EDAIC Format 2026: Paper A, Paper B and MTF Questions Explained

The EDAIC Part 1 written examination is the gateway to the European Diploma in Anaesthesiology and Intensive Care. Before you open a textbook or build a study timetable, you must understand the EDAIC format inside out — the structure of the papers, the question mechanic, the domains being tested, and how the scoring works. This article dissects the anatomy of the exam so you know exactly what you are preparing for.

Two Papers, Two Domains

The EDAIC Part 1 comprises two separate written papers sat on the same day:

• Paper A: Basic Sciences
• Paper B: Clinical Anaesthesia and Intensive Care

Each paper is a self-contained examination. You must pass both to proceed to Part 2 (the structured oral examination). If you pass one paper but fail the other, you carry forward the pass and resit only the failed paper at the next sitting — a small mercy that rewards partial success and spares you repeating work already done.

The two papers test complementary knowledge. Paper A anchors you in the foundational sciences that underpin safe anaesthetic practice. Paper B applies that knowledge to clinical scenarios, special populations, and the breadth of perioperative and intensive care medicine.

Paper A: Basic Sciences

EDAIC Paper A covers six domains:

1. Anatomy — airway anatomy (larynx, trachea, bronchial tree); neuroanatomy (spinal cord, autonomic nervous system, cranial nerves, brachial and lumbar plexuses); vascular anatomy relevant to central venous access and regional blocks; and anatomical relationships that matter in the operating theatre and intensive care unit.
2. Physiology — cardiovascular, respiratory, renal, hepatic, gastrointestinal and neurophysiology; acid-base balance; fluid, electrolyte and glucose homeostasis; thermoregulation; and the physiology of pregnancy, neonates, infants and the elderly.
3. Biochemistry — cellular metabolism, oxygen carriage and delivery, enzyme kinetics, haemoglobin structure and function, and the biochemical basis of disease states encountered perioperatively (e.g. diabetes, liver failure, renal failure).
4. Pharmacology — pharmacokinetics (absorption, distribution, metabolism, excretion) and pharmacodynamics (receptor theory, dose-response curves); intravenous and volatile anaesthetics; neuromuscular blocking agents; opioids; local anaesthetics; cardiovascular drugs (inotropes, vasopressors, antihypertensives); and drug interactions.
5. Physics and Clinical Measurement — the principles of monitoring (pulse oximetry, capnography, invasive arterial and central venous pressure measurement, cardiac output measurement); the physics of gases, vapours, and liquids; electrical safety; and the measurement of physiological variables (temperature, pressure, flow).
6. Equipment and Statistics — anaesthetic machines, vaporisers, breathing systems (Mapleson circuits, circle systems), ventilators, airway devices, and filters; basic statistical concepts including study design (RCT, cohort, case-control), measures of central tendency and spread, sensitivity, specificity, positive and negative predictive values, confidence intervals, p-values, and types of error.

Paper A is unashamedly theoretical. Questions demand precise recall and conceptual understanding. You might be asked about the anatomical relations of the stellate ganglion, the factors that shift the oxyhaemoglobin dissociation curve, the mechanism of action of sugammadex, or the principle behind a fuel cell oxygen analyser. There is little room for clinical intuition here — you either know the science or you do not.

Exam tip: Paper A rewards systematic, topic-by-topic revision. Build a strong foundation in physiology and pharmacology first; these two domains are the largest and feed into almost every clinical question in Paper B. Use diagrams, draw your own graphs, and test yourself with active recall rather than passive re-reading.

Paper B: Clinical Anaesthesia and Intensive Care

EDAIC Paper B tests the application of knowledge across clinical contexts:

1. General Principles of Anaesthesia — preoperative assessment and optimisation; consent and capacity; fasting guidelines; fluid therapy and blood product transfusion; infection control and antimicrobial stewardship; patient safety, human factors, and crisis resource management.
2. Regional Anaesthesia and Analgesia — neuraxial techniques (spinal, epidural, combined spinal-epidural, caudal); peripheral nerve blocks (upper and lower limb, truncal blocks); anatomy, pharmacology, ultrasound guidance, complications (high spinal, local anaesthetic systemic toxicity, nerve injury), and contraindications.
3. Special and Sub-Specialty Anaesthesia — obstetric anaesthesia and analgesia; paediatric anaesthesia (neonates, infants, children); cardiac and thoracic anaesthesia; neurosurgical anaesthesia; vascular, urological, and orthopaedic anaesthesia; anaesthesia for the elderly and for patients with significant co-morbidities (ischaemic heart disease, heart failure, chronic lung disease, renal impairment).
4. Intensive Care Medicine — respiratory failure and mechanical ventilation (modes, settings, weaning); shock (cardiogenic, distributive, hypovolaemic, obstructive) and haemodynamic monitoring and support; renal replacement therapy; sedation, analgesia and delirium; nutrition; and the management of sepsis, acute respiratory distress syndrome (ARDS), acute kidney injury, and multi-organ failure.
5. Emergency Medicine and Resuscitation — advanced life support (ALS) and advanced trauma life support (ATLS) principles; airway management in the emergency setting (rapid sequence induction, difficult airway, surgical airway); management of major haemorrhage, traumatic brain injury, burns, and poisoning; and the recognition and initial management of time-critical emergencies.
6. Pain Medicine — acute pain (postoperative, trauma, medical); chronic pain syndromes; analgesic pharmacology (opioids, NSAIDs, paracetamol, adjuvants); regional techniques for analgesia (peripheral catheters, epidural analgesia, patient-controlled analgesia); and the principles of pain assessment, multimodal analgesia, and opioid-sparing strategies.

