Their arrival was announced to deal with the Covid emergency. What happened to them?
There is no peace for medical specialists: the formation of the rankings for access to specialization schools, expected for 15 December, has been postponed again. the Ministry for University Research has announced the conclusion of the procedures shortly, but in the meantime a new tile has arrived: the young doctors were asked to participate in the campaign for administering the anti-Covid vaccine, but instead of being paid they were offered in exchange, the recognition of 4 training credits, and it is controversial: «The administration of the vaccine has nothing to do with training. With the training credits we don’t pay the bills “explain the trainees who, through the trade associations, press for the membership to be only on a voluntary basis, also because for other doctors who already have specialization there is an economic compensation. For this reason, hundreds have demonstrated in the street asking for urgent measures to regularize the positions of the trainees and fill a void that risks creating negative effects in the middle of the second Covid wave.
Urgently needed doctors
There is no doctors. The alarm was raised in full lockdown, when the pressure on the health service did not concern only intensive care, but also the shortage of personnel , in particular doctors. In view of a feared third wave , considered a concrete risk (or a certainty, according to experts), the problem has not yet been solved, indeed. On the one hand, there is the problem of recruiting doctors where situations are still critical, such as in Campania and Naples, where the call for civil protection has been almost deserted; on the other hand, there are 15,000 postgraduate scholarships which ” if not awarded within the year risk going to waste»As the president of the National Federation of Medical Orders (Fnomceo) warns, Filippo Anelli.
These are funds allocated for 2020 and which will expire on December 30, but which risk being lost “due to a bureaucratic quirk”, denounces Anelli.
Resident doctors on the bench
There are 24 thousand young doctors with degrees , qualified and now ” on the bench ” waiting to understand what will become of their competition, held months ago and now blocked due to a series of appeals . Without the publication of the rankings, stopped by the Ministry for University Research (MUR), they cannot be assigned to the locations of the Specialization Schools, using the specific scholarships allocated by the Government last spring. In the meantime, however, the trainees are providing their service, in full Covid emergency, in the medical guards, at the RSA and in the Usca, the Special Continuity Care Units., teams composed mainly of young doctors who provide home care, especially in the event of fiduciary isolation or quarantine.
Because the contest was blocked
The Federation of the Order of Doctors does not mince words and asks to “Put an end to the infinite and paradoxical story, which could be the plot of a novel by Kafka or the screenplay of a work by Samuel Beckett, of the Competition for the Schools of Specialization”. But how did this situation come about?
The competition for the year 2019/2020, after a first postponement due to the pandemic, was followed by a series of appeals that led the MUR to postpone the publication of the ranking from 5 to 26 October, when a provisional version was released , without however the assignment of the offices. By 1 December the candidates should have communicated their choices, so that the MUR would proceed with the confirmations by 3 December. But on that date a new postponement arrived: the Council of State, in fact, accepted the precautionary appeal of the MUR against some appeals. The result is yet another postponement, this time to December 15, just two weeks from the deadline to take advantage of the scholarships for specialization. The problem is that even at the deadline of December 15, a new postponement has arrived: «We trust that the judges of the Tar will decide wisely and quickly, to allow the activation of the courses on schedule, commented Anelli. “Our National Health Service desperately needs new specialists . “
How many doctors are missing from the roll call?
“According to our estimates, about 30 thousand are missing, but the problem still goes beyond the trainees: there are colleagues who have died from Covid (about 250), many are infected, others have retired and then there are the exhausting shifts. This is because there has been no real long-term planning for years. Suffice it to say that the competition offers 14,980 places against 24 thousand applications. 9,000 recent medical graduates and colleagues who have failed to access specialization in recent years will be excluded. This increases the training funnel »explains Roberto Monaco, National Secretary of Fnomceo and President of the Medical Association of Siena.
Many graduates, few doctors in the ward
« The problem has to do with the training process . To be able to practice the profession, a degree is not enough, which is fundamental, but it is only the first step of a training course that includes another 5 years for specialization (or three to become a family doctor). Specialization is therefore needed to access the National Health System, but the places are too few and every year the number of unemployed colleagues increases: they would need them in the ward, but to get there you need to go to the Specialization School, but the places are too much few. This year, thanks to strong pressure due to the health emergency and thanks to the commitment of the Government, almost 15 thousand scholarships were made available compared to 8,583 last year and about 7,000 the previous year, but they are still insufficient, ”explains Monaco.
Now the funds are also in danger of being lost: «I hope that this does not happen, even times are tight. On the other hand, scholarships are important: just think that 120,000 euros are needed to train a medical graduate, like a luxury car. The paradox is that now it is as if we had 24,000 luxury cars parked which, faced with the prospect of not standing still, could end up abroad, where instead our doctors are highly appreciated because they are well prepared. In short, it is as if these cars, after having made them, we gave them away »says the secretary of Fnomceo.
The flop of calls for doctors
Meanwhile, we are also witnessing the flop in the recruitment of doctors especially in critical areas. In Campania, for example, the Government had developed a call for the recruitment of 450 medical specialists. Just 165 responded, of which far fewer were eligible for the requirements and available places. The proposed conditions are also weighing: the contracts offered are self-employment, “including coordinated and continuous collaboration (co.co.co)”, expiring on January 31, 2021and extendable in case of further need. It is difficult to think that many are willing to move for such a short period, despite the monthly repayment proposed for off-site people. The need for doctors, then, also concerns other areas of Italy, therefore the recruitments envisaged for Campania aimed at excluding personnel already employed in the public or private sector “in order not to jeopardize the current service levels”.
«During the first wave of the calls of the Civil Protection there were candidates in number 10 times higher than the requests. Now it must be admitted that there is more discouragement. There are also differences in salary between colleagues that should not exist in the national health service “. Even in Liguria, the Region struggles to find doctors, who prefer to go to nearby Piedmont or Lombardy, where salaries are better.
New hires for the Covid vaccine
For the administration of the anti-Covid vaccine, starting from January, additional staff will be needed. Hence the need for new hires, estimated at 16 thousand (3 thousand of which for doctors) by the extraordinary Commissioner for the emergency, Domenico Arcuri. New medical graduates, postgraduates, but also retired doctors, nurses, health assistants and administrative staff are sought. In the case of doctors and nurses, the application must be submitted by 4 January 2021.
Closed number in Medicine: is it a problem?
What happened to the hypothesis of removing the limited number at the university? “We talk about it cyclically, but it would not be the solution, on the contrary it would aggravate the problem by increasing the funnel effect. Grants for specializations must be increased, also planning them according to real needs. Otherwise what is already happening happens, that is, that in the emergency rooms or in some Covid departments there are doctors with a completely different preparation because there are no suitable specialists “, concludes Monaco.
