Italian hospital doctor resignations rose 150% in 2025 to surpass retirements

Resignations overtake retirements

A 10-year study by the hospital doctors union Anaao Assomed shows that voluntary resignations among Italian public hospital doctors reached 3,767 in 2025. This figure represents a 150% rise compared to the 1,503 resignations recorded in 2024. For the first time between 2015 and 2025, voluntary departures exceeded statutory retirements, which stood at 2,876. Resignations accounted for 3.5% of the total public healthcare medical workforce in 2025, surpassing levels observed during the COVID-19 pandemic. In 12 of Italy's 20 regions, doctors leaving the National Health Service before retirement age outnumbered those reaching the pension limit.

Anaao Assomed National Secretary Pierino Di Silverio described the causes driving doctors away from public wards.

This is not a matter of routine professional turnover, but a genuine exodus driven by gruelling shifts, salaries that lag behind European standards, working conditions bordering on burnout, unsustainable bureaucratic burdens, and assaults in hospital wards.

Regional disparities and workforce tension

The study, based on data from Onaosi, the State Annual Account, and the Ministry of Economy and Finance, reveals uneven regional pressure. The highest imbalances occurred in Lazio, Trentino-Alto Adige, Friuli-Venezia Giulia, and Sardinia, where voluntary resignations were between 2.4 and 3.3 times higher than retirements. Overall human resources data indicates that for every 100 doctors hired on permanent contracts in 2025, 43 resigned and 77 departed the public system across all exit categories. The doctors stepping down are predominantly mid-career professionals with an average age of roughly 48 years.

North-South divergence and age profile

Over the 2015 to 2024 period, total hospital doctor staffing in Italy increased by 2.7%, rising from 105,380 to 108,243. However, regional distribution diverged significantly between northern and southern areas. The Central-North gained 4,029 doctors (an increase of 5.9%), while southern Italy lost 1,166 positions (a decline of 3.1%). The sharpest staffing drops occurred in Basilicata (-24.6%), Molise (-17.2%), Valle d'Aosta (-14.2%), and Calabria (-12.6%). In Piedmont, hospital doctor ranks contracted by 3.4%, falling from 8,319 in 2015 to 8,039 in 2024. Despite the departures, average doctor age declined by 2 years and 7 months for men and 2 years and 4 months for women between 2015 and 2024.

Union demands and policy proposals

The rejuvenation of staff was facilitated by the Calabria Decree, which introduced nearly 10,000 young doctors into the healthcare system between 2019 and 2025. Anaao Assomed presented a 10-point plan to the Italian government, parliament, and regional authorities to stabilise the workforce. The union calls for making the Calabria Decree permanent by converting specialist training into structured employment-training contracts. Additional proposals include removing the expenditure ceiling on personnel recruitment, aligning wages with European averages by exempting supplementary pay from taxation, and reforming medical liability legislation to limit defensive medicine. The union also demands incentives for disadvantaged facilities and a permanent national observatory to track doctor departures.