Judgment;Summary — ECLI:EU:C:2022:150
Date: 2022-03-03
Language of the case: Italian
Court formation: Eighth Chamber
Subject matter: Right of establishment;Freedom to provide services;Free movement of workers
Procedure: Reference for a preliminary ruling
Origin: Italy

Summary C-590/20 – 1 
Case C-590/20 
Summary of the request for a preliminary ruling pursuant to Article 98(1) of 
the Rules of Procedure of the Court of Justice 
Date lodged:  
10 November 2020 
Referring court:  
Corte suprema di cassazione (Italy) 
Date of the decision to refer:  
22 September 2020 
Appellants:  
Presidenza del Consiglio dei Ministri 
Ministero dell’Economia e delle Finanze 
Respondents and cross-appellants:  
UK 
HZ 
IE 
BT 
GE 
ZF 
QA 
JA 
Ministero dell’Istruzione, dell’Università e della Ricerca ‒ MIUR 
Ministero della Salute 
  
EN 
SUMMARY OF THE REQUEST FOR A PRELIMINARY RULING – CASE C-590/20 
 
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Subject matter of the main proceedings 
Remuneration of trainee specialist doctors – Directives 75/363/EEC and 
82/76/EEC – Italy’s failure to transpose Directive 82/76 within the prescribed 
period – Successive provisions of national law transposing the directive into 
national law – Dispute regarding the completeness of Italy’s transposition of the 
directive – Conflicting rulings of various chambers of the Corte di cassazione 
(Court of Cassation) concerning the existence or otherwise of an entitlement to 
appropriate remuneration for trainee specialist doctors who enrolled at specialist 
schools prior to 1982  
Subject matter and legal basis of the reference for a preliminary ruling 
Interpretation of EU law, Article 267 TFEU 
Questions referred  
Do the third paragraph of Article 189 of the Treaty on European Union and 
Articles 13 and 16 of Council Directive 82/76/EEC of 26 January 1982, amending 
Directive 75/362/EEC and Directive 75/363/EEC, preclude an interpretation 
according to which the right to appropriate remuneration provided for by 
Article 13 of Directive 82/76/EEC for doctors undergoing full-time or part-time 
training is afforded also to doctors who enrolled at a specialist school prior to 
1982 and were undergoing training on 1 January 1983, provided that all other 
requirements deriving from EU law and the case-law of the Court of Justice are 
satisfied? 
Is the right to compensation for damage resulting from the Italian State’s delay in 
transposing the abovementioned directive consequently afforded also to such 
doctors, in respect of the proportion of compensation attributable to the period 
from 1 January 1983 onwards? 
Provisions of EU law cited 
Article 5 TEU 
The third paragraph of Article 189 of the EC Treaty 
Council Directive 75/363/EEC of 16 June 1975 concerning the coordination of 
provisions laid down by law, regulation or administrative action in respect of 
activities of doctors, in particular, points 1 and 2 of the annex 
Council Directive 82/76/EEC of 26 January 1982 amending Directive 
75/362/EEC concerning the mutual recognition of diplomas, certificates and other 
evidence of formal qualifications in medicine, including measures to facilitate 
effective exercise of the right of establishment and freedom to provide services 
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and Directive 75/363/EEC concerning the coordination of provisions laid down by 
law, regulation or administrative action in respect of activities of doctors, in 
particular Articles 13 and 16 
Provisions of national law cited 
Decreto legislativo 8 agosto 1991, n. 257, Attuazione della direttiva n. 82/76/CEE 
del Consiglio del 26 gennaio 1982, recante modifica di precedenti direttive in 
tema di formazione dei medici specialisti, a norma dell’art. 6 della legge 29 
dicembre 1990, n. 428 (Legge comunitaria 1990) (Legislative Decree No 257 of 
8 August 1991 implementing Council Directive 82/76/EEC of 26 January 1982 
and amending the previous directives on the training of specialist doctors, on the 
basis of Article 6 of the Law of Community Interest of 1990, ‘Legislative Decree 
No 257/1991’), in particular, Article 6(1) and Article 8(2) 
Legge 19 ottobre 1999, n. 370, Disposizioni in materia di università e di ricerca 
scientifica e tecnologica (Law No 370 of 19 October 1999 laying down provisions 
relating to universities and scientific and technological research, ‘Law 
No 370/1999’), in particular, Article 11(1)  
Outline of the facts and the main proceedings 
1 Directive 82/76 laid down an obligation to pay appropriate remuneration to 
doctors following full-time or part-time training for specialisation in certain 
medical disciplines (point 1, second subparagraph, and point 2, third 
subparagraph, of the annex to Directive 75/363, inserted by Article 13 of Directive 
82/76).  
2 More specifically, that obligation is specified in the abovementioned annex in the 
following terms: 
‘Characteristics of full-time and part-time training of specialists  
1. Full-time training of specialists 
Such training shall be carried out in specific posts recognised by the competent 
authority. 
It shall involve participation in all the medical activities of the department where 
the training is carried out, including on-call duties, so that the trainee specialist 
devotes to this practical and theoretical training all his professional activity 
throughout the duration of the standard working week and throughout the year 
according to provisions agreed by the competent authorities. Accordingly these 
posts shall be subject to appropriate remuneration. 
… 
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2. Part-time training of specialists 
This training shall meet the same requirements as full-time training, from which it 
shall differ only in the possibility of limiting participation in medical activities to 
a period at least half of that provided for in the second subparagraph of point 1. 
The competent authorities shall ensure that the total duration and quality of part-
time training of specialists are not less than those of full-time trainees. 
