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"Missing the forest for the trees" Is there any crisis of vocation for Emergency Medicine in Italy?
Ludovico Furlan1, Giovanni Nattino2, Guido Bertolini2
1Department of Internal Medicine, IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, Italy. furlan.ludovico@gmail.com.
Abstract:
In recent years, several stakeholders in Italy have suggested a crisis of vocation for Emergency Medicine (EM). This study aimed to verify the accuracy of such claims. We conducted an observational cross-sectional study on data from the Italian national test for residency positions assignments from 2019 to 2025. We analyzed trends in the number of medicine graduates, participants in the national test and available and filled training positions. We then compared EM to other residency programs and four "competitors" considering the ratio among filled and available positions; the absolute and relative variation in available and filled positions; the rate of filled positions over the number of exams' participants. From 2019 to 2025 training positions grew, while the number of medical school graduates remained stable, the number of candidates decrease and was outnumbered by training positions in 2023-2024. The rate of filled positions in EM dropped from 90% in 2019 to 25% in 2024, then increased to 47% in 2025. Available positions in EM increased from 391 in 2019 to 954 in 2025, at a faster rate than most residency programs. EM absolute filled positions grew from 2022 to 2025, at a faster rate than most competitors. Recent years high rates of unfilled positions in EM is related to the abrupt increase in available positions. Our findings do not confirm a vocational crisis for EM in Italy.
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