PART 1 (KBA) – online exam

The next online applications for the 2025 exam are available from
26 November 2024 (13:00 CET) until 15 January 2025 (13:00 CET).

The online application process consists of 2 separate steps:

Step 1: Eligibility criteria validation process – administrative fee (100 Euro excl. VAT)

The EFRM Steering Committee will validate if the applicant is eligible to sit the EFRM – Part 1 exam. Therefore, all applicants will first need to upload all required documents via the online application platform.

Once submitted, the applicant will receive a payment link by email for the validation of the eligibility criteria: 100 Euro (excl. VAT), which is an administrative fee.
Please note that the paid fee is non-refundable under any circumstance.

Only paid submitted applications will be reviewed by the EFRM Committee. As soon as an application is accepted, this will be communicated to the applicant via the online application platform only.
Only after validation of the eligibility criteria, the applicant will automatically proceed to Step 2.

Your fully completed electronic application form must be submitted via the online application platform by 15 January 2025 (13:00 pm CET) at the latest.

All applicants must guarantee that they truly fulfil the required criteria as stated above.
All documents submitted with the application should be in English or officially translated into English. Based on the above eligibility criteria, the applicants should provide a copy of their identity card and proof that they:

a) are medical doctors
b) are Obstetricians/Gynaecologists
c) have a license to practice
d) have completed at least 2 years training in Reproductive Medicine after passing the exams of general Obstetrics and Gynaecology

Step 2: Exam Payment process – exam fee (400 Euro excl. VAT)

After acceptance of the application, the applicant will automatically receive a payment link by e-mail for the exam fee: 400 Euro (excl. VAT).
Please note that the paid fee is non-refundable under any circumstance.

Only accepted and fully paid applications, will be accepted to sit the EFRM exam. As soon as all steps are fully completed, the applicant will be informed via the online application platform.

By 10 February 2025 at the latest, all applicants will be informed whether their application to sit the exam has been accepted or declined.

PART 2 (OSCE) – oral onsite exam

• The next applications for the 2025 EFRM Part 2 exam will be available from 1 April 2025 until 31 May 2025 to participants who passed Part 1.
  
  
• Once the application has been submitted, the applicant will receive a payment link by e-mail to settle the exam fee: 600 Euro (excl. VAT).
  
  
• Please note that the paid fee is non-refundable under any circumstance, even in case of unexpected events outside the responsibility of ESHRE or EBCOG, occurring before or during the exam and which cannot be predicted, such as political instability, fire catastrophe, “big/bang”/force majeure etc., no refund will be transferred back to the applicant.
  
  
• Only paid submitted applications will be accepted to sit the EFRM exam Part 2 and be able to download their visa invitation letter. It’s the applicants’ responsibility to take care of any visa requirements. Applicants must foresee sufficient time for the visa application procedure. ESHRE cannot be held responsible in case of visa application rejection.

All communication regarding the application will be sent via the online application platform only, except for the payment links. It is the applicants’ responsibility to check their messages on a regular basis to meet the given deadline in case additional information/documents are needed. Applications should be completed within the deadline communicated by ESHRE (which can be a maximum of 7 calendar days following the date of the message).

If no feedback is received within the given deadline, the application will be declined.

• Regarding reading for the exams, there are no specifically recommended textbooks, but internationally recognised textbooks may be useful. The applicant should have a broad knowledge of the subspecialty, according to the current guidelines based on an evidence-based approach.
  
  
• Applicants are advised to visit the following webpage regarding the ESHRE training programme also including theoretical and practical knowledge based on specific modules: https://www.eshre.eu/ebcog/fellow.

• Part 1 is a knowledge-based assessment process (KBA) and takes place once a year.


• The Part 1 exam is a written exam and consists of Paper 1 and Paper 2, each lasting 2 hours (in total 90 questions). The first paper is mainly focused on Physiology and the diagnostic procedures, while the second on the treatment and the use of Clinical practice in the full range of Reproductive Medicine. The two papers are examined one after the other on the same day, with a short break in between. Two types of questions are used in each paper, i.e Single Best Answer questions (SBA) and Extended Matching Questions (EMQ).
  
  
• The ratio of the two types can change each time depending on the decision made by the EFRM Steering Committee. To pass the Part 1 exam, participants must pass both papers. The two types of questions are explained below:
  
  Single Best Answer (SBA)
  For each question, 5 potential answers will be provided. All of them can be correct, but participants should identify the one which is considered the “best”. Therefore, only one answer can be selected per question.
  
  Example SBA
  A 25-year-old woman currently on liver enzyme inducers is requesting contraceptive advice. The most reliable form of contraception in this situation would be
      a) Combined oral contraceptive pill
      b) Levonorgestrel intrauterine system
      c) Diaphragm
      d) Male condom
      e) Progesterone-only pill
  Correct answer is: (b) Levonorgestrel intrauterine system
  
  Extended Matching Questions (EMQ)
  These are questions, which start with a list of at least 10 potential answers (options) to 2-5 clinical scenarios (usually 3). There is always a “lead-in-statement” which shows the participants the correct direction (aetiology, diagnosis, management, treatment etc). For each scenario, the applicant should select the most appropriate, i.e. the best matching answer from the given options. Some answers can be used more than once and others not at all.
  
