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2025 all-candidate pass rate: 54.9% (317/577). UK resident doctors: 58.5% (120/205). European candidates: 64.2% (86/134). Pass Rate
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Question 1
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A 50-year-old man with compensated cirrhosis has transient elastography 28 kPa and platelets 92 x 10^9/L. He has no ascites and no prior variceal bleed. Endoscopy shows medium oesophageal varices without red signs. Blood pressure is 126/78 mmHg and heart rate is 76/min. Which primary prophylaxis strategy is most appropriate?

A
B
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2026 Statistics

Key Facts: ESEGH Exam

2018

ESEGH replaced the SCE in Gastroenterology and the ESBGH Examination

https://www.thefederation.uk/examinations/specialty-certificate-examinations/european-specialty-examination-gastroenterology

200

Official best-of-five questions

https://www.thefederation.uk/examinations/european-specialty-examination-gastroenterology-hepatology/esegh-faqs

2 x 3 hours

Official paper timing

https://www.thefederation.uk/sites/default/files/uploads/ESE%20Regulations%202018.pdf

7 Apr 2027

Next listed future ESEGH exam date on the official page reviewed 5 June 2026

https://www.thefederation.uk/examinations/specialty-certificate-examinations/european-specialty-examination-gastroenterology

£700 / €800 / £875

Current official fee tiers

https://www.thefederation.uk/examinations/specialty-certificate-examinations/european-specialty-examination-gastroenterology

54.9%

2025 all-candidate pass rate

https://www.thefederation.uk/sites/default/files/uploads/ESEGH%202025%20report.pdf

6 attempts

Automatic attempt limit before additional evidence is required

https://www.thefederation.uk/sites/default/files/uploads/ESE%20Regulations%202018.pdf

For current planning on 5 June 2026, eu-ebgh-exam should be treated as ESEGH, the current European Specialty Examination in Gastroenterology and Hepatology. Official facts include annual delivery, next listed exam date of 7 April 2027, two 3-hour computer-based papers, 200 best-of-five questions, no negative marking, no formal entry requirements, a six-attempt automatic limit, fees of UK £700 / ESBGH countries €800 / other countries £875, and a 2025 all-candidate pass rate of 54.9%.

