The other HERMES projects

Paediatric respiratory medicine

The paediatric assembly of the ERS published a syllabus specific for paediatric respiratory medicine in 2002, together with recommendations on training centres on a tertiary care level. In order to update this syllabus, a Paediatric HERMES task force was launched in 2007. Following the structure of the adult HERMES project, the new syllabus was published in 2009 and on the basis of this syllabus curriculum recommendations were developed, together with a special assessment toolbox. These were published in 2010. The first European examination in paediatric respiratory medicine took place in 2011.

Future tasks are the development of training networks and the accreditation of European training centres, with the aim of harmonising and standardising training in paediatric respiratory medicine across Europe. As with the adult HERMES project, the primary goal is to achieve quality control for all aspects of training, to facilitate free movement of trainees across centres and nations and to deliver the best care to children with respiratory diseases.


An ERS survey of national spirometry training programmes and research in the literature, conducted in 2008, confirmed the lack of training opportunities, under-utilisation of spirometers and diagnosis based on inaccurate results. A task force was created to set educational standards for the training and certification of spirometry.

A complete training programme was published in 2011, defining the length of training, the target audience and educational methods required for training.

It is intended that the spirometry training programme will be delivered at a national level by trained and experienced spirometry teachers. Therefore a ‘train the trainer’ course programme to train future spirometry teachers was designed. This was launched during the ERS Congress in 2012, and will be repeated each year. The training programme is designed to equip course directors with the knowledge, skills and tools to deliver a complete spirometry training programme and to acquire a ‘European Spirometry Driving Licence’, thus enabling a new generation of health professionals, nonmedical as well as medical, to perform high-quality spirometry tests. In addition, a set of training guidelines for certification, standardised educational documents for participants and trainers, a spirometry website and assessment guidelines on spirometry testing, will be produced.

Respiratory critical care

A respiratory critical care educational task force was launched in 2009. The project’s overall aim is to harmonise training in respiratory critical care medicine throughout Europe. Respiratory critical care can be defined as part of intensive-care medicine, dealing with specific respiratory problems; or as part of respiratory medicine, specifically respiratory failure that does not need direct access to general, medical or surgical intensive care units.

A syballus with 19 comprehensive modules was finalised in 2011, and plans are in motion to develop a European curriculum and, as a further step, to provide the groundwork for a diploma in respiratory critical care medicine. The curriculum will define the level of competence for adult respiratory physicians not directly involved in multidisciplinary critical care but who need knowledge of respiratory critical care. This is a first step towards a European diploma in respiratory critical care open to all physicians specialised in adult respiratory medicine who deal with intermediate respiratory intensive care units or specialised units dedicated solely to pulmonary critical care.


To address the increasing importance of respiratory sleep medicine as a subspecialty of respiratory medicine, the respiratory sleep HERMES task force and project was launched in 2009. The rationale for the project emerged from a needs analysis across 35 European countries, which confirmed the diversity and varying duration of respiratory sleep training and certification.

The project aims to establish common standards for both physicians and nonmedical practitioners. The consensus-based core syllabus, comprising nine modules, was published in 2011. On the basis of the syllabus the task force is preparing a curriculum to describe how the knowledge and skills should be taught and learned, with a view to developing an assessment in respiratory sleep medicine. As the curriculum is mainly intended for trainers, the task force is producing further educational materials (including a handbook, published in 2012) on respiratory sleep medicine to aid future trainees.

Thoracic oncology

The ERS considers comprehensive and multidisciplinary educational standards for thoracic oncology to be an important component of its mission to alleviate the suffering of patients with respiratory disease, including malignancies. The HERMES project methodology will be adopted to develop consensus-based educational standards and also to strengthen this subspecialty. The initiative is being carried out in collaboration with representatives from societies involved in thoracic oncology: the European Society of Thoracic Surgeons (ESTS), the European Society of Medical Oncology (ESMO) and the European Society for Radiotherapy and Oncology (ESTRO). One of the main objectives is to provide a comprehensive review of the current status of thoracic oncology training and certification in Europe. Another goal is to examine how to raise skill levels in thoracic oncology. This can be achieved through developing consensus-based standards with a European syllabus and curriculum and recommendations for a certification programme.

Respiratory physiotherapy

The respiratory physiotherapy HERMES project began in 2012. The project aims to develop a postgraduate respiratory physiotherapy training programme with a specific training period defined by task force members. The project will closely follow the development strategy for educational standards defined through HERMES.

See the entire Specialist clinical training (HERMES) chapter