Appropriate remuneration shall consequently be attached to such part-time 
training.’ 
3 Article 16 of Directive 82/76 set 31 December 1982 as the deadline for 
transposing the directive and the abovementioned obligation. 
4 The Italian Republic failed to implement the abovementioned obligation within 
the period laid down by Directive 82/76. Infringement proceedings were initiated 
against it for that reason and, by judgment of 7 July 1987, Commission v Italy 
(49/86, EU:C:1987:335), the Court of Justice declared that that Member State had 
failed to fulfil its obligations. 
5 Following that judgment, the Italian legislature adopted Legislative Decree 
No 257/1991, Article 6(1) of which provides as follows: 
‘Those admitted to specialist schools, within the limits of the plan referred to in 
Article 2(2), in connection with a full-time engagement for their training shall 
receive, throughout the duration of the course, excluding periods when the 
specialist training is suspended, a study bursary which in 1991 shall be [ITL] 
21 500 000. From 1 January 1992, this amount shall be increased annually on the 
basis of the anticipated rate of inflation and shall be revised every three years by 
decree of the Minister for Health …’. 
In accordance with Article 8(2) of that legislative decree, the provisions thereof 
are to apply from the beginning of the 1991/1992 academic year. 
6 As a result of that legislation, trainee specialist doctors were awarded an annual 
study bursary of ITL 21 500 000. However, it was provided that that remuneration 
should be paid only to doctors admitted to specialist schools in or after the 
1991/1992 academic year, to the exclusion, therefore, of doctors who had enrolled 
in specialisation courses in preceding years. 
7 That difference in treatment was strenuously challenged in the courts by doctors 
denied the benefit of appropriate remuneration. The Court of Justice gave rulings 
on the situation in its judgments of 25 February 1999, Carbonari and Others 
(C-131/97, EU:C:1999:98), and of 3 October 2000, Gozza and Others (C-371/97, 
EU:C:2000:526), in which the Court held that doctors enrolled at specialist 
schools prior to the 1991/1992 academic year, and more specifically doctors 
enrolled in specialist training courses in the 1990/1991 academic year (Carbonari 
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and Others, paragraph 19, and Gozza and Others, paragraph 20), were entitled to 
remuneration. 
8 The Italian Republic consequently adopted Law No 370/1999, Article 11(1) 
provided as follows: 
‘To doctors admitted by universities to medical specialist schools from the 1983-
1984 academic year to the 1990-1991 academic year who are addressees of the 
final judgments of the Tribunale amministrativo regionale del Lazio (sezione I-
bis) [(Regional Administrative Court, Lazio, Section Ia)], numbers 601 of 1993, 
279 of 1994, 280 of 1994, 281 of 1994, 282 of 1994, 283 of 1994 …, the 
Ministero dell’università e della ricerca scientifica e tecnologica [(Ministry of 
Universities and Scientific and Technological Research)] shall pay, in respect of 
the entire duration of the course, an all-inclusive study bursary of [ITL] 
13 000 000. The said sum shall not bear statutory interest or be adjusted in line 
with inflation.’ 
9 As a result of this, the range of beneficiaries widened, but doctors who had 
enrolled in specialisation courses prior to 1 January 1983 – that is, prior to the 
deadline for transposing Directive 82/76 and the corresponding obligation to pay 
appropriate remuneration – were excluded from the benefit of appropriate 
remuneration. 
10 In so far as concerns the main proceedings, the referring court states that, by 
summons served on 16 April 2008, a number of doctors issued proceedings before 
the Tribunale di Roma (District Court, Rome) against the Presidenza del Consiglio 
di Ministri (Prime Minister’s Office) and various ministries. The doctors’ aim was 
to establish their right to appropriate remuneration in respect of the work they had 
done in the course of their specialist training and to obtain an order requiring the 
defendant authorities to pay the sum of ITL 21 500 000 for each year of the 
corresponding specialisation course and for each course followed, or alternatively 
such other sum as might be deemed equitable, together with statutory interest. 
11 The applicants stated in their application that they were all doctors who had 
specialised in one or other healthcare discipline and who had obtained their 
specialist qualification in the period between 1983 and 1990, having enrolled in 
courses either before 1983 or after, and that they had received no remuneration in 
respect of the work they had done in the course of training as specialists.  
12 The applicants have requested that they be paid ‘appropriate remuneration’ as 
provided for in the annex to Directive 75/363, inserted by Article 13 of Directive 
82/76. In that context, they have argued that, although the deadline for transposing 
Directive 82/76 and the obligation laid down by that directive to pay appropriate 
remuneration to trainee specialist doctors had been set, by Article 16 of the 
directive, at 31 December 1982, the national legislature had not effected that 
transposition until it adopted Legislative Decree No 257/1991, after the Court of 
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Justice had found against the Italian Republic in its judgment in Case 49/86, 
Commission v Italy. 
13 The defendant authorities entered an appearance in the proceedings and submitted 
that the applicants’ claims were time-barred. 
14 By Judgment No 6691/2012, the District Court, Rome, dismissed the applicants’ 
claims, finding them to be time-barred. 
15 By judgment No 5628/2016, filed on 27 September 2016, the Corte d’appello di 
Roma (Court of Appeal, Rome) dismissed the claims of the doctors who had 
enrolled at specialist schools prior to the 1983-1984 academic year, as well as 
those of the doctors who had attended specialisation courses not contemplated by 
the abovementioned directives. Following the more common of the precedents set 
in the case-law of the Court of Cassation, the Court of Appeal held that the right 
to remuneration provided for by Directive 75/363, as amended by Directive 82/76, 
was not afforded to individuals who had commenced courses prior to 1 January 
1983, even if their courses had continued after that date. That was on the ground 
that the failure of the Italian State to bring its domestic laws on healthcare 
specialisation courses into line with Community law had materialised on 
31 December 1982, that date being the deadline laid down in Directive 82/76 for 
its implementation. 
