Medicine and universities, the outlawed specialization schools: what they are and why | Milena Gabanelli

To become a surgeon, gynecologist, pediatrician, neurologist, orthopedist, after graduating in Medicine you need to do 4-5 years of specialization school. At the beginning of November 18 thousand new trainees will begin the courses, in addition to the other 34 thousand who are already attending. Land Postgraduate schools accredited by the ministries of health and the university today are 1,326. The requirements are: competent professors, adequate number of tutors, equipped laboratories, hospital wards connected to schools to guarantee specific training with a minimum number of surgeries performed. These standards were defined, for the first time, in 2017 with a decree wanted by the then ministers Beatrice Lorenzin and Valeria Fedeli. Accreditation can also be given on a provisional basis to schools that do not meet all the requirements, as long as they guarantee to comply within two years with the presentation of an adaptation plan (art.8, legislative decree 402/2017). Who has to decide who qualifies and who does not have the National Observatory for Specialized Health Training (established in 1999), and which depends on the ministry of the University.

So things got better, but only halfway. Here is what emerges from the questionnaire that the Ministry of the University published in April 2021 to monitor the condition of the Specialty Schools (here) and to which about 11,000 postgraduates answered anonymously. In 79 schools, at least two thirds of the trainees declare that they have never, or rarely, had a compulsory tutor by law every three trainees. To the question: Did the school offer a formal didactic activity in line with the training plan? In 42 schools, more than two thirds said no. Those in training must rotate between departments of different hospitals in order to have a training network that allows them to have a varied experience: the postgraduates declare that in 7 schools there is no network, in 31 they do not send them to us. In return in 267 schools, trainees declare that they are obliged to work over 38 hours per week because they are forced to cover the shortage of staff.