Educational goals

The Italian language single-cycle Master's degree course in Medicine and Surgery, called 'Golgi' (Class of degrees in Medicine and Surgery, LM-41, annexed to Ministerial Decree no. 1649 of 19-12-2023) sets out to train 'expert medical doctors', endowed with the scientific foundation, theoretical and practical preparation and professional competence needed to practise the profession of medical doctor, and the ability to perform activities in positions of responsibility in various professional roles and areas. Bearing in mind international standards on medical training and the educational goals of the Medicine and Surgery degree Class, Master's graduates must in particular be able to: - provide high quality and safe healthcare in collaboration with the patient and respecting the core values of the profession, correctly and independently applying medical knowledge, skills and clinical competence; - make clinical decisions and carry out preventive, diagnostic and therapeutic procedures within their field of knowledge and aware of their limitations, collect, interpret and critically evaluate information and data relating to an individual's state of health, also considering the characteristics of the environment in which he or she lives; - go through a correct decision-making process, considering individual variables, knowing how to assess specific circumstances and patient preferences, resource availability, best practices from evidence-based medicine and, when appropriate, precision medicine; - use, in a knowing manner, constantly updated scientific evidence and innovative technologies, for the benefit of the patient in complex prevention, diagnosis and treatment processes; - implement up-to-date, ethical and efficient clinical practice, conducted within a team ethic and in collaboration with patients and their families, other healthcare professionals and the community; - plan for and conduct their own continuing vocational training to keep up with the latest scientific research, and critically evaluate relative results; - act with the utmost professionalism, fully adhering to the ethical principles of the profession and observing the Code of Ethics, being fully aware of the conduct and attitudes that a doctor must adopt; - understand the global health and equality needs of the community and the population (Global Health, One Health, e-health), working to mobilise the resources needed for change and contributing, through experience and work, to improving the health of the community and population, ensuring equal access to quality healthcare. In order to carry out their profession with a full awareness of their role, Medicine and Surgery course graduates must have acquired: - fundamental knowledge and competences in the basic sciences, with a focus on subsequent professional application, including scientific methods, principles of measuring biological functions, evaluation of scientific evidence and data analysis; - knowledge and competences in biomedical, biotechnological and clinical research methods, with a focus on translational scientific research, being able to conduct research on specific topics, having the right mindset to critically interpret scientific data, with a good knowledge of digital technologies applied to medicine; - competence in detecting and critically evaluating data on an individual's well-being, health and disease status, from a clinical point of view, in a holistic vision of the person extended to the gender-related, socio-cultural and environmental dimensions, knowing how to interpret data in relation to scientific evidence, pathophysiology and organ, apparatus, cellular and molecular pathologies; - the skills to responsibly and independently address and solve an individual's health problems in terms of health promotion, prevention, diagnostics, prognostics, therapeutics and rehabilitation, on the basis of in-depth clinical and surgical knowledge, combined with skills, experience and self-assessment capabilities, applying the principles of healthcare economics in decision-making processes; skills in listening to the patient and his/her family members, combined with the ability to relate to and communicate with them in a clear, humane and empathic way, managing an effective patient-centred therapeutic relationship, knowing how to elicit patient engagement through a true partnership with the patient and his/her family members. Graduates will also be able to deal effectively with communication in difficult situations and carry out effective counselling, health education and health promotion for the patient's mental and physical wellbeing (communication as part of treatment time); - ability to work efficiently with other professionals in the healthcare group, making a conscious use of the activities of 'communities of practice', so that the patient's 'treatment process' is as effective and complete as possible; - ability to recognise community healthcare problems, with a focus on diversity and inclusion, being able to intervene competently and apply the principles of 'advocacy' for healthcare and social justice, knowing the principles of 'global health/One health/eHealth' and those related to 'disaster medicine'; - in