From the Official Gazette to the National Health Service, osteopathy, after a twelve-year wait since the first institutional step, finally joins the recognized health professions. With the publication of the latest implementing decree on the equivalence of qualifications, a complex regulatory process concluded on May 22, 2026, transforming a widespread practice into a fully integrated and regulated health discipline in the area of prevention and health promotion.
THE COMPLETION OF A HISTORIC PATH
The publication of the decree in the Official Gazette represents the “completion of a path” and the “consecration of a collective commitment” which, according to Mauro Longobardi, President of the Italian Osteopaths Registry (ROI), has prevented the risk that osteopathy would be “absorbed as a mere specialization of other health professions.”
The process, recalls Quotidiano Sanità, has gone through fundamental stages such as Law 3/2018, which identified the profession, DPR 131/2021, which defined its profile, and Interministerial Decree 1563/2023, which established the university educational system. This regulatory milestone finally recognizes the skills built over decades of activity, as also highlighted by Diego Catania, President of the National Federation of TSRM and PSTRP Orders, who confirmed the willingness to “welcome Osteopaths into our Orders.”
TWO PATHS FOR THE EQUIVALENCE OF QUALIFICATIONS
The decree establishes strict criteria for the recognition of previous qualifications, distinguishing professionals based on their educational background. For those holding an osteopath qualification obtained at the end of at least a three-year course without already being a healthcare operator, 2,400 hours of theoretical training (equivalent to 96 ECTS) and 1,000 hours of supervised practical internship in the musculoskeletal system field are required. Conversely, for those already holding a qualifying degree in another healthcare profession, the minimum theoretical hours are set at 1,500 hours (60 ECTS), while the 1,000 hours of internship obligation remains unchanged. In both cases, teaching must have been delivered by lecturers with degrees consistent with the subject taught and, for clinical disciplines, by graduates in Medicine and Surgery.
VALUING WORK EXPERIENCE
A fundamental provision of the measure concerns the possibility of compensating any deficiencies in the practical internship through professional activity already carried out. Work experience can be evaluated if the internship does not reach 1,000 hours, provided it has been exercised for at least 36 months, even if not continuous, over a period starting from the entry into force of the law on January 11, 2018, and extending up to 24 months after the publication of the agreement in the Official Gazette. Such activity must be rigorously proven through possession of a VAT number, collaboration contracts, and fiscal documentation certifying the actual exercise of the profession during the declared periods.
SPECIAL LISTS AND THE QUALIFICATION DEADLINE
To manage the transitional phase, the decree establishes special lists to be exhausted at the Orders of Medical Radiology Technicians and Technical, Rehabilitation, and Prevention Health Professions. Those who have started or completed at least a three-year training course and hold a secondary school diploma may apply for registration by the deadline of August 31, 2026. However, registration on these lists does not guarantee immediate transfer to the professional register.
Registered individuals have 6 years to take a qualification exam at the Universities where Osteopathy degree courses are active, under penalty of “forfeiture” and consequent removal from the list. Once the exam is passed, the university issues the degree certificate or equivalence that allows definitive registration in the professional register.
COMPENSATORY MEASURES AND NEW ACADEMIC STRUCTURE
Admission to the qualification exam requires completion of compensatory measures totaling about 30 ECTS in specific thematic areas. The path includes knowledge of forensic medicine, ethics, and deontology (3 ECTS), health management (3 ECTS), workplace safety and radioprotection (3 ECTS), as well as first aid and resuscitation techniques (3 ECTS). Additionally, 12 ECTS are provided in interdisciplinary medical-surgical knowledge and 6 ECTS dedicated to prevention and health promotion strategies. For those already healthcare professionals, these credits may be recognized based on previous educational paths.
The decree also establishes that, from September 1, 2026, qualifying training will be the exclusive competence of Universities upon accreditation by the MUR, definitively closing the era of private schools for new aspiring osteopaths. Finally, the measure ensures financial neutrality, stating that “no new or greater burdens must arise for public finances.”
