Licensing Regulations

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Approval orders ( Latin approbatio "endorsement, approval" outdated, " appointment ") law are regulations that in Germany admission to the academic medical professions doctor , dentist , veterinarian , psychotherapist , child and adolescent psychotherapist and pharmacist rules. They are from the Federal Ministry of Health on the basis of the relevant federal laws enacted and put federally the training for the profession (u. A. Minimum duration, expiration, and mandatory content of the studies and other necessary training periods), conditions for state tests and other requirements for the granting and the withdrawal of approval laid .

Human medicine

Basic data
Title: License to practice medicine for doctors
Previous title: Examination regulations for doctors
Abbreviation: ÄApprO (not official)
Type: Federal Ordinance
Scope: Federal Republic of Germany
Issued on the basis of: § 4 BÄO
Legal matter: Special administrative law ,
professional law for the medical professions
References : 2122-1-8
Original version from: May 28, 1901
( ZBl. P. 136)
Entry into force on: October 1, 1901
New announcement from: July 14, 1987
( BGBl. I p. 1593 )
Last revision from: June 27, 2002
( BGBl. I p. 2405 )
Entry into force of the
new version on: 		October 1, 2003
Last change by: Art. 3 G of March 16, 2020
( Federal Law Gazette I p. 497, 500 )
Effective date of the
last change: 		March 1, 2022
(Art. 5 G of March 16, 2020)
GESTA : M019
Please note the note on the applicable legal version.

history

Development of medical training and license to practice medicine:

  • Trade regulations for the North German Confederation 1869
  • Reichsgewerbeordnung 1883
  • Examination regulations for doctors 1893
  • Examination regulations for doctors 1901
  • Appointment regulations 1939
  • Appointment regulations for doctors 1953
  • Federal Medical Regulations 1961
  • License to practice medicine for doctors 1970
  • License to practice medicine for doctors 2002

The forerunner of the first license to practice medicine was the ordinance for doctors of July 17, 1939. Here the National Socialist government stipulated ten semesters of study, six months of nursing , six weeks of factory or rural service and six months of internship . The federal government also issued an appointment regulation for doctors (BO) of September 15, 1953. It stipulated an eleven semester training course at the university and a two-year period as a medical assistant . The first license to practice medicine was issued in 1970, the current license to practice license in 2002.

In December 2011, the Federal Ministry of Health announced change plans. These were approved by the Federal Council on May 11, 2012, subject to conditions; the new law came into force on July 24, 2012. As a result of the resolutions, the temporary two-part exam was repealed and a three-part one was reintroduced. Since April 2014, the new second section of the "Medical Exam" has been carried out again before the "Practical Year". The third section, the oral-practical part, follows after the practical year.

Current status

The license to practice medicine for doctors (ÄApprO) is issued by the Federal Ministry of Health on the basis of the Federal Doctors' Ordinance (BÄO). The new version of June 27, 2002 replaced the license to practice medicine from October 28, 1970. According to § 1 (Paragraph 1), the goal of medical training is “the scientifically and practically trained doctor who is capable of self-reliant and independent medical professional practice, further training and ongoing training. The training is intended to impart basic knowledge, skills and abilities in all subjects that are required for comprehensive health care for the population. The training to become a doctor is carried out on a scientific basis and is practice-oriented and patient-oriented ”.

A six-year study of medicine at a university or equivalent college is required, whereby the last year includes a continuous practical training of 48 weeks ("practical year" = PJ). In addition, training in first aid , a nursing service of three months and clinical traineeships of four months in total are required. Finally, the medical exam has to be taken, which has been divided into three sections since 2012. The standard period of study , including the exams, is six years and three months.

The first section of the medical examination after two years of study (formerly: "medical preliminary examination" or " Physikum ") comprises the basic subjects of physics and physiology , chemistry and biochemistry , biology and anatomy , medical psychology and medical sociology . The second section after studying for a further three years was followed by the practical year, followed by the third section of the medical examination. After passing all sections, the graduates can apply for their license to practice medicine. With effect from July 27, 2004, the previous 18-month period as a doctor in internship (AiP) has been abolished.

Deviation in the event of an epidemic

The ordinance dated March 30, 2020 ( BAnz AT March 31 , 2020 V1 ) deviating from the licensing regulations for doctors in the event of an epidemic situation of national scope contains provisions that deviate from the licensing regulations for doctors regarding the times and requirements for the implementation of the individual sections of the medical profession Examination and ensures that the students, as a result of their involvement in health care in connection with the epidemic situation of national scope determined by the German Bundestag on March 28, 2020, do not suffer any disadvantages for the progress of their studies.

