Exam structure, current dates and official resources for ISRA members preparing for the ESRA-DRA.

ESRA Diploma

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.

2PartsA written exam, then an oral and a practical
300Documented blocksFor Part II: at least 150 neuraxial and 150 peripheral
20Workshop pointsFor Section B exams from 1 July 2027. Until then, three workshops

ISRA membership includes ESRA membership, which you need for both parts. Many ISRA courses also earn ESRA-DRA points.

Join ISRA

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.

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.

What you need for each exam

Each tick is something you need before you apply for that exam.

Before you apply for
Part Iwritten
Section Aoral
Section Bpractical
ESRA membershipIncluded with ISRA membership
✓
✓
✓
Two years of trainingIn an official anaesthesia training programme
✓
✓
✓
A pass in Part INo time limit before Part II
–
✓
✓
Your block logbookAt least 150 neuraxial and 150 peripheral blocks, confirmed in writing. Which blocks count
–
✓
✓
Hands-on workshopsAccredited courses that earn ESRA-DRA points. How workshops and points work
–
–
✓
One ESRA CongressFull registration, any time before your final Part II exam
–
✓
✓

You also need a medical qualification and good working English.

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:

150at least
Neuraxial blocksIncluding spinal, epidural and combined spinal-epidural
75at least
Upper limb blocksIncluding interscalene, supraclavicular, infraclavicular, axillary, and distal blocks at the elbow and wrist
75at least
Lower limb blocksIncluding sciatic, femoral, popliteal and ankle blocks
No minimum
Other blocksESRA also asks for experience of various other blocks, without setting a number, including paravertebral, intercostal, abdominal wall, PECS, penile, caudal and IVRA (Bier's block).

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.

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:

Ultrasound pointsScanning live models or needling on phantoms
Cadaveric pointsHands-on work with cadavers
Other pointsTeaching that is not hands-on, such as anatomy lectures

2. How ESRA counts them depends on your Section B date

Section B exams up to 30 June 2027

Count workshops: you need three

1 cadaver1 ultrasound1 ultrasound

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

10+ ultrasound6+ cadaveric4 more

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.

ESRA sets out the change to points in its FAQ on workshops for Part II ↗.

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. ESRA’s next Innsbruck cadaver workshop ↗ (26–27 February 2027) is listed with 14 points: 7 cadaveric, 5 ultrasound and 2 other, pending ESRA’s approval. Upcoming ISRA courses

Exam dates

Part I · writtenNot yet announced2027 dates
Part II · A · oral vivaNot yet announced2027 dates
Part II · B · practical12 November 2026 · CairoRegistration closed
Part II · B · practicalSaturday 23 January 2027 · Längenfeld, AustriaApply by 15 December 2026, or sooner if places fill
ESRA Annual Congress1–4 September 2027 · BolognaPart I is also held here
Check dates and apply with ESRA ↗

ISRA does not run the exam. ESRA handles applications, fees and deadlines.

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

Superficial cervical plexusInterscaleneAxillary brachial plexusDistal upper limb
Supraclavicular brachial plexusInfraclavicular and costoclavicularSuprascapular (anterior and posterior)Axillary nerve (posterior humeral)Intercostobrachial + medial cutaneous nerve of armCutaneous nerves at the elbow (posterior, lateral, medial)

2Trunk

Erector spinae plane (ESP)Serratus anterior plane (SAP)Rectus sheathTAP (midaxillary and subcostal)
PECS I (IPPB) / PECS II (PSPB)Parasternal (superficial and deep)Thoracic paravertebral (parasagittal and transverse)Quadratus lumborum (anterior, lateral, posterior)Ilioinguinal / iliohypogastric

3Lower limb

Femoral triangleFemoral nerveSuprainguinal fascia iliacaPopliteal
Lateral femoral cutaneous nervePENGObturator (anterior and posterior branches)Proximal sciatic (anterior approach)Sciatic (lateral midfemoral approach)iPACK + genicularAnkle

4Spine

Lumbar neuraxial scan

From ESRA's block list, version 2.0 (August 2025). ESRA's full list (PDF) ↗