practising one's profession, ability to develop reflective thinking techniques, including in the domain of the historical, epistemological, sociological, psychological and ethical dimensions of medicine and everything within the scope of the 'medical humanities'. - ability to exercise critical judgement on the ethical aspects of clinical decisions and research. The specific educational objectives described above (or expected learning outcomes), given for the single-cycle Master's degree course in Medicine and Surgery, are based on the guidelines of the World Federation of Medical Education (WFME) in the 2007, 2015, 2020 editions, the TUNING-CALOHEE Medicine Guidelines and Reference Points for the Design and Delivery of Degree Programmes in Medicine (Edition 2024) and the TUNING Project (Medicine) Learning Outcomes/Competences for Undergraduate Medical Education in Europe according to the European descriptors (5 Dublin descriptors). The suggestions of the International Association for Health Professions Education (AMEE) from the AMEE Guides and the BEME (Best Evidence Medical Education) Guides have also been followed. The Educational Objectives described above also mirror the specific educational objectives set out in Ministerial Decree 1649 of 19/12/2023 (https://www.mur.gov.en/en/acts-and-regulations/decreto-ministeriale-n-1649-del-19-12-2023), and are consistent with the core curriculum for the Master's degree in Medicine and Surgery proposed by the Permanent Conference of Presidents of Italian CLMs (Master's degree courses) in Medicine and Surgery (http://presidenti-medicina.it/). Description of Educational Path In accordance with current European Directives, the duration of the Master's degree course in Medicine and Surgery is six years, consisting of at least 5,500 hours of theoretical and practical teaching carried out at or under the supervision of the University. The Single-cycle Master's degree course in Medicine and Surgery requires the student to acquire a total of 360 University Credits (CFUs), spread over six years. These include at least 60 CFUs from practical training activities aimed at developing specific work-related skills (vocational training credits). The course is divided into 12 semesters, with no more than 36 integrated courses, to which CFUs are assigned in the specific scientific-disciplinary sectors according to the University's academic regulations, in compliance with the ministerial table of fundamental educational activities (Ministerial Decree No. 1649 of 1912-2023). As part of the CFUs to be obtained over the entire educational path from the above-described vocational training activities, 15 CFUs are awarded for the three-month Practical-Assessment Internship (TPV), within the Course of studies referred to in Article 3 of Decree no. 58 of 9 May 2018 of the Minister of Education, University and Research, as amended, with a view to qualifying to practise the medical profession (https://www.gazzettaufficiale.it/eli/id/2018/06/01/18G00082 /sg). The TPV lasts for a number of hours corresponding to at least 5 CFUs for each monthly period, and is divided as follows: one month in the Surgery Area; one month in the Medicine Area during the fifth and/or sixth year of the course; one month, not before the sixth year, in the General Medicine Area. Periods do not have to be consecutive. The months of TPV in question may not overlap. Each CFU for the TPV must correspond to at least 20 hours of vocational teaching activity, and no more than 5 hours of individual study. Pursuant to Article 102(1) of Decree Law no. 18/2020, the final examination of the Single-cycle Master's degree course in Medicine and Surgery is valid as a State examination enabling the student to qualify to practise the profession of Medical Doctor, subject to passing the TPV. Pursuant to Article 3(6) of Ministerial Decree 1649 of 19-12-2023, the course affords students full access to the educational activities referred to in Article 10(5) of Ministerial Decree no. 270 of 22 October 2004, reserving a total of no fewer than 30 CFUs for the activities referred to therein, of which no fewer than 8 for the activities referred to in point a) (elective activities) and no fewer than 12 for the activities referred to in point b) (training activities related to or supplementary to basic and/or vocational training activities). In addition to the 8 CFUs for elective activities, the course reserves up to 5 CFUs freely chosen by the student within the scope of compulsory CFUs for vocational training activities required for the Class in question. This part of the course gives students a better self-awareness of their professional future, allowing them to make a well-grounded and conscious choice about their post-graduate pathway. Description of the main teaching methods adopted in the Degree Course The teaching method followed in the Golgi Study Course entails the horizontal integration (between different subjects in the same semester or year) and vertical integration (for similar or complementary topics over several years) of knowledge, a method based on sound cultural and methodological knowledge acquired from the study of preclinical subjects, before focusing on problem-solving and