To become an Anesthetist in Italy it is necessary to hold a Medicine and Surgery Degree (6 years-long course of studies).
After graduation the candidate must pass an exam to enter the Post Graduated Specialization School in Anesthesiology and Intensive Care, on a grant basis. Every year the italian Education Ministry esthablishes the Country needs for the various medical and surgical specialists, consequently the number of candidates admitted to the Post Graduated Schools is planned.
The Anesthesia & Intensive Care study-course is 4 years long and it is subdivided in theoretic and pratical sessions developed either at Universities' Clinics or at NHS's teching hospitals. Once Post-Grauated it is necessary to win Hospitals' Competitive Examinations to get a job.
There is no academic distinction during the studies between Anesthesia, Intensive Care, Pain Management and Hyperbaric Medicine.

Anaesthesia and Intensive Care, as an indipendent medical speciality, officially born in Italy in the late '50s
Traditionally, Critical Care providers, as also Pain Management specialists and Hyperbaric Medicine specialists, all come from Anaesthesia, the "Commune Mother": Anesthesia. ICUs in Italy are runned only by personnel graduated in Anaesthesia & Intensive Care; other specialists (surgeons, cardiologist, pneumologists) can manage step-down units only.
Actually in Italy there are more than 10.000  specialists in Anaesthesiology & Intensive Care.