Postgraduate School of Digestive Diseases

Integrated (i.e., core) training objectives
The trainee must have acquired satisfactory theoretical knowledge and professional competence in the clinical and instrumental diagnosis and treatment, including emergency and urgent conditions, of the most common internal medicine diseases. The trainee must acquire fundamental knowledge of the pathophysiology of various organs and systems, the theoretical and practical knowledge necessary to recognize diseases affecting the various body systems, theoretical and practical knowledge of the main areas of instrumental and laboratory diagnostics related to the aforementioned diseases, and the ability to evaluate internal medicine and specialist connections and influences. Therefore, the trainee must be able to recognize the clinical and functional symptoms and signs of diseases affecting various organs and systems, having acquired the fundamental diagnostic, therapeutic, psychological, and ethical knowledge necessary for a comprehensive patient perspective. To this end, the trainee must develop the ability to clinically assess the patient based on the medical history and physical examination; develop critical and analytical diagnostic skills; Become familiar with the main diagnostic procedures and laboratory and instrumental investigations; recognize and be able to address major medical emergencies; familiarize themselves with therapeutic resources to plan their optimal use and recognize their indications and contraindications, as well as the effects of interactions and potential iatrogenic effects; acquire fundamental knowledge of clinical research methodologies and pharmacological trials; and understand the fundamental issues related to prevention, public health, and social medicine. The trainee must have acquired satisfactory theoretical knowledge and professional competence in the recognition and treatment, in emergency situations, of the most common pathologies. Finally, the trainee must also have clinical and therapeutic knowledge of the most common pathologies covered by other categories of the class.

Basic Educational Objectives
The trainee must acquire advanced knowledge of the morphology and function of the gastrointestinal tract, liver, biliary tract, and exocrine pancreas, master the biological, molecular, and immunological bases of digestive function and related pathologies, and learn and apply techniques in gastroenterological, hepatic, and nutritional physiology and pathophysiology.
General Educational Objectives: The trainee must acquire the correct epidemiological approach and the methodological foundations of laboratory, clinical, and therapeutic practice, as well as the ability to continually update their professional knowledge, including through the use of up-to-date information technology.


The trainee must acquire advanced knowledge of the etiopathogenetic mechanisms that determine digestive diseases and their progression; understand the pathophysiological bases of diseases of the gastrointestinal tract, liver, bile ducts, and exocrine pancreas by actively participating in physiopathological studies and be able to apply this knowledge in interpreting the clinical pictures of patients with hepato-gastroenterological and pancreatic diseases, placing them in the context of the patient's overall assessment; understand and be able to interpret the anatomical, clinical, and pathological bases of diseases and tumors of the gastrointestinal tract, liver, bile ducts, and exocrine pancreas; acquire clinical and technical knowledge related to gastroenterological diagnostics and therapy and the ability to apply them correctly; perform fundamental and advanced endoscopic diagnostic and therapeutic procedures according to good clinical practice standards. Acquire theoretical and practical skills in laboratory and instrumental methods applied to the pathophysiology and clinical aspects of digestive diseases, with particular emphasis on cyto-histopathology, immunological techniques, functional assessment techniques for various parts of the digestive system, the liver, and local circulation, and gastroenterological imaging. Apply the most up-to-date knowledge to the epidemiological assessment, prevention, diagnosis, treatment, and rehabilitation of digestive diseases. Understand and apply good clinical practice standards in controlled clinical trials. Be able to evaluate the pathophysiological and clinical connections between digestive problems and problems affecting other organs and systems. Participate in clinical activities that include, in the field of diseases of the gastrointestinal tract, liver, biliary tract, and exocrine pancreas, contributions from internal medicine, gastrointestinal surgery, diagnostic imaging, pathological anatomy, clinical oncology, pediatrics, clinical nutrition, and nursing.

Specific areas of expertise include: clinical management of neoplastic and non-neoplastic diseases of the gastrointestinal tract, liver, biliary tract, and exocrine pancreas; diagnostic and therapeutic endoscopy procedures of the digestive tract; the pathophysiology of digestion, nutrition, and liver metabolism; other instrumental diagnostic procedures within the specialist's remit; prevention and treatment of non-neoplastic and neoplastic diseases of the gastrointestinal tract, liver, biliary tract, and exocrine pancreas, and the rehabilitation of affected patients.


Mandatory professional development activities to achieve the educational objectives of this program include:
- having treated at least 250 patients across the major gastroenterological, hepatic, biliary, pancreatic, and nutritional pathologies, at least one-third of which were neoplastic in nature. Initially, and then personally, participating under the supervision of tutors in the collection of anamnestic and objective data, planning adequate and appropriate diagnostic and therapeutic interventions based on knowledge derived from clinical evidence, and critically evaluating the clinical cases themselves;
- having presented at least 40 clinical cases in the School's educational meetings;
- having actively performed, under supervision, and progressively acquired independent proficiency in performing at least 200 esophagogastroduodenoscopy procedures, including at least 20 esophageal variceal ligation procedures, 25 hemostasis procedures, and 25 polypectomies;
- have actively performed, under supervision, and acquired progressive autonomy in performing at least 200 colonoscopies, 1/3 of which were completed with polypectomy procedures;
- have actively participated in the performance of at least 30 ultrasound-guided liver biopsies and/or abdominal punctures;
- have actively participated in the performance of at least 200 diagnostic ultrasound scans of gastroenterological interest, with at least 1/3 performed personally;
- have actively participated in an adequate number of the following activities: therapeutic endoscopies; ultrasound endoscopies; retrograde cholangiopancreatography, stent placement, stricture dilations, and mucosectomies;
- have participated in an adequate number of manometric procedures;
- have conducted, under supervision, an adequate and appropriate number of clinical nutrition interventions (enteral and parenteral);
- have conducted, under supervision, an adequate and appropriate number of proctology procedures;
- have participated in the clinical management of patients pre- and post-liver transplant.

The trainee may apply for the diploma after completing the professional development activities.

As part of their training, the trainee must learn the scientific foundations of the School's structure in order to achieve full maturity and professional competence. This includes adequate interpretation of scientific innovations and critical thinking that allows them to effectively manage both their healthcare and their own development. This may include participation in meetings, conferences, the production of scientific publications, and periods of attendance at qualified Italian and foreign institutions useful for their training.