decision-making, early patient contact, acquisition of a good professional identity and skills that include excellent clinical skills and human relations, the student learning how to "take care of the patient". The planning of teaching is highly integrated, with the intention of fostering in students the ability to acquire knowledge in an integrated, non-fragmented manner, and to keep it "alive" for longer. Students will be able to acquire all the basic professional skills and knowledge in the field of internal medicine and specialist medicine, general surgery and specialist surgery, as well as community healthcare, with the ability to detect and critically evaluate data on an individual's state of health and disease from a clinical point of view, with a holistic vision that also includes the socio-cultural dimension. With regard to 'practice-based learning' and a forward-looking vision, the aims are also for: 1) closer integration with the clinical context, from the first to the sixth year of the course; 2) the well-defined and growing empowerment of students within the treatment process, during their educational path; 3) an ever-increasing consideration of student collaboration within the National Healthcare System; 4) considering students as 'student doctors', and the possibility of registering with ENPAM (Italian welfare organisation for medical doctors) in their student status; 5) an increasingly evident and important link between 'medical education' and 'healthcare delivery'. The general organisation of the course comprises two intersecting and complementary vertical paths: An initial "biomedical" vertical path, from the first to the sixth year of the course, having an "inverted triangle" shape with regard to the organisation of fundamental preclinical and clinical training activities and the beginning of clinical activities right from the first year ("early clinical contact"); - A second 'psychosocial' vertical path, dedicated to medical and scientific methodologies and human sciences, in the areas of bioethics, forensic medicine, epidemiology, general hygiene and occupational medicine, scientific methodology, the doctor-patient relationship and inter-, intra- and trans-professional relations in the complex healthcare process, health issues related to gender, ageing, chronicity and multimorbidity, social status, economics and relations with the environment, diversity and disability, vulnerable individuals, the clinical approach of narrative-based medicine, sundry topics from the areas of psychology, sociology of health, healthcare economics and management; other topics, taken together and correlated with the 'biomedical' path, help to develop the students' professional identity. These two main vertical paths are closely linked to each other, with different weights in CFUs correlated with the educational profile in which the same topics are re-examined with increasing degrees of complexity and difficulty, leading to the formation of an "expert medical doctor" within the limits specified above, who possesses 1) an excellent knowledge of medicine and clinical practice (technical capability) 2) excellence in clinical practice (doing the right thing); 3) an awareness of reaching an excellent level of professionalism (the doctor knows he is acting professionally - the right person doing it). The specific contents of courses and educational objectives are based on the tasks that society entrusts to the medical profession, responding to a health need and requiring knowledge and skills indispensable for professional practice, identified by a shared 'core curriculum'. Vocational training credits and practical training must ensure the acquisition of indispensable competences and skills, linked to 'knowing how to' and 'knowing how to be' a medical doctor, this too identified by the 'core curriculum'. The educational project of the Medicine and Surgery degree course therefore proposes the right balance of vertical and horizontal integration, between: - Basic sciences, with a broad knowledge base, including a knowledge of evolutionary biology, molecular biology and genetics, biological complexity, understanding the structure and functioning of the human organism under normal conditions for the purpose of health maintenance and the proper application of translational scientific research; - Knowledge of disease development processes and underlying mechanisms, also with a view to prevention, diagnosis and therapy; - Paticularly sound clinical medical practice and its methodological foundations, through extensive use of tutorial-based teaching, capable of transforming theoretical knowledge into personal experience, in such a way as to build one's own scale of values and interests, and to acquire the professional competences needed to manage complex medical matters, building up one's own professional identity; - The human sciences, knowledge useful for becoming aware of what being a doctor is and the profound values of medical professionalism, in relations with the patient and society as a whole; - Acquisition of scientific, technological, medical, clinical and professional methodologies in relation to the health issues of individuals and the community, paying due attention to