Description and Purpose of the Internship

The internship is an essential and structural component of the educational pathway of the Single Cycle Master's Degree in Medicine and Surgery, alongside the theoretical part.

Internships align with the study plan and consist of the theoretical acquisition of skills in the classroom and through microsimulation activities, followed by practical application in macrosimulation, using skill trainers and high-fidelity simulators. Finally, the practical skills acquired through simulation are applied to patients under the supervision of clinical tutors.

The primary rule in organising internships is: “Never on patients the first time.”

This experience is designed to promote the development of cross-disciplinary and interdisciplinary skills in relation to subsequent study cycles and the employability outcomes of graduates. The structure of the internship, divided into curricular and qualifying phases, is configured as a progressive pathway towards clinical and decision-making autonomy, in accordance with the highest national and international standards of educational excellence.

• Curricular Internship

Definition and Objectives

The curricular internship is an integral part of the academic programme, spanning all six years of the integrated master’s degree course, with a gradual progression of required skills. The primary objective is to acquire practical competencies in clinical, diagnostic, and therapeutic fields. This begins with microsimulation and macrosimulation activities, followed by hands-on experience in hospital departments and outpatient clinics, under the supervision of clinical tutors. The educational aim is to develop both technical and non-technical skills, allowing students to familiarise themselves with clinical approaches, diagnostic-therapeutic methodologies, and the ethical, communicative, and relational principles fundamental to the medical profession.

Main Features

• Application Areas: Students undertake internship activities in various settings, including microsimulation and macrosimulation at the Medical Simulation and Advanced Training Centre (CSMAA) at Cattinara Hospital, as well as in different clinical, outpatient, and hospital contexts within the teaching network of the Medicine and Surgery degree course at the University of Trieste (Trieste, Monfalcone, Gorizia, Pordenone).
• Training Methodologies: The training approach includes microsimulation, macrosimulation using skill trainers and high-fidelity mannequins, as well as observational and participatory activities with patients, under the supervision of qualified clinical tutors in hospital departments and outpatient clinics.
• Assessment: The learning of internship items is monitored by internship tutors and concludes with an annual internship examination, conducted by course lecturers at the end of the scheduled activities for the year (ECTS credits, items listed in the Handbook).

Specific Objectives

• Acquire technical skills through micro and macrosimulation
• Learn how to manage simple and complex clinical cases through macrosimulation
• Develop a methodological approach to clinical assessment, with a focus on medical history taking and physical examination of patients
• Actively participate in diagnostic-therapeutic processes
• Recognise clinical priorities
• Develop non-technical skills: effective communication with patients, relatives, and colleagues; teamwork abilities; and interdisciplinary collaboration skills

• Qualifying Internship

Definition and Objectives

The qualifying internship (Tirocinio Pratico Valutativo - TPV) represents the final and crucial phase of the training pathway, serving as an essential requirement for obtaining authorisation to practise as a medical professional. This experience takes place from the sixth year of the course for general medicine (MMG) and from the fifth year (after completing all fundamental exams and the internships of the first four years of the course) for the internship in the Medical and Surgical Area. It is aimed at assessing practical skills and verifying the student's ability to work autonomously, albeit under the supervision of a tutor during the qualifying internship. Moreover, it marks the transition from academic training to professional practice.

Key Features

• Internship structure: It is organised into compulsory modules in three fundamental clinical areas: medical area, surgical area, and general medicine (MMG) (community-based).
• Educational objectives: The focus is on the ability to interact appropriately with patients, relatives, and colleagues, on the development of diagnostic and therapeutic plans, on assuming diagnostic-therapeutic responsibility, on understanding bureaucratic procedures, and on interaction with the healthcare system at its various levels.
• Supervision and assessment: Each student operates under the guidance of a medical tutor, who certifies their suitability through direct observation and the application of standardised assessment criteria.

Specific Aims

• Demonstrate competence in adequately collecting medical history and performing physical examinations.
• Demonstrate the ability to propose an appropriate diagnostic and therapeutic pathway.
• Demonstrate the ability to formulate differential diagnoses.
• Demonstrate the ability to communicate effectively with patients, relatives, and colleagues.
• Develop the capacity to work in a team, adopting a proactive role in patient management.
• Integrate clinical practice with the principles of medical ethics and professional conduct.
• Demonstrate the ability to operate in emergency and urgent conditions, particularly in the autonomous management of simple cases.
• Demonstrate the ability to work in outpatient settings and hospital wards, particularly in the autonomous management of simple cases.
• Demonstrate knowledge of the bureaucratic processes required for diagnostic and therapeutic procedures in outpatient and hospital settings.

