When participants complete one of the PEP books they can apply to the Trust to write the formal examination. Each book has its own examination. Successful candidates receive a PEP certificate which states that the participant has completed that course. The examination consists of 75 multiple choice questions. As these questions are selected from the chapter tests, candidates must score at least 80% to pass. Currently, the clinical skills are not tested at the end of the course although some hospitals have arranged their own skills examinations. The supplementary books each have a seperate examination and a certificate which is issued to successful candidates.

The group leader has the responsibility for arranging the time and venue for the examination. A reliable person (usually a nursing manager) is asked to convene the examination and mark the examination papers. The list of correct answers is sent to the examination convenor. Examination papers may be ordered from the Trust. When placing orders give the name of the book studied, and the number of candidates taking the exam, and allow at least two weeks for posting. As the responsibility for studying the PEP book is taken by the individual participants themselves, their sense of pride and achievement is great. They are encouraged to arrange a celebration where the PEP certificates can be awarded.

The final exam can also be written online at the EBW Healthcare Exam Centre.

By the end of 2009, over 15 000 PEP certificates had been awarded in South Africa.