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Every year, in mid-September, the European Society of Anaesthesiology and Intensive Care (ESAIC) organizes the written examination for the European Diploma in Anaesthesia and Intensive Care (EDAIC Part-i) at approximately 100 centers in different cities around the world.
In Spanish-speaking countries, there are 9 examination centers in Spain and 4 in South America. This year, Asunción (Paraguay) joined the network of EDAIC centers in South America, which already included Buenos Aires (Argentina), Montevideo (Uruguay), and Rancagua (Chile), in addition to the centers in Fortaleza and São Paulo, Brazil. Moreover, the EDAIC Part-i exam can be taken in Spanish at any center in the world 1
Thus, a little over 3,400 candidates sat the examination globally in 2024.
History and use of the EDAIC in different countries
Since its inception in the 1980s, the EDAIC (formerly also known as DEAA or DESA) has served as certification that an anesthesiologist has acquired the requisite knowledge in basic sciences and clinical anesthesia to practice in accordance with high European standards. It certifies a level of excellence in Anesthesia and Intensive Care. Since the second decade of this century, the number of candidates registered for the different EDAIC examinations has been growing all over the world, including Spain and other Spanish-speaking countries 2,3.
In recent years, EDAIC exams have been incorporated as mandatory, equivalent or optional into the specialty curriculum in an increasing number of countries, either partially (Argentina, Austria, Belgium, Egypt, Finland, Indonesia, Hungary, Poland, Portugal, Romania, Switzerland, the Netherlands, and Turkey) or fully (Malta, where EDAIC is the official specialist diploma) 4.
From an institutional perspective, while the EDAIC is not mandatory in many European countries yet, it is highly valued 5. Additionally, it is recognized by the British RCOA as equivalent to the FRCA-i, and by the College of Anaesthetists of Ireland as equivalent to the first specialty examination 4. The EBA/UEMS recommends it in their European Training Requirements 6, and while it is not required for professionals trained in Spain, its value is widely acknowledged. Indeed, the commission for the recognition of non-EU degrees in Spain positively considers obtaining this diploma for the recognition of the specialist diploma.
Preparation for the EDAIC examinations
The written Part 1-examination is the first step towards obtaining the EDAIC. Once passed, candidates are eligible to register for the second part, which consists of a structured oral examination of the VIVA type 7. The oral examination can be conducted in person at various centers or on-line in several languages, including Spanish 4.
Successful completion of both examinations, along with recognition as an anesthesiologist in each candidate's country, allows for the acquisition of the EDAIC diploma and the title of Diploma of the ESAIC (DESAIC) on the curriculum and the cards of admitted candidates.
In recent years, ESAIC has developed training and preparatory programs for the EDAIC exams to enhance candidates' knowledge and increase the likelihood of success in both EDAIC Part 1 and Part 2, through the Basic Sciences and Clinical Anaesthesia Course (BSCAC) 8 and the VIVAC course 9. The Online Assessment (OLA) is the official training test for the EDAIC Part 1 and is conducted annually in April 7.
Current status of reaccreditation or recertification in Colombia
Historically, in the region, the United States implemented a specialty certification system starting in 2000 through the American Board of Anesthesiology. The concept of medical recertification dates back to 1933, when the Commission on Medical Education suggested the need for continuous training for physicians and, since 1973, the American Board of Medical Specialties has promoted voluntary recertification as an integral part of certification programs. Over time, this process shifted from voluntary to mandatory 10.
In Colombia, Voluntary Medical Recertification (VMR) is a government initiative implemented in response to the need for continuous theoretical and practical knowledge updates for healthcare professionals, complementing their undergraduate and postgraduate training. This recertification serves as a quality seal that identifies healthcare professionals who strive to maintain their knowledge and professional practice up to date and aligned with the social responsibility that comes with ethical and safe practice 11,12.
