EHRA Certification in Invasive Cardiac Electrophysiology for Physicians (EP)

Exam

Eligibility

The EHRA EP written examination is open to physicians with a special interest in invasive cardiac electrophysiology. 

At registration time, candidates will be asked to provide a copy of their medical diploma (MD) issued by a National Health Authority. 

We strongly recommend that candidates who wish to take the EHRA EP exam acquire knowledge and clinical experience before participating in the exam. 

EHRA EP Certification is not a compulsory or regulatory certificate of competence or excellence. Individuals' rights to report and sign clinical studies in individual countries remain to be defined by national laws and regulations.

Exam format

The EHRA EP examination is a multiple-choice written examination in English. The exam is also available in Spanish (developed in collaboration with LAHRS). 

The examination consists of 130 questions, divided into two parts of 65 questions each.

Each part takes place over three hours with a one-hour break in between. 

Questions are designed to assess the candidate's knowledge.

• They are based on a clinical scenario
• There are five answer options with only one single best answer. 
• There is no negative marking.

Questions are drawn from the entire spectrum of electrophysiology reflecting the EHRA Core Curriculum.

• Topic distribution of the examination questions (examination blueprint)

Appeal

ESC/EHRA aims to deliver examinations of the highest quality and provide the best level of service for all candidates. To ensure that all candidates are assessed fairly, there is a procedure to allow candidates to appeal against their exam results.

More information is available.

Policies for online proctoring examinations

For more information, please refer to the ESC online proctoring examination terms & conditions. 

Logbook

Once candidates have passed the exam, they can then apply for the logbook part of the programme to prove their practical experience in the electrophysiology field. No late submissions will be accepted and, if the deadline is not respected, the candidate will have to repeat the exam in order to apply for certification.

Eligibility

The EHRA EP logbook part of the programme is accessible to all successful candidates for the exam. 

Access to the logbook platform is granted to candidates only after having successfully passed the written exam.

Requirements

Candidates are required to provide evidence of their clinical experience.

Candidates must provide the following documents:

• Letter of endorsement (on letterhead paper) from National Cardiac Society or National Working Group
• A letter of support from their supervisor
• A list of 200 EP procedures including at least:
  • 15 AVNRT
  • 15 Accessory pathway (concealed or manifest)
  • 25 Cavo-Tricuspid Isthmus (CTI) for typical atrial flutter
  • 10 Non-CTI atrial tachycardia - focal or reentrant
  • 5 AV node - ablation
  • 50 AF ablation
  • 5 VT/PVC ablation in normal hearts
  • 5 VT/PVC ablation in structural heart disease
  • 10 Diagnostic EP study

Candidates 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.

Logbook regulations

Not complying with the below regulations will result in the logbook being returned to the candidate for modification and as such, delay the grading process.

• The application must be submitted in English. Any document in local language must be accompanied by a translation. 
• The application must not include any patient data, in order to comply with GDPR regulations. 
• The application must be submitted no later than two years after having received the exam results. 
• Cases included in the logbook must have been collected within a period of 36 consecutive months - these 36 months, as a maximum, can be taken anytime from two years before up to two years after the exam date. 
• Each patient may be present only once in the logbook. It is not allowed to add multiple studies of the same patient. 

Candidates are not asked to submit the full reports, although they may be requested by the EHRA graders and EHRA certification committee. Thus, candidates are asked to keep this information available. 

Supervisor

There are no specific requirements to be a supervisor for the EHRA logbook. The supervisor does not need to be EHRA Certified, and the candidate doesn’t need to upload any documentation regarding the supervisor’s qualifications. The supervisor should be the person supervising the candidate’s work, possibly the person that taught the candidate how to perform the procedures and should be experienced in the field. The supervisor needs to provide a letter of support and also sign off on the logbook, certifying the accuracy of the application content and that the candidate had done all the procedures listed in the logbook.

Logbook results

As soon as the logbook is compliant with the requirements, the application is sent for grading to members of the EHRA Certification Committee. Graders may require additional information from the candidate in order to provide their grading. 

Results are sent by email within three months of submitting the e-Logbook. Please note that some delay in the grading can occur due to the high volume of applications received throughout the year. 

Appealing the logbook

Candidates who fail to the logbook part may raise an appeal.

More information on the logbook. 

Extension requests

There is a two-year window to complete the logbook part of the programme. In exceptional circumstances, candidates may request an extension to submit their application.

To ensure the process remains fair and robust, extensions will generally only be given in the following circumstances: parental leave, less than full-time work or illness of the candidate.

Extension requests must be accompanied by a signed letter from your supervisor briefly explaining the situation and stating the duration of the extension required. Requests cannot be considered without this letter. The request must be submitted before the deadline.

Please note that extension requests are not guaranteed and are reviewed on a case-by-case basis by the certification committee.    

Contact us to submit such requests and for further information.

Recertification

Candidates will be granted certification in invasive cardiac electrophysiology once they have completed the exam and logbook parts of the programme. The certification is valid for 10 years after which the candidate must apply for recertification to keep the certification valid. 

If a candidate does not want to go through the recertification process described below, he/she can also decide to retake the exam. In this case, the candidate will also have to go through the logbook part again to obtain the full certification.

In case the candidate has passed the exam only, the candidate has to retake the exam to recertify. 

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 Cardiac Society. 
• Evidence of attendance of at least:
1. Attendance at a minimum of two EHRA congresses in the last five years

or

2. One EHRA congress and one ESC Congress, in the last five years.

or

• 3. Completion of the DASCAM (Level 3) programme during the certification period, as evidence of continued commitment to advanced education and professional development.
• Letter of endorsement from National Cardiac Society. 
• Evidence of attendance of at least two EHRA congresses, or 1 EHRA congress and 1 ESC Congress, in the last five years.
• of attendance at a minimum of two EHRA congresses in the last five years.
• Participation in at least five live EHRA webinars in the last 2 years. Participation in recorded webinars will not be considered for recertification. 

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 two years.

or

     2. obtaining 15 CME Credits on the ESC eLearning platform in the last two years from EHRA Educational Courses

or

    3. Active participation as speaker/contributor in EHRA educational activities (documents and courses or webinars)

To retain the respective certification, candidates must apply for recertification from six months before to six months after the 10‐year certification expiration date.

IMPORTANT: As the first EHRA exam was delivered in 2005, all candidates with a certification already expired for more than six months can apply for recertification until 2025. From 2026, the rule "candidates must apply for recertification from six months before to six months after the 10‐year certification expiration date" will be applied. 

Recertification fee

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

How to apply?

Candidates who are eligible will receive an automatic notification to start the recertification process. 

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

Extension requests

There is a one-year window to apply for recertification (from six months before to six months after the current certification expiration date). In exceptional circumstances, candidates may request an extension to submit their application.

To ensure the process remains fair and robust, extensions will generally only be given in the following circumstances: parental leave, less than full-time work or illness of the candidate.

Extension requests must be accompanied by a signed letter from the candidate's supervisor briefly explaining the situation and stating the duration of the extension required. Requests cannot be considered without this letter. The request must be submitted before the deadline.

Please note that extension requests are not guaranteed and are reviewed on a case-by-case basis by the certification committee.    

Contact us to submit such requests and obtain further information.

Certification result and list of certified candidates

Candidates will be granted certification in invasive cardiac electrophysiology once they have completed the two parts of the programme (exam and logbook). The certification is valid for 10 years after which the candidate must apply for recertification to keep the certification valid. 

EHRA is pleased to share the list of invasive cardiac electrophysiology certified individuals.