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The German Beureucracy in Medicine

Must be interesting to know that Germany is a high Beureucratic country. Beureucracy means that not a single step be completed if a lot of paperwork is not done. In simple words a lot of paper work is required to start a residency programm.
The three offices are involved namely the local city office, the ministry of labour and the doctors union ( Aerztekammer).
The time period is more or less 8 to 12 weeks for all the process to complete.
In Germany as a rule from the ministry of labour one is not entitled to have a paid job in Medical field, so one needs to get a sponsor or sponsor himself/herself for the whole period of residency(6-8 years).
The residency programm in Germany is not well defined as in US for example. Here is how it looks for Internal medicine.
first two years on the station of your medical speciality, this is a bit crappy, you directly start with a subspeciality instead of General Medicine.
Then next two years rotations in 4 subspecialities of your choice for 6 months each.
Finally for the rest of the two years you come back to your origional station and sit in outpatient and do more skilled work.

Hamburg - Center for Research

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In addition, new ideas and fresh perspectives enrich the culture and flair of the cosmopolitan Hamburg metropolis. Names, data and facts will help you find your way around the metropolis of knowledge.

Formalities for Doctors from non-EU-States

Generally for the citizens from non-EU-countries, who have already completed their medical training, it is difficult to get work permission to work in the health instiutions in Germany. Physicians from non-EU-Countries need the following:
A. Residence Permit (Aufenthaltserlaubnis)
B. Working Permit (Arbeits- und Berufserlaubnis)
C. License to practise medicine (Approbation): The constitution of Germany gives most government powers to its 16 constituent Bundesländer (states). The foreign medical graduates from non-EU-States have to get the Approbation from the responsible state authorities (Bezirksregierung) as licensing bodies.
Some States demand a so called Adaptationtime (Anpassungszeit) before giving a "Approbation". In this Case the Applicants have to work with a preliminary Professionpermit (vorläufiges Berufserlaubnis) between 12 or 18 Months, depending from which Country they are coming, in a Hospital. The Adaptation-Time must be split between the departments internal medicine, surgery and a third Specialty.
The second step for doctors after getting approbation is to register themselves with the responsible state medical associations (Landesärztekammer). Applicants have to prove, they have sufficient knowledge of the German language (kleines Sprachdiplom vom Goethe Institut) .

Working in Germany as a Foreign Physician

Generally EU citizens, who have already completed their medical training, are allowed to work as physicians in Germany. The constitution of Germany gives most government power to its 16 constituent Bundesländer (states). They have to get their Approbation (license to practise medicine) from the state health authorities (Bezirksregierung), who are the responsible licensing bodies.
The second step for doctors after getting approbation is to register themselves with the responsible state medical associations (Landesärztekammer). Applicants must prove, that they have sufficient knowledge of the German language.
The Citizens of the EU-Countri


Working as a specialist

Applicants, who had already completed their post-graduate training and want to work in Germany as specialists, have to submit their qualifications to the responsible state medical association (Ländesärztekammer). They determine the status of diplomas.



In contrary to previous years, the situation for physicians in the German labour market has changed. Because of the uncontrolled intake to medical schools there is a resultant surplus of physicians. Unemployment has become a problem within the profession.

The unemployment rate is currently 2,3 percent (Ärzteblatt 98, Heft 21 vom 25.05.01). As a result many German doctors have gone to countries such as Norway, Sweden or UK, which actively recruit Physicians from Germany.

It is difficult to undertake a medical postgraduate training for both German and foreign physicians.

After finishing medical school the medical graduates begins their post-graduate training with the so called "Arzt im Praktikum", AIP (pre-registration period). AIP lasts 1.5 years.

In Germany a physician has to complete his postgraduate training, before he is allowed to establish himself in a outpatient practice. In addition there are regional restrictions for setting up a medical practice with compulsory health insurance based on overall levels of demand and supply. State Associations of Compulsory-Health-Insurance (Regionale Kassenärztliche Vereinigungen) are responsible for the authorisation of the outpatient medical practise with CHI.
Foreign Doctors in Germany
At the end of the year 2000 there were 14 306 (previous year 14 243) foreign colleagues working in Germany. This represent a marginal increase over the previous yearend. The number of foreign clinic-doctors over the same time period increased by 3,4 percent and practice-doctors by +0,7 percent (2000).
The most common countries of origin are the former Soviet Union, Greece, Turkey, Poland and the Netherlands.

Requirements For German Residency

This is a list of the documents that shall be required for starting a resideny program in Germany (Valid for all medical specialities)

1. CV (curriculum vitae), current and complete with a photograf and signature
2. Certificate of birth.
(if applicable: Marriage certificate, birth certificate of children).
3. Good standing certificate, 'no criminal record' from Police.
4. A letter from your home ministry stating the reason for your German Residency.
This is to say that in your home country it's not possible to do this speciality due to so and so reason.
5. Final Degree of Medicine with single grades of every subject ( mark sheet).
6. Over wiew of your practical work so far.
7. Testimonials of practical work so far done by you.
8. Letters of Recommendation.
9. Statement of your financial support and who shall support you in case you don't find a paid job.
It should be metioned in your sponsor letter a monthly scholorship of approx. 1500 Euros for the period of 6 years
10.German language certificate ( upto level b2).
11. Health Insurance for the period of stay.
12. A non-objection certificate(NOC) from the Medical council of your respective home country or from the place you have done your medicine schooling.
13. Registration certificate as a doctor by your local medical council.

The above mentioned documents and Certificates must be TRANSLATED into German and MUST be Certified or Attested.

Medical Residency In Germany

Much Information is available on this topic but it's in German language.
Let me briefly expain you all how does the Medical system here in Germany works.

The total time it takes for an MD (Doctor Medicine) is six years and the final exam is after a successful Internship.
After the exam , a working permit and medical practice license is given and the person can begin his/her Residency program.
This situation was for a German national or a person who has studied Medicine in Germany.

What should a Foreigner do?

Learn good German language preferably level b2 which might take 6 months to a year.
People can find a place so that they can do observerships and not spend all the time only learning the language. Doing an observership ( i.e no patient contact) is easy to get and moresover, no license is required.

After satisfactorily doing the language there are two but many options.
1. Do an Exam, similar to that done by the German students. But, the whole exam is in German language. This makes it a bit tougher.

2. Doing an evaluating exam in which the authirity shall find out your level and will decide where you fit.

The above mentioned options sounds silly.
There are other options as well.

Many foreign doctors (excluding EU nationals) who come to Germany are treated as Guest Doctors, that implies, that they shall after completion of their education return to their home country.
Moreover, they are not liable to work for paid jobs.
The situation is not easy.
There are many criterias that shall be fulfilled.

Usually, a residency programm takes 6-8 years to complete.