population and gender differences. In order to meet real-world needs and ensure flexibility in a forward-looking vision, the characteristics of the course's educational programme require: 1) adaptation of the curriculum, so that it is increasingly geared to the needs of the real world (authentic curriculum) and is not merely an "excellence" detached from the social context; 2) a flexible curriculum that increasingly meets the needs of students and fosters 'adaptive learning', instead of a standardised curriculum; - the creation of strong motivational foundations making interpersonal collaboration between students (peer-to-peer, team-based learning) increasingly normal, and isolation and individualism less common; 4) consideration of the student as a true partner in the educational process, rather than a 'customer'; 5) greater appreciation of the quality of teaching and lecturers who obtain excellent ratings in students' evaluations of their teaching, compared to today's consideration of the overall quality of integrated courses. Special features of the Degree Course The special features of the Golgi Master's degree course in Medicine and Surgery, aimed at achieving specific educational objectives, are summarised below: - The planning of objectives, programmes and course subjects is multidisciplinary, within the scope of current legislation. - The teaching method is interactive and multidisciplinary, with daily integration of basic sciences and clinical subjects and early clinical involvement of students. From the first year onwards, students are involved in practical course activities dedicated to the acquisition of BLS techniques and basic surgical and ultrasound procedures (which may then be implemented) acquired in the Clinical Simulation Laboratory. These activities create the foundations for a more comprehensive clinical involvement from the third year, with the vocational training internship. The basic sciences and clinical issues are thus addressed in all years of the course, albeit in different proportions, but with a single, integrated vision. - The specific objectives of core syllabuses are based on the relevance of each objective in terms of human biology, and on the need for a background of knowledge in order to address current or foreseeable clinical issues. The specific objectives of core syllabuses are chosen on the basis of epidemiological prevalence, urgency and possible treatment, severity and suitability of the subject for teaching purposes. Students are required to spend time in hospital wards and outpatient clinics of community-based facilities, and to learn about relations with the patient, including psychological aspects. - The course also makes use of innovative teaching methods (the use of which will grow over time), capable of building professional competences with a sound foundation and ensuring equal student involvement in both large classes and small groups. Training initiatives will promote the use of new platforms available at the University of Pavia, including "panopto" and "wooclap", which are particularly useful when managing large groups. The 'Peer observation of teaching' pilot project, a voluntary activity designed to stimulate and foster the professional growth and self-awareness of lecturers, has been running since October 2024. A well-structured tutorial system is used for the management of small groups, with rotation ensuring this important type of teaching activity is available for all students, being able to explore specific topics in depth, and encouraging and motivating the students involved. All these activities are also designed to support and encourage 'independent learning' on the part of the student. - Great care is taken with the acquisition of skills and abilities related to knowing "how to do" and "how to be" a doctor through: a) learning the semiological basics of clinical sciences at the sick person's bedside and in the Clinical Simulation Laboratory from the first year of the course through the use of dummies, models, virtual patients and simulated patients; b) attending, from the third year of the course, Hospital wards and Medical Centres located throughout the territory for vocational training, including the practical-assessment internship. These clinical activities will be organised in such a way that they do not overlap with other planned course activities and with optional activities chosen by the student, if applicable; They will be organised mainly as short periods of vocational training in multiple hospital wards and in any case in such a way as to always ensure the application of theoretical knowledge and scientific content in a clinical practice setting. The teaching methods used are classic 'bedside teaching' methods, and entail a direct relationship between the student and the patient, and with the clinical tutor, in the various clinical contexts (hospital ward, outpatient clinic); c) participation in research programmes, including translational ones, during the internship, also for the purpose of preparing degree theses. - Medical education nowadays cannot disregard the use and role of technology, involved in countless aspects of the profession, therefore space is given to the teaching of