Specialist training contract

Upon enrolling in the Postgraduate school, the medical student enters into a specific specialist training contract with the University for a period of time equal to the official duration of the programme (pursuant to Legislative Decree 368/1999), replacing the medical specialisation scholarship governed by the previous Legislative Decree 257/91.

The contract entered into with the University of Milan and the Lombardy Region, does not ensure any rights of access to permanent employment as a member of staff, nor does it constitute an employment relationship with the National Health Service or with the University.

For the purposes of welfare and social security, doctors undergoing specialist training are registered with the INPS separate pension and welfare scheme for the self-employed. The contract provides for maternity protection in accordance with the pregnancy regulations referred to in Law 151/2001.

During the specialised training period, resident doctors are forbidden to work as freelance professionals outside of the healthcare facilities in which they are training. Neither can they enter into permanent or temporary employment with the National Health Service, or with public or private enterprises and organisations, for the entire duration of their specialist training.

Notwithstanding the full-time employment rule, medical students are permitted to stand in for general practitioners operating within the National Health Service on a temporary basis and be registered in the lists of emergency medical staff to work overnight, on weekends and national holidays, and to provide healthcare for tourists, but only when there are not enough doctors registered in these lists available to work at these times (pursuant to art 19, paragraph 11, Law No. 448 of 28 December 2001).

Regulatory references

The specialist training contract established with Legislative Decree 368/99 replaces the medical specialisation scholarship governed by the previous Legislative Decree 257/91.

The contract in brief

Student doctors undergoing specialist training are required to complete a full weekly programme of theoretical and practical activities, in line with the School’s programme regulations.

The commitment required for a specialised training course is the same as that required by full-time National Health Service medical personnel.

 

To record attendance during the entire training period and ensure that the contract is properly managed, each medical student is required to sign a daily sign-in sheet prepared by the tutor.  

The sign-in sheet records all absences, including those due to attendance at meetings, seminars and conferences as part of the training.

The Academic Services Office of the Postgraduate school sends the monthly attendance sheets to the appropriate office (presenze.specializzandi@unimi.it).

For the entire official duration of the programme, specialist medical students receive an all-inclusive annual salary of 25,000 euros for the first two years of specialisation and 26,000 euros for subsequent years, exempt from personal income tax and paid in monthly instalments in arrears.

The salary comprises a fixed portion and a variable portion:

  • The fixed portion amounts to 22,700 euros gross per year
  • The variable portion amounts to 2,300 euros gross per year for the first two years of the course, and 3,300 euros gross per year for subsequent course years.

The salary includes all national insurance contributions payable by the contracting parties: both the two thirds payable by the University and the one-third payable by the specialist medical student. 

Notification of payment details and personal data

The salary is paid into the bank current account of the specialisation student who must notify the administration office of:  

  • their personal data and bank account details using the Personal Data Form
  • any changes to these details, using the Change of Details Form.

Both forms must be emailed to: contratti.specializzandi@unimi.it.

Requests for leave for personal reasons must be addressed to the School’s Management using the appropriate form and:

  • must not exceed 30 working days in total per academic year
  • must not jeopardise the achievement of educational targets
  • cannot be made up
  • do not result in a salary suspension.

Leave for personal reasons does not include leave due to participation in meetings, congresses, courses and seminars authorised under ‘educational activities’ by the School’s Management.

Temporary impediments lasting more than 40 consecutive working days will result in the suspension of the specialist student’s training period and oblige him/her to make up the absence.

In such cases, the School’s Management must notify the Human Resources Department and the Office for Training and Research Contracts of the specialist student’s absence. During the period of suspension, the student will only receive the fixed portion of their salary and only for a maximum total period of 1 year more than the official duration of the course.

  • For suspension due to pregnancy, female specialisation students must follow the procedure set out by the Occupational Health and Safety Department.
     
  • Absences due to illness must be electronically certified by the student’s GP or by a doctor operating within the National Health Service.
    The specialist student is obliged to immediately notify their absence to the School’s Management and to provide the reference number of the electronic certificate (PUC, printed top left) and the duration of the illness by email, by no later than the day following the start of the illness, to:

The specialisation student must specify the ‘University of Milan’ as the addressee in order for the medical certificate to be accurately completed.

At the end of the period of suspension, the School’s Management is obliged to email presenze.specializzandi@unimi.it notifying the date on which the specialisation student resumes his/her training.

Temporary impediments lasting less than 40 consecutive working days are not considered as absences for personal reasons (MIUR No. 3750 of 06/02/2019).
In this case also, absence due to illness needs to be electronically certified, as described above. 

Prolonged unjustified absences will result in the termination of the contract. A prolonged unjustified absence is considered as an unauthorised absence that does not allow the achievement of the training objectives; the School’s Management must immediately notify such absences to the Office for Training and Research Contracts so that the necessary processes can be put in place.

Female students enrolled in postgraduate schools are entitled to the protection of their maternity rights.

Training must be strictly suspended during the period of compulsory maternity leave and resumed afterwards. Only the fixed portion of the salary will be paid during absence for maternity leave.

The healthcare facility at which the medical specialisation student carries out his/her medical training provides and pays for professional risk insurance, third party civil liability and insurance for accidents connected with the healthcare activities carried out in their facilities, at the same conditions as the insurance provided for their own medical personnel. Insurance for gross negligence is not provided, however.

Specialist training can also be undertaken in health facilities in foreign countries, within the framework of integrated scientific educational collaboration agreements between universities, in compliance with the medical student’s personal training programme and as recommended by the School’s Council.

The period of stay must not exceed 18 months in total, notwithstanding the fact that the specialisation student must take the official annual exam by the specified deadlines.

The decision of the School authorising the period of training abroad must be conveyed to the Student Administration Office and to the Human Resources Department. The School is responsible for noting the training period abroad on the daily attendance sheet.

In order for the medical student to be able to carry out his/her activities in hospitals abroad, the Postgraduate School Director must contact the relevant offices of the host university, who must provide all the operational instructions to guarantee the appropriate insurance cover for the entire period of the student’s stay abroad.

 

Reasons for early termination of contract
 

The following reasons will give rise to early termination of the contract:

  • the specialisation student’s withdrawal from his/her study programme
  • violation of the rules relating to incompatibility
  • prolonged unjustified absences from the training programme, or exceeding the so-called period of protection (12 months), in the case of illness
  • failing the programme exams established by each individual school of specialisation.

Serious violation of the Code of Conduct for Employees of the University of Milan is another reason for early termination of the contract.

The attached circulars, addressed to the Postgraduate Schools Directors, specify:

  • the main administrative obligations with which the Schools must comply
  • recommendations on the management of absences.