16 The Prime Minister’s Office brought an appeal against that judgment. A number 
of the doctors who had already appeared in earlier stages of the case brought 
cross-appeals. 
17 Hearing the appeals, the Employment Chamber of the Court of Cassation, noted 
the discrepancies between the rulings of various chambers of the Court of 
Cassation and referred the case for judgment to the Combined Chambers of the 
court, by order filed on 16 January 2020.  
Principal arguments of the parties to the main proceedings 
18 The cross-appellants’ complaint is that the Court of Appeal refused to recognise 
the entitlement of some of the doctors named in the application to remuneration in 
respect of their years of specialisation for the reason that they had enrolled at a 
school prior to 1983 (between 1980 and 1982). That was on the ground that 
Directive 82/76 had set 31 December 1982 as the deadline for its implementation, 
meaning that, prior to that date, there could not have been any failure on the part 
of the Italian State to fulfil its obligations. 
19 The cross-appellants submit that Italy should instead have conformed to the 
relevant provisions of Community law also with regard to individuals who, on 
31 December 1982, were already attending a specialisation course or had, in any 
event, enrolled at one of the specialist schools without yet having commenced 
their specialist training. That is because the relevant EU rules in no way provide 
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that the provisions relating to the remuneration of trainee specialists do not apply 
to courses already under way. 
20 They argue that that principle is confirmed by the case-law of the Court of Justice, 
in particular its judgment of 3 October 2000 in Gozza and Others, as well as by 
some of the rulings of the Italian Court of Cassation. 
Outline of the grounds for the reference for a preliminary ruling 
21 The Court of Cassation (Combined Civil Chambers), the referring court in this 
case, observes that the EU and domestic legislation in question has given rise to 
significant interpretative uncertainty, especially concerning the temporal scope of 
the Italian State’s liability arising from its late implementation of Directive 87/62. 
More specifically, the question has arisen of whether or not its liability should be 
deemed to extend to doctors who enrolled at a specialist school before 1 January 
1983, the date on which the State’s failure to fulfil its obligations materialised, 
Italy having missed the 31 December 1982 deadline for implementing the 
directive. These uncertainties as to interpretation were not allayed by the judgment 
of the Court of Justice of 24 January 2018, Presidenza del Consiglio dei Ministri 
and Others v Pantuso and Others (C-616/16 and C-617/16, EU:C:2018:32) – 
delivered on a reference for a preliminary ruling from the Italian Court of 
Cassation – which, on the contrary, has given rise to two diverging approaches, 
one of which is more common than the other. 
22 The referring court observes that the terms of the question were initially decided 
upon in consequence of the judgments of the Court of Justice in Carbonari and 
Gozza. In the first of those ruling, relating to individuals enrolled at specialist 
schools in the 1990/1991 academic year, the Court of Justice held that, ‘in 
applying national law and in particular the provisions of a law which, as in the 
main proceedings, were specifically introduced in order to implement a directive, 
the national court is required to interpret its national law, as far as possible, in the 
light of the wording and the purpose of the directive in order to achieve the result 
pursued by the latter and thereby to comply with the third paragraph of 
Article 189 of the EC Treaty’ (paragraph 48). As a result, Community law 
required the Member States to ‘make good damage caused to individuals through 
failure to transpose a directive, provided that three conditions are fulfilled: the rule 
of law infringed was intended to confer rights on individuals and the content of 
those rights can be identified; the breach is sufficiently serious; and there is a 
direct causal link between the breach of the State’s obligation and the damage 
suffered by the persons affected’ (paragraph 52). In this connection, the Court 
stated that ‘retroactive application in full of the measures implementing a directive 
enables the harmful consequences of its belated transposition to be remedied, 
provided that the directive has been properly transposed’ (paragraph 53). 
Accordingly, the Court concluded that ‘Article 2(1)(c) of [Directive 75/363] and 
point 1 of the annex thereto, as amended by Directive 82/76, must be interpreted 
as follows: – the obligation to provide appropriate remuneration for periods of 
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training in specialised medicine is binding only in respect of the medical 
specialties which are common to all the Member States or to two or more of them 
and are mentioned in Article 5 or Article 7 of [Directive 75/362]’ (paragraph 54, 
first indent). That obligation – applicable, according to the referring court, to 
individuals who enrolled at specialist schools between 1983 and 1991 – is 
‘unconditional and sufficiently precise in so far as it requires, for a medical 
specialist to be able to benefit from the system of mutual recognition established 
by [Directive 75/362], that his training be full-time and remunerated’ 
(paragraph 54, second indent). The Court also held that, ‘in those circumstances, it 
is for the national court to determine to what extent all provisions of national law, 
and more specifically, for the period after their entry into force, the provisions of a 
law adopted in order to implement Directive 82/76, can be interpreted after the 
date of entry into force of those provisions in the light of the wording and the 
purpose of that directive in order to achieve the result pursued by it’ 
(paragraph 49). 
23 On the matter of the scope of the State’s liability, the second of the two rulings, 
the judgment in Gozza and Others, went still further. In that ruling, also 
concerning doctors having undertaken specialisation courses in an academic year 
prior to the 1991/1992 academic year, the Court held that the analysis contained in 
the earlier judgment in Carbonari, regarding full-time training, was entirely 
applicable to ‘part-time training in specialised medicine’ (paragraph 41). That 
conclusion followed from both the purpose and the wording of Directive 75/363 
and Directive 82/76, inasmuch as they provided that part-time training should also 
attract ‘appropriate remuneration’. 