Regulations

The placements of the Bachelor's Degree Course are governed by the Vademecum Tirocini, which outlines the learning objectives (items) to be achieved for each academic year and details the university credits (CFU) to be completed in various settings. The Vademecum is regularly updated, ensuring consistency between the placements outlined therein and the educational programme of the Degree Course. All placements must be duly recorded in the yellow booklet, provided by the Degree Course and available at the Reception of the Teaching Centre at Cattinara Hospital.

As of 04/11/24, we are in the process of implementing the Easy Internship platform, which enables electronic attendance tracking. During the first six months of implementation, attendance will be double-checked through both the yellow booklet and the platform.

During the placement, students are required to wear the uniform, lab coat, ID badge, and appropriate protective equipment (PPE). In 2024, an agreement was established with ASUGI specifically for the distribution, labelling, washing, and tracking of uniforms for students enrolled in the Medicine and Surgery Degree Course.

Expected number of hours

For each university credit (1 CFU) related to the internship, 25 hours of practical activity are required. Reaching the expected annual number of hours is an essential prerequisite for accessing the final internship examination.

Therefore, until the full implementation of the Easy Internship platform, once the mandatory hours have been completed, students must submit the Yellow Booklet to the Reception of the Teaching Centre before taking the exam. The Teaching Secretariat of the Degree Course will proceed with counting the hours completed.

Document Delivery and Collection

Please note that all operations related to the delivery and collection of student record books, as well as any other document requiring signatures or stamps, must be carried out exclusively at the Reception of the Teaching Hub at Cattinara Hospital. The Teaching Hub Reception is open Monday to Friday from 8 AM to 7 PM (excluding public holidays).

• External Internship (Non-Erasmus)

Starting from the third year of the programme, students have the opportunity to undertake an internship at facilities outside the teaching network of the Medicine and Surgery degree programme at the University of Trieste (UniTS).

This type of internship is only possible if a specific agreement already exists between the University or the Clinical Department of Medical, Surgical, and Health Sciences and the host institution. If there is no agreement in place between the University or the Department of Medical, Surgical, and Health Sciences and the host institution, the internship CANNOT be authorised. The external internship may only be carried out during teaching-free periods.

Maximum Credits Allowed per Academic Year:

• Third year: maximum 3 CFU
• Fourth year: maximum 4 CFU
• Fifth year: maximum 3 CFU
• Sixth year: maximum 2 CFU
• External internship abroad: maximum 5 CFU

It is not possible to entirely replace attendance at facilities within the Medicine and Surgery degree programme’s teaching network with activities in external hospitals, as the University is responsible for the final certification of the internship. Therefore, training activities must be supervised and certified by tutors accredited by the University of Trieste.

Internship Content and Requirements

The external internship must adhere to the contents outlined in the Internship Handbook for the student’s year of enrolment or previous years.

Before starting the internship, for insurance reasons, it is mandatory to verify the existence of an agreement with the host institution and to arrange an Individual Training Project with the host institution (which must include the designated tutor). The host institution must also complete the Risk Assessment Form

Procedure for Carrying Out the External Internship

1. Verification of the existence of an agreement or the possibility of establishing one (within the period allocated for the external internship).
2. Defining the training activity: The student must agree with the company and the designated medical tutor on the activities to be carried out.
3. Completion of forms:
   • Individual Training Project for External Internship
   • External Internship Application Form
   • Risk Assessment Form (to be completed by the external institution)
4. Submission of documentation:
   • At least 90 days before the start of the external internship period, all documents must be sent via email to the Teaching Office (lm.ciclounico6.dsm@units.it) as a single PDF file.

Final Evaluation and Registration of Hours

At the end of the internship:

1. The host tutor must complete and sign the Student Evaluation Questionnaire.
2. The student must record the total hours completed in the yellow booklet (or in the Easy Internship programme once fully implemented).
3. Once the required hours for the academic year have been completed, the yellow booklet, along with the tutor’s evaluation, must be submitted to the Reception Desk of the Teaching Centre at Cattinara Hospital (or through the Easy Internship programme once fully implemented).

Note: If the final evaluation is missing or the outcome is negative, the internship will not be recognised

• Erasmus+ Study and Erasmus+ Traineeship

Students enrolled in the Single Cycle Master's Degree in Medicine and Surgery at the University of Trieste have the opportunity to enhance their academic path through international mobility programmes, both for study purposes (Erasmus+ Study) and for professional training placements (Erasmus+ Traineeship).

