Admission to the specialisation school of General Surgery is subject to passing a national competitive examination.

The specialisation in General Surgery is completed over a five-year period following the acquisition of 300 credits (CFU).

Core learning objectives

• The acquisition of in-depth knowledge of pathophysiology, surgical anatomy and operative medicine;
• the knowledge required for the epidemiological assessment and classification of clinical cases, including through the use of computerised systems;
• the organisation and management of healthcare services in accordance with the latest guidelines.
• the trainee must acquire the necessary knowledge base to organise and manage their work as a surgeon in accordance with the characteristics of the facilities and the local area in which they are required to practise; knowledge of the medico-legal aspects relating to their profession, and the laws and regulations governing healthcare provision.

Learning objectives for this type of course

• To acquire a fundamental understanding of topographical anatomy relevant to the clinical examination in surgical medicine, the principles of asepsis and antisepsis, and issues relating to the organisation and environmental hygiene of operating theatres;
• to become familiar with surgical instruments and suture materials, as well as traditional and alternative surgical techniques and methods;
• to acquire in-depth fundamental knowledge and the relevant practical experience for a comprehensive clinical assessment of the disease and the patient, drawing on knowledge of clinical pathologies, pathological anatomy, surgical pathophysiology, clinical methodology, and diagnostic instrumentation and imaging, and to determine the most effective medical or surgical treatment based on the risks, benefits and outcomes for each individual patient;
• be able to select the surgical solutions deemed most appropriate for the treatment of surgical conditions, both in terms of indications and technical aspects;
• possess the appropriate knowledge to address issues relating to the planning and management of the post-operative course and long-term follow-up;
• to acquire the appropriate multidisciplinary skills that will enable the specialist to approach the clinical case correctly, going beyond purely technical and surgical expertise, and to integrate this into a team-based approach that takes overall responsibility for the pre- and post-operative phases.

Integrated training objectives

The trainee must:

• acquire a satisfactory level of theoretical knowledge and professional competence in the clinical and diagnostic imaging assessment and treatment – including in emergency and urgent situations – of the most common surgical conditions;
• acquire a fundamental understanding of the pathophysiology of the various organs and systems; the theoretical and practical knowledge necessary for the recognition of diseases affecting the body’s various systems; the theoretical and practical knowledge of the main areas of diagnostic imaging and laboratory testing relating to the aforementioned diseases; and the ability to assess the connections and influences between internal medicine and specialist fields;
• be able to recognise the clinical and functional signs and symptoms associated with diseases of various organs and systems, having acquired the fundamental diagnostic, therapeutic, psychological and ethical knowledge necessary for a holistic view of the patient. To this end, they must develop the ability to clinically assess the patient on the basis of the medical history and physical examination;
• develop critical and analytical diagnostic skills;
• become familiar with the main diagnostic procedures and laboratory and instrumental investigations;
• be able to recognise and manage the main medical emergencies;
• become familiar with therapeutic resources in order to plan their optimal use and recognise their indications and contraindications, as well as drug interactions and possible iatrogenic incidents; acquire a fundamental understanding of clinical research methodologies and pharmacological trials;
• understand the key issues relating to prevention, public health and social medicine;
• acquiring satisfactory theoretical knowledge and professional competence in the recognition and management, in emergency and urgent care settings, of the most common conditions;
• Finally, the trainee must also be familiar, from a clinical and therapeutic perspective, with the most common conditions falling within the remit of other specialisms in the programme.

These are related or complementary objectives

• To acquire the basic knowledge and experience required to diagnose and treat – including surgically – the most commonly encountered conditions falling within the remit of specialist disciplines in general surgery (plastic and reconstructive, thoracic, vascular, paediatric, urological, gynaecological and orthopaedic surgery) or those characterised by the urgent need for immediate treatment;
• to recognise, diagnose and plan treatment, establishing priorities within a holistic framework in cases involving multiple conditions or injuries, in patients requiring the necessary involvement of other specialists (cardiac surgery, neurosurgery, maxillofacial surgery).

The following professional training activities are compulsory for achieving the educational objectives of this specialisation:

• to have performed at least 30 major surgical procedures, 10 per cent of which as lead surgeon. The remainder as second surgeon;
• to have performed at least 80 moderate surgical procedures, 25 per cent of which as lead surgeon. The remainder as second surgeon;
• to have performed at least 325 minor surgical procedures, 40 per cent of which as lead surgeon (including outpatient and day-case procedures). The remainder as second surgeon;
• to have provided direct and responsible care, including relevant diagnostic and therapeutic procedures, for an adequate number of elective, critical and emergency/urgent patients.

The trainee must have provided direct clinical care for a total of at least two semesters in emergency, surgery, accident and emergency and trauma surgery, in anaesthesia and in the specialist surgical disciplines specified by the regulations, in accordance with the procedures defined by the School Council. They may apply for the diploma after completing their surgical training.

As part of their technical training, it is advisable, where possible, to study surgical techniques on cadavers. A training course using virtual simulators and practice stations for laparoscopic techniques is also useful. The basic techniques of experimental microsurgery must be learnt in the laboratory through a preparatory course.

The trainee may apply for the diploma after completing the professional training activities. As part of the training programme, they must learn the scientific foundations specific to the school’s specialism in order to achieve full professional maturity and competence, encompassing 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.