  Example EMQ
  Title: INFERTILITY TREATMENT
  Options:
  a) Antibiotics
  b) Expectant management
  c) FSH/HCG
  d) Intracytoplasmic sperm injection (ICSI)
  e) Intrauterine insemination (IUI)
  f) In vitro fertilisation (IVF)
  g) Salpingectomy
  h) Surgical sperm recovery
  i) Testicular biopsy
  j) Varicocelectomy
  k) Vitamin E
  
  Lead-in-statement: For each one of the following scenarios, select the most appropriate treatment from the above list of options. Each option may be used once, more than once or not at all.
  
  1) A 34-year-old woman with primary infertility of 3 years duration has been referred to the infertility clinic. Her past medical history is not significant. She has regular periods and the hysterosalpingogram shows bilateral tubal blockage. Her husband has severe oligozoospermia.
  
  The most appropriate treatment is (d). Because of tubal factor infertility, IVF is the appropriate treatment. Nevertheless, due to the male factor, ICSI is recommended. The latter is expected to be more successful than any other treatment.
  
  2) A 29-year-old woman with primary infertility of 2 years duration has been referred to the infertility clinic. She has regular periods, while her past medical history is not significant. Her husband is 30 years old, and his semen analysis shows persistently low count almost azoospermia. He has low serum levels of FSH and LH in the area of hypogonadotrophic-hypogonadism.
  
  The most appropriate treatment is (c). Treatment with FSH and HCG for several months is expected to improve semen characteristics and fertility (NICE)
  
  3) A 32-year-old woman presents with primary infertility of 3 years duration. She has regular cycles and the hysterosalpingogram shows patent tubes. Her husband is 35 years old. His past medical history is not significant. However, there are moderate semen abnormalities that are characterized as idiopathic. In his semen, a number of leucocytes are identified.
  
  The most appropriate treatment is (f). The presence of leucocytes in the semen does not mean infection and treatment with antibiotics does not improve pregnancy rate (NICE).

NUMBER OF ATTEMPTS

• There is no restriction on the number of times one can sit Part 1 of the examination. Passing Part 1 is the only eligibility criterion for sitting the Part 2 examination. If a participant fails to pass Part 1 of the examination, he/she cannot sit Part 2. Participants who pass Part 1, should sit Part 2 within the next 3 years. If that period expires or the participants have failed to pass Part 2 within the next 3 years of passing Part 1, they will have to re-sit Part 1.

BEFORE THE EXAM

• The timetable of the exams is published on the ESHRE website.
  
  
• Participants will have to accept the "Online home exam policy" before starting the Part 1 online exam. Any non-compliance of the applicant with the online home exam policy (for whatsoever reason) can cause the exam to be invalid. Any exam not completed or not submitted in accordance with the online home exam policy (for whatsoever reason) will be considered invalid
  
  
• Relevant information and instructions will be sent to the participants via the online application platform.

ON THE DAY OF THE EXAM

• Part 1 will be available in English only. No dictionary or any other translation device will be allowed to be used during the exam.
  
  
• As Part 1 of the exam is conducted online, the participant will need to use their own laptops (no tablets/no smartphones). ESHRE does not have any responsibility if participants miss the exam because of problems with their laptop.
  
  
• The onboarding (max. 30 minutes) will be conducted by ProctorExam (proctoring). All participants must provide identification (ID-card/passport – containing their name and photograph).
  
  
• During the exam, the participant must behave according to currently stated rules (including rules of silence, no communication with any other person, etc). If fraud/inappropriate behaviour is detected during the exam, the participant will be forced to terminate the exam and leave the virtual exam room. In such cases the exam will be considered invalid, and the participant will be disqualified (Online Exam policy). In case the infraction is discovered afterwards, the exam can be invalidated, and the certificate (if already issued) can be revoked. All detected cases of fraud/inappropriate behaviour discovered during or after the exam will result in exclusion from future ESHRE activities. Funds (including, but not limited to, application fees) for the exam are not reimbursed if inappropriate behaviour/fraud is detected.

• Part 2 is an objective structured clinical exam (OSCE) and takes place after the Part 1 exam, preferably at the location of ESHRE’s annual meeting. However, time and location are subject to changes decided by ESHRE every year.
  
  
• Part 2 is used to measure clinical competence of the candidates. Various types of clinical skills are evaluated, including history taking, technical skills, communication, teamwork, integration of knowledge into clinical problem solving, and evaluation of the clinical relevance of a scientific article.
  
  
• The structure of the exam is based on successive stations where the examiners evaluate the performance of the participants and mark them accordingly.
  
