Hospitation and Approbation in Germany
A lot of doctors are dreaming of specialisation and training in the best German hospitals, which are famous all over the world. But in the same time they are facing a lot of obstacles in their way. Therefore Studyadmission decided to assist the doctors which want to work and specialise in Germany by giving them an overview about their possibilites and chances.
- Hospitation – Medical Internships in Germany
The students of human medicine can apply for a medical internship – a so called Hospitation – during or after their graduation. The lenght of this internship can be between three and six months and it can take place in one specialisation of their choice. Therefore the student should have a clear vision about the area in which he wants to work in the future and chose the internship in this discipline.
The applicant should be good in German language (at least B1 certificate). There is small numbers of internships which can be done in English, but you will never be able to have the same learning experience as if you spoke German. Just think about patient contact or small chats with colleagues on the side.
This internships are normally not paid. Therefore the student must proof his financial capability of self supply by opening a bank account with a German bank before applying for the visa.
The role of the student during the internship is the one of a non-active observer. This sound as if it would not be helpful in the end – but in reality, there is still a lot of things to gain from this internship. There is a lot of advantages, like improvement of the medical language abilities, getting to know German working standards and – most important- networking and getting in contact to future colleagues and employers.
In the end of this internship, you normally will be supplied by a letter of recommendation. In it you will be judged according to your behaviour and professional appearance as well as the capacity of team work and learning sucess.This letter will surely enhance your future internship or job applications.
- Approbation in Germany – Work permit as a doctor
In order to be able to work as a doctor in Germany, every medical student needs a special work permit, the so called Approbation.
The student needs to contact the German health authority „Gesundheitsbehörde“ in order to have his diploma evaluated regarding the question if the education was equal (gleichwertig) to the German education and if all standards and requirements were met.
There is two possible results:
First: your education is equal (gleichwertig). In this case you are granted Approbation directly, if his language abilities are also fulfilling the requirements. The level of German can differ from Bundesland to Bundesland between B2 and C1. Some even ask for a special language course which is called „Telc Medizin“.
Second: your education is not equal (nicht gleichwertig). This means that the German Health authority couldn’t detect if your education is maybe lacking some points or topics which are considered necessary for the future work as a doctor. This often happens if the transcript of records is not detailled enough or the hours of studies for certain topics are not explained – or in some small cases – your education really didn’t cover this areas fully.
In this case you will be asked to make an exam which tests if you maybe have the knowledge already (Gleichwertigkeitsprüfung).
If the authority sees a lot of gaps, they give you the chance to make good for the missing knowledge by getting some practical experience in the specialisation area before this exam. In most cases, they will ask for one year or longer, the so called Anpassungsjahr or Anpassungszeit. This Anpassungszeit normally has to be done in the areas of surgery, internal medicine and one other area of your choice. During this year, you will be granted work allowance (Berufserlaubnis). It only allows you to learn under the supervision of an approved doctor and only in the Bundesland where you asked for it.
In order to avoid exploitation of the doctor during this year, the German law says that the hospital must pay him in an appropriate way for your effort. In the field, this interpreted broadly, so that most of the times you can’t expect to get a real salary, but rather you will be granted small extras like free housing or free feeding, which can of course also be helpful in your situation.
After sucessfully finishing this Anpassungszeit, you will finally do the exam and show that you now are on up to date with all regulations and requirements. After a succesfull exam, you will be granted full working permit for all Germany. In some cases this practical experience is taken in account in your future resident time as Assistenzarzt.
The exam (Gleichwertigkeitsprüfung) is split in two parts: The oral exam and the practical exam. The focus in the oral exam will be in the areas of surgery and internal medicine, where the examiners will ask questions about certain topics in these areas. The practical exam will be a simulation of a real medical examination with a patient. The most important fact in the whole exam is the language abilities, which should be enough to finish these parts without any problem.
After all of this, there is the resident time, which normally will last 5 years. In this time you will be called Assistenzarzt and you will have an appropriate salary, which differs from Bundesland to Bundesland and from hospital to hospital. Having finished this further specialisation, you will be a fully trained specialist, the so called Facharzt.
- How can you prepare yourself for the Gleichwertigkeitsprüfung?
As mentioned, the examinee has to have good language abilities. Training for the test can be found on this website, which gives also an overview about vocabulary for communication with the patient.
There is also books like „Deutsch für Ärztinnen und Ärzte: Kommunikationstraining für Klinik und Praxis“, which can be fully recommended.