ORTHOPAEDICS AND TRAUMATOLOGY DISCIPLINE IN ITALY HISTORY AND EVOLUTION 01.
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Transcript of ORTHOPAEDICS AND TRAUMATOLOGY DISCIPLINE IN ITALY HISTORY AND EVOLUTION 01.
ORTHOPAEDICS AND TRAUMATOLOGYDISCIPLINE
INITALY
HISTORYAND
EVOLUTION01
ITALY GEOGRAPHICAL CHALLENGES
- 58.462.375 Inhabitants - 301.230 km2
- length of coastline 7600 km - Italy has a particular shape of
a boot, much longer than it is wide. The heel is in the region of Puglia, while the toe in the region of Calabria, points towards the island of Sicily
- Medicine doctors 406.92O (4.1 Inhabitants, second only to Greece 4.8) - Specialists in Orthopaedics and Traumatology: the members of the Italian Society of Orthopaedics and Traumatology are 4641; women only 204 (4.4%)
02
Since 1840 in Naples University First Course of Traumatology.
Since the end of XV Century in Rome “Teaching of Chirurgia Istantanea”
to-day is “Traumatology”.
Since 1871/72 in the University“la Sapienza” in Rome Regular Courses of Traumatology
Since 1885 in Naples University the First Chair of Orthopaedics hosted beside the Surgycal Clinic
Since 1910 in The University “La Sapienza” in Rome the First Fusion of Orthopaedics and Traumatology
DISCIPLINE HISTORY
03
1931 Bologna First School of Specialisation in Orthopaedics Three Years Length
1934/35 Rome First Teaching in Medical School of Orthopaedics and Traumatology of Motor Apparatus
1946 Rome One year after the end of the Second World War The First School of Specialisation in Orthopaedics and Traumatology of Motor Apparatus
THE ORGANIZATION OF THE POST GRADUATE
SPECIALISATION SCHOOLS: HISTORY AND EVOLUTION.
I
04
THE ORGANIZATION OF THE POST GRADUATE SPECIALISATION SCHOOLS:
HISTORY AND EVOLUTION.II
1982: THE LEGISLATIVE DECREE n.162, THAT RISED THE LENGTH FROM THREE TO FIVE YEARS FOR ALL
THE SCHOOLS OF SPECIALISATION OF SURGICAL AREAS
1991: THE LEGISLATIVE DECREE n. 257, THAT INTRODUCED THE EDUCATIONAL GRANTS
LASTING ALL OVER THE FIVE YEARS LENGTH.THE TRAINEES PROGRAMMED NUMBER.
05
IN YEAR 2000 THE MINISTRY OF EDUCATION CHARGED A “TEAMWORK“ OF FULL PROFESSOR SPECIALISTS IN
THE VARIOUS SPECIALTIES FROM ALL THE UNIVERSITIES.THE FIRST ACTION FOR THE QUOTED “TEAMWORK“ WAS
TO SOLVE THE PROBLEM TO REDUCE THE EXCESSIVE NUMBER OF SCHOOLS OF SPECIALISATION OF
“MEDICAL AREA”. THIS WAS A BIG AND DELICATE PROBLEM, BUT FINALLY
THE NEW NUMBER IS: 59 OF DIFFERENT TYPOLOGY. THE DIFFERENT TYPOLOGY SCHOOLS ARE GROUPED IN FOUR AREAS: MEDICAL - SURGICAL - DIAGNOSTIC
SERVICES - PUBLIC MEDICINE
06
THE ORGANIZATION OF THE POST GRADUATE SPECIALISATION SCHOOLS:
HISTORY AND EVOLUTION.III
IN YEAR 2005 THE MINISTERIAL “TEAMWORK“ OF FULL PROFESSORS OF THE DIFFERENT SPECIALTIES CONCLUDED THE
ACTIVITY. THE REORGANIZATION OF THE SCHOOLS OF SPECIALISATION OF HEALTH AREA IS A REALITY. COMMON TRUNC,
ACCURACY FOR PROFESSIONAL TRAINING, MULTIDISCIPLINAR APPROACH, MINIMAL REQUIREMENTS, ETC., ARE ACTUALLY
ESTABILISCED BY LAW. THE NEW LAW DECRETS “1° M 5-11-2005” and “29 MARCH 2006”
ACCORDING WITH U.E.M.S. GUIDE LINES.OUR PROPOSALS (PERUGIA, MAROTTI),
WILL BE APPLIED AND OPERATING BY LAW SINCE NOVEMBER 2006
07
THE ORGANIZATION OF THE POST GRADUATE SPECIALISATION
SCHOOLS: HISTORY AND EVOLUTION.
