Study of medicine

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Nursing internship 1972: Medical students from Berlin's Humboldt University worked at the Charité for three weeks during their lecture-free time .

As a study of the medicine or shortly medicine study the scientific and practical training of doctors referred. Similar to other courses of study, the scientific basis is linked with practical professional components. In order to work as a doctor in Germany, a license to practice medicine is required after graduation, which can be issued immediately after graduation. In Switzerland , which has also switched to the Bologna system with a Bachelor's and Master's degree in medicine, this corresponds to the federal examination for human and dental medicine.

Afterwards, further training can be completed in which one specializes in a field of medicine ( general medicine , surgery , etc.) and acquires the specialist title . In the past, a branch as a general practitioner was possible without this specialization and at times without further training - today, approval as a contract doctor requires further training in these cases, too.

history

The medical degree has a long tradition . It was given a formal definition for the first time in antiquity , best known from the oath and teachings of Hippocrates . In the Middle Ages , the first foundations for medical training institutions were created at universities . The prototype of modern medical universities was the school of Salerno , which was established in the 10th century and which had received binding and recognized statutes for the training of doctors in the 13th century under Friedrich II. Its regulations were expanded in 1241 and since then a medical student has had to pass public exams in front of the teachers of the school, sometimes called the first university, and representatives of the king, which, after being approved by König, entitle them to practice as a doctor in a certain region. Johanna I then decreed in 1359 that every doctor who had been qualified in Salerno was allowed to practice throughout the Kingdom of Naples even without a royal license. German-speaking universities, where the study of medicine was also offered from the beginning, have existed since the founding of Charles University in Prague in 1348.

Today, the goal of medical training is "the scientifically and practically trained doctor who is capable of self-reliant and independent medical professional practice, further education and ongoing training ." (From § 1 of the license to practice medicine for doctors of June 27, 2002). This also includes self-reflection.

Legal

In the member states of the European Union , basic medical training in accordance with Directive 2005/36 / EC of the European Parliament and of the Council must include at least six years and 5,500 hours of theoretical and practical instruction at a university or under the supervision of a university.

In the case of studies structured as a bachelor's and master's degree within the framework of the Bologna process , only the master's degree allows the practice of the medical profession in all countries of the European Union. The Bachelor of Science should then qualify for medical-related professions, but not for medical work. It has not yet been clarified which activities the Bachelor's degree should entitle to exactly. By 2007, only a few of the countries that signed up to the Bologna Declaration had introduced a Bachelor / Master degree in human medicine. Seven countries, Switzerland , Denmark , the Netherlands , Belgium , Iceland , Armenia and Portugal , have made such a restructuring mandatory for their medical faculties. Four states leave the decision to their universities. In contrast, 19 countries have expressly forbidden their universities to implement it, including many Eastern European countries, but also Italy and Spain . By 2007, eleven countries had not yet made a final decision. According to a study by the Association for Medical Education in Europe (AMEE), these include Germany.

The International Federation of Medical Students 'Associations (IFMSA), the European Medical Students' Association (EMSA) and the Federal Representation of Medical Students in Germany (bvmd) advocate the Europe-wide introduction of a Bachelor's / Master's degree in human medicine. However, the associations see risks as well as the opportunities that this presents. To distinguish them from other subjects, they may require a. the introduction of a Bachelor of Medicine and Master of Medicine .

Medical studies in Germany

The medical degree is regulated nationwide by the license to practice medicine (ÄAppO). Entry requirement is the general higher education entrance qualification or a correspondingly creditable school or vocational training qualification .

According to the licensing regulations of 2002, the training

“Provide 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 and patient-related. she should

convey on the basis of the current state of research . The training should also include aspects of medical quality assurance and promote the willingness to work with other doctors and with members of other health care professions. "

The standard period of study is 12 semesters and 3 months. The average length of study at German universities in 2003 was 12.9 semesters.

The course is divided into two sections in the standard course:

  • Preclinical part (first to fourth semester), at the end of which there is the first part of the medical examination (former designations: medical preliminary examination, physikum ),
  • and a clinical part (fifth to twelfth semester). In the last academic year it includes a coherent practical training (practical year, PJ) of 48 weeks. The second section of the medical examination (written) takes place before the practical year, the third and last section (oral-practical) after the practical year.