Dentistry

Basic data
Title: License to practice medicine for dentists
Previous title: Examination regulations for dentists, license to practice medicine for dentists
Abbreviation: ZApprO
Type: Federal Ordinance
Scope: Federal Republic of Germany
Issued on the basis of: Section 3 ZahnheilkG
Legal matter: Special administrative law ,
professional law for the medical professions
References : 2123-6 (old: 2123-2)
Original version from: March 15, 1909
( ZBl. P. 85)
Entry into force on: October 1, 1909
Last revision from: Art. 1 of July 8, 2019
( Federal Law Gazette I p. 933 )
Entry into force of the
new version on: 		October 1, 2020
Last change by: (new :) Art. 14 G of 19 May 2020
( Federal Law Gazette I p. 1018, 1034 )
(old:) Art. 11 G of August 15, 2019
( Federal Law Gazette I p. 1307, 1330 )
Effective date of the
last change: 		(new :) May 23, 2020
(Art. 18 G of May 19, 2020)
(old :) March 1, 2020
(Art. 54 G of August 15, 2019)
GESTA : M040 (old: B041)
Please note the note on the applicable legal version.

The license to practice medicine for dentists regulates the dental training, the examination regulations and the other requirements for the granting of the license to practice as a dentist. Thereafter, the dental training includes a ten-semester course in dentistry at a scientific university, which consists of a pre-clinical part of four semesters and a clinical part of six semesters. The standard period of study within the meaning of the University Framework Act, including the examination time for the dental exam, is ten semesters and six months.

The regulation was revised as the license to practice medicine for dentists on July 8, 2019 ( Federal Law Gazette I p. 933 ). The new version will come into force on October 1, 2020.

New license to practice medicine 2019

On August 2, 2017, the Federal Cabinet took note of the ordinance on the new regulation of dental training and thus paved the way for a fundamental reform of the license to practice medicine for dentists. It will be forwarded to the Federal Council, which still has to approve this project.

The course is divided into a pre-clinical phase of four semesters, in which the basic medical and dental knowledge is imparted, and a clinical phase of six semesters for practical training. The courses in dentistry and medicine were aligned in the first few semesters and the clinical section is being supplemented by more medical courses. This means that general illnesses will be better reflected in dental training in the future. Dental findings, as early symptoms, leading symptoms and accompanying symptoms, can provide information for the diagnosis and treatment of a general disease. Conversely, general medical diseases and their therapy have an impact on dental treatment.

With the new license to practice medicine, the focus on prevention and tooth preservation will be included in the training better and at an early stage. Through the introduction of the cross-sectional area “Scientific Work” with a focus on medical biometrics , medical informatics , literature research and evaluation and evidence-based medicine , the abilities of the students for scientific work are strengthened. In addition, the course is interdisciplinary and problem-oriented and thus meets the requirements of modern and interdisciplinary teaching. The relationship between teachers and students during practical training has been improved. In the so-called phantom course, the staff-to-student ratio has been improved from 1:20 to 1:15 and in patient lessons from 1: 6 to 1: 3.

  • Dental studies are taught at the university for five years as before
  • It is divided into four semesters of scientific and theoretical basics as well as dental (not dental) propaedeutics - analogous to medical studies (with the same physics)
  • followed by two semesters with basic medical-theoretical and clinical subjects and dental-medical treatment simulation courses (on the "Phantom")
  • followed by four semesters of integrated clinical dental lessons
  • training in first aid
  • a month-long nursing service and
  • a four-week internship.

As a result of the reorganization of the licensing regulations, an additional annual burden of 5.6 million euros as well as a one-off charge of 8 million euros can be expected for the state administration.

Criticism of the Science Council of the old license to practice medicine for dentists

In 2005, the Science Council classified the current licensing regulations for dentists from 1955 as very out of date and recommended a "fundamental reorientation" in order to take into account the " professional development " and "the requirements for modern and interdisciplinary teaching".

In the licensing regulations that are currently being worked on, dentistry, as required by the Science Council, will be brought closer to human medicine so that more medical aspects can be incorporated into the course.

See also

Studied dentistry

psychotherapy

Basic data
Title: License to practice medicine for psychotherapists
Previous title: Training and examination regulations for psychological psychotherapists and training and examination regulations for child and adolescent psychotherapists
Abbreviation: PsychThApprO
Type: Federal Ordinance
Scope: Federal Republic of Germany
Issued on the basis of: Section 20 PsychThG
Legal matter: Special administrative law ,
professional law for the medical professions
References : 2122-7-1
Original version from: December 18, 1998
Entry into force on: January 1, 1999
Last revision from: March 4, 2020
( BGBl. I p. 448 )
Entry into force of the
new version on: 		September 1, 2020
Please note the note on the applicable legal version.

