Introduction iv In recognition of the increasing demand for education and revalidation in respiratory medicine, the European Respiratory Society (ERS) has initiated the Harmonised Education in Respiratory Medicine for European Specialists (HERMES) project. The aim is to promote the highest possible standards of practice in the specialty and to improve harmonisation of training across European countries. The HERMES project has been implemented by ERS Education through a task force coordinating inputs from representatives of more than 52 countries. After describing the knowledge and skills a European Respiratory Specialist should have (see the index to this book)1 and delineating requirements for the core training curriculum2,3, the further phases of the project include assessments and accreditation of training centres4,5. The European Examination in Adult Respiratory Medicine is one of the assessments developed within the HERMES project4,5. It is a knowledge-based test evaluating topics outlined in the European syllabus. The examination consists of 90 multiple-choice questions (MCQs) to be solved within a 3-h examination session. Practising respiratory specialists holding a national accreditation and aiming to receive a European Diploma are eligible to take the examination. An increasing number of trainees undergoing specialist education, as well as postgraduates who wish to evaluate their knowledge, have now taken the examination. All participants receive a detailed analysis of their performance in different areas of the  eld, but the Diploma is reserved for nationally accredited practising specialists in respiratory medicine. The MCQs selected for the HERMES examination are created by a panel of authors from various countries and settings, i.e. from academic centres, community hospitals and specialist practice. The authors undergo special training in order to produce valid questions. The HERMES examination committee evaluates each new question during workshops and selects those meeting high standards in terms of clinical relevance, unambiguous scientic accuracy and formal aspects. Only questions passing this evaluation are subsequently incorporated into examinations. Questions are further assessed for their difficulty, selectivity and formal suitability. The pass/fail limit of each year’s HERMES examination is set according to predened rules. They incorporate difficulty scores given by committee members for each question reecting the likelihood of a minimally qualied examinee answering any particular question correctly (Angoff method) a calibration is also performed by comparison of performance in a set of previously used questions (Rasch equating). Thus, rather than targeting any particular pass rate, the pass limit is set at a level that assures that successful candidates demonstrate a high level of knowledge. In response to requests from candidates preparing for the HERMES examination as well as from practising respiratory physicians, the ERS Education Council has prepared this handbook. It is a collection of MCQs with answers and comments intended to be a self- assessment companion to the ERS Handbook of Respiratory Medicine5,6, which contains a systematic discussion of topics relevant for the specialist in adult respiratory medicine. We are fully aware that many respiratory professionals at all levels from senior specialists to junior trainees wish to test their knowledge personally without necessarily embarking on the HERMES examination. The MCQ handbook meets that need in a constructive didactic way. The broad range of topics is selected from the syllabus and the relative representation reects the weights attributed by the examination committee to the different topics,