Educational goals

The single-cycle Master's degree course in Medicine and Surgery, hereafter called "Harvey" (Class of degrees in Medicine and Surgery LM-41, annexed to Ministerial Decree no. 1649 of 19-12-2023), sets out to train 'expert doctors', endowed with the scientific foundation, theoretical and practical preparation and professional competence needed to practise the profession of medical doctor, taking on positions of responsibility in various professional roles and areas both nationally and internationally. Taking into due account international standards on medical training and the educational objectives of the Class of degrees in Medicine and Surgery, Master's graduates in this class must be able to: - provide high quality and safe care, collaborating with the patient and working in accordance with the core values of the profession, correctly and independently apply medical knowledge, skills and clinical competence; - make clinical decisions and perform preventive, diagnostic and therapeutic actions in one's area of competence, being duly aware of one's limits, collect, interpret and critically evaluate information and data relating to the individual's state of health, also considering the characteristics of the environment in which he/she lives; go through a correct decision-making process, considering individual variability, evaluating specific circumstances and patient preferences, resource availability, best practices from evidence-based medicine and, when appropriate, precision medicine; - use scientific evidence and innovative technologies in a knowledgeable manner, keeping up-to-date with the latest developments, for the benefit of the patient in complex prevention, diagnosis and treatment processes; - conduct ethical and efficient clinical practice, keeping up with the latest developments, working in a team and in collaboration with patients and their families, other healthcare professionals and the community; - conduct one's 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 conduct, being fully aware of what it takes to "be" a medical doctor; - 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, graduates of the Harvey English-language degree course in Medicine and Surgery 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, state of health or disease, 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 well-being (communication as part of treatment time); - ability to work efficiently with other professionals in the healthcare group, making a conscious use of 'communities of practice' activities, 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'; - ability, when practising the profession, 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.it/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 the Presidents of the 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 specific scientific-disciplinary sectors according to the University's academic regulations, in compliance with the ministerial table of fundamental training 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 Professional Qualifying Internship (PQI), 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 a profession (https://www.gazzettaufficiale.it/eli/id/2018/06/01/18G00082https://www.gazzettaufficiale.it/eli/id/2018/06/01/18G00082/sg). The PQI 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 Surgical Area; one month in the Medical 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 PQI in question may not overlap. Each CFU for the PQI 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 takes on the status of a State examination enabling the student to qualify to practise the profession of Medical Doctor, subject to passing the PQI 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 number of no less than 30 CFUs for the activities referred to therein, of which no less than 8 for elective activities and no less than 12 for 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 path. Description of the main teaching methods adopted in the Degree Course. The teaching method adopted 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 solid cultural and methodological knowledge acquired in 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, in the context of the most frequently encountered clinical problems and emergencies, excellent clinical skills and human relations, becoming capable of "taking 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 update knowledge over time. 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 in 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" pattern 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 (Global health, One health, e-Health), 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, various 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 CFU weights related to 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 doctor" within the limits specified above, who possesses: 1) an excellent knowledge of medicine and clinical practice (capabilities and doing the right thing) 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. To correctly manage the study course and have a future-looking vision, the educational programme must ensure: 1) adaptation of the curriculum, making it increasingly geared to the needs of the real world (authentic curriculum) and not merely an "excellence" detached from the social setting; 2) a flexible syllabus that increasingly meets the needs of students and fosters 'adaptive learning', instead of a standardised curriculum; 3) 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. Special features of the Degree Course The special features of the Master's degree course in Medicine and Surgery, aimed at achieving general, intermediate and specific educational objectives, are summarised below: 1) The planning of objectives, programmes and course subjects is multidisciplinary in nature, within the scope of current legislation. 2) 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 such as suturing surgical wounds, positioning bladder catheters, measuring blood pressure, collecting medical histories, acquiring BLS techniques in the Clinical Simulation Laboratory. These activities prepare students for greater clinical involvement during the internship organised starting in the third year as a guided tutorial activity and continuing until the end of the six-year course. Problems relating to 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. 3)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 knowledge based in order to address current or foreseeable clinical issues, referring in particular to the scientific method. 4)The specific objectives of more specialist 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. 5)The teaching process uses and implements modern teaching methods that engage students and build a sound base of required professional competences. To manage large groups, classroom response systems are commonly used to enhance student engagement, and clinical triggers are promoted in lectures on basic sciences and clinical presentations. 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. Teaching methods used include problem-based learning, clinical teaching, team-based learning, brainstorming, role-playing, journal clubs and the extensive use of seminars, interactive lectures, debates, peer teaching by students, and activities that also aim to support and encourage 'independent learning' on the part of the student. 