After that, you can apply for state approval (approbation) to practice as a doctor.

The total number of medical students in Germany was 43,368 in 1975, rose to 93,198 in 2007, was lower again in the following years and then rose continuously from 78,545 in 2007 to 93,946 in 2017.

Admission to Studies

There is a nationwide admission restriction ( numerus clausus ), since each semester significantly more applicants apply for medical studies than the universities can accept. Most universities only accept new students in the winter semester, but some also in the summer semester.

In the 2019/20 winter semester, almost 42,000 high school graduates applied for one of the 9,458 study places at a state university, which corresponds to 4.4 applicants per place. At this point in time, an Abitur grade of 1.0 or 1.1 or a waiting period of fifteen semesters was necessary for a university place.

In the years 1986 to 1996, the test for medical courses (“medical test”) was used uniformly to select applicants. It is now being carried out again by individual universities (“University selection process”, see below).

Today, a fifth of the available places are allocated by the Foundation for University Admissions (SfH) based on the average Abitur grade (“best Abiturb”). The SfH also awards 20% to those applicants who wait the longest ("waiting semester"; the waiting semester is one semester after passing the Abitur, in which one is not enrolled at a German university). The other places - 60% - can be allocated by the universities themselves; this is organized by the SfH (so-called “university selection process”; “AdH”). In 2017, the Federal Constitutional Court overturned the regulation that universities in some federal states could expand the catalog of selection criteria given, as well as the fact that the Abitur grade must play a role in this catalog. The legislature now has to change the affected laws by December 31, 2019.

In view of the demand that far exceeds the number of study places, some study place applicants try to obtain a study place through legal action . The lawsuits are directed against suspected errors in the universities' capacity calculations. If they are successful, the universities must create additional study places. The costs per procedure are around 1500 to 10,000 euros.

In 2013, 62% of freshmen were female.

History of the admission of women

On March 11, 1891, the general demand for women to be admitted to study at German universities in the guise of a Reichstag petition had sparked "immense amusement" there. The first German female doctor of recent times, Franziska Tiburtius (1843–1927), reports in her memoirs. Tiburtius had received his medical doctorate in Zurich in 1876, but was initially only allowed to work as a non-medical practitioner in Germany . However, it took another nine years until 1900 in the Grand Duchy of Baden women were allowed to enroll at the two universities of the state, Freiburg and Heidelberg , retrospectively to the winter semester 1899/1900 . This made Baden a pioneer in the admission of women to study in Germany. Bavaria and Württemberg followed in 1903/4, Prussia for the winter semester 1908/1909; Mecklenburg came in last in the summer semester of 1909. Women now studied at all German universities and were thus clearly against the old prejudice of female educational inability.

Preclinical part

In the preclinical training section , the natural and social science basics of medicine are taught. At the end of the pre-clinical phase, the student should have understood scientific principles and know how the human body functions and is structured in a normal state. Knowledge of diseases and healing follows in the clinical part.

In order to be able to face the "first section of the medical examination" at the end of the preclinical clinic, 14 events must be attended with success and sufficient attendance and the corresponding exams must be passed:

Internships in physics, chemistry, biology, physiology, biochemistry / molecular biology, course in macroscopic and microscopic anatomy , course in medical sociology and psychology , seminar in physiology , biology / molecular biology , anatomy, internships to introduce clinical medicine, medical terminology , occupational field exploration. In many cases the most stressful and exciting course called preclinical, the dissection of the gross anatomy, all macroscopically visible rule pathways and tissues of man dissected, and all the internal organs and the head and neck region and the CNS shown. For an optimal view of deep-lying tissues and organs, the corpses are partially halved in the pelvis and organs such as the intestine are completely separated, removed and washed out.

There is also an elective. In addition, a nursing internship (90 days, which can also be divided into two or three sections of at least 30 days each) and (since October 1972) training in first aid must be proven.

