The development of a HERMES curriculum for training in respiratory infections is now in progress http://ow.ly/Y76aO
In 2014, the European Respiratory Society (ERS) took the lead in harmonising training programmes in a field of emerging interest across Europe, respiratory infections. In order to establish defined standards of knowledge and skills in this new field, the ERS has launched the educational task force \u201cRespiratory Infections\u201d under the HERMES (Harmonised Education in Respiratory Medicine for European Specialists) initiative (hermes.ersnet.org). Most countries do not have their own system for training physicians in respiratory infections. To fulfil this unmet need, the educational task force aims to support the harmonisation of training through different tools: in the first instance, by developing a training syllabus and curriculum for respiratory infections, and in the future, by designing educational resources that could lead to voluntary assessments and certification. In this editorial, we will focus on explaining the rationale behind the HERMES Respiratory Infections project and present the first steps in the development of a training syllabus

A. Niculescu

G. Rohde

J. Noel

S. Aliberti

Breathe

PubMed

Alexandra Niculescu

Julie-Lyn Noel

Stefano Aliberti

Gernot Rohde

Directory of Open Access Journals

Introducing a new HERMES project on respiratory infections

Niculescu, Alexandra

Noel, Julie-Lyn

Aliberti, Stefano

Rohde, Gernot

NARCIS 

AIR Universita degli studi di Milano

http://doi.org/10.1183/20734735.012515 Breathe | March 2016 | Volume 12 | No 1 5
Cite as: Niculescu A, Noel J-L, 
Aliberti S, et al. Introducing 
a new HERMES project on 
respiratory infections. Breathe 
2016; 12: 5–7.
https://www.linkedin.com/groups/4348517
@erstalk
alexandra.niculescu@ersnet.orgAlexandra Niculescu1, Julie-Lyn Noel1, Stefano Aliberti2 and Gernot Rohde3 
on behalf of the Respiratory Infections HERMES Task Force4
1European Respiratory Society, Lausanne, Switzerland. 2School of Medicine and 
Surgery, University of Milan Bicocca, Clinica Pneumologica, AO San Gerardo, 
Monza, Italy. 3Dept of Respiratory Medicine, Maastricht University Medical Center, 
Maastricht, The Netherlands. 4For a list of the Respiratory Infections HERMES Task 
Force and their affiliations see the Acknowledgements section.
In 2014, the European Respiratory Society (ERS) 
took the lead in harmonising training programmes 
in a field of emerging interest across Europe, respi-
ratory infections. In order to establish defined 
standards of knowledge and skills in this new 
field, the ERS has launched the educational task 
force “Respiratory Infections” under the HERMES 
(Harmonised Education in Respiratory Medicine 
for European Specialists) initiative (hermes.ersnet.
org). Most countries do not have their own system 
for training physicians in respiratory infections. 
To fulfil this unmet need, the educational task 
force aims to support the harmonisation of train-
ing through different tools: in the first instance, 
by developing a training syllabus and curriculum 
for respiratory infections, and in the future, by 
designing educational resources that could lead 
to voluntary assessments and certification. In this 
editorial, we will focus on explaining the rationale 
behind the HERMES Respiratory Infections project 
and present the first steps in the development of 
a training syllabus.
The need for harmonisation 
of training across Europe
Respiratory infections pose a major threat to 
public health worldwide as they represent one 
of the leading causes of morbidity and mortality 
in most countries [1]. Pneumonia, for example, 
is a prominent cause of death for children under 
5 and adults over 65 years of age, particularly in 
developed countries [2]. Meanwhile, tuberculosis 
remains a common infection and a serious 
 clinical issue, especially for middle- and low- 
income  countries. In 2013, a significant number 
of  tuberculosis cases (64 844) was reported in 
30 European Union/ European Economic Area 
countries [3]. In addition, in certain economic or 
geographical contexts, a new problem arises, the 
emergence and spread of multidrug-resistant 
tuberculosis. As a consequence, there is a risk 
that poor clinical and public health management 
of individuals with latent or active disease favours 
the emergence and spread of the infection. Given 
the differing epidemiology and resources available 
at local levels, the management of the diseases 
included in this field is still a challenge. At the 
same time, recent developments in diagnostic 
techniques have made respiratory infections a 
field of emerging interest. Nowadays, respiratory 
infections are one of the central topics in the 
training of respiratory physicians. However, 
the education of physicians with an interest in 
respiratory infections is still heterogeneous across 
European countries.  Respiratory infections as 
a subspecialty of respiratory  medicine covers 
knowledge and skills in partial overlap with other 
major disciplines in medicine, such as medical 
microbiology and infectious diseases. Clear 
definitions of the knowledge and skills central to 
respiratory medicine as well as these overlapping 
areas are needed in order to better coordinate and 
improve patient care as well as to identify areas 
of collaborative future research. In summary, 
Introducing a new HERMES 
project on respiratory infections
@ERSpublications
The development of a HERMES curriculum for training in respiratory infections is now 
in progress  http://ow.ly/Y76aO
Introducing a new HERMES project on respiratory infections
6 Breathe | March 2016 | Volume 12 | No 1
there is a pressing need to standardise knowledge 
and expertise in the field of respiratory infections 
among different European countries in order to 
