In Italy the shortage of doctors is no longer just a problem linked to the number of graduates or retirements. Today the difficulty also concerns specializations. Some areas of medicine are becoming real professional deserts, with an ever-increasing number of specialization grants remaining unallocated. According to an analysis conducted by Anaao Assomed (the main union of doctors and healthcare managers) and byFree Specialists Associationthere are disciplines in which over 70% of scholarships for specialist training are not exploited. An alarming signal that reflects a crisis of attractiveness and an imbalance between healthcare demand and the interest of young doctors.
The medical specializations most in crisis
Among the most affected areas stand out microbiology and virology, where almost 80% of the grants (79.6%) remained unassigned. Immediately behind are pharmacology (78.1%) and clinical pathology (75.7%).
These are fundamental specializations for the functioning of the healthcare system, but which often remain in the shadows, do not guarantee direct contact with patients, offer less visible career paths and, in many cases, less competitive salaries compared to other clinical disciplines.
Yet microbiologists and virologists are at the forefront of virus identification, diagnostic test development, and vaccine research. Today, however, the new generations of doctors seem to be moving towards clinical paths, leaving crucial areas for public health and biomedical research uncovered.
The disciplines with over 60% of uncovered scholarships
On a general level, the picture is also worrying for other specialist areas which record high percentages of unawarded grants. In particular, in radiotherapy 64.7% of grants are unassigned, in community medicine 64.2% and in health statistics 63.8%.
In radiotherapy, a fundamental branch of modern oncology, and in community medicine, which should represent the pillar of the territorial reorganization envisaged by the Pnrr, almost two out of three grants remain empty.
Even in areas of high social relevance, such as palliative care and nuclear medicine, the numbers show a worrying trend. In the first case, almost 59% of the grants remain unassigned, in the second the share stops at 55%.
Finally, even among the most practical and operational disciplines, the data still shows signs of suffering.
In emergency medicine and thoracic surgery, 43.7% of grants are not awarded, while in general surgery the share reaches 35.8%.
Then there is nephrology, a medical specialization linked to kidney diseases and dialysis treatments, which has a share of uncovered scholarships equal to 38.8%.
In the case of an emergency, the difficulties are well known: long shifts, high stress, and a chronic shortage of staff make the emergency room one of the most difficult environments in which to work. Many young doctors, despite having a strong vocation, prefer specializations with more sustainable work rhythms and greater balance between private life and profession.
General surgery, once among the most sought-after, is experiencing a decline in interest linked to the complexity of the paths, strong competition and economic prospects that are not always proportionate to the commitment required.
A structural and cultural problem
The phenomenon of unallocated grants is not new, but in recent years it has reached critical levels. According to experts, the causes are multiple.
First of all, there is a misalignment between healthcare needs and training offers. The number of grants for some specializations does not reflect the real demand in the healthcare job market. Furthermore, many students do not receive adequate information on opportunities and career paths in various disciplines.
However, the difficult working conditions have a greater impact. Grueling shifts, salaries that are not always competitive and bureaucratic burdens discourage entry into some specialties, especially hospital ones.
The lack of specialists in certain areas is not just an academic problem, but has direct consequences on the functioning of the healthcare system. In the coming years, there is a risk of significant shortages in key departments for prevention, diagnostics and care for chronic patients.
An emblematic example is emergency medicine. The shortage of new specialists will force many facilities to reorganize shifts or resort to temporary staff.
Likewise, the lack of community doctors will slow down the transition towards a territorial healthcare model, further compromising the achievement of the objectives of the Pnrr and the proximity care strategies.