Paper B questions are more applied. A stem might describe a clinical scenario — a patient with severe aortic stenosis presenting for emergency hip fracture repair, or a ventilated ICU patient with rising peak airway pressures and hypoxaemia — and the five statements will probe your understanding of pathophysiology, risk stratification, monitoring choices, drug selection, and the recognition and management of complications.

This is where your basic sciences come alive. A question about spinal anaesthesia in a parturient draws on anatomy (vertebral levels, termination of the dural sac, sacral nerve roots), physiology (aortocaval compression, uteroplacental blood flow, maternal cardiovascular adaptation), and pharmacology (local anaesthetic choice, dose, baricity, duration, and the risk of systemic toxicity).

Key point: Paper B is broader than Paper A but less granular. You need working knowledge across many clinical areas rather than exhaustive detail in one. Breadth beats depth here. Read widely, integrate your clinical experience, and practise applying basic science principles to clinical problems.

The MTF Question Format

Both EDAIC Paper A and EDAIC Paper B use the MTF (Multiple True/False) format, sometimes called the multiple completion or Type K format. Each question consists of:

• A stem (a statement, clinical vignette, or direct question)
• Five items labelled A, B, C, D, E

You judge each item independently as True or False. There is no forced distribution — all five could be true, all five could be false, or any combination in between. Each correct answer (a true statement correctly identified as true, or a false statement correctly identified as false) scores one mark; each incorrect or blank answer scores zero.

Crucially, there is no negative marking. This policy was introduced in 2014 and remains in force. If you are unsure about an item, you should still answer — a guess has a 50% chance of scoring a mark, whereas leaving it blank guarantees zero. This changes the strategy fundamentally: never leave a statement unanswered.

The MTF format is cognitively demanding. You cannot eliminate options to improve your odds on a single choice; you must make five independent binary decisions per question. A question is only fully correct if you get all five items right, but partial credit (for correctly answered items within a question) still contributes to your overall score and can be the difference between passing and failing.

Common MTF Pitfalls

• Overthinking: The first instinct is often correct. Changing answers without good reason usually costs marks.
• Absolute terms: Words like "always", "never", "all", or "none" often (but not always) signal a false statement. Read carefully.
• Partial truths: A statement must be entirely true to be marked true. If any part is false or misleading, the whole statement is false.
• Clinical context: In Paper B, the stem provides context. An intervention may be true in general but false for the specific patient described.

Timing and Examination Conditions

Each paper is three hours long. ESAIC does not publish the exact number of questions per paper in advance, but each paper contains multiple MTF questions designed to assess the breadth of the syllabus comprehensively within the time available. Candidates should confirm current details on the official EDAIC (myESAIC) website.

This gives you several minutes per question on average. It sounds generous, but MTF questions demand careful reading — especially in Paper B, where clinical stems can be dense with information. You must read the stem, evaluate five statements, mark your answers, and move on without rushing into careless error.

The exam is computer-based in most centres, with an on-screen interface for selecting True or False for each item. You can flag questions for review and navigate back and forth within a paper during the allocated time. Use this facility strategically: if a question stumps you, flag it, move on, and return with fresh eyes and any remaining time at the end.

Exam tip: In the first pass, answer every question you are confident about. In the second pass, tackle flagged questions and make educated guesses on any remaining items. Never submit a paper with blank answers.

Scoring and Standard Setting

The EDAIC uses criterion-referenced standard setting, specifically a modified Angoff method. A panel of experienced examiners estimates, for each item, the probability that a "borderline competent" candidate — one who has just reached the minimum acceptable standard — would answer it correctly. These probabilities are aggregated across all items to set a pass mark that reflects a defined standard of competence, not a fixed quota or percentile.

This means:

• The pass mark varies slightly from sitting to sitting, depending on the difficulty of that particular set of questions.
• You are not competing against other candidates. If everyone meets the standard, everyone can pass; if no one does, no one passes. (In practice, pass rates are stable but not fixed.)
• There is no published "pass mark" in advance — it is determined after the exam by the standard-setting panel.
• Your raw score (total correct items) is converted to a scaled score, and you are told whether you passed or failed each paper. You do not receive a numerical mark, only a pass/fail outcome.

