First published in 2006, the first European core syllabus in Adult Respiratory Medicine was developed with the intention of harmonising education and training throughout Europe. Internationally recognised by the European Union of Medical Specialists and identified as the first document of its kind in respiratory medicine, it has provided a comprehensive guide for both local and national institutions in the development of adult respiratory training programmes.Like all fields in education, respiratory medicine is an ever-changing area and as such, respective syllabi, curricula and training programmes must adapt and diversify in line with the evolution of core medical concepts. Given the proven importance of the Adult Respiratory Medicine syllabus from both a national and international standpoint, it is of equal importance that said syllabus remains abreast of emerging trends so as to sustain the synchronisation of respiratory medicine in Europe. In order to develop an updated programme, a comprehensive review process of the current syllabus is a necessary endeavour and a step that the European Respiratory Society (ERS) has undertaken through the process of a needs assessment.

pictures of identifiable patients unless we have their permission or the permission of their next of kin. In the case of Tony Bland his parents had given permission for the press to reproduce his picture. They will have had their own reasons for taking that decision, but we believe that publishing a picture ofhim adds importantly to the information available in words. Some doctors have never seen a patient in a persistent vegetative state. Another reason for publishing pictures is to distinguish one section of the journal from another. We rarely publish pictures, tables, or graphs in the editorial section, and we do not add pictures to the original papers. We deliberately include them in the news section to give this section a different identity. These pages are designed to look "newsy," which means including pictures. Newspapers carry pictures, and so do journals like Nature, Science, and the Economist. Sometimes these pictures will not be as relevant as we would like. But this problem is experienced by all publications putting together news pages fast. What J K Anand and J W Myles may not understand is that the BMJ is the most general of the world's general medical journals. Few general practitioners read either the Lancet or the New England