For further information, students are invited to visit the dedicated International Mobility page.

• Practical Evaluation Internship (TPVES)

The Practical Evaluation Internship for the Exercise of the Medical Profession (TPVES) is a compulsory professional training activity aimed at verifying the student’s practical, clinical, and ethical competencies. This internship must be carried out at the structures listed below. The main aspects are outlined as follows:

Educational Objectives

The TPVES aims to verify the student's ability to:

• Apply biomedical and clinical knowledge to medical practice, addressing issues related to diagnosis, therapy, and prevention.
• Solve matters related to professional ethics and medical deontology.
• Demonstrate a clinical problem-solving attitude, with reference to key areas of medicine, surgery, related specialities, laboratory and instrumental diagnostics, and public health.
• Use effective communication principles in professional relationships and with patients.

Duration and Admission Requirements

• The TPVES lasts a total of three months, equivalent to 15 CFU credits (375 hours).
• Admission is allowed from the fifth year of study, provided the student has passed all core exams required in the first four years of the curriculum.
• The monthly module in General Medicine can only be undertaken in the sixth year of study.

Internship structure

The internship is divided into three monthly modules, each corresponding to 5 CFU credits (125 hours). These modules can be completed in non-consecutive periods. The activity areas include:

• Surgical Area: Practical and educational activities in surgical wards.
• Medical Area: Clinical and diagnostic activities in general and specialised medicine wards.
• General Medicine: Activities at a General Practitioner’s office, to be completed in the sixth year of study.

Recognition of Credits

The 15 CFU credits from the TPVES are part of the total internship credits required by the curriculum of the Single-Cycle Master’s Degree in Medicine and Surgery and constitute an essential requirement for medical qualification.

Certification and Assessment

The certification of attendance and assessment of activities carried out during the internship are the responsibility of:

• Clinical tutors (university professors or senior medical staff) at the hosting facility.
• The General Practitioner for the period completed in their office.

The assessment consists of:

• A descriptive part, documenting the activities undertaken by the student.
• An evaluative part, determining the level of competence demonstrated.

Upon positive evaluation, a certificate of eligibility is issued in the internship logbook.

Conditions for passing the TPVES

The internship is considered successfully completed only if the student obtains a positive assessment in each of the three modules (medical, surgical, and General Medicine).

Flexibility in Completion

The TPVES can also be carried out during periods without scheduled teaching activities, ensuring the completion of the 125 hours required per module as mandated by ministerial regulations.

This integrated approach allows students to consolidate their clinical and relational skills while ensuring the acquisition of necessary requirements for entering the medical profession.

Implementation Rules for the Degree Course in Medicine and Surgery - UniTS

The procedures and regulations concerning the Practical Evaluation Internship (TPVES) for qualification as a Medical Doctor are described in detail in the official document "Regulations of the Practical Evaluation Internship".

Enrolment in the practical assessment internship

Access to the TPVES is granted upon submission of the APPLICATION FOR ENROLMENT IN THE PRACTICAL ASSESSMENT INTERNSHIP, a fillable PDF form, which the student must:

• Complete in full;
• Send via email in PDF format, attaching both the internship enrolment request form and a copy of a valid identity document, to the Teaching Office of the Degree Course in Medicine and Surgery at the following address: lm.ciclounico6.dsm@units.it.

Before starting the Practical Assessment Internship activities, the student must wait for confirmation from the Teaching Office.

Technical and support services area

Each student will receive three logbook-diaries, each dedicated to a specific area of the internship:

• Medical Area
• Surgical Area
• General Medicine (to be carried out no earlier than the 6th year of the course at a general practitioner’s authorised practice).

Student's tasks

• Logbook Completion: Students are responsible for recording the activities carried out, specifying in the Medical and Surgical Area logbooks:
  • The assigned wards;
  • The designated Evaluating Tutors.
• Active Participation: Students must attend the assigned areas consistently and with commitment, complying with the provisions set out for the internship.

