The EDAIC Part 1 Format: Paper A and Paper B 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 schedule a study session, you need to understand the EDAIC format inside out — the structure of the papers, the question mechanic, and the domains being tested. This article dissects the anatomy of the exam so you know exactly what you're 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 not the other, you carry forward the pass and resit only the failed paper at the next sitting — a small mercy that rewards partial success.

The two papers are designed to 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.

Paper A: Basic Sciences

EDAIC Paper A covers six domains:

1. Anatomy — airway anatomy, neuroanatomy (spinal cord, autonomic pathways, cranial nerves), vascular anatomy relevant to regional blocks and central lines, and anatomical relationships that matter in the operating theatre.
2. Physiology — cardiovascular, respiratory, renal, hepatic, and neurophysiology; acid-base balance; fluid and electrolyte homeostasis; thermoregulation; and the physiology of pregnancy, neonates, and the elderly.
3. Biochemistry — cellular metabolism, oxygen carriage and delivery, enzyme kinetics, and the biochemical basis of disease states encountered perioperatively.
4. Pharmacology — pharmacokinetics and pharmacodynamics; intravenous and volatile anaesthetics; muscle relaxants; opioids; local anaesthetics; cardiovascular drugs; and drug interactions.
5. Physics and Clinical Measurement — the principles of monitoring (pulse oximetry, capnography, invasive pressure measurement); the physics of gases, vapours, and electrical safety; and the measurement of physiological variables.
6. Equipment and Statistics — anaesthetic machines, ventilators, breathing systems, airway devices; and basic statistical concepts (study design, sensitivity, specificity, confidence intervals, p-values).

Paper A is unashamedly theoretical. Questions demand precise recall and conceptual understanding. You might be asked about the anatomical course of the recurrent laryngeal nerve, the shape of the oxyhaemoglobin dissociation curve at different pH values, or the mechanism by which a Clark electrode measures oxygen tension. There is little room for clinical intuition here — you either know the science or you don't.

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.

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, consent, fasting guidelines, fluid therapy, blood transfusion, infection control, and patient safety.
2. Regional Anaesthesia — neuraxial (spinal, epidural, combined spinal-epidural) and peripheral nerve blocks; anatomy, pharmacology, complications, and contraindications.
3. Special and Sub-Specialty Anaesthesia — obstetric, paediatric, cardiac, thoracic, neurosurgical, and vascular anaesthesia; anaesthesia for trauma, the elderly, and patients with co-morbidities.
4. Intensive Care Medicine — respiratory failure and mechanical ventilation; shock and haemodynamic support; renal replacement therapy; sedation and analgesia; nutrition; and the management of sepsis, ARDS, and multi-organ failure.
5. Emergency Medicine — resuscitation (ALS, ATLS principles); airway management in the emergency setting; management of major haemorrhage, burns, and poisoning.
6. Pain Medicine — acute and chronic pain; analgesic pharmacology; regional techniques for analgesia; and the principles of pain assessment and multimodal analgesia.

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

This is where your basic sciences come alive. A question about spinal anaesthesia in a parturient draws on anatomy (vertebral levels, dural sac termination), physiology (aortocaval compression, uteroplacental blood flow), and pharmacology (local anaesthetic dose, duration, and 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.

The MTF Question Format

Both papers use the MTF (Multiple True/False) format. Each question consists of:

• A stem (a statement, clinical vignette, or 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 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, you should still answer — a guess has a 50% chance of scoring, whereas leaving it blank guarantees zero. This changes the strategy fundamentally: never leave a statement unanswered.

The MTF format is less forgiving than single-best-answer MCQs. 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) still contributes to your overall score.

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 within the time available. Candidates should confirm current details on the official EDAIC 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, and mark your answers without rushing into 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. Use this: if a question stumps you, flag it, move on, and return with fresh eyes if time permits.

Scoring and Standard Setting

The EDAIC uses criterion-referenced standard setting (Angoff method). A panel of examiners estimates the proportion of a "borderline competent" candidate who would answer each item correctly. These estimates are aggregated to set a pass mark that reflects a defined standard, not a quota.

This means:

• The pass mark varies slightly from sitting to sitting, depending on the difficulty of that particular paper.
• You are not competing against other candidates. If everyone meets the standard, everyone passes; if no one does, no one passes.
• There is no published "pass mark" in advance — it is determined after the exam by the standard-setting process.

Your raw score (total correct items) is converted to a scaled score, and you are told whether you passed or failed each paper. Candidates who narrowly miss the pass mark often fall short by just a handful of items, underscoring the importance of answering every statement.

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. Part 2 (the oral examination) is generally conducted in English, so English fluency becomes essential at that stage.

Candidates with documented disabilities or learning differences can apply for reasonable adjustments (extra time, separate room, assistive technology). Contact ESAIC well in advance of the registration deadline if you require accommodations.

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 three or four questions.
• Paper B rewards clinical integration. Read questions in the context of your clinical experience. If you have never managed a patient with aortic stenosis, read about it 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.
• 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.
• Three hours per paper is tight but fair. Practice timed questions. Learn to read stems efficiently and avoid re-reading items multiple times.

Frequently Asked Questions

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

Paper A tests basic sciences (anatomy, physiology, pharmacology, physics, equipment, statistics). Paper B tests clinical anaesthesia, intensive care, regional anaesthesia, emergency medicine, and pain. You must pass both papers to proceed to Part 2.

Are EDAIC Part 1 questions single-best-answer or MTF?

All EDAIC Part 1 questions are MTF (Multiple True/False). Each question has five items (A–E), and you judge each independently as True or False. There is no negative marking, so answer every item.

How many questions are in each EDAIC Part 1 paper?

ESAIC does not publish the exact number in advance. Each paper is three hours long and contains multiple MTF questions designed to comprehensively assess the syllabus. Check the official EDAIC 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 current to proceed to Part 2.

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, and gives you the confidence to walk into the exam hall ready.

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