equally prevent and better manage respiratory 
infections.
Current situation of training 
and management of 
respiratory infections
A recent situational analysis run by the ERS among 
the newly established Respiratory Infections edu-
cational task force asked the opinion of its 13 
members and two advisors with respect to two 
main areas: current training in respiratory infec-
tions and management of the disease. The task 
force members/advisors, mostly respiratory infec-
tions and tuberculosis experts from the Respira-
tory Infections Assembly of the ERS, represented 
several European countries, including the UK, 
 Germany, the Netherlands, Italy, Spain and Malta, 
as well as the USA.
Concerning current training in respiratory infec-
tions, we have learned about the following aspects.
●● In most countries, respiratory infections train-
ing is included in the general respiratory training 
(nine out of 11 responses) and respiratory infec-
tions are not recognised as a specialty or sub-
specialty in most countries (11 out of 13 cases).
●● Furthermore, in most countries, there is 
 neither a specific syllabus available for training 
programmes (10 out of 12 responses) nor are 
there any specialised training centres for respi-
ratory infections in the countries investigated 
(10 out of 11 responses).
●● There is no specialty examination available in 
any of the respondents’ countries of work (12 
out of 12 cases) and, although some countries 
make use of written tests, case-based and 
oral examinations (four out of 12 responses), 
in general, there are no specific assessments 
in place (eight out of 12) that are specifically 
 targeted for respiratory infections.
With respect to the current management of respira-
tory infections, we reported on the following aspects.
●● The first diagnosis in adult patients is usually 
performed by the general practitioner (12 out 
of 12 responses).
●● Once a diagnosis has been given, the treatment 
and management of the patients is decided 
either by the general practitioner (four out of 
12 cases) or a respiratory medicine specialist 
(four out of 12 cases).
●● Patients with respiratory infections are mostly 
followed up by the respiratory medicine spe-
cialist (eight out of 12 cases) and then by the 
general practitioner (five out of 12 cases) or 
an internal medicine specialist (five out of 12 
cases).
Objectives, target audience 
and next steps
Following the successful development of 
other HERMES projects (discussed previously by 
De Backer and Simonds [4] and Pitta et al. [5]), 
the Respiratory Infections educational task force 
aims to develop a curriculum for training in respi-
ratory infections. The intended target audience 
is respiratory physicians with a special interest in 
respiratory infections. As a first step in this process, 
the  educational task force has started to work on 
a consensus-based syllabus, listing the knowledge 
and the core skills that are considered central to the 
field of respiratory infections. A web-based Delphi 
technique is currently used as the main method 
to consult a large group of experts in the field of 
respiratory infections, consisting of members of 
the ERS Respiratory Infections Assembly, national 
experts and representatives of ERS membership 
countries. The syllabus will be structured into 
clearly defined modules, such as mandatory and 
optional, according to the paradigm of the previous 
HERMES syllabi. Once established, the syllabus will 
be used as the main input for the development of a 
consensus-based core curriculum. This will include 
the learning outcomes, competencies, assessment 
methods, educational resources and the learning 
opportunities necessary to teach the educational 
content described in the syllabus. The syllabus 
and curriculum will have no legal weight per se 
but will serve as a blueprint to guide and facilitate 
the implementation of a training  programme in 
respiratory infections, based on identified needs 
at a national level. During this process, ERS will 
also seek the collaboration of members of the 
other organisation involved in respiratory infec-
tions, such as the World Health Organization, the 
European Society for Clinical Microbiology and 
Infectious Diseases, and the European Scientific 
Working Group on Influenza.
Acknowledgements
The authors would like to thank Sharon Mitchell 
(ERS, Lausanne, Switzerland) for the groundwork 
on this project.
The members of the Respiratory Infections 
HERMES Task Force are Francesco Blasi (Università 
degli Studi di Milano & Fondazione IRCCS Cà 
Granda Ospedale Maggiore Policlinico Milano, 
Milan, Italy, James Chalmers (University of Dundee, 
Dundee, UK), Felix Ringshausen (Hannover 
Medical School, Hannover, Germany), Michael 
Loebinger (Royal Brompton Hospital, and Imperial 
Introducing a new HERMES project on respiratory infections
Breathe | March 2016 | Volume 12 | No 1 7
College, London, UK), Giovanni Battista Migliori 
(Fondazione S. Maugeri, Care and Research 
Institute, Tradate, Italy), Albert Osterhaus 
(University of Veterinary Medicine, Hannover, 
Germany), Robert Read (Faculty of Medicine, 
University of Southampton, UK), Giovanni Sotgiu 
(University of Sassari, Sassari, Italy), Antoni Torres 
(Respiratory Institute, Hospital Clínic of Barcelona, 
Barcelona, Spain) and Mark Woodhead (Faculty 
of Medical and Human Sciences, University of 
Manchester, and Dept of Respiratory Medicine, 
Central Manchester University Hospitals NHS 
Foundation Trust, Manchester Academic Health 
Science Centre, Manchester, UK).
Conflict of interest
A. Niculescu and J-L. Noel are employees of the European Respiratory Society. Disclosures can be found 
alongside the online version of this article at breathe.ersjournals.com
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