The European Examination Board in Otorhinolaryngology was created in 2008 in order to ‘harmonise the knowledge base among otorhinolaryngolgists throughout Europe’. Declan Costello spoke to new Chairman of the Board, Ulrik Pedersen.
Congratulations on your appointment as the Chairman of the European Board Examination in Otolaryngology – Head and Neck Surgery (EBEORL-HNS) exam board. How did you first become involved with the exam?
For 30 years, I have been Consultant and Associated Professor at the department of Otorhinolaryngology - Head and Neck Surgery, Aarhus University Hospital, Denmark. I have been delegate for The Danish Society for Otorhinolaryngology, Head and Neck Surgery to the UEMS ORL Section since 1999. Through this, I have for many years been involved in European training programmes for trainees in otorhinolaryngology - head and neck surgery. As well as the training programme and logbook for general ENT-HNS, we have also now created training programmes and logbooks for all the subspecialties in ORL-HNS. One of these subspecialties is head and neck surgery; I was the chairman for this group until 2013.
For our readers who don’t know much about the exam, could you explain who it is aimed at?
In 2008 our UEMS section started discussions about creating a European ORL-HNS exam. The decision was taken and the first written exam was performed during the first Meeting of the European Academy of ORL-HNS in Mannheim, Germany in 2009. The first oral exam was in Vienna in 2010. It was decided from the beginning that the exam should consist of a written part and a part two based on oral guided questions.
Board of EBEORL-HNS. Back row (L-R): Dr Dominik Wild, Austria; Mr Paul Pracy, UK; Mr Ricard Simo, UK; Director of examinations, Prof Marcus Neudert, Germany; Prof Cem Meco, Turkey; and Prof Heikki Lopponen, Finland.
Front row (L-R): General Secretary, Miss Victoria Ward, UK; Chairman, Dr Ulrik Pedersen, Denmark; Honorary Chairman, Prof Angelos Nikolau, Greece; Treasurer, Prof Klaus Albegger, Austria.
As a member of the section, I was partly involved in the project from the beginning, but first examiner at the oral exam in Vienna in 2011. I was also examiner the next two years until I, in November 2013, became president of the UEMS ORL Section. From then, I changed to be board member of the exam, supervisor and member of the head office. As president of UEMS ORL Section, I was born board member of the EBEORL-HNS with the title of Vice President of the exam.
After the general assembly of the EBEORL-HNS this November in Vienna, we have changed the structure and I became chairman of the exam.
“Countries that do not have an exam are encouraged to use the European one and the EBE are regarded as a quality mark for safe independent practice at the end of training.”
Honorary Fellows of EBEORL-HNS, Vienna, 2016.
The EBEORL-HNS is based on the UEMS – Glasgow declaration from 2007. This declaration says that the European Board Exam is complementary to the national one if it exists. Countries that do not have an exam are encouraged to use the European one, and the EBE are regarded as a quality mark for safe independent practice at the end of training.
The Glasgow declaration says, furthermore, that the European exams are aimed at certified specialists or candidates at their last year of training and it should be open to any nationality in the world.
Office of EBEORL-HNS, Vienna, 2016. (L-R): Treasurer, Prof Klaus Albegger, Austria; Honorary Chairman, Prof Angelos Nikolau, Greece; Permanent Secretary, Dr Maria de la Mota, Spain; Chairman, Dr Ulrik Pedersen, Denmark.
If someone is thinking about taking the exam, could you let us know the advantages of having the qualification?
Why take the exam if it’s not obligatory? It is a difficult question to answer. There will be many views on that issue. The most common answer will in my opinion be to enhance your CV. In some countries for instance (the Middle East, Abu Dhabi, Emirates, Saudi Arabia) the health authorities demand either the American or The European Exam to be employed as a consultant.
Having the EBEORL-HNS Diploma in these countries also means a raise in salary compared to those without it. In some other countries, we know that the European Exam can replace the National one. Finally, it is obligatory for the application to the CEORL/ UEMS European Fellowships. The candidates coming from outside EU are informed that the EBEORL-HNS Diploma is not a passport to EU.