By obtaining recertification and renewing it every five years, certified professionals provide their patients with the assurance of having dedicated a specified period to training in their field, thereby contributing to improved quality and safety in service delivery 11. Currently, the process is entirely voluntary and is coordinated by the Colombian Council for Accreditation and Voluntary Recertification of Medical Specialists and Related Professions (CAMEC), which oversees voluntary medical recertification processes carried out by participating Medical Associations and Societies, including the Colombian Society of Anesthesiology and Resuscitation (SCARE) 13.
Colombia and SCARE have made significant progress in this process. From 2013 to 2023, 758 anesthesiologists were recertified following the standards defined by SCARE, and new options have emerged to facilitate and broaden the process for more professionals.
EDAIC and reaccreditation in Colombia: towards a common path?
To align the EDAIC examination with the recertification process in Colombia, a framework that integrates the competencies assessed by the EDAIC with national recertification standards would be necessary. Here are some suggestions and considerations to achieve this convergence:
Mutual recognition of certification: Just as some European countries already value the EDAIC as equivalent to national exams, Colombia could consider recognizing the EDAIC as part of the recertification requirements. This would allow anesthesiologists who obtain the EDAIC to automatically fulfill a portion of the recertification process in Colombia.
Content alignment: It is important that the content assessed in the EDAIC, which includes competencies in basic sciences and anesthesia practice, be recognized as equivalent to Colombian standards. This could be achieved through a joint review by SCARE and ESAIC, ensuring that both evaluation processes address the essential competencies for anesthesia practice. EDAIC aims at covering the content defined by the UEMS, see: https://www.uems.eu/european-training-requirements
Development of joint training programs: Creating training and preparatory programs that include EDAIC content and Colombian recertification requirements would enable professionals in Colombia to prepare for both processes. These programs could include courses in basic sciences, clinical updates, and the use of tools such as the EDAIC's Online Assessment (OLA). Visit the ESAIC academy-website to get an idea of the available resources: https://academy.esaic.org/esaic
Facilitation of exams and recertification in national centers: Since the EDAIC is already conducted at centers in South America, Colombia could explore the possibility of becoming an EDAIC examination center. This would provide Colombian anesthesiologists with direct access to the EDAIC, while simplifying coordination with the national recertification process.
Establishment of equivalence criteria for voluntary recertification: By including EDAIC certification as part of the recertification process, SCARE could establish equivalence criteria for professionals seeking recertification, ensuring that international training and evaluation are recognized within the Colombian framework. SCARE could apply different passing grades for recertification in Colombia than those applied by ESAIC for the exam.
Integrating the EDAIC with the Colombian recertification system could promote continuous international knowledge updates and strengthen the ongoing training of anesthesiologists in Colombia, enhancing the quality of care and the global recognition of professionals. This integration would also reinforce the reputation of Colombian anesthesiologists by aligning with European standards of excellence in anesthesiology.
CONCLUSIONS
Various studies have shown that certification and recertification are associated with better quality of care. For instance, research indicates that certified anesthesiologists tend to perform better, and certification is directly related to improved patient outcomes, particularly in terms of safety and quality of anesthetic procedures. This suggests that a structured and rigorous certification process not only ensures a minimum level of competence but also encourages continuous professional development and improvement.
In this context, the potential to create synergy between the European Diploma in Anaesthesia and Intensive Care (EDAIC) examination and the certification and recertification process in Colombia presents a valuable opportunity. Integrating both systems could allow anesthesiologists in Colombia to benefit from the high international standards of the EDAIC, which could facilitate the adoption of best clinical practices and access to advanced training programs. At the same time, aligning with the national recertification process could ensure that these competencies meet the needs and specificities of the Colombian healthcare system.
This synergy would not only strengthen the competency and international recognition of Colombian anesthesiologists but also contribute to the standardization of quality levels in anesthetic practice in the country. This way, professionals would be better equipped to face the challenges of modern clinical practice, ensuring higher quality patient care and reinforcing society's trust in the ethical and competent practice of the specialty.
