BHRS FAQs

Please find a list of Frequently Asked Questions regarding BHRS Certification

General Certification Questions

The BHRS recommend accredited physiologists should now practice at Agenda for Change band seven level.

  • Exam registration will open at 11:00 on Saturday 1st August, 2020.
  • Registration and payment will be online at bhrs.com  
  • The exam will be on the 10th November at 8:00am
  • The location for the exam can be chosen by the candidate from over 150 Pearson VUE locations across the UK. 
  • Locations across the EU and around the world will also be available 
  • The exam will start promptly at 8:00
  • The exam will finish at 12:00 unless you have applied successfully for an extension or are resitting
  • There will be a 7 minute comfort break after 2 hours 
  • Extensions may be applied for during the initial registrations process. Further details will be available on 1st August 
  • All candidates will have a choice of three exams, clinical devices or EP
  • Any resits from 2019 will just take the part of the exam they need to resit (resits will start at 8am and end at 10am)
  • Candidates should arrive at the test centre 30 minutes prior to their exam.
  • The candidate can choose from over 150 locations across the UK at any of the Pearson VUE sites
  • From early September you can create an account and book in with Pearson VUE and select which site you would like to site the exam at (the sooner you do this the more choice you will have).  We will send you the link to the test centre booking page when it is available for you to book

The logbook process is being streamlined for devices candidates to minimise the amount of “paperwork” that historically has been required, whilst ensuring the high standard of the BHRS certification. We will be doing this by focusing on practical work in a live environment.

As part of the accreditation process we will be introducing several DOPS (Direct Observation of Procedural Skills). These will be observed and reported on by an approved local supervisor.

The DOPS guide and associated web pages to upload to will be available from November 11th, 2020.

If you are a resit candidate you can continue collecting for your logbook and submit as usual.  The new version is relevant for new device candidates for 2020.  EP will remain the same and log books will need completing.

Registration opens on 1st August on the BHRS website and will remain open for 12 weeks from this date. You can book your test centre location and check in for the exam from early September (following registration on the BHRS site).  You will be sent a booking link by BHRS.

No, the examination only takes place once per year.  If you need to resit you can do so the following year.

Resits are held the following year at the same time as the new examination.  This year this will be 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.

There is only one fee for the entire certification process. This includes both the written examination and the log book. The fee is non-refundable and the cost is currently £350.

There is no reduced fee for resits due to the increased cost of hosting the exam through Pearsons.

The location for the exam can be chosen by the candidate from over 150 Pearson VUE locations across the UK.   Locations across the EU and around the world will also be available

Under some circumstances (e.g. those shielding) will also have the option to take the examination virtually. A letter from your GP will be required

You can only do the exams (Device and EP) back to back in successive years. For example, year 1 sit (and pass) the device paper and in year 2 sit the EP paper.

Your pass / fail grade will be announced after all marks have been assessed. This will take approximately 3 weeks.

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.

Training will be hosted by Stuart Allen, Chair of BHRS Accreditation.

Content will cover:

  • An introduction to the new examination and logbook format
  • Pharmacology
  • EP Studies/Arrhythmia Mechanisms
  • EGM Case Studies

Training Registration Form

You may sit the exam in the 1st or 2nd year however if you sit the exam in the 2nd year and fail you will not have enough time to re-sit and will need to re-register for the whole certification process again.  It is therefore strongly recommended that all candidates sit the exam at the 1st available sitting after they have registered with BHRS.  You should start collecting evidence for your logbook as soon as you’ve completed registration and NOT after you have passed the written exam.

Yes, 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.

Yes, extensions may be applied for during the initial registrations process. Further details will be available on the registration form and relevant proof will need to be uploaded.

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 on Tuesday 10th November).  You can choose the section you’d like to resit when registering.  The price of the resit is £175.  We’ve had to 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.

Yes.  During registration you can request extra time and upload evidence.  Reasons for consideration are as follows: long-term health conditions, mobility difficulties, mental health conditions, autism spectrum conditions sensory impairments, specific learning differences.  Each case will be considered for approval for extra time.  Extra time allowed will be an additional 1 hour.  Resits candidates will be allowed an additional 30 minutes.  No additional breaks will be added.

Log Book Questions

Please note: The certification and examination process and format will be changing this year for those candidates sitting ‘Devices’. We will be adding full details of the new format after the examination on 12th November. EP candidates and 2019 candidates will still be required to complete a log book.

All log books must be submitted electronically via Dropbox to exam-logbook@bhrs.com.  You complete ONE log book only and the log book should not exceed 2GB (as this is the maximum Dropbox will allow).  More details can be found below.

Further instructions of how to use dropbox can be found here.

Requests for log book extensions must always be submitted via email (and not by telephone) to exam-logbook@bhrs.com giving full reasons why an extension is being sought.  Requests will then be considered on a case by case basis by the certification committee.  Please note that extension requests require clear mitigating circumstances (e.g. ill-health, pregnancy).  Extensions will not be given for candidates who have failed to achieve the requisite number or type of cases.  No extension will be awarded retrospectively.  Also, please note that any request for an extension needs to be received before the 31st December of the year the log book should be submitted.

Your supervisor must be experienced in device management and ideally (but not essential) hold BHRS certification (previously Heart Rhythm UK certificate of accreditation) or the IBHRE qualification (pacing and devices) or the EHRA CP/AP qualifications.

