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European Diploma in Pain Nursing

Due to travel and meeting restrictions created by the COVID-19 crisis, the European Pain Federation EFIC has unfortunately been unable to organise any examinations in 2020. If you are interested in taking the exam in 2021, sign up via the button below and we will be in touch as soon as updates become available.


The purpose of the European Pain Federation EFIC Examination for the Diploma in Pain Nursing (EDPN) is to improve the standard of pain assessment and treatment through the provision of a qualification for all medical professionals that tests their broad understanding of all types of pain and their treatment.

The EDPN is not designed to replace national qualifications, but to establish a harmonised understanding of pain across Europe through a qualification open to all European doctors, as well as doctors from outside of Europe, and to provide a qualification in those countries where a national equivalent does not exist.

The content of the Examination is based upon the European Pain Federation EFIC Curriculum for the European Diploma in Pain Nursing (‘the Curriculum’). The EDPN is open to all qualified doctors who see and treat pain. Appropriate clinical experience in pain assessment and treatment is essential. Residents and fellows working in multidisciplinary pain centres or multidisciplinary pain clinics are ideal candidates, though the qualification is open to all doctors, specialists or general practitioners, with an interest in pain and its management.

The Examination is composed of two parts:

  • Part 1 will be a multiple-choice question (MCQ) examination.
  • Part 2 will be a series of objective structured clinical examinations (OSCEs) and viva examinations

The Examination Committee may decide to hold part 1 and part 2 separately or together in one sitting. Completion of part 1 alone, entitles the participant to the EFIC® Certificate in Pain Knowledge, to reward their possession of a strong level of knowledge on pain types and their treatment.


The MCQ examination is designed to test the participants’ knowledge of pain assessment and treatment.

The MCQ examination will feature 50 questions. Each question will be composed of a stem followed by five answer statements. Each answer statement will either be true or false. There will be no negative marking.

The time provided for the MCQ examination will be 90 minutes.

The MCQ examination will be in paper form, and papers should be completed using either a pen or a pencil. Participants should take care to ensure that one choice of either true or false is marked per answer statement.


The OSCEs are designed to test the participants’ clinical experience, judgement, interpretation of evidence, attitude and communication skills.

The OSCEs will take place within an examination facility, typically a wing of a teaching hospital or University with an appropriate lay-out and equipment for the conduct of OSCEs.

There will be 6 stations, each representing a simple clinical situation. Participants will be provided with 7 minutes to complete each station, with a short break in between each station. Each station will be marked using an examination paper, to be completed by the participant, or in some specific cases by an examiner who will attend the station.

Each OSCE will be organised in a way that participants are provided with information which is as objective as possible. Any communication from examiners or actors shall be as objective as possible and based on guidance provided in advance at the Examiner briefing.


Vivas are designed to test the participants’ clinical experience, judgement, attitude and communication skills.
Vivas are oral examinations, in which the participant is asked to engage in a dialogue with an examiner. There will be two sets of two vivas, each set lasting 15 minutes, and the viva examination as a whole totalling 30 minutes. Each set of vivas will have two components, one based upon a case history submitted by the participant, the other will be based upon a typical clinical situation designated by the Examination Committee.. Five case histories must be submitted by the applicant in the application process.

Case histories should represent cases in which the participant was actively involved in the assessment, investigation and treatment of a patient suffering from pain. The case histories should include presenting symptoms, brief details of disability and distress, differential diagnosis, management and outcome. The case histories should ideally include implementation of the biopsychosocial model of pain and a comprehensive approach to pain management. The word count should not exceed 500 words for each case. 


Pass mark

Each component of the Examination will receive a mark out of 20. To pass a component, a participant will need to receive at least 10 out 20. All three components need to be passed. A mark of 8-9/20 can be compensated for by higher marks in other components. The Exam Director will be responsible for any decision to permit a pass through these means after a deliberation meeting with present members from the Board of Examiners immediately after the examination.

Concerning the marking scheme for each component:


The MCQ paper features 250 questions. If a candidate answers 75% of those question correctly, they receive a score of 10 for this component. If a candidate answers 100% of those questions correctly, they receive a score of 20. If a candidate answers 50% or fewer of the question correctly, they receive a score of 0. Any mark between 50% and 100% will be given a proportionate score.


Each OSCE station will have its own marking scheme depending on the clinical skills being evaluated. The marks for the 6 stations will be pooled, and a participant will receive a score out of 20 based on performance across all stations. A candidate receiving 50% of marks available will receive a score of 10. All score awarded will be proportional based on percentage of marks received; 100% = score of 20.


Examiners will be provided with a descriptive scoring table, with levels assigned between 1 and 20. The examiner will be asked to provide a score reflecting their view on the participants clinical reasoning and skills using this scoring table. The scores of the two examiners in each station will be pooled, and then pooled with the scores identified by the examiners in the second station. Agreement will be found amongst all concerned examiners and any significant disagreement will be mediated by the Exam Director.

Eligibility criteria

Candidates will be accepted for participation if they meet the following eligibility criteria:

  • Demonstrable possession of a Medical Degree.
  • Curriculum Vitae detailing at least two years’ clinical work in which patients with pain have been assessed and treated. Clinical work during postgraduate training and fellowships in which patients with pain have been assessed and treated can be used as proof of relevant clinical experience.
  • Letter of support or endorsement from two referees. For example, a head of department, clinical director or senior colleague.
  • Endorsement letter should state that the candidate is in good standing in their country, and in their department, and is involved in seeing and managing patients with pain on a regular basis.
  • Strong working knowledge of English (oral and written).
  • Payment of fees ahead of the requested deadline.
  • Submission of all supporting documents required for vivas and any other presentations.

The confirmation of any participant’s registration is at the discretion of the Examination Committee. Participants whose registration is not accepted shall be informed in writing with a brief justification, reflecting the eligibility criteria for the Examination.

The Examination Committee shall have the right to establish a maximum number of participants for any part of the Examination at any time should the number of eligible candidates exceed the resources available for the conduct of the Examination. Candidates who are not accepted on this basis will be eligible to apply in the future, but are not automatically included on a waiting list for the subsequent Examination.


The Examination content, both written and oral, will be in English. Participants are advised that a high-level of spoken and written English is required. Translation or interpretation services are not possible for this Examination.


Candidates will be provided with pens and pencils. No additional materials can be taken into the Examination venues. Electronic devices such as phones, tablets, computers, smart watches or similar are strictly prohibited.
Communication between participants during the Examination is strictly prohibited.
Any participant found to be breaching these rules, or to be jeopardising the fair conduct of the Examination in any other way will be excluded. Any participant found to have passed any part of the Examination through fraudulent means will have their qualification rescinded.

Appeals process

Any participant wishing to appeal should write to the Examination Committee via the European Pain Federation EFIC Secretariat within four weeks off receiving their results. Appeals will be responded to by the Examination Committee within six weeks of the initial communication of results.


To sit the Examination in full, a registration fee of 700 Euros is required for participation.

Where the Examination is available in two separate parts, the following registration fees are applied:

  • Part 1: 250 euros
  • Part 2: 450 euros

Fees may entail VAT and all fees are non-refundable.