The GIMBE Foundation weighed in on the reform of entry into the medical school. In light of the admission test results, the criticisms raised by students and universities, and the subsequent political clash, the Foundation reiterated its position that the reform was unnecessary. It also calls on institutions to implement concrete measures to curb the exodus from public health.
«After the Caporetto of the entrance tests – explains Nino Cartabellotta, president of the Fondazione GIMBE – the GIMBE Foundation, with the aim of informing public debate and guiding political decisions, has reevaluated the numbers and dynamics of the medical profession, highlighting elements of propaganda and the issues with a reform that today requires a true “state-wide amnesty” to avoid excluding thousands of students who aspire to become doctors».
International Comparison
The Foundation’s analysis starts with a comparison between the number of doctors in Italy and those in other international settings. The data undermine the hypothesis of a doctor shortage in our country.
According to OECD data, updated on December 5, 2025 and covering all active physicians in Italy from graduation to retirement, in 2023 there were 315,720 doctors, or 5.4 per 1,000 people. This figure is higher than both the OECD average (3.9) and the European average (4.1), placing Italy second among the 31 countries for which data is provided.
In 2023, graduates in Medicine and Surgery were 16.6 per 100,000 inhabitants, a figure higher than the OECD average (14.3) and slightly above the European average (16.3), which places Italy ninth among the 31 countries considered. «These data – explains Cartabellotta – confirm that the premises of the reform were not based on an absolute shortage of doctors, nor on an insufficient number of Medicine and Surgery graduates».
National data 2023 (latest available year)
- Publicly employed doctors: according to the Annual Account of the State General Accounting Office (CA-RGS), doctors employed by the National Health Service (SSN) were 109,024 (1.85 doctors per 1,000 inhabitants).
- Contracted physicians: according to data from the Interregional Structure for Contracted Health Services (SISAC), contracted physicians totaled 57,880, of which 37,260 were general practitioners (GPs), 14,136 pediatricians in private practice (PPS), and 6,484 contracted ambulatory specialists.
- Physicians in specialty training: according to data from the Association of Free Postgraduate Students (Associazione Liberi Specializzandi), enrollments in specialty programs totaled 50,677.
- Physicians enrolled in the Specific Training Course in General Medicine: according to FIMMG estimates, about 6,000.
- From the comparison with OECD data, nearly 93,000 doctors registered in Italy, accounting for 29.4% of the total, do not work for the SSN as employees or contracted providers, nor are they enrolled in post-graduate training pathways.
The Issue of Selective Shortages
As Cartabellotta emphasizes, Italy’s problem isn’t an absolute lack of doctors, but their gradual departure from the SSN and the presence of selective shortages, also due to the fact that fewer young people are choosing general practice and some specialties are less attractive.
For family physicians, based on SISAC data, as of January 1, 2024 the GIMBE Foundation estimates a shortage of 5,575 GPs. For specialists, shortages can be estimated by looking at the acceptance rates for specialist training contracts. In the 2025-2026 competition, with 14,493 contracts, only 12,248 were awarded (85%), but with low or very low allocation rates in areas crucial for the SSN’s functioning, such as emergency and urgent medicine, general surgery, community medicine and primary care, radiotherapy, and all laboratory specialties.
«The solution to address these selective shortages – notes Cartabellotta – cannot simply be an increase in the number of medical school enrollments. Instead, targeted actions and extraordinary interventions are needed to restore attractiveness to general practice and to specialties abandoned by young doctors».
Upcoming Retirements Already Balanced
According to the data gathered by the Foundation, moreover, future retirements are already offset by the training capacity.
- Programmed slots: over the last ten academic years, 152,159 places have been programmed in Medicine and Surgery degree programs, with a steadily rising trend. In particular, in the last three years, advertised slots grew by more than 51% (from 15,876 to 24,026) and, with the Bernini reform in 2025-2026, by an additional 3,159 units compared to the previous year (+15.1%).
- Graduates: from 2015 to 2024, 95,533 students graduated in Medicine and Surgery, with a rising trend from 7,396 in 2015 to 9,497 in 2024. The annual average of graduates rose from 8,961 in 2015-2019 to 10,145 in 2020-2024.
- Expected retirements: according to Agenas, between 2026 and 2038 more than 39,000 publicly employed doctors will retire, and between 2026 and 2035 more than 20,000 contracted doctors, with an average reduction of about 5,000 units per year. A retirement figure that, even before the Bernini reform, was largely offset by the existing training capacity.
«The data – explains the GIMBE president – clearly show that the so-called “pension hump,” after peaking in the 2023-2025 period, was set to fall steadily in the years that followed. For this reason, the massive increase in medical school slots does not satisfy a real structural need».
There is another crucial timing element: «The new doctors trained under the current reform will enter the workforce no earlier than 9–11 years from now. This means that the sharp rise in admissions risks, in the medium-to-long term, producing a number of graduates that exceeds the SSN’s absorption capacity, opening a new era of a doctor glut, already experienced in the past and associated with poor professional appreciation and underpaid work».
Abbonati a Karla Miller
