Cardiovascular Surgery
Critical Care Certification

Information for candidates

Introduction

Purpose

Since the origins of Cardiovascular and Thoracic Surgery postoperative critical care management has historically been led by surgeons.

Cardiovascular surgery critical care has consolidated a distinctive area of practice within our specialty. Leaders of multidisciplinary, high-performing teams are uniquely educated, trained, and skilled surgeons. Cardiovascular surgical intensive care units remain dynamic environments of complex, critical, and high-risk surgical practice. The procedures that patients undergo are highly specialized, technologically advanced, involving the vital organs within the chest and beyond, and performed by highly skilled surgeons. The ultimate responsible for a patient’s outcome - both at a human and legal level - remains the primary surgeon. This responsibility is unchanged throughout the operative and postoperative phases of care.

Cardiovascular surgery encompasses the operative, perioperative, and surgical critical care of patients with acquired and congenital pathologic conditions within the chest and beyond. Cardiovascular surgeons are uniquely positioned to have a leadership role in the multidisciplinary team within a rapidly evolving specialty and hold the ability coordinate the fast-changing modalities of care.

For that, standardized education, training, experiential, skill, and professional criteria for assessment of proficiency, either by fulfilling these requirements or by passing an examination becomes mandatory. EACTS, as a worldwide leading surgical organization, has seen this certification as a priority for our surgical profession. Providing the ability to assess and certify the existence of this critical expertise within each Institution shall ultimately translate into better patient outcome.

The European Board of Cardiothoracic Surgery will offer this subspecialty examination annually. The primary aim of EACTS and EBCTS is to encourage common high standards and qualifications in cardiovascular surgery critical care in all European countries and beyond. This examination aims at mutual recognition of these qualifications between European countries and elsewhere.

Standards

The standards are set to award certificates of the Board to surgeons who have attained levels of knowledge, experience and proficiency in cardiovascular surgery critical care that can be recognized as appropriate for independent subspecialty practice in the intensive care unit and the entire postoperative course of cardiovascular surgery patients.

Question writing panel

The Board has an experienced Question Writing Panel for this Examination that has undergone professional training in the construction of MCQs and oral examination delivery.

The Cardiovascular Critical Care Examination – What to expect

The Cardiovascular Critical Care Examination consists of 2 parts, which will assess the entire scope of the Syllabus:

Part 1 is a Multiple-Choice Question (MCQ) examination consisting of a 3.5 hour, 140 question paper. This examination will be quality assured using standard set questions and pass mark. This method of professional delivery of high stakes examinations is established and secure. This is a MCQ consisting on 5 possible choices with only 1 correct answer (not discounting in case of wrong answer).
Part 2 consists of an oral examination conducted in person, through vivas/oral examination with our EBCTS examiners. You will be tested on your knowledge, interpretation of investigations, management, and judgement by pairs of examiners working together at a table. Tables will ask you questions based on clinical scenarios themed to coincide with major areas of practice and which are covered in the Cardiovascular Surgery Critical Care Syllabus. Questions are designed to facilitate a conversation between the candidate and the examiner as professional surgeons on important topics in practice. The total examination time will usually be around 90 minutes.

This exam will be delivered at the EACTS office in Windsor, UK.

The exam will be held on 19 March 2025. The first part will be delivered in the morning and the second part in the afternoon.

Syllabus

The Candidates

Candidates applications will be reviewed to ensure that they are eligible to take the examination. Candidates should read the Regulations of the European Board carefully before applying to ensure that they are eligible to take the examination.

Application for examination

The Board intend to set up examinations at least once a year. All applications and required documents will have to be submitted online before the specified deadline.

The documents required are:

A completed EBCTS online application form
A recent photograph
A copy of national medical diploma.
A copy of licence to practice medicine
A copy of ‘national specialist diploma’ or CCST (Completion of Specialist Training) and/or official Specialty recognition registration number issued by the appropriate official body of that Country. (Alternatively, evidence of eligibility for a National Specialist Diploma or CCT may be considered at the Board’s discretion). Applicants from Switzerland must obtain a letter of support from the Secretary of the Swiss Board of Cardiac and Thoracic Vascular Surgery.
Two completed Structured Reference Form’s (one must be from the Head of Department or Head of Training) (template provided during application)
A logbook summary of procedures performed and assisted – last 5 years. (This summary must be validated by the referees. This evidence will ONLY be accepted on the template provided in the application form.
The specific logbook of Cardiovascular Surgery Critical Care experience. This evidence will ONLY be accepted on the template provided in the application form.

Note 1: Those individuals that have already presented the documentation for the MEBCTS examination and have been accepted for the Membership examination will only need to present the specific logbook of Cardiovascular Surgery Critical Care experience and one specific letter Structured Reference Form.

Note 2: all documents which are not in English must be accompanied by an official signed and stamped translation.