The prerequisite for obtaining the psychotherapeutic specialist knowledge is a successfully completed postgraduate training at a specialist medical level. Access is given to psychologists ( psychological psychotherapist , child and adolescent psychotherapist ), for the area of ​​child and adolescent psychotherapy as well as (social) pedagogues and licensed medical practitioners ( medical psychotherapist ). In contrast to the other academic health professions, the licensing of psychological psychotherapists and child and adolescent psychotherapists does not take place after the basic study, but only after the completion of the postgraduate training, which ends with a state examination. In addition to practicing medicine independently, it is then possible to make an entry in the doctor's register of the statutory health insurance associations and thus bill the statutory health insurance companies.

Approval for psychological psychotherapists and child and adolescent psychotherapists is regulated in Section 2 of the Psychotherapists Act that came into force in 1999 . It implies a degree in psychology completed with a diploma or master's degree , training in a "scientifically recognized" psychotherapeutic procedure and the nationality of a member state of the European Union or another signatory to the Agreement on the European Economic Area or homeless foreigners within the meaning of the law on legal status homeless foreigners ahead. For child and adolescent psychotherapists, in addition to a completed degree in psychology, education and social education are also approved.

Amendment of the license to practice medicine

In the course of the amendment to the Psychotherapists Act, the reorganization of psychotherapy training is also under way. The reform is to be implemented in the upcoming legislative period as part of a legislative procedure. A license to practice medicine is planned, the structure and structure of which is based on the study of human medicine. This is intended to replace the previous two-part training. The existing training and examination regulations are to be incorporated into a joint license to practice medicine. With this amendment, licensed physicians should also continue to have access to psychotherapy training; after their license to practice, licensed psychotherapists should be able to further train themselves to specialize in a specialty or a psychotherapy procedure analogous to a specialist.

Veterinary medicine

Basic data
Title: Ordinance on the license to practice medicine for veterinarians
Previous title: Examination regulations for veterinarians
Abbreviation: TAppV
Type: Federal Ordinance
Scope: Federal Republic of Germany
Issued on the basis of: § 5 sentence 1 BTÄO
Legal matter: Special administrative law ,
professional law for the medical professions
References : 7830-1-6
Original version from: December 24, 1912
( ZBl. 1913 p. 2)
Entry into force on: April 1, 1913
Last revision from: July 27, 2006
( Federal Law Gazette I, p. 1827 )
Entry into force of the
new version on: 		October 1, 2006
Last change by: Art. 7 G of August 15, 2019
( Federal Law Gazette I p. 1307, 1330 )
Effective date of the
last change: 		March 1, 2020
(Art. 54 G of August 15, 2019)
GESTA : B041
Please note the note on the applicable legal version.

The revised ordinance on the licensing of veterinarians (TAppV) of July 27, 2006 (Federal Law Gazette 2006, Part I, pages 1827 ff.) Came into force on October 1, 2006. It replaces the veterinary license to practice medicine (TAppO) of November 10, 1999 (Section 69 (2) TAppV). The standard period of study is five and a half years and thus comprises 11 semesters .

The course is divided into sections. The first four “pre-clinical” semesters include the preliminary veterinary examination. This is traditionally divided into the "Vorphysikum", in which physics , chemistry , zoology and botany are examined in the first and second semester , and into the "Physikum", in the third and fourth semester anatomy , histology and embryology , biochemistry , physiology and Animal breeding and genetics are examined. The timing of the exams differs between universities. After passing the physics course, the student becomes a candidate for veterinary medicine (cand. Med. Vet.).

The veterinary examination can begin after a total of at least five completed semesters. The subjects are covered in several examination blocks from the 5th to the 11th semester

checked. The distribution of examination subjects and the number of examination blocks varies between universities.

The course ends with the sixth examination block of the "Veterinary Examination". For admission to the last examination block, several internships must be proven: a four-week internship in a curative practice, a three-week internship in the slaughterhouse, a two-week training course in hygiene control and food monitoring in a competent authority, a two-week internship in public veterinary services and an optional internship of 16 Weeks duration.

After completing the third part of the "veterinary examination", the examinee can apply for the license to practice medicine and, once it has been granted, is entitled to call himself a veterinarian and to work as a veterinarian . The course can be followed by a doctorate and further postgraduate training ( specialist veterinarian , Diplomate of the European College ).

pharmacy

Basic data
Title: Licensing regulations for pharmacists
Previous title: Examination regulations for pharmacists
Abbreviation: AAppO
Type: Federal Ordinance
Scope: Federal Republic of Germany
Issued on the basis of: §§ 5, 14 Abs. 3 BApO
Legal matter: Special administrative law ,
professional law for the medical professions
References : 2121-1-6
Original version from: May 18, 1904
( ZBl. P. 150)
Entry into force on: October 1, 1904
Last revision from: July 19, 1989
( BGBl. I p. 1489 )
Entry into force of the
new version on: 		October 1, 1989
Last change by: Art. 9 G of 15 August 2019
( Federal Law Gazette I p. 1307, 1330 )
Effective date of the
last change: 		March 1, 2020
(Art. 54 G of August 15, 2019)
GESTA : B041
Please note the note on the applicable legal version.

