Home » Missing doctors, because eliminating the limited number in Medicine is useless | Milena Gabanelli

Missing doctors, because eliminating the limited number in Medicine is useless | Milena Gabanelli

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Missing doctors, because eliminating the limited number in Medicine is useless |  Milena Gabanelli

Whenever there is talk of doctors who are missing, the limited number of Medicine is brought up as the cause of the problem. At a time when staff shortages are the real emergency of the nITbecause they affect the attestation list and do not assure us of being assisted quickly and in the best possible way, the eternal question returns: why don’t we abolish the closed number a Medicine? Deputy Prime Minister Matteo Salvini is also convinced that it is better to eliminate him, who reiterated during the election campaign: Let’s cancel it to make up for the shortage of doctors (who). a position that mirrors the thought of most of the students which collide with it barragealso considered an obstacle to expectations about your future. Let’s see how things really are.

Because the closed number was born

The limited number is established by law 264 of 1999 of the then Minister of Education Hortensius Zecchino which links the number of places in Medicine to the availability of classrooms, teachers, laboratoriespossibility of internships and student participation in mandatory training activities. The reasons for the choice are mainly two: to guarantee future doctors the best training possible – who has to deal with the availability of teachers who teach and patients to visit – e don’t churn out too many unemployed. Thus, every year the universities notify the university ministry of the number of places available. Simultaneously the State-Regions Conference collects data on the need for doctors who will be ready to enter hospitals in 10 years. At this point a program table is opened between the ministry and the State-Regions Conference in which they are defined university places per university.


The State of Milan last 410 places in 2013 a 515 in the 2022; the Sapienza e Tor Vergata from Roma respectively from 908 a 1.156 it’s yes 240 a 290; Bologna and 400 a 614; Firenze and 330 a 378; the Frederick II from Napoli and 413 a 623. If instead there hadn’t been the limited number and if today it was eliminated, Would the situation be different and could we have the doctors we need? No. That’s why.

Training funnel

The problem is not the limited number in Medicine, but what happens afterwards. Between 2013 and the 2018 are 51,369 new graduates in Medicine solo 43.748 were able to complete the course of study entering the Graduate schools (36,733) or by attending i corsi from training triennial for family doctors (7.015): it means that at least 7.621 they have not had the opportunity to do either.

The number of places made available is undersized for economic reasons both with respect to the future need for doctors and with respect to the number of recent graduates

The training of a specialist costs the state from 102 thousand to 128 thousand euros and weighs on the budgets of the moment. In a document of the State-Regions Conference of 21 June 2018 reads: For the 2017-2018 academic year the requirement estimated of doctors equal to 8.569 unitwhile the resources available for the same year allow for funding from the State budget of 6,200 specialist training contractswith a difference of 2.369 unit. The significant negative gap between the needs of doctors and what can be concretely satisfied with state resources was also recorded in previous academic years. The phenomenon destined to produce a shortage of doctors specialized for the NHS. Thus far, therefore, the problem is the so-called training funnel.
Poor programming

Then things change: as we have seen since 2019 i rectors of universities are committed to guaranteeing more places a Medicine (4.961 more in 2022 compared to 2018i.e. the 50% more). And at the same time the places in the Specialty schools (7.091 more between the 2018 and the 2022i.e. more than doubled) and in the three-year courses for family doctors (1.313 in pi dal 2018 al 2022pi 60%). But, as we have already denounced in a recent Computer room (here), faced with the possibility of a wide choice, the places in the Specialties that are most needed are not filled: to 7 November the 58% of places in Emergency Medicine-Urgency discoveredin Anesthesia e Resuscitation il 21,5%; in Radiotherapy il 73,5%. Now, therefore, one of the main problems is being able to make the doer programming (the Ministry of Health) and who bans i places in graduate schools (the Miur) balances the offer by reducing, for example, the places in the specialties that are not needed and which are often the most in demand. It is urgent to correctly calculate how many doctors and for which specialties will be needed 4-5 years that the time it takes to form new specialists.

Quality selection

Therefore, eliminating the limited number would not solve the problem of the lack of doctors. Stay, for, there anger of the students who can’t get over the Entry test and that they see theirs broken dream to enter the lane. this is the reason why it is essential that the selection criteria for those entering Medicine are the best possible: the entrance test cannot be a lottery. In the 1999 proof of 90 questionsthen from 2000 al 2012 from 80 and from 2013 to today of 60. Every correct answer counts 1.5 pointsthe wrong ones -0,4those in white 0.

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The test has been modified almost every year: the understanding and logic part has decreased and the one concerning the questions of scientific disciplines has grown

But there has been no shortage of ridiculous questions over the years that have nothing to do with identifying the skills you need to become a good doctor.

How does the entrance exam change?

From 2023 the test changes again on the decision of the Draghi government: decree 1107 of 24 September 2022 (here) double the test sessions – which will be two a year and no longer one – and will be held to April e July 2023. In addition, not only those who are doing the can participate high school graduation or has already done it, but all subscribers at last or penultimate year of high school that they will be able to enter their own best score in the platform where it will be drawn up there ranking.


The goal is to make sure that the entrance test is no longer a lottery. Also because the more the number of places in Medicine is increased, the more it is destined to decrease the quality of the candidates who will then be our doctors from tomorrow. The new government will have the task of implementing the reform.

November 24, 2022 | 07:07

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