European Exam in Core Cardiology (EECC): format, eligibility and preparation

The European Exam in Core Cardiology (EECC) is the examination used across much of Europe to test whether a cardiology trainee has the core knowledge required for independent practice. It is run as a joint venture between the European Society of Cardiology (ESC), the Union of European Medical Specialists Cardiology Section (UEMS-CS) and participating National and Affiliated Cardiac Societies, with independent academic oversight.

In the ESC's own words, the exam sets out to "provide a broad, balanced and up-to-date test of the core cardiology knowledge required by cardiology specialty trainees for independent practice."

This guide covers what the exam contains, who can sit it, how it is delivered and how to prepare. It reflects the information published by the ESC for the 2026 examination; always confirm the current details with your own National Cardiac Society, which is the body that registers you.

At a glance

Who can sit the EECC

This is the point that surprises most candidates, and it is worth stating plainly:

Registration is exclusively restricted to the candidates identified and registered by their National Cardiology Society and is not open to individuals.

You cannot sign up directly with the ESC. Eligibility is decided individually by each National and Affiliated Cardiology Society, so the training stage at which you are permitted to sit — and whether the exam is compulsory at all — depends entirely on the country you train in. In some countries the EECC forms part of the national specialty certification process; in others it is voluntary.

The practical consequence: your first step is not the ESC website but your own national society. They decide who is put forward, when, and at what cost.

As of the 2025 examination, the EECC involved 29 ESC National Cardiac Societies, 3 ESC Affiliated Cardiac Societies and 2 ESC Global Partners — the Asian Pacific Society of Cardiology (APSC) and the Gulf Heart Association (GHA). That international reach is part of why the exam has become a common reference point for the standard of a European-trained cardiologist.

Exam format

The EECC is a single written paper of 120 multiple-choice questions, sat in three hours with no break. Each question offers five options with a single best answer, and there is no negative marking — so an unanswered question and a wrong answer score the same. Leave nothing blank.

Questions are based on clinical scenarios rather than isolated factual recall. This matters for preparation: the exam is testing whether you can apply knowledge to a patient in front of you, not whether you can recite a guideline table.

Three hours for 120 questions works out at 90 seconds per question. That is a genuine time pressure when each item carries a clinical vignette to read, and it is the single most common reason well-prepared candidates underperform. Practising against the clock matters as much as knowing the content.

How it is delivered

The exam is taken online through a proctoring platform (CYIM with ProctorU®), described by the ESC as "accessible from anywhere in the world." You sit it on your own device — a computer only, not a tablet or phone — and you are monitored by a human proctor in real time.

There is no test centre to travel to, but there are consequences worth planning for:

• Your computer, webcam, microphone and internet connection become part of the exam. Test them well in advance.
• You need a quiet, private room for three uninterrupted hours.
• Live proctoring means rules about what may be on your desk, who may enter the room, and where you may look. Read your society's instructions carefully rather than assuming.

What the exam covers

The EECC is aligned to the ESC Core Curriculum for the Cardiologist, published in 2020. That document is the definitive statement of scope, and it is the right place to start when planning revision.

The ESC is explicit that there is no single source from which all questions are developed, and encourages candidates to read widely — including ESC Clinical Practice Guidelines, the ESC Textbook of Cardiovascular Medicine, and practice-changing clinical trials.

In practice, the core curriculum spans the breadth of general cardiology:

• Coronary artery disease — chronic coronary syndromes, acute coronary syndromes, secondary prevention
• Heart failure — acute and chronic, HFrEF, HFmrEF and HFpEF, devices and advanced therapies
• Arrhythmias — supraventricular and ventricular arrhythmias, atrial fibrillation, bradycardia and conduction disease, pacing and ICDs
• Valvular heart disease — assessment, timing of intervention, surgical and transcatheter options
• Cardiomyopathies and myocardial disease — hypertrophic, dilated, restrictive, infiltrative and inflammatory
• Pericardial disease
• Aortic and peripheral vascular disease
• Adult congenital heart disease
• Pulmonary hypertension and pulmonary embolism
• Hypertension and cardiovascular prevention
• Cardiovascular imaging — echocardiography, CMR, cardiac CT and nuclear techniques
• Electrocardiography — a thread running through almost every other topic

Because the questions are scenario-based, topics rarely appear in isolation. A single question may require you to read an ECG, recognise the underlying condition, and choose the management step the guidelines support.

