FMH Board Certification

To be granted the FMH title in Nephrology (board specialist certification), you have to fulfill the requirements given by FMH. Look at the FMH website and read the further education programme for more details: pdf (De), pdf (Fr).

You also have to pass the oral board certification examination — the Swiss Society of Nephrology (SSN) is responsible for its organization. You first have to pass the written examination (ESENeph) to be able to take the oral one. ESENeph is delivered every 9 months; the SSN oral exam takes place once a year.

The written part of the examination is called the European Specialty Examination in Nephrology (ESENeph) and it is jointly organized by European and United Kingdom nephrological societies. The ESENeph is derived from the United Kingdom specialist exam that was slightly adapted for other European countries by a panel of experts.

Although there are no entry requirements for the ESENeph, we recommend that you take the examination not before the second year of your nephrological training. You can resit the exam multiple times.

The next ESENeph will be held on 19 February 2025.

How to apply for the ESENeph?

You apply for the ESENeph on the MRCPUK website. The registration period is announced in advance and usually lasts over one month in autumn. From 2022 onwards, the examination will be held every 9 months.

What is the structure of the ESENeph?

The examination covers the whole spectrum of nephrological curriculum and consists of 200 multiple-choice questions (you find the covered topics in this blueprint (pdf)). The 'best of five' question format means one correct and four incorrect answers. Only the correctly answered questions count, there is no penalty for a wrong answer (always try to answer all of the questions!). The exam is computer-based.

Most of the questions are designed as small clinical cases. Some questions are accompanied by visual material: clinical pictures, radiological images, or histology slides. Only SI units are used in the main text, but a conversion table into conventional units is available during the exam. To get a general idea about the exam format and type of questions asked, you can take a mock exam with 50 sample questions.

How long does the ESENeph take?

The ESENeph takes the whole day — 100 questions in 3 hours in the morning and another 100 questions in 3 hours in the afternoon — with a break for lunch at noon. Do not underestimate the time and don't forget to take a small snack and something to drink with you. The day will be long.

Where does the ESENeph take place?

The ESENeph takes place in test centers around the world that are administred by a company called Pearson VUE. The centers are chosen according to the spectrum of candidates of the given year. You can state your preferred test center, region during the registration process. The details about the final test center should be confirmed to you per email at least three weeks before the examination. Although there is no absolute guarantee that there will be a test center in Switzerland available for the given year of your exam, the SSN always tried to secure a test center in Switzerland.

How to prepare for the ESENeph?

ESENeph is a complex exam that focuses on the whole curriculum of nephrology. It is therefore impossible to recommend just one study source. We recommend you to check our resources section for valuable online material. Because some questions of the exam are accompanied by histology images of kidney biopsies, the AJKD Atlas of Renal Pathology is an excellent aid.

Don't forget to take the official mock exam, or download the sample questions from 2021 (pdf). You can download another set of 50 sample questions from 2016 (pdf). In 2015, a book called "200 Best of Five Questions for Nephrology Specialty Certificate Exam with Revision Notes and Guidelines" (Dr Ebadur Rahman and Dr Raees Farhan Mushtaq) was published by Tricorn Books. Another excellent series of 3 books: NephroShotz, has been published recently by a London-based nephrologist John Booth (@ThePeanutKidney).

Regarding online materials, the Welsh Kidney Club created a free question bank for the exam. The BMJ OnExamination is providing an online paid subscription service for the ESENeph exam. Finally, the StudyPRN is offering a 3 months free access to their question bank and mock exam (thanks to a sponsorship from pharma).

Further opportunity for exam preparation is participation at the UK Advance Nephrology Course in Oxford that primarily addresses those who plan to take the specialty exam.

Another excellent learning material covering the essentials of nephrology is the Kidney Self-Assessment Program (KSAP) offered by the American Society of Nephrology (ASN). KSAP is composed of challenging questions based on case vignettes (just like the ESENeph). The program is free for ASN members, and the ASN membership is free for nephrology fellows and physicians in training!

What are the criteria to pass?

The examination results are either PASS or FAIL. The percentage of correct answers required for a pass are slightly different every year (more about this here).

Have a look at the Results Report from 2020 (pdf) and Results Report from 2021 (pdf) for the exams´ statistics.

When do I get my results?

The results are usually delivered per email 4 weeks after exam date. You will receive a pdf confirming the results (passed or failed) and details of your performance including an analysis of answered items by topic (% of correctly answered questions).

Oral Examination of SSN

The next oral oxam will be held on 16-17 January 2025 in Bern.

The Swiss Society of Nephrology (SSN) organizes the oral examination. You have to pass the ESENeph to be allowed to take the oral examination. You can register for the oral examination even before having the results of the ESENeph; if you don't pass the ESENeph, your registration for the oral exam will be canceled (the SSN will refund you the registration fee).

The oral examination is held once a year. You have to register over the SSN webpage. The fee for the oral exam amounts to 500 CHF.

What to expect at the oral examination?

The oral examination is designed to prove your ability to: 1/ handle diverse clinical scenarios; 2/ analyse and interpret scientific literature.

First, the members of the examination committee challenge you with two clinical cases — they will guide you and provide you with additional information as you advance through the cases. This part simulates real-world clinical scenarios: you should propose a diagnostic process, make the correct diagnosis, and suggest treatment.

The second part of the exam deals with the analysis of current scientific literature. A couple of weeks prior to the exam, you receive 10 scientific articles — you can expect anything from epidemiological papers, to clinical studies, to basic research papers (see the list of articles from the previous years below). At the exam, two articles are chosen for you to discuss. You should read the articles carefully in advance to be able to present them during the exam. Make sure that you understand the methodology, and that you know the background of the studies including relevant additional literature.

List of past articles for the oral exam: