From Leonardo da Vinci’s designs for ball bearings to the incredible engineering wizardry behind the Ferrari, the inventive, inquisitive, and ingenious spirit of the engineer has always lived—and thrived—in Italy. From education to research to product development, Italy has always been regarded as an engineering leader. But does this apply to biomedical engineering (BME)? Despite many successes, questions loom, as they do at engineering schools worldwide. Concerns such as whether BME programs are providing students with enough focused, practical, hands-on training remain at the forefront, as does the question of whether graduates will be able to find jobs in industry after university studies are over. Here, IEEE Pulse explores these topics with Riccardo Pietrabissa, president of the Gruppo Nazionale di Bioingegneria (National Bioengineering Group) and a full professor in the Department of Chemistry, Materials, and Chemical Engineering at Politecnico di Milano.
IEEE Pulse: Can you give us a brief history of BME education in Italy?
Riccardo Pietrabissa: In Italy, biomedical engineering as a research field was born in the 1960s through the National Research Council [Consiglio Nazionale delle Ricerche (CNR)] with applications in well-established disciplines such as biological system modeling based on automation, biomedical instrumentation as part of electronic instrumentation, and life-support systems as part of energetic and fluid dynamics. Those experiences contributed to the establishment of classes in biomedical engineering at the Polytechnic University of Milan (Politecnico di Milano) in 1968 and soon after at the universities of Genova, Rome, Bologna, Florence, Naples, and Pisa.
Ph.D. programs were the first courses fully dedicated to the discipline, starting in 1983 with nine students distributed in nine Italian universities. Teaching and research activities consolidated in the following ten years; then, in 1995, the first undergraduate program in biomedical engineering was launched at the Polytechnic University of Milan and at the University of Genova. Soon after, several universities launched their programs, and in the year 2000, as a result of the Bologna Process, which unified European higher education and redesigned the Italian higher-education structure, the program became a three-year program followed by a two-year program.
IEEE Pulse: What does the BME university program look like currently?
Pietrabissa: In the academic year 2013–2014, Italy featured 13 three-year programs and 14 two-year programs in biomedical engineering with a total of 7,500 students; 2,900 of them were new students and 1,500 graduated that year. There are about 200 professors in biomedical engineering. Programs in biomedical engineering are in high demand, and some universities have a higher number of students in biomedical engineering than more traditional engineering programs such as electrical and mechanical engineering. The largest biomedical engineering programs feature more than 500 students. In Italy, biomedical engineers receive an education covering the fundamentals of engineering, biology, and human physiology.
IEEE Pulse: In the United States, as well as in many other countries, there have been concerns that biomedical engineering students are not learning enough core fundamentals. The argument is that biomedical engineering is too much of a hybrid discipline and that more attention needs to be placed on hands-on knowledge in electrical and mechanical engineering rather than on biology or physiology. Is this a concern in Italy? And, if so, has there been any move to address this concern?
Pietrabissa: Historically, all biomedical engineering programs in Italy stem from traditional mechanical or electrical engineering programs; therefore, our students still have solid fundamentals in mathematics, physics, and chemistry. However, in order to consolidate their education in topics such as biology and physiology, the most traditional mechanical and electrical engineering disciplines are taught less extensively. Moreover, in the most recent years, in response to the increased use of engineering methods applied to biology and biochemistry research questions, most of the biomedical engineering programs have added classes with strong biological content. This phenomenon can only be seen as a positive development for the discipline, as long as engineering fundamentals remain at the center of biomedical engineering education. In Italy, at this point in time, no program shows signs of weakened ties to such fundamentals. An Italian biomedical engineer is an engineer whose knowledge of medicine, in terms of biology and physiopathology, is employed for determining design requirements, characterizing him/her more as an “innovation provider” rather than a “problem solver.”
IEEE Pulse: What does the Italian biomedical industry look like?
Pietrabissa: Italian industry is historically characterized by a high number of companies of small size. The biomedical engineering sector is no different (about 3,000 companies with about 45,000 employees including production, distribution, and services). Due to the critical economic situation in Italy, the sector has been shrinking. In 2012, import of medical devices was €6.68 billion, while export was €5.91 billion. Production was €7.44 billion, which makes the domestic market worth €8.2 billion, with investments in research and development of €0.46 billion. It is evident that there is room for growth in Italy in the sector. Education in the field will definitely play a fundamental role.
IEEE Pulse: Do biomedical engineering students find jobs relatively easily after graduating? If so, where are they principally going? A few years ago, we had heard that many engineering graduates had to leave the country to find work in their field. Is that less the case today?
Pietrabissa: It is well known that Italy suffers from a North–South development discrepancy. This applies to markets, production, infrastructures, services, and also education. The schools in the northern cities show outstanding numbers for job placement. The students who graduate in biomedical engineering from the Polytechnic University of Milan all find jobs within a short time: 15% of them in hospitals, 30% in medical devices companies, 25% in research, 10% in other bioindustries (pharmaceutical, etc.). Only 20% of them find jobs in unrelated fields. These figures show that the biomedical engineering program is successful. Unfortunately, in universities located in other regions, environmental, historical, and organizational limitations have impeded progress. Some of the programs in biomedical engineering suffer from a lack of faculty members, who, as a result, must dedicate most of their time almost exclusively to teaching activities, limiting research and even more the chances for balanced development. In a time when the productivity of faculty members is measured mostly by their research activity, assets such as a high number of students can become detrimental for faculty career development. The centralized Italian education system has the potential to address and fix the problem. It is up to us to find solutions that would allow the less fortunate parts of the country to offer the same opportunities that students have elsewhere.
Another effect of the unbalanced education system is the migration of many biomedical engineers to other European, North American, and, more recently, far Eastern countries. This is particularly true for those who want to dedicate their professional life to research. Italy’s high-level education and research system is underfunded, and understaffed and, in recent years, the number of positions at public universities is significantly decreased. Researchers with an Italian education in biomedical engineering are well recognized in many biomedical engineering topics such as biomechanics, human movement analysis, neurosensory systems, prostheses and biomaterials, tissue engineering, life-support systems, bioinformatics, biorobotics, biomedical devices, clinical engineering, biological systems models, and cellular bioengineering. However, among the Western European largest countries, Italy is the country with the lowest spending in R&D (1.25% of the GDP in Italy as opposed to 1.77% in the United Kingdom, 2.25% in France, and 2.98% in Germany). The result is that money spent to educate so many good people does not come back and other countries gain competencies at a limited cost.
IEEE Pulse: What do you think will be the advantage of holding the International Conference of the IEEE EMBC in Milan this year?
Pietrabissa: It will be an opportunity for Italian students and younger scientists to exchange their experiences with equals from other parts of the world and to find additional motivation to get involved in research and development in biomedical engineering. It will also represent the worldwide acknowledgment of the role played by the Italian biomedical engineering community in the development of the discipline. The biomedical engineering community in Italy has a long history of sharing experiences. The Gruppo Nazionale di Bioingegneria is a voluntary group formed to promote and coordinate the activities in the field. Annual summer schools with relevant book series, biannual conferences, and a teaching book series are proud assets of our community. The EMBC is a unique opportunity to show who we are and what we can offer to build “a bridge to improve the quality of health care and the quality of life” in the world. I would like to expressly thank my dear friend and colleague Sergio Cerutti for taking the initiative in organizing the first EMBC in Italy.
Dr. Ugo Della Croce, a professor at the University of Sassari, Italy, and the University of Virginia and a lecturer at Harvard Medical School, helped translate this interview from Italian.