24 The referring court emphasises that, according to the EU Courts, ‘the obligation to 
provide appropriate remuneration for periods of both full-time and part-time 
training in specialised medicine is binding only in respect of the medical 
specialties which are common to all the Member States or to two or more of them 
and are mentioned in Article 5 or Article 7 of Council Directive 75/362/EEC of 
16 June 1975 concerning the mutual recognition of diplomas, certificates and 
other evidence of formal qualifications in medicine, including measures to 
facilitate the effective exercise of the right of establishment and freedom to 
provide services. That obligation is binding only if the conditions for full-time 
training set out in point 1 of the annex to Directive 75/363, as amended by 
Directive 82/76, or those for part-time training, set out in point 2 of the annex to 
Directive 75/363, as amended by Directive 82/76, are complied with by the trainee 
medical specialists’ (judgment in Gozza and Others, paragraph 45 and operative 
part). 
25 Following these two rulings of the Court of Justice, Law No 370/1999 was 
adopted. Pursuant to Article 11(1) of that law, the entitlement to appropriate 
remuneration was extended to include trainee specialist doctors who enrolled in 
specialisation courses in the years 1983 to 1990. 
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26 However, even this new legislation gave rise to conflicting interpretations in the 
case-law of the various chambers of the Court of Cassation. 
27 The referring court points out that, once the Italian Court of Cassation had taken 
note of the relevant Community legislation and of the initial rulings of the Court 
of Justice confirming the entitlement to remuneration of trainee specialists 
following the entry into force of Directive 82/76, and the consequential right of 
trainee specialists to receive compensation for damage sustained as a result of the 
delay in implementing the directive, it began to address in its case-law the 
question of whether doctors who had enrolled at a specialist school prior to 
1 January 1983 (that being the date on which the Italian State’s failure to 
implement Directive 82/76 by 31 December 1982 and no later materialised) were 
entitled to appropriate remuneration. 
28 In some of its judicial decisions, including its earliest rulings on this point, the 
Court of Cassation, taking an approach that has proved to be the more common, 
held that that question should be answered in the negative. 
29 According to this first approach, the entitlement to compensation for damage 
resulting from the failure to fulfil obligations under Directive 82/76, acquired by 
individuals who had followed medical specialisation courses beginning between 
1 January 1983 and the 1990/1991 academic year (who would have acquired the 
rights provided for by the directive had it been implemented) was not afforded to 
individuals who had already commenced a specialisation course by 31 December 
1982, since there had, by that date, been no failure to fulfil obligations (Judgment 
of the Court of Cassation No 17067 of 10 July 2013). 
30 It was observed in this connection that it was on 31 December 1982 that 
materialised the Italian State’s failure to fulfil its obligation to bring domestic 
legislation governing medical specialisation courses into line with the Community 
directives, from which the right to remuneration arose. There could be no 
entitlement to remuneration for the years following that date because courses had 
to be considered as a unit and, when they began their courses, the trainee specialist 
doctors in question had not yet acquired any actual entitlement to remuneration. It 
followed that the different treatment of trainee specialists, depending on the year 
in which they had enrolled in a course, was responsive to the need to treat courses, 
and the underlying relationships, as a single unit (as well as being responsive to 
requirements relating to public finances). The provision in question, giving 
expression to an acte clair, precluded the obligation to refer the question to the 
Court of Justice of the European Union for a preliminary ruling (Judgments Nos 
14375 of 9 July 2015 and 15198 of 20 July 2015 of the Court of Cassation). 
31 According to the other approach, on the other hand, the right to compensation for 
damage sustained as a result of the failure to fulfil obligations under Directive 
82/76, which, in accordance with the principles repeatedly confirmed by the Court 
of Justice (the judgments in Carbonari and Gozza), arose in favour of individuals 
who had followed medical specialisation courses in the academic years between 
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1983 and 1991, was afforded also to trainee specialist doctors who had already 
begun their specialisation course by 31 December 1982. That interpretation was 
supported by the fact that the directives mentioned did not limit the range of 
individuals entitled to remuneration so as to include only doctors who enrolled in 
a specialisation course on or after 1 January 1983. In any event, any different 
interpretation would have to be regarded as conflicting with the criterion – 
instrumental in the compensation of individuals who have suffered harm as a 
result of delay on the part of the legislature – of retroactive and full application of 
measures implementing Community rules. 
32 The referring court observes that this approach has been supported by recognition 
of the principles laid down in the case-law of the Court of Justice, including (a) 
the principle of the primacy of Community law, (b) the principle that a failure to 
transpose, or incomplete transposition of a directive into internal law entitles the 
individuals affected to rely on any precise and unconditional provisions of the 
directive in question as against the Member State, (c) the principle of 
‘jurisdictional equivalence’, which requires that the scheme for the compensation 
of damage in the event of infringement of Community law must not be less 
favourable than that which applies to similar actions based on the infringement of 
rules of domestic law. Accordingly, since the relationship which arises from a 
doctor’s enrolment in a specialisation course is one that continues over a period of 
time, then, in the context of domestic law, it is necessary to apply the principle 
that the supervening law – especially if it is a Community law – governs the 
ongoing legal relationship so long as the effects of that relationship, which arose 
earlier, have not yet been exhausted and provided that the new law is not intended 
to govern the event which gave rise to the relationship, but rather the relationship 
over time (Judgment No 10612 of 22 May 2015 of the Court of Cassation). 
