An Italian surgeon who after years abroad returned to Italy to run a new international transplant centre in Palermo, Sicily, has resigned because of dissatisfaction with the national health system.
The surgeon, Ignazio Marino, said: "Personal privilege prevails, obstacles are created for those who work well, instead of trying to work better in the interests of the patient." He has now taken a job at Philadelphia's Jefferson University.
Professor Marino, 47, graduated in Italy and worked for almost 20 years in the UK and then in the US, becoming a transplant specialist. In 1996 he was among the promoters of the Palermo project to establish a state-of-the-art transplant centre backed by the Italian government, along with the Sicily region, two Palermo hospitals and the Medical Center of the University of Pittsburgh. The idea was to create a high-profile, US-style institute that would inspire the rest of Italian medicine.
The Istituto Mediterraneo per i Trapianti opened in 1999 with Professor Marino as director and an American nucleus of senior doctors and administrators.
Italian president Carlo Azeglio Ciampi said he was "deeply sorry" about Professor Marino's resignation. "I hope the conditions will be created in which he can reconsider," he said. Mr Ciampi was possibly unaware that Professor Marino resigned in September but only announced his resignation on the day he left.
But health minister Girolamo Sirchia, himself a doctor with teaching experience, said that Italy's brain drain could be largely blamed on the universities themselves, for "holding back young people in the name of gerontocracy, bureaucracy and nepotism. Merit does not count," he said.
Pittsburgh has appointed transplant surgeon John Fung to take over direction of the institute.
Dr Fung said: "It is not surprising that certain difficulties developed in the initial set-up of the institute. My approach has always been to be inclusive and to engender a cooperative environment. We will integrate the institute faculty and staff with University of Pittsburgh healthcare providers and promote exchanges."