A needs assessment conducted of the Tuscan emergency system revealed a resource-rich, well-developed system that lacked formal training in emergency medicine. This lack of training resulted in variability of emergency care delivery between hospital EDs and within individual EDs. Regional healthcare leaders saw the need to move towards adoption of a model in which physicians working in the EDs are trained and qualified in emergency medicine.


Together with regional and university leadership, we devised and implemented a three-phase plan which included:

  • Creation of a “Train the Trainers Program,” which would educate a core group of trainers from Italian medical specialties who would serve as the foundation to future emergency medicine education initiatives;
  • Building a process to qualify emergency physicians already working in the system which would train, qualify, and effectively “grandfather” these physicians into a new emergency medicine specialty;
  • Providing a mechanism to train future physicians through a 3-year Emergency Medicine Master’s Course and eventually a university-based Emergency Medicine Residency program – the first in Italy

Led by HMFP faculty member, Kevin M. Ban, MD, this 6-year project brought about a transformation of Emergency Medicine in Tuscany.

  • Successfully trained 81 instructors/trainers and more than 900 Tuscan emergency physicians to become Emergency Medicine specialists with standardized competencies.
  • Effectively started the transformation in Tuscany to a single-provider model of emergency medicine in the region.
  • Developed standardized emergency medicine training for the region of Tuscany through the creation of a 3-year Emergency Medicine Master’s Degree which eventually became an official Emergency Medicine residency program.