Italy suffers doctor epidemic

THE ITALIAN federation of medical registrars has asked medical schools to halt enrolments for a year to combat a massive surplus of doctors.

Aldo Pagni, the organisation's president, said there were already 80,000 unemployed doctors in Italy, which has the world's highest density of doctors, dentists and specialists.

"We have asked the university minister, Luigi Berlinguer, to suspend enrolments in medical and dentistry schools for the 1997/1998 academic year," Dr Pagni said.

The request appears difficult, if not impossible, to meet, and Dr Pagni admitted it was calculated to goad the ministry into effective planning. He believes that plans to programme admissions have been so diluted in the face of opposition from student organisations that they will be largely ineffective, and that only strictly limiting admittance will have any effect.

Italy has 325,000 doctors, one for every 173 inhabitants - twice as many as France and roughly three times as many as the United Kingdom. According to Dr Pagni, 80,000 specialists are unemployed and another 20,000 are about to finish their postgraduate specialisation. And 60,000 general practitioners are on the waiting lists for an opening in the state health service, which already employs 60,000 family doctors.

"The vast majority of doctors have to work sporadically for a pittance, often until they are well over 40 years old, before they get a decent job," said Dr Pagni. "We have reached the paradox of doctors treating illnesses which are more imaginary than real and of prescribing an infinity of complex tests which are largely useless except for earning a living for the doctors involved. We have to stop deceiving students that once they are doctors their future is assured."

Luca Lani, a student union spokesman, said: "The truth is that doctors and dentists are afraid of competition. If there is to be programming, then the total number of new students should be decided by the government, not by the faculty councils that run the medical schools which are made up of doctors. If there really is such an abundance of doctors and dentists, why does Italy have the most expensive private practices in Europe along with one of the least efficient state health systems?

"Dr Pagni cannot take it for granted that a doctor, just because he is a doctor, should be guaranteed a substantial income. What about graduates in other fields?

"The real scandal is that in medicine, careers are regulated by family relationships and patronage. The medical profession is a tightly-knit feudal system, it is on that that the government and the university ministry should act."