The Swedish Knowledge Test for Psychiatrists: now competing with both the EPA Board Exam and UK Exams
- Karl Lundblad
- Jun 23
- 4 min read
The Swedish Psychiatric Association launched the Swedish Knowledge Test for residents and specialists in adult psychiatry in spring 2024. In 2025, we introduced a new annual version. Meanwhile, in February 2025, the EPA and UEMS launched the EPA Board Examination. How do these tests differ? And how do they compare to the Royal College of Psychiatrists’ exams in the United Kingdom?
Exams for residents and specialists in psychiatry exist internationally, with a longstanding tradition in one of our closest neighbors, the United Kingdom. In Sweden, there is a growing trend among medical specialties to create their own exams or assessments—for example, in Neurology and OB/Gyn. Some specialties, such as Anesthesiology, use common European exams. Until recently, there was no active joint European exam in the field of psychiatry—although some psychiatrists did take the UK’s Royal College exams. This changed with the launch of the European Board Examination in Psychiatry (EBEP) by the UEMS (European Union of Medical Specialists) and the EPA (European Psychiatric Association).
The Swedish Knowledge Test
The Swedish Psychiatric Knowledge Test covers the entire field of adult psychiatry, targeting the level of a “skilled, newly qualified specialist in adult psychiatry.” It is challenging but not overly difficult or filled with obscure trick questions based on esoteric research. Instead, it is a reasonable, clinically relevant, and hands-on test based on well-known sources, common knowledge, and established guidelines.
Since the test has no formal certification status, a simple pass/fail outcome would be of little use. Instead, it functions as a progress test, which can be taken at the beginning or end of residency. Senior specialists can also use it for self-assessment and continued education.
The test consists of approximately 100 “single best answer” questions, each with four options. So far, it has only been administered in person (participants use their own devices but are seated together in the same room at the same time) at our annual conferences—either the residency conference in January 2024 or the large Swedish psychiatric conference in March. We are currently considering offering a remote version of the test in autumn 2025.
Individual test results are not published. However, participants who score above the mean will be eligible to receive a diploma of excellent performance.
The Royal College of Psychiatrists Exams
During psychiatric training in the UK, trainees are expected to complete—alongside other learning activities such as sit-ins—two theoretical exams (Paper A and Paper B), followed by a clinical OSCE.
Paper A consists of 150 questions: two-thirds multiple choice questions (MCQs) and one-third extended matching item (EMI) questions. Topics include:
Behavioural science and sociocultural psychiatry;
Clinical psychopharmacology;
Classification and assessment in psychiatry;
Basic neurosciences and human development.
Paper B also contains 150 questions, with:
One-third focused on critical review (science and evidence-based medicine);
Two-thirds covering clinical topics, including:
General adult psychiatry;
Organisation and service delivery;
Forensic psychiatry;
Learning disability;
Child and adolescent psychiatry;
Substance misuse;
One-third focused on critical review (science and evidence-based medicine).
The final major assessment is an OSCE (Objective Structured Clinical Examination), which evaluates clinical competence through multiple stations. Candidates rotate between stations and are assessed on specific tasks. This is known as CASC (Clinical Assessment of Skills and Competencies). The CASC includes:
5 stations focused on history taking, including risk assessment;
5 stations focused on examination—both physical and mental state, including capacity assessment;
6 stations focused on patient management.
The EPA board examination in psychiatry
The EPA, together with the European Union of Medical Specialists – Psychiatry Section (UEMS-PS) and the European Federation of Psychiatric Trainees (EFPT), has developed the European Board Examination in Psychiatry (EBEP). This examination is a key step toward harmonizing psychiatric training and professional standards across Europe.
The first EBEP was held remotely on Friday, 28 February 2025, and a new version is planned for 2026.
The EBEP is a supplemental examination, intended as a mark of excellence in psychiatry. Its goals are to:
Promote a strong foundation of essential psychiatric knowledge;
Support professional mobility across Europe;
Ensure high-quality mental healthcare.
The EBEP does not replace national qualifications and is not a license to practice in Europe.
The exam consists of 100 questions in English, primarily using single best answer format, but also includes short answer and image-based questions. Approximately 200 participants across Europe took part in this inaugural exam.
So, what’s the difference? Do we need both national and international exams?
Clearly, the UK system is the oldest and most advanced, with two substantial written exams and a rigorous OSCE for clinical skills. These exams are taken by psychiatric trainees from around the world—mainly from the UK, India, Pakistan, and other former British colonies. They are, however, not commonly taken by European residents outside the UK.
In discussions with Andy Brittlebank, Chair of the EPA Board Exam, the need to harmonize standards of psychiatric care, knowledge, and skills across Europe becomes evident. A joint exam could be a way forward and might also ease cross-border professional mobility.
However, regional differences in Europe remain significant—especially regarding involuntary care and legal regulations—which suggests that both national and international exams may still be needed. That said, we should avoid duplicating content unnecessarily across both levels. □
Questions?
Feel free to contact us at: kunskapstest@svenskpsykiatri.se
Karl Lundblad MD, Psychiatrist Board Member, Swedish Psychiatric Association
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