 

Example of Wards for the Medical and Surgical Areas

In accordance with Decree Prot. No. 909 of 27 May 2022, the wards that may be assigned to students for practical-evaluative internship activities in the following areas are specified:

• Medical area structures:
  • Internal Medicine
  • Gastroenterology
  • Nephrology
  • Medical Clinic
  • Pneumology
  • Infectious Diseases
  • Rheumatology
  • Clinical Immunology
  • Endocrinology
  • Diabetology
  • Haematology
  • Cardiology
  • Liver Study Centre
  • Hygiene and Preventive Medicine
  • Clinical Pharmacology
  • ICGEB, Cattinara, Maggiore, IRCCS Burlo Laboratories
  • Medical Simulation and Advanced Training Centre (CSMAA)
  • Neurology
  • Radiology
  • Nuclear Medicine
  • C.I.E.U.
  • Underwater and Hyperbaric Medicine
  • Psychiatry
  • Forensic Medicine
  • Occupational Medicine
  • Immuno-transfusion Centre
  • Pathological Anatomy
  • Dermatology
  • Oncology
  • Geriatrics
  • Palliative Medicine
  • SSD Breast and Female Reproductive System Oncology (ORSAF)
  • Medical Genetics
  • Paediatrics
  • Gynaecology
  • Emergency Medicine

  • Emergency Department

     

• Surgical Area Structures

  • General Surgery
  • Thoracic Surgery
  • Vascular Surgery
  • Plastic Surgery
  • Cardiac Surgery
  • Maxillofacial Surgery
  • Orthopaedics
  • Otorhinolaryngology
  • Ophthalmology
  • Odontostomatology
  • Neurosurgery
  • Urology
  • Autopsy Room

General Practitioner (GP) / Student Association

The association between students and General Practitioners (GPs) for the internship in General Medicine is regulated within the territorial locations of Trieste, Gorizia, and Pordenone. This ensures an appropriate distribution of students and a diversified educational experience.

This organisation aims to provide students with a comprehensive and integrated perspective of medical practice in both hospital and community settings.

Final assessment and evaluation

Intermediate assessments: During the internship, each Departmental Assessment Tutor will provide an evaluation of the student's acquired skills.

Final evaluation: Once the required hours and ECTS credits for each area have been completed, the Area Coordinator Tutor will formulate the final evaluation based on the assessments provided by the Departmental Tutors.

The final evaluation will be decisive in certifying the student's suitability for professional qualification.

Authorisation to Practise as a Medical Doctor

In accordance with Article 102, paragraph 1, of Decree-Law No. 18/2020, the final examination of the Single-Cycle Master’s Degree in Medicine and Surgery (Class LM-41) simultaneously serves as the State Examination for authorisation to practise as a Medical Doctor.

Obtaining authorisation is subject to passing the final examination of the sixth-year practical-evaluation internship, which certifies the student’s suitability in acquiring the professional skills required for medical practice.

Relevant Ministerial Documents

The authorisation to practise as a Medical Doctor and the related regulations are governed by the following ministerial documents:

• Ministerial Decree of 9 May 2018, No. 58: Regulation of the training and authorising procedures of the degree course in Medicine and Surgery.
• Ministerial Ordinance No. 20 of 10 February 2020: Specific provisions for the practical-evaluation internship and the State Examination.
• Supplement to Ministerial Ordinance No. 20/2020: Subsequent updates and modifications.
• Article 102 of Decree-Law No. 18 of 17 March 2020: Introduction of the qualifying nature of the final examination of the Single-Cycle Master’s Degree in Medicine and Surgery.

These documents form the regulatory framework for the training and authorisation process of Medicine and Surgery students in Italy.

Graduation Internship

The Graduation Internship is an integral and significant part of the Study Plan. The hours of the Graduation Internship must be recorded in the appropriate booklet (red booklet).

Procedure to Start the Graduation Internship:

To start the Graduation Internship and request its recognition upon completion (subject to online registration for the exam session), students must complete and send the following documents via email from their university email account to the Teaching Office (lm.ciclounico6.dsm@units.it):

1. Graduation Internship Start Request Form: Must be sent at least 15 working days before the start date of the internship.
2. Graduation Internship Recognition Request Form: Once the required hours have been completed, students must submit this document to request recognition of the internship, at least 5 working days before the exam session date. Students are reminded that, in addition to submitting the document, registration for the corresponding exam session through the Online Student Service (Esse3) is necessary for the official recording of the Graduation Internship.  

