delle società scientifiche
per la riduzione
del rischio cardiovascolare


Oct 21, 2010

Il dibattito aperto fra noi sull’Agenzia per la Ricerca ha innescato varie riflessioni, fra cui quelle del collega Francesco Cosentino pubblicate su European Hearth Journal, che riportiamo qui di seguito.


Climbing the academic ladder in cardiology: Italy



Unfortunately, the situation described by Prof. Francesco Cosentino, MD, PhD, FESC, associate professor of cardiology at the 2nd Faculty of Medicine, University ‘Sapienza’ of Rome, Italy, in a Circulation article in 2006 has not changed.1

Improvements towards merit-based selection criteria for academic position appointments are still underway, research is underfunded, and there is a lack of appealing opportunities for young cardiology researchers. The result is thatmany young cardiologists go abroad to other European countries or toCanada and theUSAto pursue a career in academia.

This is despite the fact that the Italian postgraduate system for cardiology is completely aligned to other countries in Europe and follows the European Society of Cardiology core curriculum. ‘I believe that the Italian postgraduate specialist training programmes nationwide deliver a high level of competence both in core and specialty areas of cardiology’, says Cosentino. ‘However, for young Italian specialists willing to climb the academic ladder, then they have to face these limitations’.

There are three levels in academic cardiology in Italy—assistant, associate, and full professor. All cardiologists are entitled to apply for an assistant professorship, although a PhD title is highly recommended. Appointments to cardiology posts aremade by a committee of three to five cardiologists, most of whom are full professors. Committee members are recruited from all over the country and include the full professor of the university with the vacant position.

Once an academic appointment is made in Italy, official confirmation is given after 3 years. Positions then last a lifetime, regardless of scientific productivity.

‘I think this is wrong because you need stimulation’, says Cosentino. ‘If you know that after every number of years you will get judged for what you have produced, then you are more active’.

Politicians are becoming aware that research and development by academic institutions is a must for the country. Anewlawis being discussed in Parliament which could see a number of new reforms to the system, including the evaluation process of candidates to academic positions.

Elections to committees are going to be abolished and replaced with a random selection from the list of full professors in Italy. The professors who sit on committees to make appointments would also be subject to regular evaluation by a new agency that will be created. They will be required to meet a set standard of scientific productivity that will be defined by objective criteria. Cosentino says: ‘If you are to judge young promising scientists you have to be yourself a productive researcher’. Failure to meet the required standard will prevent people from sitting on appointments committees.

Another reform being discussed is inviting professors of other countries to sit on the selection committees to stimulate more objective decisions.

The university system will be modernized so that the distribution of funding to each university is based on merit and on productivity. Universities will be responsible for their choice of Fellows. If they appoint Fellows who are unproductive in terms of scientific research or teaching, they will get less public funding.

It will provide motivation to choose the most brilliant people in order to achieve a high level of productivity. ‘I think this is a positive loop which will give fruit’, says Cosentino.

Until now, the autonomy of universities has not been based on productivity and has been interpreted simply as the ability to independently organize teaching activities, rather than a virtuous mechanism to improve fundraising.

Cosentino believes that the university reforms will create more efficient centres of excellence in quality. He also hopes that the demographic structure of university professors in Italy will change as a result. Currently, more than 20% of professors are over 60 years of age, compared with 13% in France and 8% in the UK, whereas just 4.6% professors in Italy are below 35 years of age, compared with 16% in the UK. The figures demonstrate how long it takes to reach a position of responsibility.

It also means a long wait before receiving an attractive salary. Newly appointed assistant professors in Italy are poorly remunerated and less funded for research activities compared with other countries, which reduces the incentive to choose this career path.

Under the proposed new system, more efficient institutions (universities, schools of medicine, and departments) would receive more research funding.

The new law is currently being debated in Parliament. Although it is difficult to foresee when the new system will take place, Cosentino is optimistic. He says: ‘There will be reformation of the system, and for sure we are going towards better possibilities for young physicians to enter the academic career’.

J. Taylor, MPhil


1. Cosentino F, Francia P. Viewpoint: climbing the academic ladder in Italy. Circulation 2006;114:f193–f194



COSENTINO_Climbing the academic ladder in cardiology.pdf