BHRS Examination Guidance & Support Documents

In order to achieve BHRS Certification candidates must pass an examination


The examination was first introduced in 1999 as part of the BPEG Certificate of Competency.  In 2006 the examination became the Heart Rhythm UK Certificate of Accreditation and structure of the examination was revised, with the introduction of core and specialist sections.  It is a requirement that you must be a BHRS member to take the examination.

In 2011, the examination paper was marked electronically for the first time.  Since then, the questions and candidates responses have been evaluated in detail so that we can continue to improve the quality, relevance and validity of the questions.

In 2013, the number of questions was increased to 120 (60 core and 60 specialty), in part, to bring the examination into line with the EHRA examination.  As a consequence, the duration of the examination was increased to 4 hours.  Also in 2013, we introduced a third “clinical” specialist section.  This section is aimed at nurses with a special interest in CRM and is complimented by a new “logbook equivalent” of case discussions. It was not felt appropriate that nurses with a special interest in CRM complete a logbook, instead there is a requirement to complete a number of case studies.

The exam this year (2020) will consist of 120 questions (no separate core and specialist papers) with the syllabus essentially unchanged (no DVLA questions) with the emphasis on specialist questions (i.e. EGMs).  To make the examination more accessible BHRS decided to hold the it via Pearsons Vue training centres which gives candidates the choice of choosing a local setting to them.

If you are wishing to resit a failed section from last year you will be able to choose the section you’d like to resit on the registration form.  Resit examinations are two hours.


Next year’s exam will be held on 19th May 2021 and 20th October 2020.  We will inform all members and publicise here when registration opens.

2020 BHRS Examination

Tuesday 10th November at 8am

We will hold the BHRS examination this year on Tuesday 10th November at 8am. The examination will be held via Pearsons Vue centres. This means you can choose a Pearsons Vue centre local to you to avoid unnecessary travel. Under some circumstances (i.e. those officially shielding) will also have the option to take the examination virtually.  A letter from your GP must be produced.

The exam this year will consist of 120 questions (no separate core and specialist papers) with the syllabus essentially unchanged (no DVLA questions) with the emphasis on specialist questions (i.e. EGMs).

Once you are able to book your examination please do as soon as possible to ensure you have as much choice as possible of your test centre as these get booked up quickly.

You will have 4 hours to complete the examination.  A 7 minute comfort break is scheduled at 10am.  Candidates should arrive at the test centre 30 minutes prior to their exam.

Registration will open 1st August at a cost of £350.  Registration will be open for 12 weeks from this date.

Note: Extensions may be applied for during the initial registrations process. Further details will be available on the registration form.

Note: You must be an active BHRS member to register for the examination. Activating a new membership can take up to 2 weeks so please ensure (due to the direct debit set up) you join BHRS member in plenty of time so you can register for the examination.

Examination Training & Revision

Saturday 19th September at 11am to 4pm

The initial training for the exam will take place 11:00 to 16:00 19th September 2020 (we will ensure this is available, to those registered, moving forwards if you miss it). Access to training carries a fee of £50. You will need to be an active member to access the training. All those registered for training will receive their individual zoom access details w/c 14th September.

NOTE: Registration for Training is now closed.


Tuesday 10th November at 8am

Any resits from 2019 will just need to sit the part of the exam that was failed the previous year (resits will start at 8am and end at 10am).  You can choose the section you’d like to resit when registering.  The resits will consist of 60 questions of the section you have chosen to resit.  You will have 2 hours to complete the resit.  The price of the resit is £175.  We’ve had to marginally increase this cost to cover using Pearsons Vue.

Please note: If you failed all sections last year you will need to register as a new candidate.


BHRS Examination Details

Please be aware that the next BHRS written examination will be held 10th November 2020. Registration will open in August 2020. The venue will be your local Pearson Vue centre.

Instructions for 2019 Exam Candidates


Exam Pass Marks

Please note, pass marks vary slightly from examination to examination to take account of the relative difficulty of examinations presented to candidates, ensuring that the pass standard remains constant.  The pass mark is determined by a ‘standard setting’ process.  or example, in 2016, 136 candidates sat the Core section with the vast majority passing. The median mark is shown below for each section of the 2016 exam. Please note the median mark IS NOT the pass mark.

  • Core 57% n=136
  • Devices 57% n=133
  • EP 58% n=10
  • Clinical 55% n=5

All candidates who reach the required standard for the appropriate exam will pass, however it has been and continues to be the decision / policy of the BHRS Council not to disclose the actual pass mark or to enter discussions with individual candidates about their marks / examination performance.

Sample Exam Questions

For any potential candidate considering taking the exam in the future, you may find it useful to view the below representative questions for the devices and EP sections:

View Sample Devices Questions
View Sample Devices Answers
View Sample EP Questions
View Sample EP Answers
View Sample Clinical Questions
View Sample Clinical Answers

Exam Answer Sheet Guidance

Since 2011, the examination papers have been marked electronically. This allows British Heart Rhythm Society to be able to examine the questions and candidates responses in more detail, so that we can work to improve the quality and validity of the questions. It is therefore essential that candidates are aware of how they are required to mark their answers on the exam answer sheets



2009 EXAM PAPER SAMPLE (with answers)





No. of Qs

 1.1 Anatomy/Physiology/Clinical Assessment  8
 1.2 Arrhythmias – Diagnosis/ECGs  10
 1.3 Devices (Inc. clinical trials)  15
 1.4 Electrophysiology (Inc. clinical trials)  15
 1.5 Guidelines/DVLA/MHRA  6
 1.6 Pharmacology  6





2.1 Pacemaker biophysics & physiology 7
2.2 Device indications & modes 10
2.3 Pacemaker follow-up, troubleshooting, CXR 15
2.4 Cardiac Resynchronisation Therapy 10
2.5 Implantable Cardioverter Defibrillators 10
2.6 ECGs/Infection/Lead extraction/ILR 8





3.1 Basic EP (genetics, channels, drugs, clinical) 10
3.2 General concepts: Catheter position, access, signals, filter-setting.  Intervals, block/gap, Arrhythmia mechanism – Pacing manoeuvres 10
3.3 Invasive electrophysiology – standard atrial arrhythmias (SVT, typical flutter) 15
3.4 Invasive electrophysiology – complex atrial arrhythmias (AF, atypical flutter, atrial tachycardia) 10
3.5 Invasive electrophysiology – complex ventricular arrhythmias (scar related, non-scar related, PVCs) 10
3.6 Invasive electrophysiology – Specific ablation aspects: lesion formation, energy sources.  Complications & Imaging mapping systems 5





4.1 Clinical assessment/Guidelines 10
4.2 Arrhythmias – Diagnosis/Mechaniss/ECG 15
4.3 Pharmacology 10
4.4 Syncope diagnosis and treatment 5
4.5 Devices (Pacemaker/CRT/ICD) 10
4.6 Electrophysiology 10