Le professioni sanitarie nel XXI secolo: il Rapporto Frenk sulla Medicina di Comunità in Italia

The Health Professions in the 21st Century: The Frenk Report 2010 and the Community Medicine in Italy

Bruno Paccagnella

In 1910, the well known Flexner Report (FR) on «The Medical Education in the USA and Canada» had a huge impact on the Schools of Medicine in Northern America and afterwards in Europe and in other countries.

Many items have been changed according to the FR in what was concerning the admissions of students to the schools, the curricula, the basic scientific disciplines (chemistry, physic, biology, physiology), the relationships with the universities and with the teachers, the years of study, the relations with the hospitals, etc. It was a sort of revolution and many schools have been closed.

During the last century many changes have been registered in the populations; for instance, in demography on the aging of the populations, in epidemiology from the prevalence of acute to chronic diseases, in the culture, sociology, technology, economy, policy, in the organisation of the health services, in the concept of health, etc. and, in the present time, on the effects of the ongoing globalisation process, while the basic model for the education of the physicians didn't changed significantly during the last century.

Therefore an international Commission has been appointed in January 2010 – with the support of the Rockefeller Foundation, Bill and Melinda Foundation and the China Medical Board, chaired by Julio Frenk – consisting of 20 professional and academic leaders with the task to develop a shared vision and a common strategy for post secondary education in Medicine, Nursing and Public Health that reached beyond the confines of national borders and the silos of individual professions.

Many aspects of the whole matter have been explored by the Commission adopting a global outlook, a multiprofessional perspective and a systems approach. The vision of the Commission for the new century will require a series of instructional and institutional reforms moving from informative learning to produce experts, to formative learning to produce professionals, to transformative learning to produce enlightened change agents and developing leadership attributes in order to make competent professionals to partecipate in patient and community-centred health systems as members of locally responsive and globally connected teams.

The vision of the Frenk Commission is consistent with the specialisation in Community Medicine, which has been introduced in Italy for the medical practitioners in the year 1996, after a long debate.