The journey of Italian emergency medicine
Authors: Licheri Ennio 
Published: May 2023

The Emergency Medicine school in Italy is relatively young. It was founded in 2008, and the first specialists were trained 5 years later, in 2013. The school was created to give relevance to the role of the emergency doctor and try to obtain highly specialized and trained figures in managing, quickly and effectively, the various situations that can occur in an emergency department. Before the creation of the school, many colleagues believed that anyone could go to work in an emergency room (ER), even without a specific traineeship for that. In reality, the school was created to try to equate the level of training of Italian first aid doctors to the standards of other western countries, in which the school of emergency medicine had already been established. After a somewhat sluggish start, over the years the emergency and urgency medicine (MEU) school has gained its importance and more and more people have enrolled in what is the most adrenaline-filled and varied training school of all. With the neospecialists there has been a gradual filling of the ERs with highly trained figures in the management of various medical emergencies and equipped with various diagnostic-therapeutic skills. Unfortunately, the situation has changed in recent years. In fact, since 2020 our national health system (SSN, Servizio Sanitario Nazionale) has deteriorated significantly in terms of services and quality. Even before the 2020 various critical issues could have been noticed, such as the lack of staff in many departments, the overcrowding of hospitals, the lack of an effective territorial health support system, it is with the COVID-19 epidemic that our public SNN has really started to falter. Italy, as some may already know, was one of the European countries to suffer the most from the pandemic especially due to the large number of elderly people in Italy. Hospitals, and ERs in particular, were always under pressure and those who worked there were subjected to exhausting shifts. Unluckily, among the consequences of the emergency situation there has been an important departure of doctors from the national health system towards either the free profession or even abroad. Needless to say, among the most abandoned departments in recent times, there are the critical area and intensive care departments and the ER. This led to a major health crisis to which a real solution has not yet been found. Almost all Italian ERs are now understaffed and the doctors who work there have to face exhausting working days and take on many responsibilities. Waiting times in most Italian ERs are getting longer and longer, and episodes of physical and verbal aggression carried out by patients against doctors and healthcare staff are now very so much common. Sadly, the prospect of a life of so many sacrifices has led to a slump in enrollment in graduate school of emergency medicine, with more than 60% of the places available each year vacant. Various ERs have closed and others will be closed if the situation does not improve. In this moment, no effective proposals to solve the problem have been presented by the Italian government. However, there are many doctors who claim their rights and who work with passion every day in often difficult environments. More and more demonstrations and protests are being organized which demand an improvement in working conditions, a higher wage in line with European standards, a reduction in working hours and an increase in annual days off. It goes without saying that emergency medicine doctors are at the forefront of all of this. There are those who say that only by improving the working conditions in the Italian ERs could it be possible to recover the Italian public health system from its serious crisis which forces the Italian government to hire doctors from other foreign states and conversely, Italian doctors to emigrate to other countries that guarantee greater attention to the rights of health professionals, that I cannot be agree with those.