ArticleUpdates in surgery2026
Surgery without surgeons: a national wake-up call on the state of surgical training in Italy.
Article in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Comment on: Surgery without surgeons: a national wake-up call on the state of surgical training in Italy.Updates in surgery · 2026Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionConcerns regarding surgical training quality and workforce sustainability are increasing across Europe. In Italy, despite a nationally regulated framework, growing dissatisfaction among trainees and rising numbers of unfilled surgical residency positions suggest systemic shortcomings.
methodsWe conducted a nationwide, cross-sectional, anonymous online survey coordinated by the Collegio Italiano dei Chirurghi (CIC) and disseminated through surgical societies and residency programs (January-July 2025). Respondents were surgical residents and early-career surgeons across specialties. Primary endpoint was overall training satisfaction; key secondary endpoints included perceived operative exposure and teaching climate, mentorship/governance, and support for specific reforms. Multivariable analysis evaluated associations with dissatisfaction, including sex, age, and geographic macro-area.
resultsAmong 645 valid responses, 68.7% reported dissatisfaction with surgical training. The most frequently cited weaknesses were poor teaching attitudes (51.9%) and inadequate operative exposure (34.7%). Only 25.6% reported adequate primary-operator case volume and 29.5% a supportive teaching environment. Support for reform was high (87.8%), including endorsement of standardized accreditation/competency tracking and structured, paid post-residency fellowships (70.4%). Female trainees reported lower satisfaction than men independent of age and geographic macro-area (adjusted OR 0.68, 95% CI 0.47-0.98), while regional differences were modest. DISCUSSION: Despite a formally regulated training system, surgical education in Italy is undermined by fragmented implementation, limited quality assurance, and delayed acquisition of operative autonomy. These deficiencies threaten workforce retention, equity, and long-term healthcare sustainability. Coordinated national reform focusing on governance, accreditation, mentorship, and merit-based progression is urgently needed to align surgical training with contemporary European health-care delivery standards.
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