The future of Primary Health Care in Italy: needs, concerns and aspirations of physicians in training

Background: The COVID-19 pandemic exposed longstanding weaknesses in Italy's primary care system. In response, the country launched a reform aligned with Primary Health Care (PHC) principles, including the creation of Community Health Houses (CHH). However, little is known about how future physicians perceive their training and preparedness for this evolving landscape. Purpose and research design: This paper draws on a 2024 national cross-sectional exploratory survey of trainees in General Practice (GP) and Primary Care and Community Medicine (PCCM). Descriptive analysis explores trainees' motivations for choosing the GP or PCCM pathway, their perceptions of training adequacy, and their career aspirations and concerns within the context of ongoing reform. Results: Both groups reported gaps in training. Many GP trainees called for curricular reform and improved contractual conditions, while PCCM trainees expressed frustration with regulatory barriers preventing them from practising as GPs. Perceptions of CHH diverged: GP trainees were often sceptical, whereas PCCM trainees viewed them as coherent with their training and professional orientation. Conclusions: This study offers the first national evidence on how future professionals position themselves within the Italian primary reform, shedding light on the conditions influencing their engagement with change. The findings point to the need for strategies aligning training, organisational models, and regulation frameworks to support the transition to a PHC-oriented system.