Clinical part

In the clinical section, the following subjects are taught:

In addition, proof of performance is required in the following cross-sectional areas :

These are usually named with their number, e.g. B. Q13 - Palliative Medicine

Clinical traineeship

After passing the first section of the medical examination up to the beginning of the practical year (PJ), a total of four months of clinical training must be completed during the non-teaching periods . The purpose of the clinical internship is to familiarize the students with medical patient care. she finds

  1. for a period of one month in an outpatient health care facility managed by a doctor or a suitable medical practice,
  2. for a period of two months in a hospital and
  3. for a period of one month in a primary care facility.

Practical year

The practical year (PJ) takes place in the last year of medical studies. It is divided into three training phases (tertials) of 16 weeks each:

  1. in internal medicine,
  2. in surgery and
  3. in general medicine or in one of the other clinical practice areas.

At the Medical Faculty Mannheim at Heidelberg University , the practical year is divided into four sections (quarters) of 12 weeks each. In addition to the two compulsory subjects internal medicine and surgery, there is another compulsory quarter in outpatient medicine. Another quarter is also to be completed in an elective.

In this training section, the focus is on training on the patient. The students should deepen and expand the medical knowledge, skills and abilities acquired during the previous course. To this end, they carry out the medical tasks assigned to them according to their level of training under the guidance, supervision and responsibility of the training doctor. The training includes participation in clinical conferences, including pharmacotherapeutic and clinical pathological discussions. Throughout the year, the so-called PJ-students have 30 days off, of which they can take a maximum of 20 days in one of the three sections. The term absent days encompasses both vacation days and illness-related absent days, so that in the event of a new, protracted illness or serious accidents, a way should be found as early as possible with the clinic management and state examination office that prevents the possible repetition of the practical year. A popular and sensible approach is to save 20 of the 30 days of absence until the end in order to have more time to study and to be able to buffer possible new illnesses towards the end. For this reason, it is also considered sensible not to place your elective in the third tertial, as this then represents the shortest tertial and as a rule the elective is the one that you would like to pursue professionally later, unless you would like to become an internist or surgeon.

As a counterpart, there is the elective year of study at Swiss universities, which is completed in the fifth or sixth year, depending on the place of study. Practical skills should be learned in everyday clinical practice. Unlike the PJ in Germany, the positions in Switzerland can largely be chosen freely and do not have to be completed as tertials.

Medical exams

North German Federal Law Gazette 1869 with license to practice medicine

The first part of the medical examination consists of a written and an oral-practical part. In the second section from a written, and in the third, last section of the medical examination, again from an oral-practical part. The written examinations at the end of the pre-clinical stage of study (the written part of the first stage of the medical examination, still referred to as physics by most medical students today due to the historical development of the examination regulations ) and before the practical year (second stage of the medical examination) are carried out by the Institute for Medical and Pharmaceutical Exam Questions ( IMPP ) prepared. The third section of the medical examination (oral-practical) is completed after the practical year (PJ) has been successfully completed and is organized by the medical faculties.

In 2016, 9,647 students graduated in Germany.

Examination names, synonyms, abbreviations and colloquial names (since the First Ordinance on the Amendment of the Licensing Regulations for Doctors of July 17, 2012)

official designation according to the licensing regulations abbreviation
1st section of the medical examination - M1 (coll .: Physikum) 1. ÄP or (coll .: 1st state examination)
2. Section of the Medical Examination - M2 2nd ÄP or (coll .: 2nd state examination)
3. Section of the Medical Examination - M3 3rd ÄP or (coll .: 3rd state examination)

Synonyms of the examination names (old (!) Licensing Regulations from 2002)

official designation according to the licensing regulations colloquial among students abbreviation used in book titles
1st section of the medical examination Physikum 1. ÄP or 1. Stex Physikum exact (Thieme Verlag), Das Physikum (Elsevier Verlag), Das Erste (Springer Verlag), 1. ÄP (Thieme Verlag)
2nd section of the medical examination Hammer exam 2. ÄP or 2. Stex The hammer exam (Elsevier Publishing), the Second (Springer-Verlag), Hammer exam (Medi-Learn Verlag), 2. AEP (Thieme Verlag)

A section is only considered passed if both the written and the oral-practical part have been passed. The earlier possible compensation of a defective part of the examination with a “good” in the other no longer applies. The earlier first and second state exams no longer exist under the new license to practice medicine. Instead, the faculties must completely take over the knowledge review after the first section of the medical examination. As an admission requirement for the second section of the medical examination, every student must provide evidence of achievement in 22 main subjects and twelve cross-sectional subjects (see above).

