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Europe (UEMS)1,362 questions

Upper GI Board Exam Preparation — FEBS Oesophagogastric Cancer Surgery

The Fellowship of the European Board of Surgery in Oesophagogastric Cancer Surgery (UEMS/ISDE) covers the upper gastrointestinal tract. Practise with FEBS-ECS questions on oesophageal and gastric cancer, GIST and benign oesophagogastric disease, each referenced to ESMO guidelines and the CROSS and FLOT trials examiners expect you to know verbatim.

Content reviewed 26 August 2026 against current guidelines.

🇪🇺Europe1,362 questionsWritten simulatorOral simulatorExam guide
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Exam format

Format
Written (100–150 MCQ, 3–5 h) + OSCE (6 stations × ~10 min)
Duration
Written: 3–5 hours; OSCE: ~60 minutes
Frequency
Annual, with the ESDE / ISDE congress
Pass rate
75% (at least 450 of 600 points)
Exam fee
See UEMS Upper GI pages (uemssurg.org)

Eligibility requirements

  • ›Minimum 5 years postgraduate surgical training
  • ›At least 2 years dedicated upper GI oncological surgery in a recognized high-volume center
  • ›Operative logbook demonstrating proficiency in esophagectomy and gastrectomy procedures
  • ›UEMS-recognized European training context

Syllabus breakdown

Esophageal Cancer (SCC, AC — staging, esophagectomy techniques, neoadjuvant)35%
Gastric Cancer (staging, D1/D2 gastrectomy, perioperative chemotherapy)35%
GEJ Tumors (Siewert classification, surgical approach, multimodal treatment)20%
GIST, Neuroendocrine Tumors & Other Upper GI Pathology10%

A real FEBS-ECS question

Taken from the bank, not written for this page. Answer it in your head, then open the explanation.

A 67-year-old male with upper gastric (cardia) adenocarcinoma (cT2N0M0, Siewert III — below the GEJ by 3 cm in the gastric cardia) is evaluated for surgery. EUS confirms cT2N0, no lymphadenopathy. PET-CT negative for distant disease. He has ECOG 0 and good cardiorespiratory reserve. What is the most appropriate surgical procedure for this Siewert III gastric cardia tumour?

  1. AProximal gastrectomy — organ-preserving approach for cardia cancer
  2. BTotal gastrectomy with D2 lymphadenectomy and distal oesophageal resection (if needed for margin) — appropriate for Siewert III
  3. CEndoscopic submucosal dissection (ESD) — T2 cardia cancer is amenable to endoscopic resection
  4. DDistal gastrectomy with D2 — cardia tumour can be resected distally
  5. EIvor Lewis oesophagectomy — Siewert III tumours require oesophagectomy for adequate proximal margin
Show the answer and explanation

Correct answer: B

Siewert classification of GEJ tumours: Type I — adenocarcinoma of the distal oesophagus (Barrett's), centre 1-5 cm above the GEJ; Type II — true cardia cancer, centre within 1 cm above to 2 cm below the GEJ; Type III — subcardial gastric cancer, centre 2-5 cm below the GEJ. Siewert III is a subcardial gastric cancer — treated primarily as gastric cancer (not oesophageal cancer). Standard surgical approach for Siewert III: total gastrectomy with D2 lymphadenectomy is the recommended procedure. Rationale: (1) Total gastrectomy (vs proximal gastrectomy) provides better oncological clearance with D2 nodal harvest; (2) Distal oesophageal resection may be needed if the tumour extends towards the GEJ — this is assessed intraoperatively with frozen section; (3) Reconstruction: Roux-en-Y oesophago-jejunostomy. Siewert III tumours do NOT require an oesophagectomy approach — the operation is a total gastrectomy performed via laparotomy or laparoscopy. Option E (Ivor Lewis) — Siewert I requires oesophagectomy; Siewert III does not. Ivor Lewis is for Siewert I (and sometimes Siewert II). Option A (proximal gastrectomy) — oncologically inferior to total gastrectomy for Siewert III with N0 staging; D2 total gastrectomy achieves better nodal clearance. Option D (distal gastrectomy) — incorrect; cardia/proximal stomach tumour cannot be resected distally. Option C (ESD) — ESD is for T1a and selected T1b lesions, not T2 tumours.

Teaching point. Siewert III (subcardial gastric cancer, 2-5 cm below GEJ): treated as gastric cancer with TOTAL GASTRECTOMY + D2 lymphadenectomy (not oesophagectomy). Siewert I: oesophagectomy. Siewert II: surgical approach more variable (total gastrectomy or extended oesophagectomy based on tumour extent and institutional practice).

Referenced to JGCA 6th Ed. 2021; ESMO Gastric/GEJ 2023; Siewert (1998 — original classification)

Every question is explained like this — start with 50 free ›

Preparation tips

  • ›Focus your first weeks on the highest-weight syllabus areas — they account for over half the marks and offer the fastest return on study time.
  • ›Use active recall with timed question sessions rather than passive re-reading: the FEBS-ECS multiple-choice paper rewards speed and precision under pressure.
  • ›Cross-reference every explanation with the guideline section it cites. Over a 3–6 month cycle that builds the mental index the 3-station oral demands, where you have to justify a decision rather than recognise it.

How these questions are validated

Every question is written by Pablo Lozano Lominchar, MD, PhD, and mapped to this board’s published syllabus. Before it enters the bank it has to pass an automated check: five options, a written explanation, and a citation — a named society guideline or a named trial. Benign and functional topics cannot be published without a society guideline; oncological ones cite NCCN, ESMO or AJCC, and the classification systems that govern a topic — Bethesda, TIRADS, Atlanta, Prague, Chicago — have to appear where they apply. The author has audited the full active bank against current guideline versions: what fails is re-cited, rewritten or withdrawn. 650 questions are currently withdrawn and are served to nobody.

Frequently asked questions

How do I prepare for the FEBS Oesophagogastric (ECS) exam?

Know the CROSS and FLOT trial data verbatim, the Siewert classification that drives surgical strategy, and GIST risk stratification with adjuvant imatinib thresholds. Practise timed upper GI questions and rehearse structured case reasoning for the oral component.

How many FEBS-ECS practice questions are available?

SurgBoardsQ&A provides more than 1,300 oesophagogastric practice questions mapped to the FEBS-ECS syllabus, each with a detailed, guideline-referenced explanation.

What topics does the FEBS-ECS exam cover?

The exam covers oesophageal cancer, gastric cancer, gastrointestinal stromal tumours (GIST) and other rare upper GI tumours, and benign oesophagogastric disease.

Is there a free FEBS-ECS question bank?

Yes — start with 50 free upper GI surgery practice questions, no credit card required.

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