33 Again according to the referring court, it has been held, to this same effect, that 
‘the limitation to doctors who enrolled in specialisation courses after 31 December 
1982 is not to be found in the EEC directives of 16 June 1975, No 75/363, and of 
26 January 1982, No 82/76. Indeed, it is indirectly belied by Article 14 of 
Directive 82/76, pursuant to which ‘part-time specialist training begun before 
1 January 1983 under Article 3 of Directive 75/363/EEC may be completed in 
accordance with that article’. In any event, such a limitation is inconsistent with 
the criterion of retroactive and full application of measures implementing 
Community rules, entailing provision for the possibility of compensating any 
individual who has sustained harm, to which the Court of Justice has pointed as a 
remedy for the harmful consequences of late implementation of the directive. 
Furthermore, there can be no question but that Article 14 of Directive 82/76 
applies to the Italian State, inasmuch as limiting the applicability of that provision 
to Member States which had, prior to the coordinating directive, Directive 
82/76/EEC, conformed their legislation to one of the earlier directives coordinated 
by that directive … contradicts the principles which can be inferred from the case-
law of the Court of Justice of the European Union on the subject and, therefore, 
conflicts with the principle of the primacy of Community law’ (Judgment 
No 10612/2015 of the Court of Cassation). 
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34 Having taken note of this inconsistency in the case-law, the Combined Chambers 
of the Court of Cassation made a reference for a preliminary ruling of the Court of 
Justice, which resulted in the judgment of 24 January 2018, Presidenza del 
Consiglio dei Ministri and Others v Pantuso and Others (C-616/16 and 
C-617/16). 
35 The questions on which the Court of Justice was asked to give a ruling were as 
follows: 
‘1. Is Directive [75/363 as amended] to be interpreted as including within its 
scope full-time and part-time courses for trainee medical specialists which had 
already begun by 31 December 1982 and continued after that date, that being the 
date by which the Member States were to have adopted the necessary measures to 
comply with [Directive 82/76], in accordance with Article 16 thereof? 
If Question 1 is answered in the affirmative: 
2. Is the annex which was appended to [Directive 75/363] by Article 13 of 
Directive [82/76], to be interpreted as meaning that, with respect to specialist 
training courses which had already begun by 31 December 1982, the obligation to 
provide trainee specialists with [appropriate] remuneration is dependent on 
fulfilment of the obligation to reorganise courses or on compliance with the 
requirements of the abovementioned directives? 
3. With respect to specialist doctors who pursued specialist training courses 
which began before 1 January 1983 but had not ended by that date, was there any 
obligation to pay them [appropriate] remuneration for the entire duration of the 
course or for the period after 31 December 1982 alone and, if so, to what 
conditions, if any, was that obligation subject?’ 
36 The referring court recalls that, in response to those questions, the Court of Justice 
examined the temporal issues raised by the debate and held ‘it is not apparent 
from Directive 75/363 as amended that the obligation on Member States to 
provide appropriate remuneration for periods of full-time and part-time specialist 
training would not apply to such training begun before the expiry, on 1 January 
1983, of the deadline for the transposition of Directive 82/76 and continued after 
that date’ (paragraph 37 of the judgment in Joined Cases C-616/16 and C-617/16). 
However, the Court also held that, ‘in those circumstances, the answer to the first 
question referred is that Article 2(1)(c), Article 3(1) and (2) and the annex to 
Directive 75/363 as amended must be interpreted as meaning that any period of 
full-time or part-time specialist medical training begun in 1982 and continued up 
to 1990 must be subject to appropriate remuneration, within the meaning of that 
annex, provided that that training concerns a medical speciality common to all the 
Member States or to two or more of them and is referred to in Articles 5 or 7 of 
Directive 75/362’ (paragraph 38 of the judgment).  
37 The referring court observes that, although paragraph 37 of the judgment seems to 
offer an answer consistent with the broad question posed by the Combined 
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Chambers of the Court of Cassation in its order for reference, confirming that all 
specialist training commenced before 1 January 1983 (and thus training 
commenced in 1980, 1981 and 1982) and continued after that date must be 
remunerated, albeit solely in respect of the portion from 1 January 1983 onwards 
(the date on which Italy’s failure to fulfil its obligations materialised), 
paragraph 38, on the other hand, seems to limit that assertion to doctors who 
commenced their specialist training in 1982. 
38 Moreover, that is the meaning expressed by the operative part of the judgment, 
which reads: 
‘1. Article 2(1)(c), Article 3(1) and (2) and the annex to Council Directive 
75/363/EEC of 16 June 1975 concerning the coordination of provisions laid down 
by law, regulation or administrative action in respect of activities of doctors, as 
amended by Council Directive 82/76/EEC of 26 January 1982, must be interpreted 
as meaning that any period of full-time or part-time specialist medical training 
begun in 1982 and continued up to 1990 must be subject to appropriate 
remuneration, within the meaning of that annex, provided that that training 
concerns a medical speciality common to all the Member States or to two or more 
of them and is referred to in Articles 5 or 7 of Council Directive 75/362/EEC of 
16 June 1975 concerning the mutual recognition of diplomas, certificates and 
other evidence of formal qualifications in medicine, including measures to 
facilitate the effective exercise of the right of establishment and freedom to 
provide services. 
…  
3. Article 2(1)(c), Article 3(1) and (2) and the annex to Directive 75/363, as 
amended by Directive 82/76, must be interpreted as meaning that appropriate 
remuneration, within the meaning of that annex, for any period of full-time or 
part-time specialist medical training begun in 1982 and continued up to 1990 must 
be paid for the period of that training from 1 January 1983 and until the end of 
that training.’ 
