Exam structure, current dates and official resources for ISRA members preparing for the ESRA-DRA.
At a glance
Two exams, a logbook and hands-on training
The ESRA European Diploma of Regional Anaesthesia is Europe's qualification in regional anaesthesia and acute pain, run by ESRA. It was formerly called EDRA.
ISRA membership includes ESRA membership, which you need for both parts. Many ISRA courses also earn ESRA-DRA points.
Join ISRAWhat you need for each exam
Each tick is something you need before you apply for that exam.
You also need a medical qualification and good working English. Sections A and B can be taken in either order. Pass all four questions to be awarded the diploma. Fail one section and you retake only that section, up to three attempts each; after a third failed attempt you start again from Part I.
Your block logbook
Before you apply for Part II, your head of department or programme director confirms in writing that you have done at least these blocks:
The 75 upper limb and 75 lower limb blocks make up the 150 peripheral blocks: 300 counted blocks in all. ESRA lists the blocks with the word "including", so they are the blocks it expects to see in your logbook, not a complete list. If you are unsure whether a block counts, ask ESRA at esra-dra@esraeurope.org.
The three exams
Part I
Written exam
- Single best answer questions on anatomy, physiology, pharmacology, regional techniques, acute pain and related clinical topics
- On your own computer
- Online early in the year, or onsite at the ESRA Congress in September
- Unlimited attempts
- No logbook needed; workshops recommended but not required
Part II · Section A
Oral viva
- About 30 minutes, remote or onsite
- Two examiners
- Question 1: a clinical case
- Question 2: managing a regional anaesthesia complication
- About 15 minutes per question
Part II · Section B
Practical exam
- 20–25 minutes, onsite only
- Live model, with ultrasound
- Question 3: a core block or neuraxial technique
- Question 4: an intermediate or advanced block
- About 10–12 minutes per question
Which blocks? They are listed in Section B blocks, at the bottom of this page.
Workshops and points
Before Section B you must show enough hands-on training. It comes from workshops: hands-on courses accredited by ESRA for the diploma, such as ultrasound scanning courses and cadaver courses.
1. Every workshop gives you points
Your certificate from each accredited workshop lists its ESRA-DRA points. One hour of hands-on practice earns one point. Points record the training you have done; they are not exam marks. There are three types, counted separately:
2. How ESRA counts them depends on your Section B date
Section B exams up to 30 June 2027
Count workshops: you need three
Six hours (6 points) of hands-on practice counts as one workshop, so shorter courses can be added together. At least one of the three must be an official ESRA workshop, and each must carry CME/CPD accreditation from a national anaesthesia college. ESRA's own include its Congress workshops, the Innsbruck cadaver workshop, the Paris and Eastern Europe workshops, ESRA Winter Week and the ESRA Trainees workshop.
Section B exams from 1 July 2027
Count points: you need at least 20
Add up the points on your certificates. At least 10 must be ultrasound points and at least 6 cadaveric points; the other 4 make up the total of 20.
Workshops count if attended in the five years before your exam; any attended after July 2022 must be on ESRA's list of accredited workshops. Keep every certificate. Example: ISRA's 2026 cadaver course gave 9 cadaveric, 1 ultrasound and 1 other point. That is more than the 6 hands-on hours needed to count as a cadaver workshop, and from July 2027 it covers the 6 cadaveric minimum but adds only 1 of the 10 ultrasound points. Upcoming ISRA courses
Exam dates
ISRA does not run the exam. ESRA handles applications, fees and deadlines.
Official ESRA information
ESRA-DRA requirements and format
Before you apply
Who can apply
- A medical qualification and at least two years in an official anaesthesia training programme
- Current ESRA membership (included with ISRA membership)
- Good working English
- No block logbook is needed
- Workshops are not required, but they are recommended
The exam
Written, single best answer
- Anatomy, physiology, pharmacology, regional anaesthesia techniques, acute pain management and related clinical topics
- Held twice a year: online in the early months of the year, and onsite at the ESRA Annual Congress in September
- In 2024: 120 single best answer questions in 120 minutes, on your own computer
- No limit on attempts
You must pass Part I before applying for Part II; there is no time limit between the two. You also need full registration at one ESRA Annual Congress, at any point between Part I and your final Part II exam.
Before you apply
What you need
- A pass in Part I, and current ESRA membership
- Written confirmation from your Head of Department or Programme Director, before you apply for either section, that you have performed at least:
- 150 neuraxial blocks, including spinal, epidural and combined spinal-epidural
- 150 peripheral nerve blocks: 75 upper limb (interscalene, supraclavicular, infraclavicular, axillary, and distal blocks at elbow and wrist) and 75 lower limb (sciatic, femoral, popliteal and ankle)
- a range of other blocks, including paravertebral, intercostal, abdominal wall, PECS, penile, caudal and IVRA (Bier's block)
- The workshop requirement, before you apply for Section B (see Workshops and ESRA-DRA points)
Section A
Oral viva
Remote or onsite · about 30 minutes · two examiners
- Question 1: a clinical case
- Question 2: the management of a regional anaesthesia complication
- About 15 minutes each
Section B
Practical examination
Onsite only · about 20–25 minutes · live model
- Question 3: a core block or neuraxial technique
- Question 4: an intermediate or advanced block
- About 10–12 minutes each, both with ultrasound. The blocks are listed under Section B blocks
Passing and retakes: pass both sections (all four questions), in either order. If you fail one section, you only retake that section. Each section can be attempted up to three times; after a third unsuccessful attempt, the whole process starts again from Part I.
Workshops are not needed for Part I or for Section A, but you must meet the workshop requirement before applying for Section B. ESRA accepts workshops attended in the 5 years before your exam date, and workshops attended after July 2022 must be on ESRA's list of ESRA-DRA accredited workshops.
Section B up to 30 June 2027
Three workshops
- One cadaver workshop
- Two ultrasound hands-on workshops
- At least one of the three is an official ESRA workshop
- Each with CME/CPD accreditation from a national anaesthesia college
- Shorter sessions can be combined: 6 hours of hands-on practice counts as one workshop
Section B from 1 July 2027
Points
The rest can be any type, including "other" points.
Official ESRA workshops
What the points mean
Points record the training you have done; they are not exam marks. Ultrasound hands-on points are for scanning live models or needling on phantoms, cadaveric points for hands-on work with cadavers, and other points for non-hands-on anatomy or sono-anatomy teaching, such as lectures. One hour of hands-on practice earns one point, and each type is counted separately.
Example: ISRA's 2026 cadaver course gave 9 cadaveric, 1 ultrasound and 1 other point. That is 11 in total, but only 1 towards the ultrasound minimum.
Keep the certificate from every workshop, and check that each course is ESRA-DRA accredited and which points it gives.
You demonstrate one core block and one intermediate or advanced block, both with ultrasound. Here they are by body region.
Core · question 3 · 13 blocksIntermediate or advanced · question 4 · 18 blocks
1Upper limb and neck
2Trunk
3Lower limb
4Spine
From ESRA's block list, version 2.0 (August 2025). ESRA's full list (PDF) ↗