Admission to the Specialisation School of Anaesthesia, Intensive Care and Pain Managementy is subject to passing a national competitive examination.

The Specialisation School in Anaesthesia, Intensive Care and Pain Management is normally completed over a period of 5 years, following the acquisition of 300 credits (CFU).

Core training objectives

• The trainee must acquire the specific knowledge of physical, biochemical and pathophysiological phenomena necessary to correctly apply anaesthetic and perioperative medical techniques, to treat patients experiencing pain, to manage critical clinical situations in both elective and emergency settings, and to care for frail patients with an appropriate level of care, including outside the intensive care unit and within the field of hyperbaric medicine.
• they must therefore develop the ability to assess risk and prepare patients scheduled for elective or urgent/emergency surgery, and/or for non-surgical diagnostic or therapeutic procedures.
• they must also be familiar with the underlying pathophysiological conditions, identifying ways to correct disorders that may influence anaesthetic management, the response to surgical, diagnostic and/or therapeutic procedures, and the perioperative course.
• they must be able to safely manage anaesthetic drugs, the airways and ventilation, and clinical risk during the various phases of induction, maintenance and recovery, including techniques for achieving adequate pain management. The trainee must be able to make decisions based on risk assessment and be able to practise the various techniques of sedation, general and/or regional anaesthesia, as well as the monitoring methods best suited to the patient’s clinical condition, in both elective and emergency situations.
• they must acquire the theoretical knowledge and practical skills to diagnose and treat, in accordance with national and European standards, all clinical conditions relating to perioperative medicine, general intensive care and specialist intensive care.
• they must learn about and be able to use monitoring systems and life-support techniques capable of sustaining vital functions in the operating theatre and in the post-operative recovery area, as well as in intensive care and during emergencies, both in and out of hospital, including the management of trauma, acute burn-related conditions and toxicological emergencies.
• they must also learn to deal appropriately with clinical situations relating to acute and chronic pain, including in multidisciplinary settings and in hospices.
• they must also manage the relationship with the patient appropriately, to prepare them adequately for the planned procedure, as well as with the relatives of patients in a critical condition.
• they must also learn to manage the organisational aspects relating to the safe transport of critically ill patients in the pre- and intra-hospital settings, as well as disaster medicine. 
• Finally, they must acquire a sound theoretical foundation regarding the legal, medico-legal and bioethical implications inherent in the professional practice of the discipline.

Educational objectives for this type of school

• The trainee must acquire the knowledge and skills required to provide appropriate and safe anaesthetic care across all branches of surgery – whether elective, urgent or emergency – for patients of all ages. To this end, they must be familiar with the indications and timing of the surgical techniques most commonly used in general surgery, specialist surgical disciplines (including transplant surgery) and obstetrics; they must also be able to manage clinical risk, from pre-operative assessment through to the post-operative phase, by applying the principles of perioperative medicine, managing pain relief and determining the most appropriate level of post-operative care.
• the trainee must be able to use and correctly interpret the main invasive and non-invasive monitoring techniques relating to respiratory, haemodynamic, neurological and metabolic parameters; they must also be able to address and manage the main medical emergencies both within and outside hospital settings, and be able to diagnose and treat the main conditions of interest in intensive care, including the most commonly observed complications in the management of critically ill patients—both medical and surgical—and in extreme emergency situations, such as trauma care, burn care and the main cases of acute poisoning.

Related and complementary objectives

• The trainee must be familiar with the administrative and managerial procedures specific to the discipline, including the relevant bioethical and and medico-legal aspects, whilst complying with standards of safety, quality and appropriateness of care provided, with particular regard to interdisciplinary collaboration in the fields of perioperative medicine, pain management and palliative care networks, transplant medicine, intensive care, emergency medicine, disaster medicine, and diving and hyperbaric medicine;

• the compulsory professional training activities (Core Competencies) required to achieve the programme’s learning objectives are identified by the training areas, classified as:

  1. General areas of expertise

  Anaesthesia and perioperative medicine

  Critical and emergency medicine

  Resuscitation and intensive care

  Pain medicine and therapy – palliative care

  Hyperbaric therapy

  Emergency toxicology

  Non-technical anaesthesiology skills (ANTS)

  Quality, healthcare management and economics, ethics, research and professional development

  2. Specialist areas of expertise

  Obstetric anaesthesia

  Airway management

  Thoracic and cardiovascular anaesthesia

  Neuroanaesthesia

  Paediatric anaesthesia

  NORA/Outpatient Anaesthesia

  Multidisciplinary pain management

As part of the training programme, the trainee must learn the scientific foundations of this type of school in order to achieve full professional maturity and competence, including an adequate ability to interpret scientific innovations and a critical understanding that enables them to manage both patient care and their own professional development in an informed manner; In this context, periods of study at recognised Italian and foreign institutions relevant to their training may be arranged, as well as participation in meetings, conferences and the production of scientific publications.