39 The referring court draws attention to a fact relating to timing which it regards as 
crucial, namely the fact, reported in the judgment in question, that ‘the doctors 
who brought the cases in the main proceedings undertook training to become 
specialist doctors in Italy between 1982 and 1990’ (paragraph 17). The Court of 
Justice’s decision is thus aligned with the facts of the dispute in relation to which 
it was asked for a ruling, inasmuch as none of the applicants had enrolled at a 
specialist school prior to 1982. However, the position in the present case in the 
main proceedings is different: a number of the doctors concerned apparently 
enrolled at specialist schools prior to 1982. 
40 As a result of the Court of Justice’s ruling in Joined Cases C-616/16 and 
C-617/16, the Combined Chambers of the Court of Cassation have held that the 
right to compensation for damage resulting from the failure to fulfil obligations 
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under Directive 82/76, which amended Directives 75/362 and 75/363, which arose 
for individuals who enrolled in specialisation courses in academic years between 
1983 and 1991, also extends to the 1982/1983 academic year, but only from 
1 January 1983 onwards and up to completion of the training course in question, 
in accordance with the Court of Justice’s findings in the abovementioned 
judgment. It follows, according to the Combined Chambers of the Court of 
Cassation, that compensation for failure to receive appropriate remuneration must 
be fixed not by reference to the entire duration of the first academic year of the 
studies, but to the proportion of the academic year following the expiry of the 
deadline for transposing the directive (31 December 1982), after which date the 
failure to fulfil obligations materialised (Judgment No 20348 of 31 July 2018 of 
the Combined Chambers of the Court of Cassation). 
41 However, the referring court observes that that ruling of the Court of Cassation 
related to a case in which the applicant doctors had all enrolled at a specialist 
school between 1982 and 1990. Since the Court of Cassation had been called upon 
to decide that particular case, it would not have concerned itself, even in that 
judgment, with the question of whether doctors who – like many of the applicants 
in the present case – had enrolled in training courses prior to 1982 were also 
entitled to appropriate remuneration. 
42 The subsequent case-law of the Third Civil Chamber of the Court of Cassation 
conforms to that judgment of the Combined Chamber. The Third Civil Chamber 
has similarly held that the apportioning of compensation for the damage resulting 
from failure to fulfil obligations under Directive 82/76 occurs, in accordance with 
the principles repeatedly asserted by the Court of Justice (in its judgments in 
Carbonari and Gozza) and by the Combined Chambers of the Court of Cassation 
(Judgment No 20348 of 31 July 2018), only where, in accordance with university 
regulations, the training course and attendance at it actually began prior to 
1 January 1983 (the day following the deadline for transposing the directive, 
31 December 1982), that is to say, in the course of 1982, as held by the Court of 
Justice in its judgment of 24 January 2018.  
43 The referring court observes that the failure to conform the domestic legislation 
prior to that date did not in fact constitute a failure to fulfil obligations and cannot 
give rise to compensation. Conversely, where the training course was both given 
and attended entirely after 1 January 1983, compensation should be awarded in 
full, because the entire duration of the course fell within the period during which 
the State was not meeting its obligations. 
44 According to this case-law of the Court of Cassation, the Court of Justice has 
therefore distinguished three categories of trainee specialist: 
(i) those who began their specialisation prior to 29 January 1982 (the date when 
Directive 82/76 entered into force), who are not entitled to any remuneration; 
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(ii) those who began their specialisation during the course of 1982, who are 
entitled to remuneration from 10 January 1983 onwards; 
(iii) those who began their specialisation after 10 January 1983, who are entitled 
to remuneration for the entire duration of their course (Judgments Nos 13761, 
13762 and 13763 of 31 May 2018 of the Court of Cassation). 
45 Finally, that position has been adopted in certain rulings of the Employment 
Chamber of the Court of Cassation (which had initially inclined toward the 
opposite solution). In those rulings, the Employment Chamber held that trainee 
specialist doctors could not be entitled to remuneration prior to 29 January 1982 
(the date of entry into force of Directive 82/76) in the absence of any statutory 
source that expressly authorised such an interpretation (Judgments Nos 20410 of 
29 July 2019 and 24625 of 2 October 2019 of the Court of Cassation). 
46 However, the Employment Chamber, called upon to rule in an action brought by 
certain doctors who had enrolled at specialist schools prior to 29 January 1982, 
revisited the matter and arrived at the conclusion that ‘there is still a conflict 
unresolved by the case-law of the Court of Cassation that has been reviewed’ 
between the two opposing approaches outlined. For that reason, by order of 
16 January 2020, the Employment Chamber referred the question to the Combined 
Chambers. 
47 The reason for the conflict between the two opposing approaches lies, in the 
opinion of the Employment Chamber, between the approach that is based on the 
so-called extended scope of the ius superveniens, represented by Directive 82/76 
and the preceding directives – or on the applicability of that legislation only to 
situations constituting a unitary legal relationship that came into being after the 
entry into force of the directive ‒ and the opposing view (which the Employment 
Chamber shares) according to which the ius superveniens governs ongoing legal 
relationships which are not unitary but continue over a period of time ‘so long as 
the effects of that relationship, which arose earlier, have not yet been exhausted 
and provided that the new law is not intended to govern the event which gave rise 
to the relationship but rather the relationship over time’. 
48 The order referring the case to the Combined Chambers of the Court of Cassation 
does not make the same assumption as is made in the more common of the 
precedents set in the case-law of the Court of Cassation, which interprets 
Judgment No 20348/2018 of the Combined Chambers, and the earlier judgment of 
the Court of Justice in Joined Cases C-616/16 and C-617/16, as meaning that the 
apportioning of compensation for damage resulting from the late transposition of 
Directive 82/76 is applicable – from 1 January 1983 onwards – solely to cases 
where the specialisation course began in 1982 and not in any previous year. 