6)Great use is made of tutors (lecturers) to help with the student's learning process, facilitating learning (special area tutors) and supporting students (personal tutors). 7)Great care is taken with the acquisition of skills and abilities related to knowing "how to" and "how to be" a doctor through: a) engagement in basic laboratory activities in the first two years of the course; b) learning the semeiological basics of clinical sciences at the sick person's bedside and in the Clinical Simulation Laboratory (skill-lab) from the first year of the course through the use of dummies, models, virtual patients and simulated patients; c) attending, from the third year of the course, Hospital wards and Medical Centres located throughout the territory for vocational training, including the Professional Qualifying Internship (5th and 6th year of course). These clinical activities will be organised in such a way that they do not overlap with other course activities envisaged and with optional activities chosen by the student, if applicable. They will be organised mainly as short periods of vocational training in the majority of hospital wards, in such a way as to always ensure the application of theoretical knowledge and scientific content in a clinical practice setting. The teaching method used is the classic 'bedside teaching', and entails a direct relationship between the student and the patient, and the clinical tutor, in the various clinical contexts of the hospital ward and outpatient clinic; d) participation in research programmes, including translational ones, during the internship period, also for the purpose of preparing the degree thesis. In modern-day medical studies, the use of technology plays an important role in facilitating the acquisition of basic knowledge, improving 'decision-making' skills, improving coordination for certain hands-on abilities or visioning critical or rare events, enhancing psycho-motor skills and implementing 'learn team training' activities. Considerable space is therefore given to computer and multimedia methodologies and the correct use of bibliographic sources. 9)Clinical methodology and the Human Sciences are studied through integrated courses spread throughout the educational path (1st-6th year). These integrated courses, seeking to steer students towards an education in the Humanities, will accompany them in the scientific and vocational training process, enabling them to 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, relations with so-called complementary and alternative medicines, prevention, chronic patient education, addiction pathologies and palliative care for the terminally ill. 10)Space is given to practical experience in community settings, and to community health issues, acquiring 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 study 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 particular features of medicine practised in rural and hard-to-reach places. 11)Student participation in internationalisation programmes is encouraged, given the international character of the Study course. Students are invited to participate in Erasmus study and residency programmes but also in internships of their choice at universities in and outside Europe. 12)Educational objectives (i.e. the levels of competence achieved) are pursued by means of certification-valid evaluation tests that are reproducible, based on objective elements, not influenced by extraneous factors (reliable) and fair (respecting the educational pact between teacher and learner), using valid methodologies for the dimension being tested in terms of both knowledge and competences. The assessment of acquired competences must therefore be aligned, coordinated, analytical and formative for the student him/herself. Examinations can be conducted in a traditional manner, i.e. oral or written examination, written examination with multiple-choice questions, interpretation of case studies, written exams with short-answer questions. Students are also assessed through in-course learning assessments (self-evaluation 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 biomedical-psychosocial. This profile is aimed at developing professional competences and professional values in this particular field. It is 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 knowingly 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 knowledge of the Humanities; - 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. The study course qualifies medical doctors for work in general practice and hospital medicine, with the potential to reach top management positions in organisations. The international dimension of the course and the in-depth study of global health topics make the Medicine and Surgery graduate ready to embark on international paths of specialisation, work and research. Job vacancies in the health sector, particularly for Medical Doctors, are on the rise, and the shortage of medical personnel is currently one of the main problems in the healthcare system not only in Italy, but also overseas. The main career opportunities for Medical Doctors are as follows: - Specialist medicine in public and private hospital facilities and national and international healthcare and humanitarian organisations, - General medicine, - Healthcare management, - Clinical research in universities, IRCCS (biomedical research institutes), public and private research institutions. The international dimension of the course and the in-depth study of global health topics make the Medicine and Surgery graduate ready to embark on international paths of specialisation, work and research.

Admission requirements

For admission to the single-cycle Master's degree course, the student must hold an upper secondary school diploma, as per current regulations, or another qualification obtained abroad, recognised as suitable by the competent bodies of the University. The number of available places, date of the admission test and selection procedures are determined annually by decree of the MUR (University and Research Ministry) and are set out in the call for applications. Adequate initial preparation and knowledge of English is also required. The ways of verifying English language knowledge and general knowledge required for admission are set out in the course's Academic regulations. Students wishing to enrol in a degree course in medicine and surgery must meet the following requirements: human relationship skills, ability to work in a group, ability to analyse and solve problems, ability to independently acquire and critically evaluate new knowledge and information (Maastricht, 1999). In addition to scientific knowledge of use for the first year of studies, and knowledge in the subjects of biology, chemistry, physics and mathematics, the student should also show a good attitude and valid motivation, important for the formation of a "good doctor" who is able handle his/her social responsibilities, as well as good logical thinking skills. Procedures for remedying any gaps in the student's knowledge base (by no later than the completion of the first year of study) are governed by the Academic regulations of the single-cycle Master's degree course.