Sample ESEGH Practice Questions

Try these sample questions to test your ESEGH exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Which description best reflects the current European Specialty Examination in Gastroenterology and Hepatology?
A.A procedural competency assessment based mainly on observed endoscopy cases
B.A pan-European knowledge-based assessment for Gastroenterology and Hepatology trainees
C.A national UK exit examination limited to UK specialty trainees
D.A stand-alone legacy examination separate from the current ESEGH pathway
Explanation: ESEGH is a pan-European knowledge-based assessment for Gastroenterology and Hepatology trainees. It is not a procedural skills examination, a UK-only test, or a separate legacy examination pathway.
2A candidate asks how the ESEGH is structured on the examination day. Which answer is most accurate?
A.One 6-hour paper containing 200 true/false questions
B.Four 90-minute papers over two consecutive days containing 100 MCQs in total
C.One written paper plus one practical endoscopy station
D.Two 3-hour papers on the same day containing 200 best-of-five MCQs in total
Explanation: The official exam has 200 best-of-five MCQs delivered as two 3-hour examinations or papers on the same day.
3Which statement about eligibility and attempts for the ESEGH is correct?
A.There are no entry requirements, but candidates are limited to a maximum of 6 attempts
B.Candidates must hold an ESBGH diploma before applying
C.Candidates may attempt the examination without limit until they pass
D.Only candidates working in countries where the examination is mandatory may sit it
Explanation: Federation guidance states that there are no formal entry requirements for ESEGH, although it is intended for trainees and specialists at the relevant stage of training. Candidates are automatically permitted a maximum of 6 attempts before extra educational evidence is required.
4Which countries currently make the ESEGH mandatory for relevant trainees?
A.United Kingdom, Ireland, and Malta
B.Germany, Austria, and Switzerland
C.United Kingdom, Netherlands, and Switzerland
D.Netherlands, Belgium, and Luxembourg
Explanation: The examination is currently mandatory in the United Kingdom, Netherlands, and Switzerland.
5A candidate is comparing current official ESEGH fee tiers before applying. Which fee pairing is correct?
A.UK candidates €800; all other countries £700
B.All candidates pay a single fee of £875 regardless of country
C.UK candidates £700; ESBGH full, associate, or observer countries €800
D.ESBGH country candidates pay £875; all other candidates pay €800
Explanation: The official ESEGH fee tiers are UK £700, ESBGH full member, associate member and observer countries €800, and all other countries or territories £875. There is not one universal fee for every candidate.
6A 68-year-old man reports progressive dysphagia, initially to solids and now also to liquids, with 8 kg weight loss. What is the most appropriate next investigation?
A.Urgent upper gastrointestinal endoscopy with biopsy
B.Empirical proton pump inhibitor therapy for 8 weeks
C.High-resolution oesophageal manometry as the first test
D.Outpatient barium swallow without endoscopy
Explanation: Progressive dysphagia with weight loss is an alarm presentation for oesophageal or gastric malignancy and requires urgent endoscopy with biopsy.
7A 35-year-old man has intermittent dysphagia to solids, food bolus impactions, asthma, and allergic rhinitis. Endoscopy shows rings and furrows. Which biopsy strategy is most appropriate?
A.Biopsy only if a stricture is seen
B.Avoid biopsy because endoscopic appearances are diagnostic
C.Biopsy only the gastro-oesophageal junction
D.Take multiple biopsies from at least two oesophageal levels
Explanation: Eosinophilic oesophagitis is patchy, so diagnosis requires multiple oesophageal biopsies from different levels, even when typical rings or furrows are present.
8A 42-year-old woman has dysphagia to solids and liquids from onset, regurgitation of undigested food, and nocturnal cough. Endoscopy excludes malignancy. Which investigation best confirms the likely diagnosis?
A.Ambulatory oesophageal pH monitoring
B.High-resolution oesophageal manometry
C.Serum gastrin concentration
D.Wireless capsule endoscopy
Explanation: Achalasia typically causes dysphagia to solids and liquids with regurgitation; high-resolution manometry is the key confirmatory investigation after endoscopy excludes pseudoachalasia.
9A patient with progressive dysphagia to solids and liquids undergoes high-resolution oesophageal manometry. Which pattern is most consistent with achalasia?
A.Normal lower oesophageal sphincter relaxation with fragmented peristalsis
B.Impaired lower oesophageal sphincter relaxation with absent normal peristalsis
C.Low lower oesophageal sphincter pressure with frequent reflux episodes
D.Hypertensive upper oesophageal sphincter with normal distal oesophageal motility
Explanation: Achalasia is defined manometrically by impaired lower oesophageal sphincter relaxation with absent normal oesophageal peristalsis. Reflux with a hypotensive sphincter, fragmented peristalsis with normal relaxation, or isolated upper sphincter hypertension does not establish achalasia.
10A 55-year-old obese man has chronic reflux symptoms. Endoscopy shows salmon-coloured mucosa extending 4 cm above the gastro-oesophageal junction, and biopsies show intestinal metaplasia without dysplasia. What is the diagnosis?
A.Los Angeles grade D reflux oesophagitis
B.Eosinophilic oesophagitis
C.Oesophageal squamous papillomatosis
D.Barrett's oesophagus without dysplasia
Explanation: Barrett's oesophagus is columnar-lined oesophagus with intestinal metaplasia and is associated with chronic GORD, male sex, central obesity, and age.

About the ESEGH Exam

ESEGH is the European Specialty Examination in Gastroenterology and Hepatology. It is the GMC-approved mandatory summative knowledge assessment for UK gastroenterology and hepatology trainees and a European benchmark for ESBGH curriculum knowledge. It is not the old separate ESBGH Examination; that examination was replaced by ESEGH.

Assessment

ESEGH is the current pan-European gastroenterology and hepatology specialty knowledge examination. It replaced the older UK SCE in Gastroenterology and the ESBGH Examination from January 2018. The exam is computer-based, consists of two papers of 100 best-of-five questions, and is selected from the official ESEGH blueprint.

