The HERMES Examinations in Adult and Paediatric Respiratory Medicine have served as the standard of knowledge-assessment for respiratory specialists at a European level, and are recognised worldwide within the profession.

Questions are based on European syllabi in respiratory medicine whereby each question undergoes a rigorous process of formulation and validation by European representatives who ensure that current, as well as authentic professional, situations are illustrated.

The annual, online multiple-choice examination is in English, with 51 CME credits assigned to the European Diploma examination category and 6 CME credits assigned to the Self-assessment and In-training categories.

The Swiss Society of Pulmonology (SSP) as well as The Swiss Society of Paediatric Pulmonology (SSPP), have both adopted HERMES exams as their mandatory written exit exam for final-year trainees in respiratory medicine.

ERS have partnered with CYIM and ProctorU to deliver the examinations online, providing convenience and easy access to the HERMES exam, but there are particular guidelines that a candidate must adhere to, before they are ready to participate on the HERMES exam.

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Examination categories

European Diploma

If you have completed your national programme or are in your final year of speciality training, you are eligible to join a highly qualified group of respiratory professionals from across Europe as a Diplomat. A Diploma is proof of excellence in the field which demonstrates commitment to life-long learning, can boost your mobility, and enables you to self-assess as a professional.


If you are currently working towards your national qualification you can use this examination to know where you stand in your current level of training, measure yourself against European standards and focus your learning as you move forward.


If you are a qualified doctor, this examination can help you to keep up to date with the latest best practices, strengthen your professional development and learn more about the field.

Examination structure

The examination is 3 hours long and composed of 90 multiple choice questions and delivered only in English.

The examination is divided into 2 parts: A type questions and K-prime questions.

Type A question 

5 answer options; 1 answer is correct.

Mark only one answer for each question:

  • In positively formulated questions mark the only correct or the most appropriate answer.
  • In negatively formulated questions mark the only exception, the only incorrect answer, or the answer that appears least appropriate.

Example of positively formulated A-type questions:

A 4-month-old boy was admitted with severe bronchiolitis. He required nasal CPAP (Continuous Positive Airflow Pressure) and 50% oxygen to maintain adequate saturations. He was discharged home after 7 days. Over the next 18 months he continued to have recurrent episodes of respiratory difficulty and wheeze whenever he had an intercurrent respiratory tract infection. These episodes were not responsive to short courses of oral corticosteroids or inhaled bronchodilators. His chest X-ray showed patchy areas and persistent hyperinflation. He was wheezy even between acute episodes.

Which of the following was the most likely cause of his persistent symptoms?

(A) Adenovirus type 7
(B) Chlamydia trachomatis
(C) Human metapneumovirus
(D) Mycoplasma pneumoniae
(E) Respiratory syncytial virus

Correct answer: A

Type K-prime

4 answer options; 0–4 correct answers

For each answer option, the candidate must decide whether it is true or false, then mark each decision appropriately with a (+) for true or a (-) for false.

Marking all four answers correctly results in 1 point, 3 correct marks result in 0.5 points.

Example of Type K-prime question:

K1. Which of the following statements concerning benign asbestos pleural effusion is/are true?

(A) The presence of hemorrhagic fluid almost always indicates malignancy.
(B) The latency period between exposure to asbestos and onset of disease is the same for mesothelioma and benign pleural effusion.
(C) It rarely produces diffuse pleural thickening.
(D) The predominant cell on cytologic examination of pleural fluid is the lymphocyte.

Correct answer: – – + – (i.e. A, B, D false; C true)

Curriculum Structure and Blueprint:

  • The examination tests knowledge and applied knowledge only.
  • The examination is designed using the consensus-based European syllabus in respiratory medicine, published in Breathe.
  • The questions selected for the examination are mapped to the examination blueprint.
    This blueprint shows all topics covered in the examination and the average percentage of questions devoted to each of these topics.
  • The blueprint is divided into the following dimensions (see below for more details):


The examinations are accredited by the European Board for Accreditation in Pneumology (EBAP).

CME credits

For an additional €10, you can obtain EBAP CME credits for sitting the examination.

You will receive:

  • 51 CME credits if you sit and pass the European Diploma examination.
  • 6 CME credits if you sit the In-training or Self-assessment examination, or you sit and fail the European Diploma examination.

Exam Scoring and Results

  • One (1) point is awarded for each correctly answered question.
  • Half-a-point (0.5) is awarded for 3 correct decisions out of 4 in case of K-prime question.
  • There is no negative marking for incorrect answers.
  • An unanswered question is considered incorrect.
  • After the examination, all answers are sent to an independent partnering institution (Institute of Medical Education (IML), University of Bern, Switzerland) for results evaluation and statistical analysis.
  • A 3-round statistical analysis with key validation and decision to keep or eliminate questions with low performance is done by the Examination committee in collaboration with the Institute of Medical Education. Based on this, the passing score is set.
  • To pass the European Diploma examination, candidate must score a certain number of points equal or higher than the passing score set by IML.
  • All documents will be uploaded to each candidate’s myERS online platform within 4–6 weeks after the examination takes place. You will also receive a notification email. These documents include:
    • Official result letter (including subscore results)
    • Certificate of attendance
    • Certificate of CME (if requested during registration)
    • HERMES certificate (successful Diploma candidates)