The license to practice medicine for pharmacists (AAppO) is issued by the Federal Ministry of Health on the basis of the Federal Pharmacists' Ordinance, the last change was made on December 6, 2011. For prospective pharmacists, it provides for a university degree in pharmacy of at least four years. The standard period of study is eight semesters.

The so-called “First Section of the Pharmaceutical Examination” (1st state examination) takes place after four semesters. It consists of four exams in the subjects of general, inorganic and organic chemistry , basics of pharmaceutical biology , physics , physical chemistry and drug form theory , as well as pharmaceutical analysis . The examination questions are asked nationwide by the Institute for Medical and Pharmaceutical Examination Questions (IMPP) in Mainz and follow the multiple-choice procedure , i.e. they are written.

After the eighth semester, the second section of the pharmaceutical examination (2nd state examination), consisting of five oral exams, follows. The subjects are Pharmaceutical Chemistry , Pharmaceutical Biology , Pharmaceutical Technology , Pharmacology and Toxicology, and Clinical Pharmacy . This examination cycle ends the university studies and entitles the holder to write a dissertation .

In order to obtain the license to practice as a pharmacist, however, a practical year must be completed, which can be divided into two halves. At least half a year has to be completed in a public pharmacy . The remaining time, but at least three months, can be completed in an institution approved for pharmaceutical training. This can be done in a company in the pharmaceutical industry, in a hospital or military pharmacy , at a scientific institute, e.g. B. at a university (also for the preparation of a diploma thesis), or again in a public pharmacy. During this time you have for several weeks (the exact time depends on the state in which you checking deposits) in the country Apothekerkammern organized Accompanying teaching events to participate, where you theoretical training in the subjects Pharmacy Practice and Special Areas of Law for pharmacists receive .

After this practical year, the third section of the pharmaceutical examination (3rd state examination) takes place. This consists of an oral examination in the subjects of Pharmaceutical Practice and Special Areas of Law for Pharmacists ( Section 19 in conjunction with Appendix 15 to Section 19 Paragraph 3 AAppO). If this examination has been passed successfully, the application for a license to practice medicine, which can be submitted prior to the examination, by submitting all necessary documents, can be complied with. In this case, you will be awarded the license to practice medicine as a pharmacist with effect from the day following the examination and will henceforth use this professional title.

Comparison with other countries

The granting of medical license is regulated very differently in the EU. Most EU member states (and many non-European countries) grant this license to practice medicine immediately after graduation. Nevertheless, there are countries, such as England or Sweden, where the license to practice medicine is only granted after a post-doctoral training (comparable to the previous AiP). In Austria, France and Switzerland, the professional license is only granted after specialist training. For psychotherapy , the situation in other countries is in some cases not comparable to that in Germany.

See also

Web links

Wikisource: Historical German legal texts on license to practice medicine  - sources and full texts

Individual evidence

  1. ^ Putz Reinhard: Science in medical studies . (PDF; 626 kB) LMU
  2. ^ Ralf Bröer: Medical legislation / medical law. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. Walter de Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , pp. 942-950; here: p. 943.
  3. ^ First ordinance amending the license to practice medicine for doctors , text, changes and reasons for the ordinance
  4. ↑ Article 3 No. 1 lit. a of the law of July 21, 2004 ( Federal Law Gazette I p. 1776 )
  5. ↑ Ordinance on the new regulation of dental training (PDF) Ordinance of the Federal Ministry of Health. August 2, 2017. Retrieved August 3, 2017.
  6. ↑ a b c Science Council recommends comprehensive reforms for dentistry at universities . ( Memento of February 6, 2008 in the Internet Archive ) Wissenschaftsrat, press release 05/2005. Complete Drs. 6436/05 ( Memento from February 6, 2008 in the Internet Archive ; PDF; 498 kB) January 31, 2005.
  7. ↑ Comprehensive reform of the Psychotherapists Act necessary. LPK BW, accessed on November 1, 2017 .
  8. ↑ Qualify psychotherapists for care. LPK BW, accessed on November 1, 2017 .
  9. ↑ Herbert Hügel , Bettina Mecking, Baldur Kohm: Pharmaceutical Law. Text collection with comments for study and practice. Edited by Bettina Mecking. 35th, updated and expanded edition. Scientific publishing company, Stuttgart 2013, ISBN 978-3-8047-3080-9