Cardiology Specialty Exam (EECC): question practice and revision.

Choose a topic for focused revision and check your plan against the official specification.

• Coronary artery disease and acute coronary syndromes
• Heart failure (acute and chronic)
• Arrhythmias and electrophysiology (incl. device therapy)
• Valvular heart disease (TAVI, MitraClip, surgical valves)
• Imaging — echocardiography, cardiac MRI, CT coronary angiography
• Adult congenital heart disease and inherited cardiomyopathies
• Hypertension and lipid disorders
• Cardiovascular risk and prevention
• Pericardial disease and myocarditis
• Pulmonary hypertension and right-heart disease
• Aortic disease and peripheral vascular disease
• Cardiovascular pharmacology and anticoagulation
• Statistics, ethics, professional behaviours

Drawn from the ESC Core Curriculum, recent ESC guideline updates (2023–2025) and item density in iatroX.

• Heart failure four-pillar therapy per ESC 2023 — sequencing ARNI/ACEi, beta-blocker, MRA and SGLT2 inhibitor; thresholds for CRT-D vs CRT-P; vericiguat and finerenone indications
• Acute coronary syndromes per ESC 2023 ACS guidelines — invasive timing in NSTEMI (immediate vs <2h vs <24h), DAPT duration in stable CAD vs ACS, bleeding risk scoring (PRECISE-DAPT, ARC-HBR)
• Atrial fibrillation per ESC 2024 AF guidelines — CHA₂DS₂-VA (the new score dropping sex), early rhythm control (EAST-AFNET 4), ablation as first-line in selected patients, LAA occlusion criteria
• Aortic stenosis and TAVI per ESC/EACTS 2021 — symptomatic severe AS thresholds, asymptomatic severe AS criteria for intervention, TAVI vs SAVR by age and surgical risk
• Cardiomyopathies — HCM SCD risk model (ESC 2014 calculator), mavacamten in obstructive HCM, transthyretin amyloidosis (tafamidis) screening, ARVC task force criteria
• Cardiac imaging — when to use stress echo vs CMR vs CTCA; the ESC 2024 chronic coronary syndromes algorithm; LGE patterns by aetiology
• Pulmonary hypertension per ESC/ERS 2022 — group 1 vs 2 vs 3 vs 4 distinction, RHC haemodynamic criteria, initial dual therapy in group 1 PAH
• Statistics in cardiology RCTs — NNT, hazard ratios, interpreting non-inferiority trials, subgroup analysis pitfalls; commonly tested in EECC

Observations from UK cardiology trainees and recent EECC candidates. Verify against current ESC guidance.

Candidate-reported observations — not official guidance.

1. EECC is GMC-compliant but examines current ESC guidelines, not UK-specific NICE guidance where they diverge. Candidates relying solely on NICE TAs miss ESC class I recommendations (e.g. invasive timing in NSTEMI, eligibility for early rhythm control).
2. Statistics — interpretation of HRs and non-inferiority RCTs is examined directly. Many candidates under-prepare for this block.
3. Confusing the new CHA₂DS₂-VA (ESC 2024) with the older CHA₂DS₂-VASc — the sex modifier has been dropped from anticoagulation thresholds. Examined directly.
4. Cardiac MRI mapping (T1, T2, ECV) and LGE patterns — distinguishing ischaemic vs non-ischaemic patterns, sarcoidosis vs HCM vs amyloid signature. Commonly muddled.
5. Adult congenital heart disease — Eisenmenger physiology, Fontan circulation, recognition of repaired vs unrepaired TOF, atrial switch vs arterial switch. Tested but under-prepared by general cardiology trainees.
6. Single-paper pacing — 120 MCQs in 3 hours with no break is 90 seconds per item. Stamina training matters; the lack of mid-exam break is unusual versus UK SCE format.
7. Online proctoring quirks — technical setup, second-camera placement, prohibited items in the room. Test the platform during the ESC preparatory window before exam day.

A pragmatic phased approach used by recent UK passers in ST5–ST6.

1. Weeks 1–6

   Foundation pass across all 13 blueprint topics. 30 questions/day with the iatroX adaptive engine. After ~400 attempts, the diagnostic dashboard identifies your bottom three areas. Read the ESC textbook chapters paired to weak topics.

2. Weeks 7–11

   Targeted weak-area drilling. Map every recent ESC guideline (HF 2023, ACS 2023, AF 2024, CCS 2024, PAH 2022). Daily ECG and imaging interpretation. Practise statistics RCT appraisal.

3. Weeks 12–14

   Two timed 120-MCQ mock exams under exam conditions weekly. Specifically practise the no-break stamina dimension. Use the ESC preparatory course in parallel.

4. Weeks 15–16

   Bookmark review only. Light reading on the newest 2025 ESC updates. Test the online proctoring platform on your exam computer. Sleep, hydrate, do not learn new material.

Dedicated Cardiology Specialty Exam (EECC) question practice with answer explanations, guided Tutor review and study planning.

• Focused question practice — Choose the relevant bank and use your answers to identify what to study next.
• Guided reasoning — Explore a difficult answer with Tutor, then apply the distinction independently.
• Review and timed practice — Return to important mistakes and choose a timed practice set where available.

Choose the relevant bank and use the official exam guidance to plan your preparation.

The Federation's Specialty Certificate Examination in Cardiology has been discontinued. UK cardiology trainees now sit the European Exam in Core Cardiology (EECC) via the British Cardiovascular Society (BCS), administered by the European Society of Cardiology (ESC). The EECC is GMC-compliant and BCS shares results with the GMC for CCT and quality assurance purposes.

Next EECC sitting: 15 June 2027. BCS registration closes on 21 February 2027. Check the BCS for the closing time and application requirements. Confirm booking and delivery arrangements with the BCS.

A single paper of 120 multiple-choice questions over 3 hours with no break. Delivered online via the ESC's proctored platform (CYIM/ProctorU). Questions cover the full ESC Core Curriculum for the Cardiologist (2020).

UK trainees must be in their third or later year of cardiology specialty training (ST5 on the 2012 curriculum; ST6 on the 2022 curriculum). Portfolio Pathway candidates require at least 2 years of dedicated UK cardiology experience and a Medical Director letter.

The iatroX cardiology bank is mapped to the ESC Core Curriculum and current ESC guidelines (2023–2025), with adaptive sequencing that surfaces your weakest topics. Substantial weighting on heart failure, ACS, AF and imaging — the four highest-yield categories in recent EECC sittings.

For the EECC, prioritise ESC. Many UK candidates over-rely on NICE TAs and miss ESC class I recommendations that diverge (e.g. invasive timing in NSTEMI, eligibility criteria for early rhythm control in AF). NICE remains relevant for UK practice but not always for EECC-marked answers.

Full Cardiology Specialty Exam (EECC) bank access is included in all-access. Up to 10 new sample questions per day are shared across exams, with no account required. A verified free account includes one guided Tutor session; continued Tutor use is included in all-access.