Contact EURACT

E-mail

Phone
(32) 16 33 74 64

FAX
(32) 16 33 74 80

ITALY

Basic Medical Education

First steps for basic medical education are now (finally !) to be organised in Italy. Now, since May 2002, we have an official agreement between University of Modena and Italian College of General Practitioners (and another one with University of Bari) to organise a structured course for students on sixth year to be taken in practices for four weeks. A course to prepare Tutors specifically for this topic was organised in Modena, medical journals wrote about, a book for Tutors is on printing. The topic is matter of discussion, finally, and it'll open the way forward. As structured, a little payment will be provided for Director of Course and for 30 Tutors.

I was invited as lecturer and member of EURACT Council National Representative at several meetings during this year in University of Milan and Parma, to speak about teaching, accreditation, research (EGPRW) and all about EURACT's acitivities.

Postgraduate specialist training

We have a postgraduate specialist training since 1994. This is a two year long training, managed in hospitals for one year, in district services for six months, in tutor GPs' practices for six months. Also, half of seminars are managed by GPs' teachers.

Now, we are preparing to change this training as a real specialist certificate, with a three year course, one year in the practices. It'll be since next course, beginning in October 2002. Teachers are paid for seminars, tutors are paid monthly, coursists are paid at lowest level for hospital doctors, not yet (differently from previous years) obliged to refuse by law every contemporary other work.

Continuing medical education

It is obligatory for National Contract with NHS, to take 40 (before it was 32) hours of CME, (20 with Health Local Authorities, 20 with Scientific Societies or in other places of choice).

Now, we are managing to arrive to a national CME system, with an accreditation of events, by credits and points attributed to events, 150 credits to collect in five years.

After a period of prove, between January and December 2001, we are now going, since 01 April 2002, to real credit points. BUT …. many colleagues involved in teaching and research and the biggest Scientific Society (Italian College of General Practitioners) are not satisfied and they are studying to arrive to a system accrediting also curricula, active participation at congresses, and distance learning systems (more difficult to organise and value). Italian College is realising this changing its bylaws with a system with membership and fellowship.

Generally, there is a fighting about “who” has to accreditate “ whom”: Government, General Medical Council, Local Medical Councils, Scientific Societies, a National College or Academy, Trust Doctors' Organisations.

Since Council in Hungary (April 2001), there was a change in Minister and a change in the Government, after political elections. After strong fighting, Scientific Societies are taken again in discussion, but, really, CME by Internet accreditation is not working and points are attributed automatically not seriously, not getting real control on providers, different credit – points just attributed to the same event in different cities, no real consideration about professional quality. …. Debate is spreading.

Health Care

New input in this field is coming from agreements between Local Health Authorities and GPs' organisations with health programmes finalised to objectives of result: on breast cancer screening, smoking cessation campaign (we brought two works about this topic at WONCA Europe Congress in Tampere). Also, Scientific Societies of GPs realised a common political and scientific document stopping a specialist initiative of not proven efficacy about prostate screening, also managed taking out GPs. …but nothing in common was done after, debate on CME is teaching, and General Practice is now in strong danger on a political change toward an “ american “ way of primary care.

Regional devolution is going on profile, and GPs' role also as gatekeepers and mainly as specific professional (still lacking in Italy) is in strong debate…!