Germany – Doctors

Introduction
Healthcare is one of the most important economic sectors in Germany, employing roughly 11% of the country’s total workforce. Ca. 140 000 doctors work in more than 2 000 hospitals in Germany. Professional standards and pay for doctors are fairly high at the European scale, as is the workload. The increasing number of young female doctors demands for more family-friendly arrangements. For several years the country has been facing a shortage of doctors (Ärztemangel), which is expected to intensify in the near future due to demographic changes, unless appropriate countermeasures are taken. This applies in particular to rural areas and East Germany. According to the Marburger Bund (2010) there is a lack of 12 000 hospital doctors. Many clinics have been actively recruiting foreign doctors to fill vacancies – with Greece, Poland and Romania being important source countries – whereas the federal government has initiated regulatory changes to ease the immigration of non-EEA doctors. In 2011 the number of foreign doctors in Germany escalated by 12% to 28 355 (according to the German Medical Association), but appears to be neutralized by equally significant moves out of Germany.

How to become a doctor
Basic medical training of at least 6 years is normally completed at universities. Hereafter the medical licence (Approbation) can be applied for and doctors can take a paid postgraduate training of up to 6 years in their desired specialty (Facharztausbildung). There are over 30 medical specialties. The writing of a dissertation allows to carry the title of “Dr. med.”. Hierarchy levels in hospitals include: assistant physician (Assistenzarzt), senior physician (Oberarzt) and chief physician (Chefarzt). For further details on how to become a doctor in Germany click here.

Hurdles to take for foreigners
Foreign doctors need to have sufficient German language skills. Most hospitals demand level “B2” (mid level) according to the Common European Framework of Reference for Languages (CEFR). The required minimum skill level has been subject to ongoing discussions among various stakeholders and may eventually result in harmonized higher standards. A dedicated patient communication test developed in 2011 is already used at several university hospitals and appears to be gaining increasing popularity.

Tyskland_bundeslaender[1]The recognition of foreign medical qualifications is administered at state (Länder) or regional level. The licence to practise medicine (Approbation) is granted by public authorities, whereas medical specialties are recognized by the 17 State Chambers of Physicians (Landesärztekammern). Membership in the latter is mandatory to practise as a medical doctor. Doctors with a qualification from another EEA Member State benefit from automatic recognition under EU Directive 2005/36/EC (with certain exceptions for Bulgaria and Romania until the end of 2013 at the latest). For non-EEA qualifications a case-by-case assessment is performed to determine equivalence. If needed, the doctor has to pass an additional medical examination and training to be allowed to practise.

For non-EEA citizens visa, work and residence permits involving the Federal Employment Agency are also necessary depending on the case. The introduction of a “blue card” – effective since 1 August 2012 – further facilitates employment in Germany. Citizenship is no longer a criterion for granting the medical licence.

Doctors may apply for work directly with hospitals or engage a recruitment agency. The main German online job portal is maintained by the German Medical Journal (Deutsches Ärzteblatt).

Where to get further info / support
German Medical Association and State Chambers of Physicians 
State health authorities
• Marburger Bund
Deutsches Ärzteblatt
Federal Employment Agency
Federal Foreign Office
European Medical Mobility Website (EMM)
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