In a decade, Italy risks having up to 10,000 more doctors each year than it needs, transforming the serious shortage of white coats that tragically emerged in these pandemic years into a plethora of unemployed. The new “Tolc” tests will begin in these days for the almost 80,000 candidates who dream of winning one of the 14,787 places up for grabs for Medicine and which the Minister of the University Anna Maria Bernini aims to grow by another 30 percent.
In ten years the need for white coats will drop
But the risk of the bubble is just around the corner due precisely to both the constant increase in places in medicine degree courses which could explode if the limited number were removed as many are asking even within the Government, but also due to the fact that new doctors will be ready only in 10 years (between degree and specialization) and therefore coinciding with the collapse of the retirement outgoings of doctors from the Health Service which between 2033 and 2036 will drop to just over 2 thousand a year, reducing the need of new white coats. A paradox if one thinks instead of the serious shortage of doctors in recent years which instead coincided with the maxi exodus of retirements which takes place between 65 and 67 years of age and which will end with the expected peak in 2026 with 5 thousand retirements.
The study that compares inputs and outputs
The training of new doctors is a topic to be treated with great delicacy as also underlined by a study developed by Anaao Assomed, the main hospital union, which has estimated as early as 2030 32,000 more graduate doctors than retirees. In fact, the study calculates that from 2021 to 2030 – according to the data contained in the Annual State Account as well as by Onaosi and Enpam – around 113,000 doctors will be retired. If the 145,000 students enrolled in Medicine in the period 2021/2030 estimated with unchanged programming (as the average of accesses scheduled for 2021/2022/2023 projected over 10 years) are subtracted from this number of retirements, we obtain this first surplus of graduates in Medicine.
The training funnel without scholarships
But this is only the first cap, because then there is the risk that, as in the past, a new training funnel will be created after graduation if, compared to the 14,000 graduates a year, there will not always be the same number of scholarships for medical specialization (which lasts from 3 to 5 years old) which are an unavoidable step for every white coat who wants to work in the hospital or in the local area, for example as a family doctor. Among other things – still warns the study by Anaao – if places continue to increase by 30% as promised by the university minister without costly intervention on postgraduate training courses, there is the risk of creating “between 6 or 7 years, a new training funnel and subsequently, as the current restrictions on the hiring of healthcare personnel persist, a job funnel, with about 19,000 graduates every year against a postgraduate training offer that stands at 16,600 – of which 14,500 are specialist training contracts and 2,100 scholarships for training in general medicine. And this will only further encourage doctors to emigrate to European or non-European countries”.
Long-term planning and strategy required
In short, increasing the number of places in Medicine “indiscriminately and without serious planning based on needs and retirement expenditure risks resulting in a waste of resources, especially in the absence of employment prospects in Italy”, he warns Charles Palermo president of Anaao and one of the authors of the study. It could be a different matter if, faced with a large increase in medicine places, “a maxi plan to strengthen the workforce was already started today to deal with new health emergencies or to fill the new structures in the area envisaged by the Pnrr or perhaps because we want to give an answer to the health needs linked to the epidemiological pressure induced by the progressive aging of the population», adds Palermo. “But – he concludes – it doesn’t seem to me that these tears are visible on the horizon”