The Specialist in Community Medicine and Primary Care must have gained theoretical, scientific and professional knowledge in the fields of diagnosis, treatment and rehabilitation of acute and chronic diseases with particular reference to the context of the primary care network. In particular, the specialist must have developed specific professional knowledge and skills in the multidimensional assessment of health needs, the formulation of integrated care plans and the drafting of care pathways that allow to guarantee continuity of care between different areas of care, hospital, territorial and home and between different services and professional skills. Specific areas of professional competence include primary care, general medicine, the management and direction of local services such as districts, Primary Care Services/Units and Community Medicine, health homes, territorial palliative care, intermediate non-hospital residential facilities, etc. The specialist in Community Medicine also acquires specific skills and experience in the following interventions: health promotion and prevention with a community approach; taking care of people with chronic and/or disabling diseases at all stages of the disease, including terminal diseases; community reintegration of persons with disabilities; Organisation, planning and evaluation of local health services and local hospital care pathways

Basic training objectives: the student must know and use epidemiological and sociological methodologies to assess the health needs of individuals, families and communities, the appropriateness and effectiveness of care interventions; know the methodologies of planning and resource management in primary health services; know the basic elements of computer and statistical methods for processing information, to monitor the health of communities, evaluate the impact of actions and interventions on it, carry out research according to modern computerized criteria; know the fundamental principles of population genetics and acquire the ability to use genetic tests for diagnostic and preventive purposes on the individual; know the main psychological functions and methods and techniques of interpersonal communication; know and acquire the principles of medical ethics and clinical bioethics for the appropriate management of individuals, families and communities;

OBJECTIVES OF THE GENERAL TRAINING: the student must acquire knowledge of methodology and physical, instrumental and laboratory semiotics; must use modern clinical and managerial research methodologies and acquire the ability to critically evaluate them and apply them appropriately in different clinical and organisational conditions;

educational objectives of the type of School: the student must know and apply the appropriate methods to: analyze the multidimensional health needs of individuals, families and communities; choose the appropriate diagnostic pathways, interpret the results of the tests, prescribe appropriate pharmacological, medical and surgical treatments; develop personalized care plans with different care intensity; organize home, outpatient, residential and semi-residential primary care interventions, integrated as needed with hospital care; working in teams and coordinating interdisciplinary operating units to implement unitary care processes; directing primary care services with a view to the global care of individuals, families and communities; manage services with a view to implementing quality; organising and coordinating clinical audits, efficacy, efficiency and quality checks, and economic analyses in the network of primary services; activate the participation of individuals, families and communities in the protection of individual and collective health; plan and carry out health education interventions for individuals, families and communities for the purposes of prevention and health promotion. The resident must then know the problems related to addictions to drugs, alcohol and tobacco smoke, the etio-pathogenetic mechanisms of their onset, the possible interventions in the field of prevention, diagnosis, treatment, social reintegration, the methods to activate the network of services in the global care of the subjects; must know the main psychiatric pathologies, the possible interventions in the field of prevention, diagnosis and treatment, the methods to activate the network of services for the global care of psychiatric patients; must know the area of disability, the methods of its assessment, of the overall care of patients to promote their maximum autonomy and social participation; he must know the pathophysiology of old age, the possible interventions in the field of prevention of non-self-sufficiency, the diagnosis and treatment of the main chronic diseases related to this age, the methods for activating the network of services in the global care of non-self-sufficient elderly subjects; he must know the infectious pathology with the greatest social impact and the methods of taking care of the patient with particular regard to the aspects related to his home and/or residential care; must be familiar with the problems of the maternal and child area and the services for primary care for women, the developmental age and the family, with particular regard to the activities of family counselling centres, family and community paediatric services and child neuropsychiatry.

The following are compulsory professionalizing activities for the achievement of the educational purposes of the type:

• have carried out care activities in the departments of the Medical Area, the classes of General Medicine, Medical Specialties, Pediatrics, and Neuroscience. During the aforementioned period, he must have directly participated in the care activities referred to at least 100 patients, including the assessments of the overall clinical situation, the functional aspects and autonomy of the patient, also in relation to his or her living environment, and finally the drafting of at least 20 protected hospital discharge plans for patients with the need for territorial continuity of care;
• have completed at least 20 shifts in urgent and emergency services such as medical-surgical, general and/or paediatric emergency departments, in 118 and territorial continuity of care services;
• have carried out care activities in General Practitioners' offices, having personally participated in the care activities of at least 360 patients including the execution of at least 120 home visits, involvement in at least 80 integrated home care plans, participation in at least 30 Multidimensional Evaluation Units;
• have carried out assistance activities in favour of minors with special needs and vulnerable and multi-problem families, both at local Maternal and Child Health Facilities with the care of at least 30 patients suffering from chronic diseases, rare diseases, disabilities and/or known for conditions of mistreatment or poor protection, and at the offices of Paediatricians of Free Choice having followed the care activities of at least 20 paediatric patients;
• have carried out care activities in intermediate non-hospital residential facilities and semi-residential facilities, such as community hospitals, hospices, RSAs, semi-residential rehabilitation facilities, taking care of at least 50 patients;
• have carried out assistance activities at mental health and addiction facilities, with participation in the care of at least 20 patients;
• have carried out assistance activities in facilities for the disabled, taking care of at least 20 patients;
• have participated in activities of planning, organization, management and verification of diagnostic, treatment and taking charge pathways, centered on the primary care system and on the continuity of care between the different care and life environments.

In the same period, he/she must:

• having followed the care pathways of at least 30 complex patients,
• having participated in the design and management of information flows within the primary care network and regional health information systems,
• have participated in actions aimed at the management, enhancement and training of personnel, in the drafting and discussion of budget plans, training plans and reorganization of services, in projects aimed at verifying and/or increasing the quality of the interventions of the primary care network, in the design, execution and evaluation of community-type health education interventions.

The student must also acquire experience in the following professional areas:

• Protected hospital discharges: in-depth knowledge and acquisition of the appropriate methods for organizing, managing and verifying hospital discharge interventions for patients requiring continuity of care in the area. To this end, the resident must have participated in the planning of at least 20 hospital discharge surgeries with scheduled access to home or residential care;
• Integrated Home Care: in-depth knowledge and acquisition of the appropriate methods for organizing, managing and verifying coordinated medical, nursing and social care home care interventions. To this end, the student must have participated in the planning of at least 10 social and health ADI interventions;
• Management of complex patients in the network of services: in-depth knowledge and acquisition of the appropriate methods to organize, manage and verify integrated activities for the global care of the elderly, psychiatric patients, disabled people, multi-problem families in the network of local services, connected to the hospital as needed.

• implementation of quality in primary services: knowledge and acquisition of the appropriate methods for planning and implementing interventions to improve the quality of primary home, outpatient, semi-residential and residential services. To this end, the student must have participated in the planning and development of at least 5 Quality Development interventions.

The student will be able to compete for the diploma after completing the professionalizing activities.

As part of the training course, the student will have to learn the scientific bases of the type of School in order to achieve full maturity and professional competence that includes an adequate ability to interpret scientific innovations and critical knowledge that allows him to consciously manage both assistance and his own updating; In this context, participation in meetings, congresses and the production of scientific publications and periods of attendance in qualified Italian and foreign institutions useful for his/her training may be envisaged.