by C.De Virgilio Suglia, GS Dalle Luche, V.Lavecchia, F.Maffettone, A.Giusti
30 SET – Dear Director,
we are the representatives of Community Medicine and Primary Care specialists (MCCP) of the Universities of Bari, Bologna, Modena and Reggio Emilia, Naples and Padua. Usually we do not intervene in political-trade union issues, however after reading the recent article of 27 September on the FIMMG document, which states that “the Community Medicine course is centered on a hygienist type approach”, It seemed appropriate to illustrate the training course of our Specialization School, which is sometimes not yet well known.
The School of Specialization in Community Medicine and Primary Care is a discipline of the Medical Area inserted by the Ministry of Health in the class of General Clinical Medicine (as well as Pediatrics, Internal Medicine, Geriatrics, etc ..). It is therefore not part of the Services area, like Hygiene and Preventive Medicine.
It was established by the MURST Decree of 3 July 1996 with the aim of training specialists in the professional sector of family and community medicine suitable for covering management roles in the area of primary health care.
As stated in the Interministerial Decree no. 68 The Specialist in Community Medicine and Primary Care has theoretical, scientific and professional knowledge in the fields of diagnosis, treatment and rehabilitation of acute and chronic diseases with particular reference to the context of the primary care network; I am, therefore, specific areas of professional competence primary care and general medicine, together with the organization of local services such as community homes, districts, UCCPs, palliative care networks, community hospitals, home care and telemedicine services.
The Ministerial Decree of 11 August 2020 makes the Specialization in MCCP equivalent to the discipline of Palliative Care, allowing MCCP Specialists to exercise clinical activities of palliative care and pain therapy.
To achieve these learning profiles, our Learning Plan is organized in 4 years, with training structured as follows:
– 2/3 in the area and 1/3 in the hospital;
– 2/3 clinical and 1/3 organizational.
Hospital attendance (about a year and a half) is mainly centered in the internist departments, emergency-urgency and in outpatient clinics for chronic pathologies; as regards, instead, territorial training (lasting 2 and a half years), the main cornerstones are represented by the General Practitioners’ Outpatient Clinics, territorial palliative care and the Departments of Primary Care / socio-health districts.
Since our training path is structured in this way, at this point we ask ourselves: why we are not allowed to practice General Medicine, despite the fact that there are two Interministerial Decrees mentioned above and the opinion of the Hygiene and Health Commission of the Senate of 23 March 2021 which recognize Medicine General among the areas of competence of the MCCP Specialist?
We also remind you that the School possesses the minimum requirements for the practice of General Medicine in accordance with the European Directive 2005/36 / EC relating to the recognition of professional qualifications (Art 28 paragraphs 3-5 on General Medicine). Why was this directive not implemented by Legislative Decree 368 of 1999 and subsequent amendments?
Because the major trade union exponents believe that university training is not suitable for training specialists in General Medicine, despite the academic pathway training many specialists working in the area (such as pediatricians) and despite the fact that in most other European countries there is training university for General Medicine?
The MCCP specialist is a physician trained for the territory and, according to current legislation, can today operate with clinical and organizational roles as:
1. medical director, in the organization of basic health services in primary care departments and districts and in palliative care and pain therapy;
2. outpatient specialist, in health homes (chronicity clinics), community hospitals, community pediatrics, hospices, etc.
In light of the PNRR and its reform impulse, we ask that the provisions of DIM 68 and the European Directive be applied and that we also exercise general medicine in the role of medical management.
For this reason, we ask the Minister of Health, the Minister of University and Research, the President of Fnomceo, the President of the Conference of Regions and Autonomous Provinces and the Coordinator of the Health Commission in the Conference of Regions to intervene to remedy this whole regulatory vulnerability. Italian.
Dr. Cesare De Virgilio Suglia
MCCP Trainee Representative Bari
Dr. Georgia Santos Dalle Luche
MCCP Trainee Representative Bologna
Dr. Vincenzo Lavecchia
Representative of MCCP students in Modena and Reggio Emilia
Dr. Francesco Maffettone
MCCP Trainee Representative Naples
Dr. Arianna Giusti
MCCP Specializing Representative Padua
September 30, 2021
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