According to the Employment Chamber, the question which had given rise to the 
need for clarification from the Court of Justice ‘related to a case in which the 
course that the trainee specialist doctors had attended spanned precisely the years 
1982 and 1983. Therefore, it cannot be inferred from the repeated references to 
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the 1982/1983 academic year that the Court of Justice intended to limit the range 
of individuals to whom the obligation to make reparation applies’. In other words, 
the judgment of the Court of Justice in no way excluded doctors who enrolled 
prior to 1982 from entitlement to remuneration. This is what gave rise to the 
reference to the Combined Chambers, so that they might clarify whether the 
obligation to pay remuneration applies ‘also to trainee specialist doctors who 
commenced their course prior to 1982, albeit solely in respect of the portion after 
1982’. 
49 Having regard to all the foregoing, the Combined Chambers of the Court of 
Cassation, which must resolve this conflict in the case-law, consider that the more 
common approach, described above, might not be consistent with EU law and the 
Court of Justice’s interpretation of it in the abovementioned judgment. 
50 Conversely, in the opinion of the Combined Chambers, the less common 
approach, according to which the Member States’ obligation to make reparation 
for the delay in transposing Directive 82/76 should extend also to doctors who 
enrolled in a specialist school prior to 1982, is not only easier to endorse, for the 
reasons mentioned below, but also appears to be more consistent with EU law. 
51 According to the referring court, various arguments militate in favour of the 
broader approach, the first of which to consider is the linguistic argument. That 
argument is based first and foremost on the fact that, in the coordination directive, 
Directive 82/76, and the earlier directives, there is no limitation whatsoever that 
restricts the range of individuals who are entitled to remuneration so as to include 
only doctors who enrolled in specialisation courses from the 1982/1983 academic 
year onwards. It is also clear, according to the referring court, that a restrictive 
interpretation, in the absence of any express limitation to such effect in the 
relevant EU legislation, could clash with the fundamental principle of the primacy 
of Community law. 
52 In the second place, the teleological argument should be considered, bearing in 
mind that the courts of the Member State concerned must, in accordance with the 
abovementioned judgments of the Court of Justice, ‘determine to what extent all 
provisions of national law, and more specifically, for the period after their entry 
into force, the provisions of a law adopted in order to implement Directive 82/76, 
can be interpreted after the date of entry into force of those provisions in the light 
of the wording and the purpose of that directive in order to achieve the result 
pursued by it’ (judgments in Carbonari and Others, paragraph 49, and Gozza and 
Others, paragraph 37). The purpose of the directive is clearly apparent from the 
second subparagraph of Article 13 of Directive 82/76, according to which the full-
time training of specialists involves ‘participation in all the medical activities of 
the department where the training is carried out, including on-call duties, so that 
the trainee specialist devotes to this practical and theoretical training all his 
professional activity throughout the duration of the standard working week and 
throughout the year according to provisions agreed by the competent authorities’. 
For that reason, having regard to the professional activity devoted by the trainee 
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specialist, including the trainee’s acquisition of the necessary specialist skills, to 
which the second subparagraph of point 1 of the annex refers, such training must 
attract ‘appropriate remuneration’. The same requirement for appropriate 
remuneration to be paid applies to the part-time training of specialists. 
53 Moreover, it has been asserted several times in the case-law of the Court of 
Cassation, to that effect, that, while the activities undertaken by doctors enrolled 
at university specialist schools cannot be regarded as falling within an 
employment relationship or as self-employed work, they do constitute a particular 
type of work-study contract, one subject to specific rules, under which the 
remuneration provided for by law for trainee specialists is intended to meet 
material needs in exchange for the commitment of the individuals concerned to 
their training, the purpose of which is their obtaining a professional qualification 
at the end of the course (Judgments Nos 18670 of 27 July 2017 and 20403 of 
22 September 2009 of the Court of Cassation). 
54 According to the referring court, it is quite clear that this requirement, expressly 
taken into consideration in Community law, with the conferral on trainee 
specialist doctors of an entitlement to appropriate remuneration, in order to 
compensate the work which they do as part of their training, exists for all doctors, 
without distinction, who have enrolled after graduating in a specialisation course. 
Aligned with that is the criterion of retroactive and full application of measures 
implementing Community rules, entailing provision for the possibility of 
compensating any individual who has sustained harm, to which the Court of 
Justice has pointed as a remedy for the harmful consequences of late 
implementation of Directive 82/76. It is therefore clear that a broad interpretation 
is by far more consistent with the objectives pursued by the Community 
legislation cited, according to the interpretation of that legislation provided by the 
Court of Justice. 
55 Such an interpretation is not precluded by the Court of Justice’s ruling of 
24 January 2018 or by Judgment No 20348/2018 of the Combined Chambers of 
the Court of Cassation, which is aligned with that decision.  
56 A comparison of the questions asked by the Combined Chambers of the Court of 
Cassation in its two orders for reference nos 23581 and 23582 of 21 November 
2016, which resulted in Cases C-616/16 and C-617/16, in which the EU judicature 
was asked to clarify whether the directives mentioned included within their scope 
the full-time and part-time training of specialist doctors ‘which had already begun 
by 31 December 1992’ or ‘which began before 1 January 1983 but had not ended 
by that date’ (see paragraph 35 above), and the general answer given by the Court 
of Justice in paragraph 37 of its judgment of 24 January 2018 suggests the same. 
