Schools of medical specialty in crisis. According to research by Anaao Assomed and the Anaao Youth Sector, the “hospital and public” specialties that have been protagonists in the pandemic fight, first of all emergency medicine, are undergoing a contraction that will already undermine the precarious balance of healthcare in Italy. THE worst data are those relating to Friuli Venezia Giulia where almost 30 percent of the state contracts announced in the last two specialization competitions (2021 and 2022) have not been awarded. In addition, the abandonment of assigned contracts stands at 7 per cent. By “unassigned contracts” we mean a contract that in the insolvency proceedings has not been assigned to any doctor because no one has chosen him. Abandoned contracts mean a contract that has been awarded but the doctor assigned has tried the competition again the following year and has changed specialization through a new assignment.
From the table with the subdivision of the amount of unassigned and/or abandoned contracts divided by Italian regions, it appears that the total amount of dispersed contracts is between 11 per cent in Sicily and 36 per cent in Friuli Venezia Giulia with a median of 20 percent.
At the national level, the data on the amount of unassigned and abandoned contracts divided by specialization are significant as well as alarming. It is interesting to note that all the branches that have been the most requested during the pandemic have the greatest amount of unassigned and abandoned contracts: emergency-emergency medicine will have 1144 fewer specialists compared to the 1884 contracts allocated (60.7%) , Microbiology 191 less than 244 (78.3%), Clinical Pathology and Clinical Biochemistry 389 less than 554 (70.2%). On the other hand, there is total use of specialization contracts relating to Plastic and Reconstructive Surgery, Ophthalmology, Diseases of the Cardiovascular Apparatus.
This is the comment of the national secretary Anaao Assomed Pierino Di Silverio: “The signal comes clear and strong, corroborated by the numbers: medicine is becoming a selective affair, in which the specialties most affected and under pressure during the Covid-19 pandemic, the specialties burdened with greater burdens and less honors are in free fall , they no longer have appeal. It is not a problem for doctors, but for specialist doctors and it is a problem that will have inevitable repercussions on the future of a system of care that is increasingly in crisis. The absence of planning and the absence of investment in the professional produces devastating effects, risking desertifying some branches and being in deficit in others”. According to Di Silverio it is necessary to have: “Adequate wages, decriminalizing the medical act, increasing hiring and eliminating the ceiling on personnel expenditure which still acts today as a trap on regions and companies by subsidizing piecework. It is necessary to integrate and give a role to postgraduates, the real driving force of an old and tired system “.