Candidates who narrowly miss the pass mark often fall short by just a handful of items, underscoring the importance of answering every statement and the value of thorough, systematic preparation.

Language and Accessibility

The EDAIC Part 1 written exam is offered in several European languages, allowing candidates to sit the paper in their native or preferred language where available. This reduces language as a barrier to demonstrating clinical knowledge. The Part 2 structured oral examination is generally conducted in English, so English fluency becomes essential at that stage, but for Part 1 you can choose the language in which you are most comfortable (subject to availability at your chosen centre).

Candidates with documented disabilities or specific learning differences (e.g. dyslexia) can apply for reasonable adjustments such as extra time, a separate room, rest breaks, or assistive technology. You must contact ESAIC well in advance of the registration deadline and provide supporting documentation. Do not wait until the week before the exam.

OLA and Part 1 Exemption

ESAIC offers an On-Line Assessment (OLA), a formative in-training assessment using EDAIC Part 1-style MTF questions. The OLA is designed to help trainees gauge their progress and identify knowledge gaps during their training. Under specific conditions set by ESAIC, passing the OLA can exempt a candidate from sitting the Part 1 written exam, allowing direct entry to Part 2.

The OLA uses the same question format and covers the same syllabus as Part 1, so familiarity with the EDAIC format and MTF mechanics is equally important whether you sit the formal exam or pursue the OLA route. Check the official ESAIC website for current OLA eligibility criteria, pass standards, and how exemption is granted.

How the Format Shapes Your Preparation

Understanding the EDAIC format is not an academic exercise — it should drive how you study:

• Paper A demands systematic coverage. You cannot afford large gaps in basic sciences. A topic you skip might appear in multiple questions. Work through each domain methodically.
• Paper B rewards clinical integration. Read questions in the context of your clinical experience. If you have never managed a patient with severe aortic stenosis or acute respiratory distress syndrome, read about it, discuss it with seniors, and mentally rehearse the case.
• MTF questions punish half-knowledge. "I think this is mostly true" is not good enough. Aim for certainty on each item, or at least informed probability based on sound reasoning.
• No negative marking means no blank answers. If you are guessing, guess on every item. Statistically, you will score more marks than leaving items blank. Make peace with uncertainty and commit to an answer.
• Three hours per paper is tight but fair. Practice timed MTF questions regularly. Learn to read stems efficiently, extract key information, and avoid re-reading items multiple times. Simulate exam conditions in your revision.
• Criterion-referenced standard setting rewards competence, not competition. Focus on reaching the standard, not on outperforming peers. Your goal is to demonstrate that you know what a competent European anaesthetist in training should know.

Frequently Asked Questions

What is the difference between EDAIC Paper A and Paper B?

Paper A tests basic sciences: anatomy, physiology, biochemistry, pharmacology, physics and clinical measurement, equipment, and statistics. Paper B tests clinical anaesthesia, intensive care, regional anaesthesia, emergency medicine, and pain medicine. You must pass both papers to proceed to Part 2. If you pass one and fail the other, you carry forward the pass and resit only the failed paper.

What does MTF mean in EDAIC MCQ questions?

MTF stands for Multiple True/False. Each EDAIC Part 1 question has a stem and five items (A–E). You judge each item independently as True or False. There is no negative marking, so you should answer every item even if you are guessing. Each correct answer scores one mark; incorrect or blank answers score zero.

How many questions are in each EDAIC Part 1 paper?

ESAIC does not publish the exact number of questions in advance. Each paper is three hours long and contains multiple MTF questions designed to assess the syllabus comprehensively. The number may vary slightly between sittings. Check the official EDAIC (myESAIC) website for the most current information.

Can I resit only one paper if I fail the other?

Yes. If you pass Paper A but fail Paper B (or vice versa), you carry forward the pass and resit only the failed paper at the next sitting. Both passes must be valid and current to proceed to Part 2. This policy allows you to focus your revision and reduces the burden of resitting material you have already mastered.

Final Thoughts

The EDAIC Part 1 format is transparent, standardised, and fair. Two papers, MTF questions, no negative marking, criterion-referenced pass marks. There are no tricks, no hidden gotchas — just a rigorous test of whether you have acquired the breadth and depth of knowledge expected of a European anaesthetist in training.

Knowing the structure is the first step. The next is to build a study plan that systematically covers Paper A's basic sciences and Paper B's clinical domains, sharpens your MTF question technique through repeated practice, and gives you the confidence to walk into the exam hall ready to demonstrate your competence.

For information about upcoming examination cycles, registration deadlines, fees, and examination centres, visit the official ESAIC/EDAIC (myESAIC) website.

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