When is a trainee qualified to be a specialist? This question was put to paediatric respiratory groups across Europe approximately 10 years ago and perhaps unsurprisingly, the answers were variable. Many European countries were only able to give a very rough estimation of the length of the period of training – ranging from ‘a few’ to ‘several’ years. Some smaller countries had no formal training and trainees often went overseas for experience, while in at least one country competence was determined by the supervisor regardless of the period in training. Training in different countries will always reflect national requirements and some differences are inevitable; however, EU legislation means that qualifications in different countries are recognised as equal and therefore consistency in training across the EU is highly desirable. In an attempt to move towards harmonised training, the ERS developed a common syllabus for PRM trainees between 2002 and 2009 – the Paediatric Harmonised Education in Respiratory Medicine for European Specialists (HERMES; This included an examination, which applicants first sat in 2011.

Before beginning training in PRM, trainees are expected to have a minimum 3 years’ experience in general paediatrics. Training in PRM usually lasts a further 3 years. Many trainees also complete an additional 2 or 3 years of training in research. At the time of writing, the Paediatric HERMES syllabus and examination were not compulsory but, in future, trainees who have passed the examination are likely to be seen as ‘stronger’ candidates when applying for specialist positions. The content of the Paediatric HERMES syllabus includes 21 mandatory modules and three optional ones (table 2).

See the entire Paediatric respiratory medicine Chapter