computer and multimedia methodologies applied to medicine. Students are taught how to use bibliographic sources correctly. - Clinical Methodology and Human Sciences are taught via integrated courses distributed along the educational path, seeking to steer students towards a "humanistic" education, which will accompany them in the scientific and vocational training process, fine-tune their skills and develop correct and innovative clinical reasoning through the application of 'evidence-based medicine' and 'evidence-based teaching' using guidelines and algorithms. These integrated courses cover topics relating to interdisciplinarity and interprofessionality, health economics, professionalism of the medical doctor, social responsibility, social and gender perspectives, chronic patient education, and palliative care for the terminally ill. - Space is given to community health issues, with a knowledge of the activities and practice of general practitioners and the activities managed by non-hospital community facilities. These specific competences can be raised further through attendance of elective teaching activities of the student's choice, dedicated to primary care in the local area, the care of frail and disadvantaged persons and the disabled, the peculiar features of medicine practised in rural and hard-to-reach places. - Educational objectives (i.e. the levels of competence achieved) are pursued by means of reproducible certification-valid evaluation tests, based on objective elements, fair and not influenced by extraneous factors (respecting the educational pact between teacher and learner), using valid methodologies for the dimension being tested in terms of both knowledge and skills and competences. The assessment of competences must therefore be aligned, coordinated, analytical and formative for the student him/herself. Examinations can be taken in a traditional manner, i.e. oral or written examination, or as a written examination with multiple-choice questions, a written examination with short-answer questions, written and/or oral diagnostic clinical reasoning tests using clinical scenarios. Students are also assessed through in-course learning assessments (self-assessment tests and mid-term interviews), students' written reports on assigned topics (portfolios), as well as through feedback from tutors during clinical activities at the patient's bedside. Specific educational profile The professional profile of the future 'medical doctor' is based on biomedical and psychosocial knowledge: studies seek to develop professional competence and values based on the importance of integrating the biomedical paradigm of treating the disease with the psychosocial paradigm of caring for the human being. The profile identifies the specific mission of the degree course, which is that of forming an expert medical doctor up to an initial professional level, who possesses and can consciously use: - a multidisciplinary, inter-professional, integrated and longitudinal vision over time of the most common health and disease problems; - knowledge oriented towards disease prevention, rehabilitation and health promotion in the local community, with a special focus on the principles of 'evidence-based medicine' and 'precision medicine' and with a "humanistic" culture; an in-depth knowledge of new treatment and health requirements, centring not only on the disease but above all on the sick person, considered in his/her totality - body, mind and spirit - life history and network of relations, inserted in a specific social, environmental, cultural and economic setting.

Career opportunities

Medical Doctor. A graduate degree in Medicine and Surgery enables the holder to be a general practitioner in private practice or provide round-the-clock medical assistance. The degree is a fundamental requisite for admission, subject to selection tests, to Specialisation schools in the Medicine and Surgery areas and related Services, as well as to General Medicine training courses, with career opportunities in NHS facilities, public bodies, State and private companies, or in private practice, as a General Practitioner. The door is also open to national and international healthcare and humanitarian organisations, public or private research centres, pharmaceutical and biomedical companies, and to University 2nd level Master's and Doctorate programmes. Practising the profession within the NHS and in private practice is governed by State legislation.

Admission requirements

For admission to the single-cycle Master's degree course in Medicine and Surgery, the student must hold an upper secondary school diploma or a foreign academic title recognised as suitable in accordance with current regulations. The initial knowledge required is that provided for in secondary school curricula in the subjects of biology, chemistry, physics and mathematics, as set out in the National Guidelines for "Liceo" (Grammar) schools and in guidelines for Technical and Vocational Colleges. Admission to the Master's degree course in Medicine and Surgery, subject to passing the so-called "filter semester", is governed by a specific provision of the Ministry of University and Research, in compliance with current regulations.