European Board Certification
The European board exam covering oesophagogastric (upper GI) cancer surgery is the UEMS Upper Gastrointestinal Surgery fellowship — sometimes referred to as FEBS-ECS. This guide covers the exam, its format, eligibility, the topics and trials tested, and how to prepare.
Content reviewed 26 August 2026 against current guidelines.
The exam that certifies oesophagogastric cancer surgery in Europe is the EBSQ examination in Upper Gastrointestinal Surgery, run jointly by the UEMS European Board of Surgery, the European Board of Thoracic Surgery and the Multidisciplinary Joint Committee of Upper GI Surgery, in cooperation with the European Society for Diseases of the Esophagus (ESDE). Depending on the base specialty, the title awarded is FEBS Upper Gastrointestinal Surgery (or the thoracic-surgery equivalent).
There is no separate UEMS fellowship under the acronym "ECS"; the upper GI fellowship is the correct European credential for oesophageal and gastric cancer surgery, and it provides a harmonised European standard across benign and malignant upper GI disease.
Written Examination (MCQ)
Practical / OSCE
The overall pass threshold is 75% (at least 450 of 600 points). Both parts are usually sat as a single event held in connection with the ESDE / ISDE congress.
Oesophageal Cancer
Staging, neoadjuvant chemoradiotherapy and oesophagectomy technique.
Gastric Cancer
D2 gastrectomy, perioperative chemotherapy and lymphadenectomy extent.
GIST
Risk stratification (NIH/AFIP), imatinib thresholds and surgical margins.
Junctional Tumours
Siewert classification and its impact on surgical strategy.
Benign Oesophagogastric
Reflux, achalasia and hiatal disease management.
Multimodal Treatment
CROSS and FLOT evidence integration into treatment pathways.
The examination is held annually, in connection with the ESDE / ISDE congress, following a two-step eligibility and examination process.
Exam dates, fees and eligibility details change each cycle — always confirm the current requirements on the UEMS Upper Gastrointestinal Surgery pages (uemssurg.org) and with ESDE before applying.
It is the recognised European subspecialty credential in upper GI cancer surgery, referenced by high-volume oesophagogastric units across Europe.
Preparation requires knowing the landmark trials verbatim and integrating them into multidisciplinary pathways — exactly the reasoning the OSCE assesses.
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.
SurgBoardsQ&A provides more than 1,300 oesophagogastric practice questions mapped to the FEBS-ECS syllabus, each with a detailed, guideline-referenced explanation.
The exam covers oesophageal cancer, gastric cancer, gastrointestinal stromal tumours (GIST) and other rare upper GI tumours, and benign oesophagogastric disease.
Yes — start with 50 free upper GI surgery practice questions, no credit card required.
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.
SurgBoardsQ&A provides more than 1,300 practice questions mapped to the exam syllabus, each with a detailed explanation and guideline citation.
Start practising
50 questions free, no credit card required. Filter by board, topic, or difficulty. Explanations cite ESMO and NCCN.