gms | German Medical Science

The structure of Medical Education in Europe: Implementing Bologna – On the way to a European success story?
International Conference hosted by the German Rectors' Conference (HRK)

10 - 11 October 2008, Berlin

The international student exchange programmes - Faculty of Medicine and Surgery, University of Florence (1): Teaching

Extended Abstract

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  • corresponding author presenting/speaker Maria Grazia Giovannini - University of Florence, Faculty of Medicine and Surgery, Dipartimento di Farmacologia, Erasmus and International Mobility Delegates, Firenze, Italy
  • corresponding author presenting/speaker Laura Della Corte - University of Florence, Faculty of Medicine and Surgery, Dipartimento di Farmacologia, Erasmus and International Mobility Delegates, Firenze, Italy

The Structure of Medical Education in Europe: Implementing Bologna – On the way to a European success story?. International Conference hosted by the German Rectors’ Conference (HRK). Berlin, 10.-11.10.2008. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc08hrk19

doi: 10.3205/08hrk19, urn:nbn:de:0183-08hrk199

Published: January 13, 2011

© 2011 Giovannini et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Introduction: The medical-surgical ‘tradition’ in Florence has a much longer history than Florence University itself, which was founded in 1924 together with the Faculty of Medicine. Indeed, a School of Surgery was present within the Santa Maria Nuova Hospital as early as in the XIIIth century. The Florentine School of Surgery was very much appreciated during the centuries, insomuch as even those who graduated in medicine at the prestigious Universities of Pisa and Siena were obliged to attend a two-year internship at the Santa Maria Nuova Hospital Surgery School in order to obtain their licence to practice as doctors. Indeed, in the Middle Ages in Tuscany, in order to develop the right skills to become a qualified medical doctor, it was considered of primary importance not to study and practice within one single university but to travel and study in distant schools: a premonition of the present international student exchange programmes. Still to-day the Faculty of Medicine at Florence University, together with the Dean, the Delegate Committee, and the Didactic Committee for International Mobility strongly believes in international student exchange programmes. The faculty considers them a top investment for the development of internationally-oriented future medical doctors. Modern-day students, travelling and studying in various countries, have the opportunity to open their minds, to learn a new language, and to acquire the right skills to practise throughout the various countries of a united Europe.

Student mobility: Erasmus is now the major part of the Life-Long Learning Programme which represents the last and most ambitious evolution of the Socrates programme for international mobility of students and teachers. The Medical Faculty of Florence has been active in the Erasmus Programme over the last 30 years. Since 1989, the university has coordinated Erasmus Interuniversity Co-operation Programmes (ICPs) building up a European network of 17 institutions. The Erasmus ICPs, however, were independent teacher-centred programmes, limited to a specific disciplinary area, in case of medicine pharmacology/biochemistry, and mostly limited to the exchange of students for laboratory work related to their thesis.

When the Erasmus ICPs were incorporated into the university-centred Socrates Programme, in its first year of activity the number of outgoing and incoming students was 10 and 5 respectively. In the subsequent years, there has been an exponential increase in the number of students exchanged by the medical faculty, both throughout Europe and overseas, reaching in the last two years over 550 students exchanged in both directions. Through the Erasmus Life-Long Learning Programme study and placement mobility, as well as through the interuniversity and interfaculty agreements, the number of incoming exchange students and teaching staff visiting the faculty has steadily increased since the programme started in 1996 (see figure 1 [Fig. 1] and 2 [Fig. 2]).

The great diversity of didactic offers and because of students’ needs on the one hand, and the increasing number of exchanged students on the other hand, required a heavy commitment to assure all students of the 33 different degree courses equal rights and equal opportunities along the procedures, starting from the preparation of their Learning Agreements down to the final recognition step. The crucial part of these procedures – defined as ‘International Didactics’ – is necessarily under the responsibility of teaching staff rather than administrative staff. Furthermore, it was recognised that only a specific didactic committee, dedicated to international mobility with representatives from all degree courses, could deal with the complexity of these procedures. The faculty dean appoints teaching staff members of the ‘Didactic Committee for International Mobility’. The committee is responsible for

the acceptance of incoming student applications and approval of their Learning Agreements,
preparation and approval of Learning Agreements of outgoing students and local recognition of their studies performed abroad as per the Transcript of Record issued abroad.

The great diversity in the didactic needs of both outgoing and incoming students from so many different European universities requires flexibility: each Learning Agreement has to be ‘tailor-made’, taking into account both the home core curriculum and that of the partner university, in relation to the specific requirements of each student.

This organizational model set up by the faculty of Medicine of Florence has been recognised as excellent, both at national and international level. Over the past 4 years the international mobility activities of the Faculty scored between the first and third place among those of all Italian medical faculties, as shown in the CENSIS statistics.

Core curriculum: The core curriculum of the Degree Course in Medicine and Surgery consists of integrated courses, modules, clinical rotations, as well as optional activities. The entire course develops over a six-year period and students must acquire 60 Italian CFU credits, equivalent to 60 ECTS credits, per year (360 in total) in order to graduate. Incoming students may take courses from the fourth year onward, according to the ‘Study Plan’ presented in Table 1 [Tab. 1] for the academic year 2010-2011.

Incoming students may attend courses, and take exams for individual modules of the integrated courses as shown in table 1, aside from pathological anatomy 1 and 2, which are considered a single exam. Most of the teaching still takes place in large lecture halls and class attendance is compulsory (minimum attendance permitted: 70%). Most lectures and clinical trainings are held at Careggi Hospital, the main University Hospital for the City of Florence. Students are also expected to study independently to prepare for exams. Exam sessions are held in February, June/July and September and are mainly oral. Some courses have written tests during the semester or before the oral exam. A number of sessions are available within each exam period and students can book the date of their choice. Students not satisfied with their exam result may take that exam again, although there are rules as to how often an exam may be taken within the same examination period.

Incoming students may also take clinical rotations in subjects of their choice (a minimum of four weeks per subject). In order to attend clinical rotations good knowledge of Italian is required. Incoming Erasmus students are offered one Italian language course free of charge at the University Language Center to book online (

Summary: Internationalisation and student mobility programmes represent an opportunity and a challenge rather than a danger. Their success depends on the following key points:

  • Flexibility - flexibility in accepting different modalities of teaching and evaluation used in different partner institutions is of primary importance for making the most of diversity.
  • Diversity does not mean a difference in quality. The acceptance of diversity must be based on trust.
  • Trust - It is crucial to trust the professional expertise and teaching methods of colleagues of other European Faculties. Medical doctors are trained to later exert their profession freely in any other member state of the European Union after passing the state examination and obtaining the licence to practise. The profession of Medical Doctor is in fact one of the seven professions fully recognised at European level without the need for further examinations. If it is possible to recognise the medical profession throughout Europe, it must be possible to give full recognition to examinations that medical students have passed in other European universities.

Florence, Renaissance cradle of culture and humanities, still today promotes diversity in the name of university.