IV
IN YEAR 2005 THE MINISTERIAL “TEAMWORK“ OF FULLPROFESSORS IN THE VARIOUS SPECIALTIES HAS CONCLUDED
THE ACTIVITY, PRODUCING ALSO THE TEACHING ORGANISATION
PART OF DIFFERENT SCHOOLS “ATTACH n°1” TO THE QUOTED NEW
LAWDECRET “5-11-2005”. AT THE SAME TIME WITH ALIMITED NUMBER OF “TEAMWORK“ WAS NAMED
“OBSERVATORY”AND WAS CHARGED TO POINT OUT THE “ATTACH n°2”: “ THEDEFINITION OF STANDARDS AND MINIMAL REQUIREMENTS OFDIFFERENT SCHOOLS OF SPECIALISATION”. THE M.I.U.R.“OBSERVATORY” IN JOINT TEAMWORK COLLABORATION
WITH THE SIMILAR “OBSERVATORY” OF HEALTH MINISTRY WILL
HAVEVERY IMPORTANT FUNCTIONS:• TO CONTROL THE CORRECT APPLICATION OF THE
STANDARDS OF THE SCHOOLS REORGANISATION.• TO CHECK THE CORRECT RUNNING OF THE
ORGANISATION AND OF THE LAW ENFORCEMENT.
08
THE ORGANIZATION OF THE POST GRADUATE SPECIALISATION SCHOOLS:
HISTORY AND EVOLUTION. V
TORINO
BRESCIA
TORINO
PISA
PALERMO
CATANIA
BARI
UDINE
TRIESTE
ANCONA
PADOVA
VERONA
2 Schools
SIENA
PAVIA
CATANZAROCAGLIARI
BOLOGNA
MODENA
FERRARAFERRARA
PARMA
PERUGIA
Firenze
SASSARI
GENOVA
VARESE
CHIETI
Geographical distribution
of the 35Schools of
Specialisation
09
ORTHOPAEDIC AND TRAUMATOLOGY
THE NUMBER OF THE TRAINEES IS ESTABLISHEDYEARLY FOR EACH SCHOOL BY THE MINISTRY OF HEALTH IN COLLABORATION WITH THE MINISTRY OF EDUCATION, UNIVERSITY AND RESEARCH (M.I.U.R.), ACCORDING TO THE NEEDS IN DIFFERENT REGIONS.
CHIEF OF THE SCHOOL: A FULL PROFESSOR OF THE UNIVERSITY IN THE SPECIALTY.
AT PRESENT TIME FIVE YEARS:- ONE-TWO YEARS: COMMON TRUNC (FUNCTIONAL ANATOMY, PHISYOLOGY, GENERAL SURGERY, ETC.).- THREE-FOUR YEARS OF GENERAL ORTHOPAEDICS AND TRAUMATOLOGY:LECTURES,ACTIVITY IN SURGERY, ETC., ACCORDING WITH U.E.M.S. MINIMAL REQUIREMENTS. THE UNIVERSITIES MAY HAVE CONVENTIONS WITH OTHER REGIONAL HOSPITALS WHICH MUST HAVE THE MINIMAL REQUIREMENTS FOR TEACHING. 10
ACTUAL ORGANISATION OF SCHOOLS
MATRICULATION EXAMINATION.- ONE EXAME YEARLY- LOG-BOOK SIGNED CONTINOUSLY BY THE
TUTOR AND COUNTERSIGNED BY THE CHIEF OF THE
SCHOOL- FINAL THESIS WHICH COULD BE PROPOSED
FOR PUBBLICATION.
- RESEARCH IS PART OF THE TRAINING
IN THE FUTURE, THE PROPOSAL IS SIX YEARS: DURING LAST YEAR COMPULSORY ATTENDANCE FOR A SUBSPECIALTY: HAND, ARTHROSCOPY, SPINE, PAEDIATRICS, ETC.).
