Exam structure, current dates and official resources for ISRA members preparing for the ESRA-DRA.
The ESRA European Diploma of Regional Anaesthesia (ESRA-DRA, also known as EDRA) is a European qualification for anaesthetists who want to show advanced knowledge and skill in regional anaesthesia and acute pain management.
It was established in 2005 and is run by the European Society of Regional Anaesthesia and Pain Therapy (ESRA). You can apply once you have completed at least two years of anaesthesia training.
How ISRA can help
- You need ESRA membership to sit both parts of the diploma. ISRA membership includes ESRA membership.
- Some ISRA events are on ESRA's list of accredited workshops, which count towards the Part II requirements.
ISRA does not run the examination. Applications, fees and deadlines are handled by ESRA.
The diploma pathway
How the diploma works
Part I
Written examination
Covers anatomy, physiology, pharmacology, regional anaesthesia techniques, acute pain management and related clinical topics. It is held twice a year: online in the early months of the year, and onsite at the ESRA Annual Congress in September.
You must pass Part I before applying for Part II. There is no time limit between the two.
Part II
Oral and practical examination
Part II has two sections. You must pass both, and you can take them in either order. If you fail one section, you only retake that section.
Section A
Oral viva
Taken remotely or onsite, about 30 minutes. Two questions: a clinical case, and the management of a regional anaesthesia complication.
Section B
Practical examination
Onsite only, about 20–25 minutes, on a live model. You demonstrate a core block and an intermediate or advanced block using ultrasound.
Each section can be attempted up to three times. After a third unsuccessful attempt, the whole process starts again from Part I.
On success
Diploma awarded
Before you apply
What you need
This is a summary. ESRA's application requirements document has the full list.
For Part I
- A medical qualification and at least two years in an official anaesthesia training programme
- Current ESRA membership
- Good working English
- Workshops are not required for Part I, but they are recommended
For Part II
- A pass in Part I
- Current ESRA membership
- Written confirmation from your department of your block experience, including 150 neuraxial blocks and 150 peripheral nerve blocks (75 upper limb, 75 lower limb)
- Until 30 June 2027, at least three ESRA-DRA accredited workshops, each with CME/CPD accreditation from a national anaesthesia college, attended within the five years before your exam date:
- one cadaver workshop
- two ultrasound hands-on workshops
- at least one of the three must be an official ESRA workshop
- Full registration at one ESRA Annual Congress, at any point between Part I and your final Part II exam
Planning Part II after 1 July 2027?
Workshop requirements are changing
For Part II examinations organised after 1 July 2027, the three-workshop rule is replaced by a points system. Your workshops will need to add up to at least 20 ESRA-DRA points, including:
Each type of point is counted separately. "Other" points are for non-hands-on anatomy or sono-anatomy teaching, such as lectures. 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.
Part II · Section B
Blocks you may be asked to show
You demonstrate one core block and one intermediate or advanced block, both with ultrasound.
Core blocks (13)
Intermediate or advanced blocks (18)
From ESRA's block list, version 2.0 (August 2025). ESRA's full list (PDF) ↗
Current information
Exam dates
ESRA has not yet published 2027 examination dates.
Information checked: 1 October 2026. Always confirm dates and deadlines with ESRA.
Official ESRA information
ISRA provides this page as a guide for members. ESRA is the official source for applications, eligibility, fees, deadlines and examination updates.
Examination requirements and format
Full details of the ESRA-DRA examinations, including prerequisites, exam formats and frequently asked questions are available at https://esraeurope.org/esra-dra/. We have included the main points you need to know below.
Prerequisites
- ESRA membership (free with ISRA membership)
- Must have two years of experience in a dedicated anaesthesiology post before applying for the exam. NB: This does not need to be a training scheme post.
- No requirement to have attended any ultrasound or cadaveric workshops.
- No evidence of having performed a minimum number of blocks required.
Format
- 120 Single Best Answer (SBA) questions in 120 minutes
- Each question has one stem with four possible answers
- More than one option may be correct, candidates must choose the single most appropriate answer.
Full details of the ESRA-DRA examinations, including prerequisites, exam formats and frequently asked questions are available at https://esraeurope.org/esra-dra/. We have included the main points you need to know below.
Prerequisites
- ESRA membership
- Successful completion of ESRA-DRA Part 1
- Written confirmation by Head of Department/Programme director that the applicant has performed:
- 150 neuraxial blocks (spinal, epidural, CSE)
- 150 peripheral nerve blocks, encompassing 75 upper limb blocks (interscalene, supraclavicular, infraclavicular, axillary and distal nerves) and 75 lower limb blocks (sciatic, femoral, popliteal and ankle)
- Various other nerve blocks including paravertebral, intercostal, abdominal wall, chest wall, caudal and IVRA.
