Speciality Training Grants in Italy at Risk of Not Being Assigned
According to Antonio Cucinella, president of Young Doctors for Italy, working in the public sector as a doctor in Italy means giving up having a personal life. Staff shortages and long working hours are pushing young doctors away from choosing to work in public hospitals, and this trend is expected to worsen as one in four medical specialization grants risks not being assigned this year.
Currently, out of a total of 16,165 specialist training places, only 11,688 have been filled. The situation is particularly worrying in emergency medicine, where only 31% of allocated contracts have been assigned. This shortage is not limited to emergency medicine, as many other specializations that offer limited options in private healthcare have also been affected. The lack of candidates for certain specializations has led to a disproportionate increase in scholarships, resulting in an excess of specialists in fields such as ophthalmology and plastic surgery, but a shortage of emergency room doctors.
The associations of Young Doctors for Italy, Anaao Young, and Association of Free Specialists (Als) have criticized the Ministry of the University for not finding effective solutions to redistribute candidates among different schools and attract more doctors to areas with shortages. Giammaria Liuzzi, the national manager of Anaao Giovani, points out that the data regarding emergency room doctors are particularly shameful, with 70% of grants not being awarded. At the current rate, Italy has only one specialist for every 100,000 people, posing a threat to the national healthcare system.
Before the COVID-19 pandemic, the number of scholarships for specialist training was significantly lower than the number of graduate school candidates. This led to a progressive decrease in specialized medical personnel and worsened working conditions in hospitals. In response to this issue, the number of contracts has increased in recent years, exceeding the number of candidates in some cases. However, this increase has not been accompanied by a redistribution of candidates or focus on addressing the shortages in specific areas.
The lack of medical staff, especially in departments such as the emergency room, has a cascading effect on the working conditions of professionals and their subsequent departure from hospitals. This perpetuates a vicious cycle that negatively impacts patient care. Liuzzi emphasizes the need for immediate intervention, particularly in emergency medicine, to prevent the collapse of the first frontier of the national healthcare system. He proposes reforms to the specialization system, including training-work contracts that provide better conditions, protections, and salaries for trainees.
Associations representing students, doctors, and postgraduates have already protested on September 25th and are considering a strike if their demands are not met. They argue that if they do not act, patient mortality rates may increase, as witnessed during strikes by young doctors in the United Kingdom. The associations call for short-term solutions, such as extending the deadline for starting service and increasing the number of scholarships assigned. Without these measures, potential trainees may not have enough time to enroll or find accommodation in the city where they have been awarded a scholarship.
The current situation for trainees is precarious, with net pay averaging around 1200-1300 euros per month after deducting various fees. Trainees often face long working hours and are treated poorly within the system. They are caught in a limbo between being considered workers and students, making it difficult for them to secure mortgages or financing.
Immediate action is necessary to address the pressing issues faced by medical specialists in Italy and ensure adequate healthcare services for the population.