L’integrazione del territorio nel sistema delle cure. Parte 2a – Proposta di un curriculum “verticale”.

University-Health Service relationship and its consequences on the undergraduate curriculum in Medicine: proposal for a ‘vertical’ curriculum The present article reports the conclusions of a forum organized by the Medical Education Working Group of the Conference of Directors of Undergraduate Curricula in Medicine, on the topic of University and National Health Service integration in the educational process of undergraduate students. Participants have been divided into four parallel workshops respectively dealing with; i) physician-patient-family interaction (early and advanced clinical contact); ii) the professional approach to the patient and its methodological implications; iii) Hospital-Health Services interaction in curing and caring; iv) management of healthcare resources in Hospital-Health Services interaction. The final debriefing and discussion have allowed some conclusions to be drawn: i) integration of the hospital and health system should cover all the community settings and all the professionals involved; ii) such an integration should be pursued in all the different steps of medical curriculum, with progressively different learning objectives, methods of teaching, and ‘actors’ to be involved; iii) the aim of community-based medical education is to make students able not only to cure but also to take care of patients, framed in their family and community context; iv) communication in every setting between physicians and health professionals, and between these and the patient, and his/her family, to warrant the continuity of cures, should be taught; v) attention should be paid to the ethic relevance not only of caring but also of making economically congruous choices in terms of diagnosis, therapy, and prevention; vi) importance of prevention, for the sake of single patients and community health promotion, should always been underlined.