Time Limit

Six hours total: two 3-hour papers taken on the same day.

Passing Score

Criterion-referenced and equated. The 2025 report states that the pass score of 432 is maintained until standards are reviewed and that the 2025 pass mark was 432, equivalent to 58.4% or 115/197.

Exam Fee

Current fees are UK £700, ESBGH full member, associate member and observer countries €800, and all other countries and territories £875. (Federation of Royal Colleges of Physicians of the UK, with the British Society of Gastroenterology and ESBGH)

ESEGH Exam Content Outline

Format

Computer-Based Best-of-Five Exam

Two same-day 3-hour papers, 100 best-of-five questions per paper, one mark for each correct answer, no negative marking, and no marks for unanswered questions.

40 of 200

Inflammatory Bowel Disease and Colonic Disorders

IBD, acute severe colitis, colorectal neoplasia, surveillance, functional bowel disease, microscopic colitis, diverticular disease, and colonic emergencies.

40 of 200

Liver Disorders

Viral, metabolic, alcohol-related, autoimmune, cholestatic, and cirrhotic liver disease, including portal hypertension, HCC surveillance, decompensation, and transplant referral.

56 of 200

Upper GI and Small Intestine

Oesophageal, stomach, duodenal, and small intestinal disorders, coeliac disease, malabsorption, nutritional problems, dyspepsia, reflux, and bleeding.

42 of 200

Pancreatobiliary, Haemorrhage, and Procedures

Pancreatitis, pancreatic cancer, biliary obstruction, cholangitis, GI haemorrhage, endoscopic triage, ERCP/MRCP/EUS decisions, complications, and quality and safety.

How to Pass the ESEGH Exam

What You Need to Know

  • Passing score: Criterion-referenced and equated. The 2025 report states that the pass score of 432 is maintained until standards are reviewed and that the 2025 pass mark was 432, equivalent to 58.4% or 115/197.
  • Assessment: ESEGH is the current pan-European gastroenterology and hepatology specialty knowledge examination. It replaced the older UK SCE in Gastroenterology and the ESBGH Examination from January 2018. The exam is computer-based, consists of two papers of 100 best-of-five questions, and is selected from the official ESEGH blueprint.
  • Time limit: Six hours total: two 3-hour papers taken on the same day.
  • Exam fee: Current fees are UK £700, ESBGH full member, associate member and observer countries €800, and all other countries and territories £875.

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

ESEGH Study Tips from Top Performers

1Use the official blueprint rather than revising hepatology and luminal gastroenterology as equal blocks; IBD/colonic disorders and liver disorders are the two largest single categories.
2Practise best-of-five reasoning by identifying the most correct answer among plausible alternatives, not just a true statement.
3Review current BSG, NICE, SIGN, EASL, UEG, and other major guidelines for indications, sequencing, and escalation decisions.
4Build timed practice around two sustained 3-hour papers because fatigue and decision consistency are part of exam readiness.
5Treat endoscopy, investigations, nutrition, and procedure safety as integrated knowledge areas rather than isolated facts.

Frequently Asked Questions

Is this a legacy ESBGH Examination entry?

No. The current official exam is ESEGH. Federation states that from January 2018 the UK SCE in Gastroenterology and the European Section and Board of Gastroenterology and Hepatology Examination were replaced by ESEGH.

How many questions are on ESEGH?

ESEGH has 200 best-of-five questions in two papers of 100 questions each, taken on the same day.

How long is the exam?

Each of the two papers is 3 hours, giving 6 hours of total testing time.

Are there entry requirements?

Federation states that there are no entry requirements, although the exam is intended for trainees and specialists at the relevant stage of gastroenterology and hepatology training.

How is ESEGH scored?

The ESE regulations describe criterion-referenced scoring with one mark for each correct answer, no negative marking, and no marks for unanswered questions. The pass mark is maintained and reviewed by the ESEGH Examination Board.

What is the next listed ESEGH date?

On the current official page reviewed on 5 June 2026, the next listed future diet is 7 April 2027, with applications from 16 December 2026 to 13 January 2027.