Neurological Board Certification in Europe

By Jan B.M. Kuks

Jan B.M. Kuks

Jan B.M. Kuks

Young neurologists can rise to the challenge in Denmark on May 27, 2016. On that day, the 8th European Board Examination in Neurology will take place in Copenhagen.

Medical specialties in Europe are working together with the European Union of Medical Specialists (UEMS) (, an organization containing 43 specialist-sections, one of these being the European Board of Neurology (EBN). Setting standards for training and practice is among the organization’s key activities. Therefore, the EBN is involved in developing harmonized models for the high-level training of the next generation of neurologists, in order to improve standards of clinical practice and, hence, patient care throughout Europe.

To achieve this, the EBN set up a core curriculum for the training of young neurologists, and — as testing drives learning — a board exam is provided as well.

Professor Wolfgang Grisold, now WFN secretary general, was the founder of this process and organized the first EBN examination in 2009. The 8th examination will take place at the site of the European Academy of Neurology (EAN) Congress. This illustrates the close cooperation between the UEMS Board of Neurology and the Academy of Neurology in Europe, an alliance without which a European training program for Neurologists would not exist.

Education in these times is not only for transferring knowledge, but is also directed toward achieving other competencies.

Successful candidates of the 7th EBN Exam in Berlin June 19, 2015 displaying their certificates

Successful candidates of the 7th EBN Exam in Berlin June 19, 2015 displaying their certificates

As in earlier days, the ability to retrieve knowledge from memory may be essential for clinical practice. But don’t we all use electronic devices in our clinics and on our ward rounds to find up-to-date knowledge as soon as possible for practicing evidence-based medicine and to offer our patients the latest achievements in our field? Is there any specialist in neurology who does not regularly want to have the opportunity for a peek inside an anatomical atlas, a handbook of neurophysiology or whatever textbook, before making a decision in clinical practice? So, today, we can’t restrict ourselves to information known by heart. We should be able to combine it with recent facts and developments. The ability to handle knowledge will become more and more important. This is the reason we offer our candidates the opportunity to take their own favorite textbooks (and in the future, electronic devices) to the examination to solve higher-order, open-book questions derived from real life, as they do in real life. Beside the great textbooks, guidelines and electronic courses from the EAN are the basis for the questions provided.

This isn’t all. Further competencies important for being a good specialist are described in several systems, such as in the CanMEDs roles ( In this system, a neurologist should not just be a medical expert, and the EBN exam should not be confined to testing neurological knowledge. Testing abilities in other CanMEDs roles like communicator, health advocate, professional and scholar comprise another and more essential part of the EBN examination.

Candidates taking the written test on the 7th EBN Exam in Berlin

Candidates taking the written test on the 7th EBN Exam in Berlin

How should we test these abilities within the other competencies? Does this need just another couple of multiple choice questions? We feel that this cannot be achieved by written computer examinations. For example, public health or global health issues (being a heath advocate) have their national emphases, and ethical points of view vary in different countries. Thus, there is no absolute truth to be tested. A face-to-face discussion is more suitable than making a choice in the closed format of a multiple-choice question for testing these competencies. Therefore we invite our candidates to prepare themselves properly for a discussion by writing essays for an oral examination. Being a scholar demands the ability to make one’s own vision clear and to dive into a problem to be solved in a scientific way. Therefore we ask our candidates to make a critical appraisal of a topic of their own choice to be presented for an oral discussion.

So taking a European Board Exam for Neurology is not being dependent on having a lucky day; it can be prepared for in advance, and candidates can develop abilities over a long period of time to be successful.

CanMedsThe validity of the examination needs the input of the scientific experts at the European Academy of Neurology. The reliability of the outcome depends on the number and quality of the participating candidates. A statistical evaluation to eliminate “bad questions” only can be realized in a group of sufficient size. Establishing a passing score can be determined by specialists prior to the test. However, modification of such a score may be necessary after getting data from a sufficient number of adequate participants.

We are happy to see the number of participants grow each year. The exam becomes attractive to more candidates from inside, but also from outside Europe — many of whom want to take the exam to increase the possibility of moving between European countries or to test their abilities on a European level. In this respect, Turkey, Belgium and Italy now take a leading role by sponsoring their young neurologists to take the EBN exam, in addition to their national exit exams.

Unfortunately, by now, board exams do not yet have a legal value in Europe, and this restrains many young neurologists from taking the examination. With increasing interest in Europe and the cooperation between European countries, we are likely to establish a goal of a European exam to be taken as an exit test in order to work as a neurologist in the European continent in the near future. Striving for such a pretentious goal forces us to look at the American board exams for neurology to try to reach their high quality level, while keeping the European flavor in our own tests.

More information about the EBN Examination can be found on our website: We would be delighted to welcome you there.

Jan B.M. Kuks is professor of clinical neurology and medical education, University Medical Centre  Groningen, Netherlands, and chair of the Examination Committee European Board of