The aging of the staff in service weighs heavily on the shortage of doctors. According to Eurostat data, in Italy over 50% of hospital surgeons are over 60 years of age (compared to 32% in Spain and 44% in France and Germany). By 2030, therefore within five years, 2,800 retirement exits are expected. The new incoming specialists will instead be less than 1,300. This could lead to a shortage of 1,500 general surgeons. "An alarming projection, the result of the gap between a 20% drop in the workforce and an expected 12% increase in the demand for surgical care expected over the next five years on the basis of demographic trends, patterns of use of health services and the relationship between surgeons and the population. All this translates into more critical access to the scalpel for patients with 1 in 10 general surgery operations at risk out of the 650 thousand performed every year, waiting times destined to become increasingly longer and ever-increasing distances to travel to receive surgical care, especially in the southern regions,” commented Docimo.
The problem concerns not only personnel outflows, but also income, which is not sufficient. Among the factors that discourage young people from entering the profession are exhausting work shifts, salaries that are not adequate to Western European standards, and medical-legal litigation that has grown by 150% in ten years. "The slow updating of the technological park also weighs heavily, especially for robotic procedures, which pushes young people to move abroad to acquire more cutting-edge skills, just when we need more up-to-date surgeons. All this induces young people to find work placements in private structures or to migrate to other countries, where they are appreciated everywhere, confirming the great training tradition of our country", underlined Docimo.
The data on the coverage of specialization grants for 2026 confirms a sector in crisis: although showing a slight improvement compared to last year (30% of places unfilled compared to 37.8% in 2025), at a national level 193 contracts out of 646 remain unassigned. The situation is particularly critical in the suburbs: in L'Aquila zero contracts assigned, while in Udine and Genoa almost 90% of the places remained empty. In Cosenza, Sassari, Campobasso and Perugia the allocations do not exceed 20%. Among the first 1,000 classified in the national competition, only 9 chose general surgery. Added to this is that 10% of trainees abandon the course before the end and another 10% move abroad or to private healthcare.
“The numbers indicate a dramatic gap between a 20% decline in headcount and a 12% increase in demand for care over the next five years,” Docimo explained. "This translates into the risk that access to operating theaters becomes critical for 1 general surgery operation in 10 of the 650,000 performed every year, with longer waiting times and greater distances to travel, especially in the South," he added. To counter the haemorrhage of white coats, the SIC calls for a strategic plan with greater economic incentives, greater access to robotic technologies and the rapid approval of the reform on professional responsibility and the "criminal shield" currently under consideration in the House.
According to a study just published in the Journal of the American College of Surgeons, 15 million people in the United States live in counties without a general surgeon. A risk that many areas of our country could now also run. “Italy does not have studies on the surgical workforce equivalent to the American one, but the signals point in the same direction, with the risk that many areas will be left without surgeons in a few years,” warned Docimo.
