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The missing doctors, because eliminating the limited number in medicine is useless | Melina Gabanelli

Whenever there is talk of missing doctors, the limited number of medicines is brought up as the cause of the problem. At a time when staff shortages are the real emergency for healthbecause it affects waiting lists And do not reassure us that help will be received quickly and in the best way possible, the eternal question returns: why don’t we cancel Closed number to me medicine? Deputy Prime Minister Matteo Salvini is also convinced that it is better to eliminate him, who repeated during the election campaign: let’s abolish it to make up for the shortage of doctors (over here). position reflects Think than most the students who collides with it hailis also considered an obstacle expectations about your future. Let’s see how it really goes.

Because the closed number is born

The limited number was determined by Law 264 of 1999 by the then Minister of Education Hortensius Zicino Which relates the number of places in medicine to availability ClassroomAnd the teachersAnd the labsPossibility training Student participation in Mandatory training activities. The reasons for choosing are mainly two: to ensure future doctors The best possible training – Who has to deal with the availability of teachers who teach and patients to visit – e Not many unemployed people. Accordingly, universities each year notify the University Ministry of the number of available places. At the same time State and Territories Conference It collects data on the need for doctors who will be ready to be admitted to hospitals within 10 years. At this stage, a program schedule is opened between the Ministry and the Conference of Regions and States as they are determined University places for each university.

Candidates and number of places

How it was in the past ten years in 42 public universities and in 7 private universities How did they come? until the 2018 on me 60 thousand candidates just enters 1 on me 7 Which means up and down 15th%. From 2019 Enter candidate on me 4Which 25%because the places are increasing from 9 thousand About 14,740 In the 2022.


there Milanese state pass by it 410 places in 2013 to me 515 In the 2022; there wisdom And the Tor Vergata From Rome straight from 908 to me 1,156 And from 240 to me 290; Bologna From 400 to me 614; Florence From 330 to me 378; there Frederick II From Naples From 413 to me 623. If not there is the rather limited number, and if it is discarded today, Would it 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 after that. between 2013 and the 2018 on me 51,369 new medical graduates lonliness 43748 were able to complete Course of Study Entry high schools (36733) or in the presence of me Courses From exercise every three years for Family doctors (7.015): It means at least 7621 They didn’t get a chance to do either.

The number of places available is smaller for economic reasons both in relation to the future need for doctors and in relation to the number of fresh graduates

Specialized training costs the state from 102 thousand to 128 thousand euros And the budgets of the moment are burdened. in document affiliate State and Territories Conference affiliate Read June 21, 2018: For the 2017-2018 academic year requirements Doctors estimate equal 8569 unitswhile the resources available for the same year allow financing from the state budget 6,200 specialized training contractswith a difference 2,369 units. The large negative gap between the doctors’ needs and what can be tangibly satisfied by the state’s resources was recorded in the previous academic years. The phenomenon directed to produce a shortage of doctors specialized for the NHS. Therefore, the problem so far is the so-called training path.
bad programming

Then things change: as we’ve seen since 2019 The Deans of universities are committed to ensuring more Places to me medicine (4,961 more in 2022 compared to 2018Which 50% more). At the same time the places in Specialized schools (7,091 more between 2018 and the 2022more than doubled) and in the three-year courses of Family doctors (1,313 more than 2018 to me 2022more 60%). But, as we have already deplored recently Datarooms (over here), with the possibility of wide selection, The most needed places in the majors are not filled: until November 7th 58% of places in Emergency medicine – urgency detectedin Anesthesia And the resuscitation The 21.5%; in Radiation therapy The 73.5%. Now, then, one of the main problems is the ability to make the actor Programming (Ministry of Health) which prohibits i Places in high schools Miur balances the offer by reducing, for example, places in specialties that are not in demand and are often the most in demand. It is necessary to correctly calculate the number of doctors and required specialties 4-5 years That the configuration time New specialists.

Choose quality

Therefore, getting rid of the limited number will not solve the problem of the shortage of doctors. stay there anger affiliate the students who can not transcend entry test And they see their brokenness Dream to enter the corridor. That is why it is essential that the selection criteria for those entering medicine are the best: The entry test cannot be a lottery. In the 1999 directory for 90 questionsthen who 2000 to me 2012 From 80 And from 2013 until today 60. Every correct answer counts 1.5 pointsThe error -0.4Those in white .

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The test has been modified almost every year: the comprehension and logic part has decreased and the part related to questions of scientific disciplines has increased

But there has been no shortage of silly questions over the years It has 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 based on the decision of the Draghi government: Decree 1107 of September 24, 2022 (over here) Double test sessions – which is going to be two a year And no longer one – and it will be held on April And the July 2023. In addition, not only those who do can participate maturity Or have already done so, but all subscribers finally or The penultimate year of high school They will be able to enter themselves best result in the platform where it will be placed there classification.


The goal is to ensure that the entry test is no longer a lottery. Also because the more places in medicine, the lower they are quality of candidates Who will be our doctors next From tomorrow. The new government will have the task of implementing reform.

November 24, 2022 | 07:07

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