Examination Fee

The examination Fee for both the MCQ and oral examination is €750 (of which €250 is for assessment of the file).
The file will not be processed until payment is received in full.
If the candidate is found not to meet the eligibility criteria, €500 will be refunded.
Should a candidate be unable to sit the examination on the appointed date, he will be offered one alternative date and the fee will be held.
If the candidate does not take the examination and does not inform the EBCTS Secretariat one month in advance, no fee will be refunded.
The candidate who attends the examination and is not successful will be offered a further five opportunities to re-take the examination (6 attempts maximum). A fee of €500 will apply to each re-sit.

Marking

The examination paper will be marked and results issued within 1 month of the examination date.

Diplomas

Confirmation of the examination results will come by e-mail from the EBCTS office. A diploma will be sent by post.

Regulations

Article 1 - Training requirements

The specialty training requirements of their country of training should have been completed and the candidate should be ready to start independent practice.

Article 2 - Accreditation

National accreditation should be available in predominantly cardiac / cardiothoracic / cardiovascular / congenital cardiac

This should harmonize with European rules for those specialties.

Article 3 - Recognition

Only trained surgeons recognized as such by their responsible National Boards/organization may apply for assessment and recognition by the European Board of Cardiothoracic Surgery.

Candidates from countries where cardiac / cardiothoracic / thoracic surgery is not an independent specialty will be evaluated on an individual basis provided that they fulfil all other requirements (eg. Numbers and type of operations) during their training. In countries where there is a Government approved National examination the EBCTS examinations cannot be used to bypass National qualifications.

Article 4 - Minimum training

Candidates should have spent at least 5 years of recognized training in either adult cardiac surgery, thoracic surgery or congenital cardiac surgery or a combination of these at the time of sitting the examination.

Article 5 - Operations performed

To apply for the Membership examination in cardiothoracic surgery the candidate should have performed, as the primary operating surgeon, over 100 major cardiac, congenital and/or thoracic operations.

For cardiac and congenital cases, these include on and off-pump operations on the coronary arteries, heart valve, thoracic aorta and the repair or palliation of congenital heart disease. Minor procedures such as pacemaker implantations, sternal revisions, ECMO decannulations or revisions, PDA ligations can be added to show the breadth of experience obtained but do not count for the total of major operations performed.

For thoracic cases, these include lung resection, VATS, decortications and other major lung operative procedures. Minor procedures such as chest tube insertions, bronchoscopies, etc. can be added to show the breadth of experience obtained but do not count for the total of major operations performed.

The operative log and experience, as well as support letters and other documentation, will be reviewed by the Board and considered in its entirety to decide on eligibility to sit the Cardiovascular Surgery Critical Care examination. Decisions on eligibility will be final and not subject to appeal.

Article 6 - Principals and competence

Beyond the necessary expertise and knowledge in Cardiovascular Surgery Critical Care all candidates should understand the principles of the generality of all the major sub-specialties of Adult Cardiac, Congenital and Thoracic surgery, including general professional issues.

Article 7 - Application

A completed EBCTS online application form
A recent photograph
A copy of national medical diploma
A copy of license to practice medicine
A copy of ‘national specialist diploma’ or CCT (Certificate of Completion of Training) issued by the appropriate official body of that Country. (Alternatively, evidence of eligibility for a National Specialist Diploma or CCT may be considered at the Board’s discretion). Applicants from Switzerland must obtain a letter of support from the Secretary of the Swiss Board of Cardiac and Thoracic Vascular Surgery.
Two completed Structured Reference Form’s (one must be from the Head of Department or Head of Training) (refer to template provided in application form)
A logbook summary of procedures performed and assisted – last 5 years. (This summary must be validated by the referees. This evidence will ONLY be accepted on the template provided in the application form.
The specific logbook of Cardiovascular Surgery Critical Care experience. This evidence will ONLY be accepted on the template provided in the application form.

Note 2: all documents which are not in English must be accompanied by an official signed and stamped translation.

Based on these submissions the European Board will decide if a candidate is eligible to be considered for the examination.

Article 8 - Accepted Candidates

Candidates deemed eligible may undertake the Cardiovascular Surgery Critical Care examination, in English, for which a fee will be payable.

A 140 MCQ (3.5 hour) examination will be set by a panel of question writers appointed by the European Board. The examination will be quality assured.

Article 9 - Appeals

After the examination, appeals may be addressed to the Chairman of the European Board of Cardiothoracic Surgery, at the address of the office of the Board. All appeals will be considered by the Board. The examiners' decision is final.

Article 10 - Examination schedule

The Board will organise Cardiovascular Surgery Critical Care examination once a year (starting in 2024).

Article 11 - Diploma

Candidates who are successful in the examination will receive a diploma recognizing them as a Fellow of European Board of Cardiothoracic Surgery - Subspecialty Cardiovascular Surgery Critical Care (FEBCTS-CVSCC).

CRITICAL CARE APPLICATION

Certificates

Certificates will be awarded by the European Board of Cardiothoracic Surgery with recognition by the European Association of Cardiothoracic Surgery and the Union of European Medical Specialties (UEMS)

1987-2016

Previous variants of the European Board exam are the equivalent to the current Level 2 (FEBCTS) examination.

1986-2012 – European Board of Thoracic & Cardiovascular Surgeons – FEBTCS
2013-2016 – European Board of Cardiothoracic Surgery – FEBCTS