- Workshop attendance (required for part 2B only, not for 2A)
- Minimum of three workshops attended
- One of the three must be a cadaveric workshop
- One of the three must be an ‘ESRA workshop’*
- All workshops must have CME/CPD approval
- Workshops must have been attended within the five years prior to applying for exam
- Any workshop attended after July 1st 2022 must be ESRA-DRA accredited (list of accredited workshops available on ESRA website).
- For any workshop <6hrs, two or more workshops can be added together, with 6hrs of hands-on practice time equating to one workshop requirement.
*ESRA workshops: ESRA Congress workshops, ESRA Innsbruck Cadaver Course, ESRA Paris or Eastern Europe workshop, ESRA Winter Week workshop, ESRA Trainee workshop.
Format
- Part 2A
- Oral VIVA examination
- 30-minute duration
- Two questions, 15 minutes each
- Q1: Clinical case discussion
- Q2: Management of a regional anaesthesia related complicatio
- Part 2B
- Practical US demonstration on live model + related questions
- 20-25 minutes
- Two questions, recent exam format change so both questions now require ultrasound rather than landmark demonstration
- Q3: Core regional block (see below)
- Q4: Intermediate/advanced block (see below)
Hands-on workshop attendance forms part of the practical training requirements for the ESRA European Diploma of Regional Anaesthesia. ESRA-DRA points record the type and duration of training completed; they are not examination marks.
Workshop attendance is not required before ESRA-DRA Part 1. The required workshop evidence must be completed and submitted before applying for ESRA-DRA Part 2B, the practical section of the examination.
What do the different points mean?
ESRA-DRA Accredited workshops may award points in three categories:
- Ultrasound hands-on points are awarded for direct practical ultrasound scanning on live models or needling practice on phantoms.
- Cadaveric hands-on points are awarded for direct practical training using cadaveric material.
- Other points are awarded for eligible non-hands-on anatomy or sono-anatomy teaching, such as lectures or demonstrations.
Requirements up to 30 June 2027
During the current transition period, candidates require evidence of at least three workshops. These must include:
- At least one cadaveric workshop;
- At least one official ESRA workshop;
- Three eligible workshops in total.
The cadaveric workshop and the official ESRA workshop may be the same workshop.
Workshops must normally have been completed within the five years before the examination. Workshops held after 1 July 2022 must have ESRA-DRA Accredited status.
Requirements from 1 July 2027
For ESRA-DRA Part 2 examinations taking place after the transition period, candidates will be required to submit accredited workshops providing at least:
- 20 ESRA-DRA points in total;
- 10 ultrasound hands-on points;
- 6 cadaveric hands-on points.
Understanding a course allocation
Points in each category are recorded separately. For example, a course awarding:
9 cadaveric hands-on points, 1 ultrasound hands-on point and 1 other point
provides 11 points in total. However, only one of those points counts towards the ultrasound hands-on requirement. Candidates may therefore need to attend additional accredited workshops to complete the required total and the minimum for each category.
Checking your eligibility
Candidates should retain their workshop certificates and check that each course has the appropriate ESRA-DRA accreditation and point allocation.
Workshop requirements are set and administered by ESRA. Candidates should review the current official ESRA-DRA regulations before applying for an examination, particularly where their Part 2B examination will take place close to or after the end of the transition period.
Information reviewed July 2026. ESRA requirements may be updated.
Core Blocks (Q3)
- Superficial Cervical Plexus
- Interscalene
- Axillary Brachial Plexus
- Distal Upper Limb Blocks
- Erector Spinae Plane
- Serratus Anterior Plane
- Rectus Sheath
- TAP (Midaxillary & Subcostal)
- Lumbar Neuraxial Scanning
- Femoral Triangle
- Femoral Nerve
- Suprainguinal Fascia Iliaca
- Popliteal
Intermediate/Advanced Blocks (Q4)
- Suprascapular nerve (Anterior & Posterior Approach)
- Axillary nerve (Posterior – Humeral Approach)
- Intercostobrachial + Medial Cutaneous Brachial N. Blocks
- Cutaneous Nerves at Elbow (Posterior, Lateral, Medial)
- Supraclavicular Brachial Plexus Block
- Infraclavicular & Costoclavicular Block
- IPPB (PECS1) / PSPB (PECS 2)
- Thoracic PVB (Parasagittal & Transverse Approach)
- IIioinguinal/Iliohypogastric
- Lateral Femoral Cutaneous Nerve
- PENG
- iPACK + Geniculars
- Ankle
- Parasternal Plane (Superficial & Deep)
- QL (Anterior, Lateral, Posterior)
- Obturator Nerve (Anterior & Posterior Branches)
- Proximal Sciatic N Block (Anterior Approach)
- Sciatic N Block (Lateral Midfemoral Approach)