Indeed, the Court of Justice held that ‘it is not apparent from Directive 75/363 as 
amended that the obligation on Member States to provide appropriate 
remuneration for periods of full-time and part-time specialist training would not 
apply to such training begun before the expiry, on 1 January 1983, of the deadline 
for the transposition of Directive 82/76 and continued after that date’. 
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57 Given this broad, general reference to training courses begun before 1 January 
1983 – which corresponds entirely to the questions asked by the Combined 
Chambers of the Court of Cassation ‒ it would appear, in the referring court’s 
opinion, that the references to specialisation courses begun in the period 1982 to 
1990, which are contained in paragraphs 38, 51 and 57 and the operative part of 
the judgment, were merely intended to align the Court of Justice’s ruling with the 
particular case before it, which concerned training undertaken during the period 
mentioned. Indeed, while, in paragraph 37, the Court stated the general principle 
that the entitlement to remuneration is also afforded to doctors who were already 
enrolled in courses by the deadline for transposing the directive ([31December 
1982]), in paragraphs 38, 51 and 57 – as is apparent from the opening words of 
each of the relevant rulings contained in those paragraphs: ‘the answer to the 
first/second/third question is …’ – the Court itself applied the general principle 
stated in paragraph 37 to the facts of the case before it, which concerned trainees 
who enrolled in the years 1982 to 1990. 
58 As mentioned above, the same approach was taken by the Combined Chambers of 
the Court of Cassation in Judgment No 20348/2018, which also concerned the 
case of doctors who had enrolled at specialist schools in the academic years 
between 1982 and 1990. 
59 But there is weakness in the argument excluding any entitlement to remuneration 
for doctors who enrolled in training courses before 1982 – which is based on the 
fact that the entitlement to the remuneration in question was introduced only from 
29 January 1982 onwards, with the entry into force of Directive 82/76 – and that, 
according to the referring court, is the fact that the Court of Justice acknowledged 
in paragraph 38 of its judgment of 24 January 2018 that that entitlement was 
afforded to all whose training had ‘begun in 1982’. That assertion is reiterated in 
paragraph 48, which states that, ‘as is clear from the answer to the first question, 
the obligation to provide the doctors concerned with appropriate remuneration 
extends to all full-time or part-time medical specialist training begun in 1982 and 
continued until 1990.’ 
60 The entitlement in question is therefore afforded by the directive to individuals 
who enrolled at any point in 1982, that is to say, at any time during that year, 
including the beginning of January, and not only to doctors who enrolled after 
29 January 1982 (the date of entry into force of Directive 82/76). That leaves 
28 days in relation to which, although Directive 82/76 had not yet entered into 
force, the Court of Justice acknowledged the entitlement to remuneration and, 
therefore, to compensation for damage. This lends strong support to the view that 
the Court of Justice acknowledged in the abovementioned judgment that the 
entitlement in question also applies to doctors who enrolled in courses in years 
prior to 1982. 
61 The reasoning adopted in some rulings to overcome that contradiction – which is 
based on the consideration that the proximity in time with the date of 29 January 
1982 made it easier for an obligation upon the Member States to conform their 
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domestic legislation to emerge (Judgment No 18053/2019 of the Court of 
Cassation) ‒ is unconvincing, for two reasons. 
62 In the first place, it is difficult to see why such an obligation to conform domestic 
legislation should not be taken into consideration also for enrolment years prior to 
1982, once Directive 82/76 had entered into force (on 29 January 1982). Nor can 
it be ruled out that some specialist schools had what was necessary to render the 
entitlement to remuneration lawful before 1982. In the second place, the Court of 
Justice’s acknowledgement of the entitlement to remuneration even in respect of 
the 28 days preceding the entry into force of the Community legislation does not 
disprove the theory that that entitlement also exists for individuals who enrolled in 
specialisation courses before 1982. On the contrary, it supports that theory, 
confirming the full retroactive effect of the measure implementing the Community 
legislation. 
63 The referring court points, in this connection, to the unjustified difference in 
treatment that would arise between individuals who had, for example, formalised 
their enrolment on 2 January 1982, to whom the entitlement to remuneration (and, 
therefore, the right to compensation) would apply, and individuals who enrolled 
48 hours earlier (for example, on 31 December 1982) to whom that entitlement 
would not be afforded. 
64 Moreover, there can be no doubt that the work-study contract under which the 
hospital activities of trainee specialist doctors must fall gives rise not to a unitary 
relationship, but to a relationship that continues over a period of time, one which 
last a number of years and is between the individual doctor and the university. 
65 To relationships that continue over time, such as those at issue in the main 
proceedings, the ius superveniens, Directive 82/76, must necessarily apply, since 
there can be no doubt that the Community provisions do not establish or regulate 
the relationship between the individual doctor and the university ex novo, but 
enable that relationship to continue over time in a manner consistent with the 
principles of EU law. 
66 Finally, a further argument, connected with the preceding argument, in favour of 
the broad interpretation illustrated above may be found in the so-called principle 
of ‘jurisdictional equivalence’, which requires that the scheme for the 
compensation of damage in the event of infringement of Community law must not 
be less favourable than that which applies to similar actions based on the 
infringement of rules of domestic law. Accordingly, since the relationship which 
arises from a doctor’s enrolment in a specialisation course is one that continues 
over a period of time, then, in the context of domestic law, it is necessary to apply 
the principle that the supervening law – especially if it is a Community law – 
governs the ongoing legal relationship so long as the effects of that relationship, 
which arose earlier, have not yet been exhausted (Judgment No 10612 of 22 May 
2015 of the Court of Cassation).