Interview with Dr. Athmaja Thottungal, Vice Chair of the ESRA-DPM Examination Committee Advancing Clinical Excellence in Pain Medicine through the ESRA-DPM

Interview with Dr. Athmaja Thottungal, Vice Chair of the ESRA-DPM Examination Committee Advancing Clinical Excellence in Pain Medicine through the ESRA-DPM

Q: Dr. Thottungal could you begin by explaining what the ESRA-DPM Examination is?

The European Diploma in Pain Medicine, or ESRA-DPM, is a structured, competency-based certification that validates the expertise of clinicians in the multidisciplinary field of pain medicine. It was developed by the European Society of Regional Anaesthesia and Pain Therapy (ESRA) to ensure that physicians working in pain medicine meet consistent, high standards of knowledge, skill, and professionalism across Europe and beyond. The diploma is recognised internationally and serves as both a mark of excellence and a benchmark for clinical practice.

Q: Why is the ESRA-DPM considered one of the best qualifications in this field?

What makes the ESRA-DPM unique is its balance between academic depth, clinical relevance, and international credibility. It is not just an examination—it reflects ESRA’s longstanding commitment to safe, effective, and evidence-based pain medicine practice. The diploma combines theoretical and practical assessment, delivered under rigorous and standardised conditions, ensuring that certified candidates possess both theoretical understanding and real-world clinical competence. Moreover, it provides a global platform for networking, professional development, and continuous learning in pain medicine.

Q: Can you describe the different components of the ESRA-DPM examination pathway?

The ESRA-DPM consists of three sequential components.

The first is the Written MCQ Examination, which assesses theoretical knowledge and applied understanding of pain mechanisms, pharmacology, diagnostics, and management strategies. The second is the Oral Examination, which tests candidates’ clinical reasoning and decision-making skills through structured case discussions.

The newest addition, and perhaps the most exciting, is the Assessment of Clinical Expertise in Pain (ACEP)—the Practical Examination. This final component evaluates the hands-on skills that are essential for safe and competent pain practice.

Q: Could you tell us more about the ACEP and why it was introduced

The ACEP was introduced to complete the diploma’s transition into a fully comprehensive competency-based framework. It carefully assesses candidates in three critical areas: Clinical Examination Skills, Ultrasound-Guided Interventional Skills, and Fluoroscopy-Guided Interventional Skills. At each station, candidates are evaluated on their ability to perform targeted physical examinations, recognise anatomy, demonstrate procedural precision, interpret images, and maintain safety standards such as radiation protection.

We introduced this component to ensure that the ESRA-DPM certification reflects the true capabilities of a practising pain physician. Knowledge alone is not enough; clinical skill, judgment, and technical execution are equally vital. The ACEP ensures all these dimensions are assessed objectively and consistently.

Q: How does this practical component fit within international standards of certification?

The ACEP aligns ESRA-DPM with global benchmarks for professional assessment in medicine. Many leading international diplomas are moving toward competency-based models that emphasise practical ability alongside theoretical understanding. With the ACEP in place, the ESRA-DPM now represents one of the most robust and internationally aligned pain medicine qualification frameworks available today.

Q: Could you elaborate on the ESRA-DPM curriculum? What can candidates expect to learn and be assessed on?

The ESRA-DPM curriculum is comprehensive and evidence-based, designed by a panel of experts representing various disciplines within pain medicine. It covers essential domains such as pain neurophysiology, pharmacological management, psychological aspects of pain, interventional procedures, rehabilitation, interdisciplinary and multidisciplinary care strategies. The curriculum ensures that candidates develop both scientific understanding and clinical reasoning, preparing them to deliver evidence based safe and effective personalised and patient centred care.

Q: Where can candidates find more information about the examination process and curriculum?

Up-to-date details about the ESRA-DPM examination, including eligibility criteria, application timelines, curriculum outlines, and resources, are available on the ESRA-DPM section of the official ESRA website. (link) Candidates can also access candidate guidelines, sample questions, and key updates regarding the ACEP component and examination venues.

Q: Finally, what message would you like to share with potential candidates considering the ESRA-DPM?

Pain medicine is an evolving and highly rewarding field, and the ESRA-DPM represents an unparalleled opportunity to demonstrate clinical excellence and commitment to high quality patient care. The examination pathway challenges candidates to expand their knowledge, refine their skills, and join a growing community of professionals dedicated to advancing pain medicine across Europe. With the introduction of the ACEP practical examination, ESRA-DPM now provides a complete validation of both knowledge and hands on expertise making it one of the most respected qualifications in the specialty.