Introducing an updated international ERS syllabus for postgraduate training 2017Setting standards for training and certification in respiratory medicine.

At #ERSCongress 2017, @ERStalk introduces an updated international syllabus for postgraduate training http://ow.ly/jEvG30erKKx.

Rationale and purpose

Within the European Union, we are bound by the free movement of medical professionals across borders, yet the provision of education, certification and indeed maintenance of certification vary widely across Europe. Providing standards for training, certification and, perhaps in the future, an international guide for lifelong learning in respiratory medicine can have a direct and measurable impact on patient care.

Adult respiratory medicine specifically refers to the medical specialty of treating adult patients with respiratory diseases. The organisation and structure is complex and the role of the European Respiratory Society (ERS) at an international level requires careful consideration of:The purpose of the ERS syllabus for postgraduate training in adult respiratory medicine is to provide a framework and structure of what content should be covered at the level and for the specific target audience of trainees.

different target audiences, including trainees in respiratory medicine, trained specialists and those working within a specific field of respiratory medicine, as well as our allied health professionals all who play a key role in this specialty area

different levels of education required for each target audience

existing national educational structures for training and certification

Background

The first European core syllabus in adult respiratory medicine was published in 2006 with the aim to harmonise education and training throughout Europe. This document marked the first of its kind in respiratory medicine to propose a guide to local and national training institutions on what knowledge and skills should be included for training in adult respiratory medicine [1]. Since its publication, this document has been used as a reference internationally through recognition of the European Union of Medical Specialist, for example, and at national and local levels by training institutions and programme directors.

Under the ERS “HERMES” initiative, several important educational activities emerged with the ambitious goal of harmonising education in respiratory medicine for European specialists at postgraduate level.Adult respiratory medicine is a well-structured and arguably well-developed specialty area. Within Europe, notwithstanding Russia, it is a recognised specialty with national standards for training and certification [6]. The focus of the 2017 syllabus in adult respiratory medicine is to provide a framework for training content for national, local and international institutions to follow. While this framework may also be useful as a guide for educational activities for trained specialists, its intended purpose is to focus on the organisation of training for trainees in respiratory medicine. For these reasons, ERS has chosen to focus on the provision of knowledge-based educational activities to complement existing national structures that have their own systems of skills-based activities, such as simulation training, mentoring and feedback, portfolios, and skills-based assessments.

A curriculum catalogue of knowledge, skills and attitudes further elaborate on the modules put forward within the published syllabus [2].

The ERS HERMES examination was launched in 2008 with the purpose of standardising the certification of knowledge for those exiting national training programmes in adult respiratory medicine [3].

The ERS HERMES summer school was established to provide an overview of the key areas of respiratory medicine, as an overall update and to support those preparing to sit the ERS HERMES examination.

The accreditation of training centres in adult respiratory medicine sought to raise standards of training through the assessment of quality assurance. The two-step approach of self-report and site visits was launched in 2012, providing an international benchmark to training centres on the minimum acceptable criteria required to provide training in adult respiratory medicine

Educational resources, including the first edition of the ERS Handbook of Adult Respiratory Medicine in 2010 [4] and the ERS Handbook: Self-Assessment in Respiratory Medicine [5], have also developed as direct initiatives in the goal to harmonise training for respiratory medicine specialists.

The 2017 syllabus in adult respiratory medicine

It is hoped that the new and updated syllabus (table 1) will ensure that emerging fields of respiratory medicine, and updates in diagnosis, management and treatment practices since the initial 2005 publication have been accounted for. It covers all major disease areas apart from paediatric respiratory medicine, which has its own syllabus [7]. The content has also been restructured into fewer modules and a more simplified structure to allow ERS and other institutions using the ERS syllabus in adult respiratory medicine as a guide for educational design and planning of teaching and learning, assessment and resources activities. Table 1 outlines each of the core modules of the ERS 2017 syllabus in adult respiratory medicine.

Table 1

Adult respiratory medicine: updated syllabus modules

Module 1	Structure and function of the respiratory system
Module 2	Physiology and pulmonary function testing
Module 3	Diagnostic approach
Module 4	Diagnostic procedures
Module 5	General principles of treatment modalities and prevention measures
Module 6	Respiratory emergencies
Module 7	Airway diseases
Module 8	Respiratory infections
Module 9	Mycobacterial diseases
Module 10	Thoracic tumours
Module 11	Sleep and control of breathing disorders
Module 12	Respiratory failure
Module 13	Diffuse parenchymal lung diseases
Module 14	Pulmonary vascular diseases
Module 15	Diseases of the chest wall and respiratory muscles including the diaphragm
Module 16	Pleural and mediastinal diseases (excluding tumours)
Module 17	Respiratory consequences of systemic/extrapulmonary conditions
Module 18	Genetic disorders
Module 19	Occupational Diseases
Module 20	Epidemiology, environment and lifestyle

Next steps

The 2017 adult syllabus is not only intended as a framework internationally but will also be used internally by ERS to build on the next stages towards the development of structured training and assessment activities for ERS members. ERS will continue to build a complementary framework for continuous professional development within adult respiratory medicine for our trained specialists. It is intended that such activities will provide a structure for existing and new teaching and learning activities.

It is planned that the full syllabus will be published within Breathe in March 2018. Watch out for updates during the ERS International Congress 2017 in Milan, Italy, and communications launching this official publication!

G. Rohde EDU-0107-2017_Rohde