Naples, doctors on the run: voluntary resignations outnumber retirements.

Naples – It's no longer just age, it's no longer just retirement that's emptying hospital wards in Campania. What's pushing doctors out of the public health service is now a spontaneous, bitter, and increasingly premature decision. For the first time in recent history, voluntary abandonment of permanent positions has outpaced the natural age turnover.

While the general accounting shows a seemingly stable regional workforce—from 9.306 doctors in 2015 to 9.152 in 2024, with a negative balance of just 154—an analysis of the reasons for leaving reveals an unprecedented structural crisis.

The historic overtaking: resignations beyond retirements

The latest report from the Anaao Assomed Research Center for the decade 2015-2025 charts the contours of this "silent hemorrhage." The study exposes a phenomenon that transcends the normal working dynamic: the fatigue of doctors no longer translates simply into a wait for retirement, but explodes into a genuine rejection of the working conditions offered by public institutions.

If in 2015 the doctors who decided to voluntarily resign from the public service in Campania were 116 (equal to 1,2% of the total), in 2023 the dramatic peak of 414 abandonments was reached (4,4%), to then stabilize at 309 in 2024 and 246 in 2025.

Despite a slight decline in the last two years, the ten-year trend shows a net increase of 2,1 percentage points. This figure reflects a historic national trend: in 2025, for the first time in the history of the National Health Service, voluntary resignations exceeded retirements (in Campania, they fell to 339 in 2025 after peaks of 670 in 2023 and 616 in 2024).

Young people fleeing to the private sector, freelance work, and abroad

Over the past decade, the average age of female doctors in Campania has dropped from 54,7 to 48,8, while that of male doctors has increased from 57,3 to 53,9. However, permanent hires—which rose from a paltry 183 in 2015 to 1.022 in 2023, and reached 728 in 2025—end up filling a leaky vessel: without a change in daily working conditions, new recruits flee after a few years to private practices, freelance work, or healthcare abroad.

Faced with this crisis of attractiveness, the regional secretary of Anaao Assomed Campania, Vincenzo Bencivenga, has formalized a strong open letter addressed to the President of the Campania Region, Roberto Fico.

A letter to Fico: "Enough with doctors being treated like pieceworkers."

The union's message is clear: public health can no longer manage medical personnel as if they were employed on an assembly line or treated as "pieceworkers," requiring only more hours, more shifts, and more performances to reduce waiting lists.

"We can't continue to minimize the problem by reducing it to a corporate issue or a temporary shift cover issue," Bencivenga emphasizes. Doctors' distress stems from unsustainable workloads, constant exposure to the risk of assault, delays in assigning career advancement positions, and salaries that aren't competitive by European standards.