Consulta degli Specializzandi
A stage of graduate medical training
DR. CESARE BALDINI
DR. GIUSEPPE FRANCHINO
DR. RICCARDO PAPALIA
Journées Nationales CliSP
June 30th- July 1st 2011
Paris
In Italy more than 40,000 students are provided with
medical education by attending to 41 Schools of
Medicine.
About 7,500 people enter a School every year, after
passing a highly-competititive selection (local level).
Medical studies last 6 years.
After the degree, medicine graduated have to pass an
examination (both theorical and practical) in order to
get the right to practise the medical profession.
Resident physicians or residents (“medici in
formazione” or “specializzandi” in Italian) are licensed
doctors who have internships in University-owned
hospitals (or in other hospitals/services in agreement
with Universities), under the supervision of tutors
belonging to medical staffs of these hospitals (or
services), following programs fixed by law.
Most residents get their salaries by the Italian Ministry
of University; some by Regional Administrations.
Universities provide medical graduated with 54 different
kinds of residency training programs.
Training programs are divided into three main areas.
- medical
- surgical
- of clinical services
Programs are 5 years long, except General Surgery (6
years).
Selection is local-based (each program in each
University has its own Commission).
Candidates are allowed to do maximum 3
application requests (one for each type of program),
not necessarily in the same University.
Examination consists of two tests: the first one is
based on multiple-choices questions, the second
one on written presentations about clinical cases.
Medical programs:
-
Allergology and clinical immunology
-Hematology
-
Cancer medicine
-Infectious diseases
-
Cardiology
-
Clinical Psicology
-Internal medicine
-Nephrology
-Neurofisiopathology
-
Community medicine
-
Dermatology
-
Endocrinology
-Pediatrics
-
Gastroenterology
-Pneumology
-
Geriatrics
-Reumatology
-Neurology
-Pediatric psichiatry
-Sports medicine
-Tropical medicine
Surgical programs:
-
Chest Surgery
-Oftalmology
-
Ear Surgery
-Orthpedics
-
Heart Surgery
-Urology
-
General Surgery
-Vascular Surgery
-
Maxillo-Facial Surgery
-
Pediatric Surgery
-
Plastic Surgery
-
Neurosurgery
-
Obstetrics and Gynecology
Clinical services
programs:
-Medical Pharmacology
-
Anesthesiology
-Medical Statistics
-
Audiology
-Medical Toxicology
-
Clinical Biochemistry
-Microbiology and Virology
-
Clinical Patology
-Nuclear Medicine
-
Hygiene and Preventive
Medicine
-Nutrition Sciences
-Occupational Medicine
-
Legal Medicine
-Patology
-
Medical Genetics
-Radiology
-Radiotherapy
-Rehabilitation
Decree of the President of the Italian Republic n.162,
March 10° 1982
Decree of the President of the Italian Republic n.341,
November 10° 1990
Decree of the Minister of University,
May 11° 1995
Law n.368, August 17° 1999
Law n.266, December 23° 2005
Decrees of the Minister of University
n. 172, March 6° 2006 and n. 17, January 9° 2008
Salary about €25,000 per year (University taxes escluded)
38 hours weekly
30 vacation days per year
Sickness, maternity and pregnancy allowances are
guaranteed
Residents are forbidden to work as doctors in other hospital
or services (either public or private), except for:
- On-call doctor (Guardia Medica) shifts during holidays,
nights and weekends
- General Practitioner substitutions
About 140 doctors enter a Hygiene Program every
year.
About 500 residents totally.
32 Universities have Schools of Hygiene and
Preventive Medicine.
5 years long.
Activities consist of both lectures and internships.
Except the last year, every year some activities are shared with
Occupational Medicine and Legal Medicine Programs.
Proportion of lectures on total activities: I year 27%; II year 32%;
III year 30%; IV year 30%; V year 15%.
Last 3 years each resident has internship in the following
structures:
◦ Hospital Direction
◦ Prevention and Public Health Department
◦ Primary Care Department
To give kwnoledge and skills of:
Healthcare organization
Prevention programs (screening)
Public health interventions
Promotion of community and individual health
Prevention of enviromental and occupational risks for
human health.
Epidemiological and statistical analysis
Residents are supervised by Tutors.
Tutors are physicians who work in the hospitals/services
where Residents have their internships.
They are chosen by the Residency Program Direction on the
basis of their knowledge, competence and scientific
curriculum.
Aim of the tutorship is to provide residents with specific
trainings and to coordinate the educational program among
different settings.
Tutors are responsable for the evaluation of Residents
supervised by them; internship activities have to be certified
in a dedicated register.
Prevention and Public Health Departments
Primary Care Departments
Hospital Directions
Direction of Local Health Agencies(LHAs)
Universities (research)
Regional Health Agencies (RHAs)
International Organizations/Agencies
-
Study started in April 2011
Italian Hygiene specialists who got their degrees not earlier
than 4 years before were sent questionnaires based on 22
multiple choise questions.
Questions about:
work personal history;
satisfaction with job;
satisfaction with the School of Hygiene attended to;
evaluation of differences between Schools.
At the moment 81 specialists have given their answers
EMPLOYMENT LEVEL
11 %
89 %
EMPLOYED
UNEMPLOYED
SECTOR
17 %
83 %
PUBLIC
PRIVATE
WHERE DO THEY WORK?
2%
2%
15 %
11 %
5%
11 %
30 %
24 %
PREVENTION DEP.
PRIMARY CARE DEP.
HOSPITAL DIRECTION
LHA DIRECTION
UNIVERSITY
RHA
CLINICAL WARD
OTHER
TYPE OF
CONTRACT
TIME NEEDED TO
FIND JOB
11%
28 %
6%
24%
59%
72 %
FIXED-TIME
PERMANENT
< 3 MONTHS
3-6 MONTHS
6-12 MONTHS
> 12 MONTHS
LEVEL OF SATISFACTION
100
80
60
%
40
20
0
YES
NO
WITH JOB
YES
NO
WITH SCHOOL
4
MONTHS
6
YEARS
1. High school degree
3. Medical
license
2. Medical degree
X YEARS
6. Permanent
contract
MONTHS/
YEARS
5. Specialist with
fixed-term contract
5-6
YY
4. Specialist
degree
A long path is needed to become
a Public Health Specialist in Italy
A long path is needed to become
a Public Health Specialist in Italy
However, this field provides Specialists
with a high level of satisfaction
A long path is needed to become
a Public Health Specialist in Italy
However, this field provides Specialists
with a high level of satisfaction
Public Health in Italy seems to be
increasingly oriented on
the Health Care Management
THANKS FOR
YOUR ATTENTION