result of such an appeal may be a higher grade, a lower grade, or no grade change. In no circumstance will you be entitled to fee refund nor damages.

Appeal process:

  • The ESC exam administration and relevant certification committee will reply within 4 weeks.
  • Reply from the ESC exam administration and relevant certification committee is final. You agree to this during the exam registration process by accepting the ESC exam delivery Terms and Conditions.
  • Appeals are free of charge.

The logbook

Once candidates have passed the exam (achieving Level 1), they can then apply for Level 2 by proving their practical experience in the field. The access to the e-logbook platform is granted to the candidate only after having successfully passed the written exam. 

NEW: New regulations have been validated by the EHRA Certification committee. These are compulsory for all candidates sitting the electrophysiology (EP) exam from 2019 on and can be followed by those who have taken the exam in 2018.

Documents to submit (new regulations from 2018)

If you successfully passed the EHRA EP written examination, you will find in your result letter a link to access the e-logbook platform. This link is strictly personal and cannot be shared. In the platform, you will able to load all information required for Level 2 certification. Please note that all document templates are downloadable in the platform.  

Procedures must be performed within a period of 36 consecutive months - these 36 months can be taken anytime from two years before up-to-two years after the date of the exam.

Documents required are:

You have to perform a minimum of 200 EP procedures with a significant amount of catheter manipulation and interpretation of the electrograms.

Diagnostic EP procedures, where no ablation is performed, can also be included in the total number of cases. However, a diagnostic EP study conducted in the context of ablation cannot be included in the logbook as a separate procedure.

EP procedures must include at least the minimum number from each of the ablation categories listed below:

Ablation categories

  • AVNRT - 15
  • Accessory pathway (concealed or manifest) - 15
  • Cavo-Tricuspid Isthmus (CTI) for typical atrial flutter - 25
  • Non-CTI atrial tachycardia - focal or reentrant - 10
  • AV node - ablation - 5
  • AF ablation - 50
  • VT/PVC ablation in normal hearts - 5
  • VT/PVC ablation in structural heart disease - 5
  • Diagnostic EP study - 0
Documents to submit (old regulations before 2018)

To submit your logbook, please send a request via Contact us (select "certification programmes" and sub category "logbook").

The following items have to be performed within a period of 24 consecutive months - these 24 months can be taken anytime from two years before up to two years after the date of the exam:

    • Letter of endorsement from the National Society
    • Letter of support from a supervisor
    • A diagnostic procedures list of 100 diagnostic EP studies - standalone or before ablation
    • An ablation procedures list of 100 EP catheter ablations as first operator. These must consist of:
      • 50 standard ablations including
        • His bundle - max 5
        • AVNRT - min 15, max 25
        • AVRT - min 15, max 25
        • RA atrial tachycardias - min 5, max 10
        • cavo-tricuspid atrial flutter - min 10, max 25
        • idiopathic RVOT VT - min 5, max 10 
      • 50 complex ablations at least 30 of which are atrial fibrillation ablations - including transseptal puncture. 

For security, candidates must keep a copy of their logbook.

A grader from the EHRA certification committee will grade the logbook. The review process should take around two months. The final results are sent by email.

Upon successful completion of the logbook process, candidates will receive an ECDS Level 2 Certificate valid for ten years.

How to prepare for the examination

EHRA offers the possibility to follow educational courses. Attending the courses may also enable participants to get further knowledge to sit and pass the certification examination.

Core Curriculum

Sample Questions

 

Recertification

NEW: The EHRA recertification process will open in January 2022. 

The EHRA certification is valid for ten years and thereafter completion of the recertification process is necessary to maintain the title of “EHRA Certified Specialist”.

The recertification process consists of a checklist to validate continuing engagement in EHRA educational activities and attendance of the EHRA annual congresses.

Candidates who wish to apply for recertification should contact us here

If all requirements of recertification are met, a certificate will be issued which will be valid for a further 10-year period.

Requirements

The recertification process consists of a checklist to validate continuing engagement in EHRA educational activities and attendance of the EHRA annual congresses.

Recertification criteria:

  • Letter of endorsement from National Society. 
  • Evidence of attendance of at least 2 EHRA Congresses in the last 5 years.
  • Participation in at least 5 EHRA webinars in the last 2 years.
  • Evidence of Continuing Medical Education in the field of Arrhythmia or Device Therapy achieved by either
    1. participation in one of the EHRA preparatory courses in the last 2 years

or

    1. obtaining 15 CME credits in ESCeL platform in the last 2 years from EHRA Educational Courses –
      • For CP recertification: Fellows Device CP Track
      • For EP recertification: Fellows EP Track

To retain the respective certification, candidates must apply for recertification from 6 months before to 1 year after the 10‐year certification expiration date. As the first EHRA exam was delivered in 2005, this rule will only be applicable for candidates wishing for recertification from 2026. From now until 2025, all recertification applications will be accepted.

Recertification fee

Only EHRA Members can apply for recertification. A fee of €200 will be charged. Recertification is free for EHRA Fellows (FEHRA).

EHRA Certified Electrophysiology Specialist (ECES)

The EHRA certification is valid for ten years.

Find below the list of professionals who are certified by EHRA in electrophysiology. Discover who they are and where they come from.

List of EHRA certified electrophysiology specialists (ECES)

 

EHRA EP Certification FAQ