[Residency in hygiene and preventive medicine: present and future].

INTRODUCTION: The changing needs and expectations of the population and the current financial distress lead the Italian health care system to face a profound challenge that requires also a new evaluation of professionals' training. Specialists in Hygiene and Preventive Medicine (HPM) are called for to develop new knowledge and skills in hygiene, public health, and management, as they fulfill leadership roles within the hospitals. OBJECTIVE: To investigate the current status of Hospital Health Management Boards (HHMB) and the specific know-how they require, in order to develop an adequate post-graduate residency training in HPM. MATERIALS AND METHODS: We conducted a literature review on the main and «gray literature» databases; then, we conducted three semi-structured interviews with the Chiefs of the HHMB operating in the major hospitals of Bologna (Northern Italy); lastly, we organised a workshop with residents in HPM and health workers of Emilia-Romagna hospitals. RESULTS: Interviews with Hospital Health Managers have highlighted the main issues faced by a modern HHMB. The main questions discussed were: the changing role of the hospital and its relationship with primary care; the increasing competition among professionals with different specialisations within the HHMB; the need to develop multi-professional teams; the necessity to enlarge HPM residency training programmes in order to meet the HHMB needs. CONCLUSION: The evolution of the HHMB reflects the evolution of the Italian health care system. HHMBs should better fit the organization to the context, and the post-graduate schools in HPM should follow this process. In the framework of the current rules and laws it is possible to focus for implementing training programmes that include management, coordination and negotiation skills, and help build an adequate leadership profile