“Setting hospital and university against each other, fueling an ideological opposition that tends to destroy the function for which the university should exist and demeaning the very function of the hospital, is a huge mistake that we want to shout out to everyone. A quality training program, by definition, is always composed of the right mix of theory/knowledge and practice/competence. Otherwise we will arrive at the disaster we are experiencing today” for this reason the training system needs a serious and concrete reform”. Thus Antonello Giarratano, president of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (Siaarti), in an open letter to the director of Quotidiano Sanità, Luciano Fassari, expresses his position aimed at overcoming the ideological opposition between hospital and university workers, in the debate opened in recent days on the opinion of the Ministry of University and Research (Mur) which intends to reinstate the exam for the passage of the year of specialist doctors hired with the so-called ‘Calabria Decree’, which was met with opposition from some professional associations of specialist doctors and some regional welfare councilors.
The scientific society Siaarti, in the letter from the president, in addition to reiterating that patient safety and the quality of healthcare must come first, highlights the need for an urgent reform of post-graduate training for specialists, in which contracts in peripheral hospitals with a final certification of skills that, in that context, could not be acquired cannot be foreseen.
“Our training system – explains Giarratano – needs a serious and concrete reform, far from ideological conditioning. Only through adequate training can we guarantee future doctors the necessary competence to face the challenges of modern healthcare. It is essential – he clarifies – to maintain high standards to ensure that doctors are adequately prepared. In the current training fragmentation, a second or third year specialist should go, with a fixed-term contract that binds him – to stay in my specialty of anesthesia, resuscitation, intensive care and pain therapy – to a hospital even a peripheral one to train where he would never ‘see’ a newborn, a neurosurgical patient, a cardiac surgery patient or an advanced pain therapy procedure or intensive care area and much much more”.
On the exam, which is “according to a 44 quater written in a frankly difficult to understand way”, the Siaarti president observes that “it would consist of a certification of the procedures carried out that, in many of the hospitals where some regions would like to fill the gaps, no one could certify simply because they are not done”. Added to this is the fact that “then at the end of the year with this ‘bogus’ certification, a board of teachers should, pretending not to know that those activities have not been carried out and without any evaluation of the studies and knowledge acquired, certify that one is a specialist? At the end of the year will we give exams to doctors in training with 2 or 3 different methods, for those who have agreed to be hired and for those who have remained on the ‘traditional’ path?”, asks Giarratano rhetorically.
The Siaarti president, highlighting the numerous critical issues of the current system, however, proposes a solution. “Let’s make a reform, let’s do it seriously by abandoning the system of decrees and articles, which will bring chaos at the end of the year at the next round of exams or diplomas and also as scientific societies, not only as teachers who do so much for training. We have ideas and contributions that we can bring to the legislator’s tables aiming at the result that interests everyone: the quality of our future doctors”, concludes Giarratano. The alternative to a reform of this type, according to the Siaarti president, could only be the definitive compromise “of the quality of Italian healthcare”, with disastrous results for patients and their safety.
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