11
ACTUAL ORGANISATION OF SCHOOLS
Genealogical Threes Of Two Most Important Orthopaedics Schools
ROMA BOLOGNARiccardo Dalla Vedova Alessandro Codivilla
1871-1942 1861-1912
QuickTime™ e undecompressore TIFF (LZW)
sono necessari per visualizzare quest'immagine.
Perugia
Marotti
12
S.O.I.“Societa’ Ortopedica Italiana”
Founded on 18911892 By laws – First Meeting
Organisation of IV SICOT Congress1936 Bologna - Roma
Presidents: VITTORIO PUTTI and CARLO MARINO ZUCO
The First Journals: “Archivio di Ortopedia” 1841
“Chirurgia Organi di Movimento” 1951At Present:
“Giornale Italiano di Ortopedia e Traumatologia”
1974 (Monticelli)“Journal of Orthopaedics and
Traumatology”2000
THE SCIENTIFIC SOCIETYHISTORY
13
1935 Foundation of the S.I.O.T
SOCIETA’ ITALIANA di
ORTOPEDIA E TRAUMATOLOGIA
14
NATIONAL SOCIETYS.I.O.T.
Societa’ Italiana di Ortopedia e Traumatologia
Regional Societies -S.E.R.T.O.T.
Società Emiliana Romagnola Triveneta Ortopedia TraumatologiaOne-Two meeting yearly
-S.P.L.L.O.T. Società Piemontese Ligure
Lombarda di Ortopedia e Traumatologia
One-Two meetings yearly
-S.O.T.I.CSocietà Ortopedia T
TraumatologiaItalia CentraleOne-Two meeting yearly
-S.O.T.I.M.I.Società Ortopedia Traumatologiaitalia medridonale ed insulareTwo meeting yearly
EVERY SOCIETY HAS ITS OWN JOURNAL
NATIONAL SOCIETYS.I.O.T.
Societa’ Italiana di
Ortopedia e Traumatologia
There are 25 Affiliates Sub-Specialties:
Oncology; Paediatrics; Sport
Traumatology; Knee and
Arthroscopy; Shoulder; Spine;etc..
- One meeting yearly
- Many of them have their own Journal
etc, etc,. 15
ANSWERS TO THE LAST QUESTIONNAIRE
THE SPECIALIST SHOULD HAVE:ABILITY
To diagnose and treat osteporosisTo diagnose and treat scoliosis in childrenTo diagnose and treat with coservative means
orthopaedic rheumatologyTo arrange for and interpret lab testTo perform punction to get body fluids or other materials To perform indication and supervision of physical therapyTo perform indication and control of orthopaedics aids (braces, etc.)To act as an orthopaedic expert witness To perform injections near spine (peridural, etc.) for
diagnosis and therapyTo perform trauma emergency management also
coworking with othersTo perform operations in orthopaedics anb orthopaedic traumaTo perform certain numbers of performed operations
required (bone, joint, tendon) classified by degrees of difficulties 16
ANSWERS TO THE LAST QUESTIONNAIRE
THE SPECIALIST DOES NOT NEED:
NO ABILITY- Of certification to perform x-rays- To perform osteo-densitometry- To perform regional anesthesia but only local anesthesia- To perform getting central venous access, CPR etc.- To perform and control transfusions, infusions. To perform chirotherapy (chiropractics)
NO ABILITY TO PERFORM BUT ABILITY TO INTERPRET- Sonographic examinations in orthopaedics- Sonographic examination in infant hips- Sonographic examination of trauma lesions (muscles, tendons,
etc.)
No possibility to get officially sub-specialties 17
Health Organisation in Italy
At present there are four Organisation levels:
- Ministry of Health- Regional Councils- Provincial Councils- City Councils
The managemeny of this situation isreally very complex and we hope that it will be modified and semplified by the the future Governement.
18
Health Organisation in ItalyTo day the Italian organisation is exactly the
same of the Norwegians Hospital Reform.Hospitals are organised as enterprises and are no
longer part of the public administration.The Hospitals are organised as separate areas of
responsibility.The Hospitals are independent legal subjects with
their own responsibility as employers.The Hospitals have an executive board and a general
management.The Ministry of Health, represented by the Minister,
is responsible for overall general management but there is extensive delegation to the underlying enterprises.
The regional health enterprises have responsibility for ensuring the provision of health services to inhabitants in their geographical area.
The Hospitals have more clearly defined roles and responsibilities as enterprises. The Are responsible for use of capital and for their own finances 19
20
Thank you