  -> Objective – The exam is objective because all participants are assessed in all stations on the same topics and are marked by the same examiners using the same marking system.
  
  -> Structured – In the different stations, simulated patients, simulators or case scenarios may be used, which are the same for all participants. If simulated patients are used, they are given specific instructions and clinical information, which is the same for all participants. The participants also receive instructions regarding the specific task they have to complete during the exam.
  
  -> Clinical examination – The aim of the exam is to assess both clinical and theoretical knowledge. The questions are standardised in a default template.
  
  
• The duration of each station is 12 minutes. The participants will move from one station to the other in a successive way. Altogether there are 5-10 stations, unless it is decided otherwise. One station may be considered as a preparative station for the participants to read a scientific article, which will be examined in the next station. Nevertheless, a scientific article may not be included in every exam. The content of the stations is determined each time by the Steering Committee.

NUMBER OF ATTEMPTS

• Participants who pass Part 1, should sit Part 2 within the next 3 years. If that period expires or the participants have failed to pass Part 2 within the next 3 years of passing Part 1, they will have to re-sit Part 1.

BEFORE THE EXAM

• Participants taking the Part 2 exam will receive an email with the exact time of their exam appointment. They should arrive at the venue 30 minutes in advance of their appointment.
  
  
• Relevant information and instructions will be sent to the participants via the online application platform.

ON THE DAY OF THE EXAM

• Upon arrival, participants will be registered before entering the exam area by providing their ID card/passport – containing their name and photograph.
  
  
• Participants are not allowed to use their phone during the exam. All mobile phones must be switched off on arrival.
  
  
• Participants should not bring laptops, tablets or books in the exam area. Nobody will look after them outside the exam area.
  
  
• If the participants, during their presence in the waiting rooms, wish to leave the exam area for personal reasons, they will be accompanied.
  
  
• Participants should leave the exam area and the venue immediately after finishing their Part 2 exam.
  
  
• If any of the participants attempts to transmit information to anybody outside the exam area during the day of the exam, they will fail and will not be allowed to re‐sit the exam during the following 2 years.

The exam results will be released to the participant through the online application platform. The pass mark is the minimum score that is required for a participant to pass the exam. For calculation of the pass mark, standardised objective methods will be used. The resulting outcome is not negotiable. Once the results have been released, no changes will be done.

Pass mark setting in Part 1 ESHRE/EBCOG exam

• For calculation of the pass mark for Part 1 (KBA) exam, a fixed method is used. This involves calculating the average score (mean±SD) of participants’ performance (the % of questions answered correctly by participants – absolute standard). From this average score, 0.75 SD is subtracted, and the resulting number is the pass mark. The pass mark for paper 1 and for paper 2 is calculated separately.

Pass mark setting in Part 2 ESHRE/EBCOG exam

• For the calculation of the pass mark for Part 2 (OSCE) exam, the modified Rothman’s method is used. Information is collected from the examiner at each station. Three sample points are used, i.e. pass, fail, borderline and the pass mark at each station is the median score of participants evaluated as “borderline” by the examiners. There are 3 prerequisites for participants to pass the exam:
     1) their score - at each station - must be equal to or greater than the pass mark of the station,
     2) they must pass at least 75% of the number of the stations (nearest integral number) and
     3) the sum of their scores must be equal to or greater than the sum of the pass marks of all stations.

Conditions for passing the exam

• In order to pass Part 1, participants need to pass both papers. Only after passing Part 1, participants will be eligible to register for Part 2 within the next 3 years. If that period expires or the participants have failed to pass Part 2 within the next 3 years (after passing part 1), they will have to resit Part 1.

• Exam results of Part 1 exam will be made available on the online application platform.
  
  
• Successful participants will become European Fellows of Reproductive Medicine (EFRM) and can use the title EFRM‐ESHRE/EBCOG. Passing the exams does not mean license to practice in any European country, but it provides a certificate. This certificate can be downloaded from the online application platform.
  
  
• Exam questions represent ESHRE's intellectual property. Due to the risk of abuse, participants will not be able to see the exam afterwards or have access to the correct answers. Copying of the questions will be considered fraud. Therefore, pen and paper are prohibited during the exam.
  
  
• Participants may notify ESHRE of complaints regarding the exam results (including invalidation of the exam) in writing to certification@eshre.eu within one month of the date of the notification of the exam results and/or the decision to invalidate the exam. If no complaints have been received by ESHRE® within this period, the participant shall be deemed to have accepted the exam results which will be non‐negotiable.
  
  
• In exceptional cases, complaints will be evaluated by the EFRM Committee, and if necessary, the ESHRE Executive Committee. The decision of the Executive Committee is final.
  
  
• ESHRE is at all times allowed to consult with its legal advisors with respect to the application of these rules to (a) participant (s). In any event, if fraud or cheating is suspected ESHRE will discuss the possible consequences with its legal advisors.