Respiratory Critical Care HERMES: a European core syllabus in respiratory critical care medicine

Europe is now referred to as borderless; over 400 million Europeans from 25 countries can travel throughout the European zone without bureaucratic obstacles at internal borders. Moreover, for the economy as well, free movement is central to the success of the single market [1]. From a medical perspective, the unification of Europe has resulted in an increasing number of physicians crossing borders and practicing in different countries. In order to ensure and maintain a high level of healthcare across Europe, the European Union (EU) has displayed its intent to achieve a harmonised definition of medical education and training. The EU adopted a directive (2005/36/EC) dictating the equality of diplomas and medical board certificates within the EU. Despite a number of initiatives such as the “Lifelong Learning Programme: education and training opportunities” for which the ERASMUS (European Region Action Scheme for the Mobility of University Students) is a sub-programme aimed at harmonising medical education during the early phases of medical training [2], there is a need to standardise knowledge and skills at later career stages, in order to guarantee and harmonise the quality of patient care in 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 dealing with respiratory failure which does not need direct access to general, medical or surgical intensive care units. Throughout Europe, respiratory medicine specialty training includes at different levels of competence, knowledge of treatment of acute respiratory care, noninvasive mechan- ical ventilation, and general principles of intensive care based on the responses of a survey discussed later in this article, critical care medicine is a subspecialty of pulmonology or respiratory medicine in general or internal medicine, and not a specialty of its own. The overall opinion from the survey participants is that there is a need in Europe for a standardised training in respiratory critical care medicine. To address this, the European Respiratory Society (ERS) supported a project within the framework of the HERMES (Harmonised Education in Respiratory Medicine for European Specialists) initiative. Thus, the respiratory critical care HERMES project was launched and aims to provide educational standards and a training framework for respiratory critical care medicine. This is consistent with the ERS mission and has the ultimate goal of providing better patient care.