Pass mark and results

There is no fixed pass mark published in advance. After each administration, the standard is set through independent psychometric analysis and review by a Standard Setting Group. This is normal practice for high-stakes medical examinations — it allows the pass standard to account for the difficulty of the particular paper rather than fixing an arbitrary percentage.

Results are not sent to you by the ESC. The ESC states that "under no circumstances will the ESC communicate results directly to candidates" — your National or Affiliated Cardiac Society releases them. If you are waiting on a result, your society is who to contact.

Fees

The ESC does not set a single price. Fees are determined by individual National and Affiliated Cardiology Societies, so what you pay depends on where you train. Some societies subsidise or fully cover the cost for their trainees. Ask yours directly.

Preparing for the EECC

The ESC runs an official online preparatory course, and is unusually direct about its status: it is described as the only official preparatory resource, with access opening to registered candidates from 16 March 2026 for the June 2026 sitting. The ESC notes that other preparation materials "have been developed without the support of the ESC and may therefore not be suitable for adequate preparation."

That is worth reading carefully rather than dismissing. It does not mean other resources are useless — it means no other resource can claim to mirror the exam blueprint. Use the official course as your spine, and everything else as supplementary practice.

A workable approach:

1. Read the ESC Core Curriculum first. It tells you the scope. Revising without it means guessing at what is examinable.
2. Work through the current ESC Guidelines for the major topics. Scenario questions tend to hinge on the recommendation, and on the class and level of evidence behind it.
3. Drill ECGs. Electrocardiography threads through the whole curriculum, and reading one under time pressure is a skill that only improves with repetition.
4. Practise question banks against the clock. Ninety seconds per question is the real constraint.
5. Review why each wrong answer was wrong, not just what the right answer was. Distractors in well-written exams are built from the common misconceptions.

Practise with our question banks

We maintain a free, interactive exam bank of 1,666 questions across 25 banks, written in the single-best-answer format the EECC uses. Answer a question and you see immediately whether you were right, with an explanation where one exists; your progress saves, so you can work through a bank in short sessions.

Banks that map most directly onto EECC topics include:

• Management of Heart Failure — 230 questions
• Management of Acute Coronary Syndromes — 171 questions
• Management of Valvular Heart Disease — 161 questions
• Management of Supraventricular Tachycardias — 118 questions
• Management of Ventricular Arrhythmias and Sudden Cardiac Arrest — 167 questions
• General Cardiology Quiz 1 — the first of nine mixed banks

Alongside them, our knowledge base covers the same curriculum in long form, and the clinical calculators cover the risk scores that scenario questions routinely turn on.

Frequently asked questions

Can I register for the EECC myself?

No. Registration is handled exclusively by National and Affiliated Cardiac Societies, and is not open to individuals. Contact your national society.

Is the EECC compulsory?

That depends on your country. Each participating national society decides how the exam fits into its own training and certification pathway.

What language is the exam in?

English only.

Can I sit it from home?

Yes. The exam is delivered online through a proctored platform and can be taken anywhere with a suitable computer and internet connection, under live human supervision.

Is there negative marking?

No. There is no penalty for a wrong answer, so answer every question.

What is the pass mark?

It is not published in advance. The standard is set after each exam by independent psychometric analysis and a Standard Setting Group.

When is the next exam?

16 June 2026. Confirm with your national society, which controls registration.

Official sources

• European Exam in Core Cardiology — European Society of Cardiology
• ESC Core Curriculum for the Cardiologist
• ESC Clinical Practice Guidelines

Details change between sittings. Treat this page as an orientation and your National Cardiac Society as the authority on dates, eligibility and fees.

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Sitting the North American equivalent instead? See our guide to cardiology board certification in the United States and Canada.