You must obtain verification of the information and completion of the assessment sections from your supervisor, who must be experienced in device management and ideally hold BHRS certification (previously Heart Rhythm UK certificate of accreditation) or the IBHRE qualification (pacing and devices) or the EHRA CP/AP qualifications. Medical device company representatives will not be accepted as a supervisor.

Yes, doctor and hospital names are fine – but as stated in the log book instructions any patient identifiable information present within the logbook will result in an automatic fail.

It is acceptable for some implant cases to be used where the slew rate is not recorded.

A variety of different companies is advantageous but not essential

The 1st implant date is the date the device was 1st implanted.  For section 1 of the device logbook and the case studies (section 3) that will be 2017/2018, for the device follow ups (section 2) it could be many years ago.

You have to complete the entire log book as stipulated in the logbook introduction.  There is only one log book covering devices. All sections of the log book must be completed prospectively with cases from within a 24-month period from your agreed logbook start date.

No.  You cannot use any box change/generator replacements for case studies.

Yes, as long as you have a before and after ECG.  For some patients no other investigations will have been performed.

Under the pacing follow-up section the column for battery information asks for voltage & impedance values however, some devices don’t provide this information, just a magnet rate & years to ERI.  In these instances you can quote these instead.

Yes please include any information relating to the case and decision-making process.  Either a copy of the report or a statement summarising the key findings of the investigations would be acceptable.

Yes. As stated in the logbook instructions for use CRT-D devices can count towards ICDs numbers and CRT/ICD devices can count towards pacemakers but not vice versa.

If your hospital doesn’t have one there is a standard list that is on the pacemaker ID card / national (NiCOR) device database.

It is acceptable to use CRT-D in place of ICDs.  As stated in the log book instructions for use CRT-D devices can count towards ICDs numbers and CRT/ICD devices can count towards pacemakers but not vice versa.

As stated in the log book instructions for use CRT-D devices can count towards ICDs numbers and CRT/ICD devices can count towards pacemakers but not vice versa.  There is a general rule that more complex devices trump simpler devices.  Therefore, you can use CRT-D as any ICD, you can use CRT-D box changes for ICD box changes, and CRT/ICD for pacemakers.

The printouts can be photocopies but please ensure that the copy quality is clear enough to read, otherwise, please use the originals. Also, perhaps self-explanatory, if patients’ names and addresses are visible this is a breach of confidentiality.

They can (and will) be different patients and do not have to come from the implant cases used for section 3.

The patients need to be different.  As stated in the log book instructions for use “Please note that no case from section 1 can be used as a case study in section 3”.

No, as stated in the log book instructions for use “Please note that no case from section 1 can be used as a case study in section 3”.

If you upgrade a pacemaker to CRT this can be included if needed. Out of the 30 pacemaker cases 5 should be for elective generator replacements (box changes).

The case studies need to be separate from implants as stated in the log book instructions for use “Please note that no case from section 1 can be used as a case study in section 3”.

No.  The log book is clear that implants refer to the role of the physiologist.  As such if an StR is performing an implant this should be as a physiologist and they should be using the analyser/PSA to perform lead measurements.  This is not possible if the operator is scrubbed.

All the data you need to submit relates to the implant and up to the point of discharge which will be either same day or next day.  We do not need 5-6 week follow up data.

If this is a case study then the candidate should be seeing the patient pre-discharge (same day or the day after the procedure) to do the necessary checks and as such should be able to get a 12 lead ECG.  If this is not possible a lab print out/rhythm strip confirming pacing post implant will be acceptable.

A rhythm strip is acceptable.

The post implant check would be the same or next day check prior to hospital discharge.

Print outs from the analysers are sufficient for case studies. You do not need physicians reports etc.

It is preferable to have de novo implants but yes upgrades can be used so long as for CRT it is an upgrade from PPM to CRT and not just an addition of RA/RV lead.

If the operator does not undertake DFT testing then the implant can still be used but you must document the reason why a DFT test was not done e.g. not departmental policy.  Very few units still routinely perform DFT tests for left sided primary prevention ICD implants.

All details of CRT implants / follow ups can be CRT-P or D devices.

It does not matter if the implants and follow ups are carried out in one day or spread out, providing you do the work and are appropriately overseen and signed off by your supervisor. The case studies need to be separate from implants as stated in the log book instructions for use “Please note that no case from section 1 can be used as a case study in section 3”.

No.  As they are “skills assessments” the candidates have to perform the test themselves and cannot have help.

Industry Specific Questions

There is a separate industry certification certificate which acknowledges theoretical knowledge as demonstrated by passing the examination.

Yes, we run industry certification.  You can get an EP or Devices (industry) certification by passing the written exam.  You not need to complete the log book component.

You can get an EP or Devices (industry) certification by passing the written exam.  You not need to complete the log book component.  You do not need to submit a log book as you are entitled to a separate industry certification certificate which specifically states that you have achieved “industry certification”.

Level of Participation Questions
for CRT/ICD Implantation

For doctors / allied health professionals completing the log you need to take on the role as a cardiac physiologist for ALL sections of the logbook including implantation section. As such you should not be scrubbed assisting the implanting cardiologist.  You should be using the analyser/PSA to check lead measurements and program device set up.

BHRS Certification is a recognition

of knowledge and practical experience in the field of cardiac rhythm management

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