Document approved by the Italian Permanent Board of Medical Degree Programme Directors
A valid curricular and organizational innovation of the Medicine and Surgery Degree Programme lays its foundations in the ongoing commitment of both professors and students, within an authentic educational community that shares a collaborative spirit aiming to take care of everybody’s social and psychophysical wellbeing. Therefore, both professors and students should share the same goals, as well as the same values and duties in the carrying out the tutorial activities within the care facilities of the territory.
Ethics as the basis of action for both professors and students
The academic community will have to turn to professors who are aware of their mission and comply with both the ethics commitment, the ethics of responsibility, the ethics of communication and the ethics of relationship.
The ethics of commitment consists in taking on a training task and actively partake in a process that involves both the professor and the student. Commitment means collaboration, goal-planning and task-setting.
The ethics for responsibility considers the professor to be a both available, efficient, assessable and a resource for the students and their future.
The ethics of communication shall be intended as the professor’s capacity for dialogue, to be an effective communicator, as well as capacity for listening in order to meet student needs.
The ethics of relationship is built upon mutual respect and mutual caring. Professors should promote a constructive and respectful relationship among their colleagues, as well as all their medical fellow professionals as to guarantee the patients’ well-being, and that of their students. Professors should also empower their students to build a healthy relationship among themselves and their patients, as they will become future members of the medical profession.
The doctor-patient relationship: essential norms of ethics
Interactions with patients are based on the inalienable rights of the patients themselves. Not only do they consider health as the fundamental human right together with the equitable distribution of this same right by both the National and Regional Government, by the University and the Hospital Institutions, but also, and above all, the individual relationship with the professional that is based on the principles of beneficence, non-maleficence, respect of the patient’s autonomy, the deontological code and social ethics.
Professors shall therefore teach these principles to their students and be their model of professional behaviour. They shall point out the rights of the patients, drawing attention to the risks of loss of personal dignity or trust, especially when the patient is confined to bed.
Besides the achievement of the specific clinical objectives of the know-how set out in the core curriculum, the clinical internship will thus ensure the basis of the ‘know-how-to-be’ through a clinical practice that highlights the patient’s fundamental rights in terms of:
Growing expertise and responsibility
Students enrolled on the Medicine and Surgery Degree Programme will assume a growing level of responsibility in accordance with the increase in their level of theoretical training and clinical ability while being under the guidance of their tutor. However, students are not allowed to take on any kind of responsibility that would exceed their degree of autonomy, as stipulated by the teaching regulations, nor are they supposed to inappropriately take over any clinical actions within the competence of tenured professors or other health personnel of the Italian National Health Service.
At the same time, students will have plenty of opportunities to strengthen their skills as they will be given an adequate amount of time to review what they have learned, for self-study in order to get prepared for the exams, as well as time to devote to extracurricular activities and self-care.
Compulsory attendance
Students must attend clinical activities for the full assigned hours by the Board of the Degree Programme. They must also abide by their allocated clinical tutor as provided for in their Study Plan. Exceptions must be strictly justified by the students. Professors are also required to inform the course coordinators and the students of any cancellation or delay ahead of time.
During their clinical attendance and under the guidance of the tutor, students will have to develop the skills for a competent doctor-patient relationship, based upon mutual respect, considering the natural asymmetry both in terms of professional competence and different emotional and existential involvement.
At the end of their clinical training, students must therefore reach the awareness that the core of the therapeutic alliance in the doctor-patient relationship is founded on two fundamental aspects: both scientific and professional competence as well as a compassionate approach will build confidence and trust in the patient.
Competency and professional awareness achieved throughout the entire period of clinical training will be assessed through a practical and an oral test in which students are supposed to discuss the experiences gathered in the portfolio (use of simulated patients, bed-side tests, structured clinical examination - OSCE).
During their clinical training students are asked to observe the regulations listed below:
Show respect to patients and all staff. As in, all patients, medical professionals, professors and fellow students. Students have to treat patients with equal consideration, respect their privacy and dignity. Students will act without discrimination, whether on grounds of age, race, sex, disability, religion or belief, marital or civil partnership status, pregnancy and parenthood, sexual orientation, gender reassignment or perceived economic worth.
Be an attentive and effective communicator. Always make it clear to patients and other healthcare professionals that you are a student and not a qualified doctor; be aware of your limitations and do not exceed your ability when giving information to patients. Understand, accept and agree to be bound by the principle of confidentiality of patient data, and also of information concerning staff and students. Do not discuss patients with other students or professionals outside the clinical setting, except anonymously.
Abide by rules and policies, follow procedures and guidelines. Students must follow rules and policies advised by the University and the Hospital. Students must also comply with appropriate health-testing requirements (such as prescriptions of vaccines) as advised by the university, teaching hospital, and Occupational Health.
Be open and honest. Do not break the law in any way, never threaten violence, act violently towards others or act dishonestly. Concealment of involvement in an incident that may lead to prosecution may be viewed as an even greater offence than the incident itself. Do not cheat in examinations.
Maintain a professional appearance. Maintain a professional appearance and demeanour and comply with the recommended Dress Code.
Take action. Take action at an early stage if a problem arises: inform the Head of the hospital ward or Tutor immediately if you become aware of any personal problems arising which may put the health and well-being of patients at risk. Seek immediate advice from the Head of the hospital ward if you think a doctor or colleague has behaved in a way that suggests that they may not be fit to practise.
Avoid abusing alcohol or drugs. Abusing alcohol and drugs may put patients at risk. It may also lead to aggressive behaviour in such a way to compromise the future professional career. It is highly encouraged to maintain a smoking-free environment on hospital grounds, though not expressly prohibited by law.