What is the format of the exam?
As I briefly mentioned above, the exam is divided in to two parts. The first part, which is usually completed during major European Congresses, is a written one based on 100 multiple choice questions. Sixty percent correct answers are needed to pass the exam. The pass-rate is 85-90 %.
For those who pass the written exam, they can apply for part two - the oral section. This exam is always in Vienna because of major logistic problems as it involves many rooms, a lot of known infrastructure, and a lot of people; both technical staff, reception of examiners and candidates, and of course a lot of examiners. The exam takes place in one day from early morning to about seven in the evening.
The oral exam is in three areas of our specialty: otology / audiology / vestibulogy - rhinology - head and neck. Inside these areas, we also have questions on paediatric ORL and facial plastics.
All candidates go through the three tables where they get four questions in each table during 24 minutes. Each round takes an hour and a half and, as we can manage nine tables in each room and six rounds in one day, we can examine 162 candidates in a day. We have two examiners at each table, and often also observers and new examiners in addition, so the total number of examiners can be 60 to 70 persons (see Figure 1). The mean pass-rate for the oral part is 73%. Those that pass can call themselves Fellows of the European Board of ORL-HNS.
Faculty of examiners, Oral exam, Vienna 2016.
Can you tell us about the sorts of candidates who enter the exam? Whereabouts in the world do they come from?
The candidates come from all over the world. Of those coming from outside EU, the majority are from Turkey and the Middle East. About 50 % of all candidates are from outside Europe. From 2010 to 2016, 646 candidates have passed successfully.
The group of examiners is very diverse: how do you ensure that there is a Europe-wide distribution of examiners?
As mentioned, we need a lot of examiners and we now have a sufficient pool of examiners to cover an oral exam in one day, up to about 180 candidates. We encourage colleagues from all over Europe to become an examiner. We have made some minimum requirements to become a new examiner of the EBEORL-HNS:
- At least five years of clinical experience after being a specialist of ENT-HNS in a UEMS affiliated country or Fellow of the European Board of ORL-HNS
- Experience in training, teaching and examining in ORL-HNS
- Proof of current work in a UEMS affiliated country
- Competency in spoken ‘medical’ English
- Evidence of continuing professional development (CPD)
- No more than three years after retirement from medical practice
- Submission of two oral guided questions and five MCQs to be evaluated by the Board of EBE-ORL
- CV and evidence of the above mentioned requirements
- Two letters of reference, one of which should be from the current head of the department.
As the United Kingdom has had experience with exit exams for the longest period, many of the examiners are from the UK.
If someone is interested in taking the exam, how can they apply?
All who would like to be a candidate for the exam are very welcome to visit the EBEORL-HNS homepage, where all information about applications can be found: www.ebeorl-hns.org
The exam has got off to a good start. We are now on track but many things can still be improved. The new board will work unitedly for that, and we hope that the exam will be increasingly popular in the European area. The accomplishment of that wish would mean:
- That the usefulness of the European Diploma will increase for future candidates
- That the national societies persuade the committees responsible for doctors employment that the EBE_ORL Diploma is an important qualification
- That more countries with a national exam accept the European one as equal to the national one
- That the reputation of the exam is increased in order to become a worldwide well esteemed qualification.
I have taken over the chairmanship from an excellent colleague from Thessaloniki; Professor Angelos Nikolau. It will be a challenging task to take over from him as he has done a lot for bringing the EBEORL-HNS to its present level.
I understand you have some interesting pastimes. Can you tell us about them?
If the exam continues to be successful, I would like to ensure that I continue activities in my non-professional life, such as sailing in my 35-foot sailing boat in the summer time, and hunting in Danish and Polish forests in the wintertime.
Dr Pedersen’s 35-foot sailing boat.
Interviewed by Declan Costello.
Declaration of competing interests: None declared.