Post-Internship Weekly Evaluation Questionnaires

At the end of each week of clinical internship, students and tutors involved are required to complete specific evaluation questionnaires via the online Easy-Internship platform. These tools are a fundamental component of the training process, aiming to promote continuous improvement through a systematic analysis of:

• The skills acquired
• The quality of supervision
• The overall educational experience

• Student assessment by the Clinical Tutor

  The Clinical Tutor completes the Student Evaluation Questionnaire, providing a detailed and structured assessment of the following areas:

  • Theoretical Knowledge: The student’s ability to integrate biomedical and clinical knowledge into practical situations encountered during the internship.
  • Practical Skills: Proficiency in diagnostic and therapeutic procedures, execution of technical manoeuvres, medical history collection, and physical examination.
  • Clinical Reasoning and Problem-Solving Skills: Ability to identify and address clinical issues with a rational and methodical approach.
  • Professionalism and Ethics: Ethical conduct, punctuality, interpersonal skills with healthcare staff and patients, and adherence to ward regulations.

  • Observations and Suggestions: A section for personal comments, training advice, and guidance on areas for improvement.

     

  • Tutor Evaluation by the Student

    In turn, the student completes the Tutor Evaluation Questionnaire, assessing the quality of supervision and teaching received. The key aspects considered include:

    • Clarity and Completeness of Teaching: The tutor’s ability to explain clinical and practical concepts in a clear and accessible manner.
    • Support and Availability: The level of attention and assistance provided by the tutor during clinical activities.
    • Teaching Effectiveness: The tutor’s ability to translate theoretical knowledge into meaningful and engaging practical activities.
    • Active Student Involvement: The tutor’s willingness to integrate the student into clinical activities, fostering experiential learning.
    • Educational Feedback: The quality, frequency, and usefulness of the tutor’s feedback on the student’s performance

Relevance and Purpose of the Questionnaires

Evaluation questionnaires are not only tools for monitoring the quality of the training pathway but also an opportunity to enhance the educational experience through mutual feedback. The data collected allow for:

• Identifying strengths and critical elements in the internship pathway
• Promoting continuous improvement for both students and clinical tutors
• Ensuring high-quality clinical training in line with academic and professional standards

Completion and Submission Methods

The questionnaires must be completed, preferably in digital format, at the end of each week of the internship. The responses must be accurate, honest, and constructive. Once completed, the questionnaires will be sent to the Teaching Secretariat for analysis and archiving. Data processing will be strictly anonymous, in compliance with privacy regulations.

Importance of participation

The regular completion of questionnaires is mandatory and constitutes an integral part of the educational pathway. Through careful evaluation, students and tutors actively contribute to improving clinical teaching and creating an education-oriented environment focused on excellence.

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  Research Activities

  The Internship Committee offers Medicine and Surgery students the opportunity to participate in research activities. This represents a fundamental pillar for integrating theory and practice, fostering a comprehensive and excellence-oriented educational pathway. Such involvement provides a dual benefit: on one hand, it enhances the effectiveness of internship activities; on the other, it contributes to the production of innovative scientific knowledge.

Advantages of Active Participation in Research

1. Critical Evaluation of Internship Activities
   1. Students can analyse the effectiveness of current training pathways by collecting and interpreting data to identify areas for improvement.
   2. Research provides tools to assess the impact of teaching methodologies on both practical and theoretical learning.
2. Development of Advanced Skills
   1. Participation in scientific studies enables students to acquire skills in methodological, statistical, and clinical fields.
   2. Students learn how to design studies, process results, and draft scientific documents—essential competencies for an academic and clinical career.
3. Production of Scientific Material
   1. Direct involvement in research projects allows students to contribute to writing scientific articles and presenting results at national and international conferences.
   2. Publishing in peer-reviewed journals not only enriches the curriculum but also represents a significant contribution to the scientific community.
4. Promotion of Educational Innovation
   1. Research findings can be used to improve internship programmes and tailor them to the needs of students and healthcare institutions.
   2. The integration of clinical practice and research strengthens the link between universities and hospitals, creating a dynamic educational ecosystem.

Modes of Participation in Studies

Students interested in actively participating in research projects related to internship activities can contact the dedicated contacts:

• Internship Committee: tirocini.dsm@units.it
• Prof. Aleksova: aaleksova@units.it

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  Internship Locations

   

  Training Network of the Single-Cycle Master's Degree in Medicine and Surgery at UniTS

  • Cattinara Hospital
  • Ospedale Maggiore
  • IRCCS Materno Infantile “Burlo Garofolo
  • San Polo Hospital Monfalcone
  • Civil Hospital of Gorizia
  • Civil Hospital “Santa Maria degli Angeli” Pordenone
  • General Practitioners' Clinics and the possibility of internships in Territorial Districts
  • Sanatorium
  • Policlinico Triestino

Internship forms and documents