Pregnancy: an end to discriminatory rules for candidates for the general practice diploma

Article 24(5) of Legislative Decree No. 368 of 1999 (Implementation of Directive 93/16/EEC on the free movement of doctors and the mutual recognition of their diplomas, certificates and other qualifications), which requires candidates for a degree in general practice to make up for the period of training lost due to pregnancy, causes an ‘undue delay’ in the conversion of fixed-term contracts to permanent contracts with the National Health Service, with permanent consequences for length of service and the conditions under which the profession is practised.

This was ruled by the Constitutional Court (judgement no. 76 of 2026), which declared the provision unconstitutional insofar as it does not provide that a diploma obtained on the first available date following the end of the period of suspension due to pregnancy and maternity leave is to be treated as equivalent to that obtained by other candidates during the ordinary examination session.

The question of constitutionality had been raised by the Lazio Regional Administrative Court with reference to Articles 3, 31, 32 and 37 of the Constitution, which safeguard, respectively, the principles of equality and equal opportunities, the family, health, and the protection of mothers and children. In particular, the Court had found the provision to be in breach of Article 25, paragraph 2-bis, of the Code on Equal Opportunities between Men and Women, according to which ‘constitutes discrimination’ any treatment which, ‘on the grounds of sex [or] pregnancy places the worker in at least one of the following situations: a) a position of disadvantage compared with other workers in general; b) a restriction on opportunities to participate in company life or decision-making; c) a restriction on access to mechanisms for promotion and career progression’.

The Constitutional Court, on the one hand, referred to Article 15 of Directive 2006/54/EC of 5 July 2006 (Implementation of the principle of equal opportunities and equal treatment of men and women in matters of employment and occupation), according to which ‘at the end of maternity leave, a woman is entitled to return to her job or to an equivalent post on the same terms, and to benefit from any improvements in working conditions to which she would have been entitled during her absence’. On the other hand, it ruled that the suspension of training activities, aimed at protecting the woman’s health and the overriding interests of the child, must not adversely affect ‘the position of the female worker who, as a result of the suspension, suffers immediate prejudice in her quasi-subordinate employment relationship’. For this reason, ‘the difference in treatment between women who have to suspend their course due to pregnancy and maternity and other participants on the same course has no legitimate justification’.