promotion

In contrast to the three to five-year doctoral studies or doctoral studies in other subjects, the duration of a medical doctorate is usually around one to two semesters for a full-time doctorate or three to four semesters if the doctorate is carried out in parallel to the current course. A doctoral thesis ( dissertation ) is not mandatory in Germany within or after completing medical studies. You can complete your medical studies with the third section of the medical examination and work as a doctor after receiving your license to practice medicine. However, you are then not awarded a doctorate . The path to a later habilitation in Germany is only possible after completing a doctorate. B. can be obtained as part of a scientific part-time position at a clinic, possible.

In 2016, 6,372 doctorates in human medicine were awarded in Germany. With 9,647 degrees at the same time, the rate of doctoral degrees in human medicine is around 66%.

Medical faculties in Germany

In addition to the medical faculties operated by the German federal states, which are affiliated with the local universities, courses of study have also emerged at German clinics in recent years that are not state-owned university clinics, and which rather have their faculties in other European countries, which accordingly do not German approval procedures and testing offices are responsible. Private universities have also emerged, as well as secondary locations for state medical faculties.

Medical training at universities in Germany
University place state Number of study places per year (1st semester)
Rheinisch-Westfälische Technische Hochschule (model course) Aachen North Rhine-Westphalia 284 (WS)
University of Augsburg (model course) augsburg Bavaria
Charité - Universitätsmedizin Berlin (model course) Berlin Berlin 656 = 331 (WS) + 325 (SS)
Ruhr University Bochum (integrated reform course) Bochum North Rhine-Westphalia 337
University of Bonn Bonn North Rhine-Westphalia 326 (WS)
Technical University Dresden Dresden Saxony 225 (WS)
Heinrich Heine University Düsseldorf (model course) Dusseldorf North Rhine-Westphalia 411 (WS)
Friedrich-Alexander University Erlangen-Nuremberg gain

Bayreuth

Bavaria 351 = 176 (WS) + 175 (SS)
university Duisburg-Essen eat North Rhine-Westphalia 225 (WS)
Johann Wolfgang Goethe University Frankfurt am Main Frankfurt am Main Hesse 393 (WS)
Albert Ludwig University of Freiburg Freiburg in Breisgau Baden-Württemberg 323 (WS)
Justus-Liebig university of Giessen to water Hesse 350 = 175 (WS) + 175 (SS)
Georg-August-University Goettingen Goettingen Lower Saxony 294 = 147 (WS) + 147 (SS)
University of Greifswald Greifswald Mecklenburg-Western Pomerania 196 (WS)
Martin-Luther-University Halle-Wittenberg Hall Saxony-Anhalt 233 (WS)
University of Hamburg (model course: iMED) Hamburg Hamburg 359 (WS)
Hannover Medical School (model course: HannibaL) Hanover Lower Saxony 270 (WS)
Heidelberg University Heidelberg Baden-Württemberg 345 (WS)
Friedrich Schiller University Jena Jena Thuringia 260 (WS)
Christian Albrechts University in Kiel Kiel Schleswig-Holstein 200 (WS)
University of Cologne (model course) Cologne North Rhine-Westphalia 378 = 189 (WS) + 189 (SS)
University of Leipzig Leipzig Saxony 320 (WS)
University of Lübeck Lübeck Schleswig-Holstein 190 (WS)
Otto-von-Guericke University Magdeburg Magdeburg Saxony-Anhalt 192 (WS)
Johannes Gutenberg University Mainz Mainz Rhineland-Palatinate 430 = 216 (WS) + 214 (SS)
Ruprecht-Karls-Universität Heidelberg , Mannheim location (model course: MaReCuM) Mannheim Baden-Württemberg 217 (WS)
Philipps University of Marburg Marburg Hesse 268 (WS)
Ludwig-Maximilians-University Munich Munich Bavaria
Technical University of Munich Munich Bavaria
Westphalian Wilhelms University Muenster North Rhine-Westphalia 282 = 141 (WS) + 141 (SS)
Brandenburg Medical School Theodor Fontane (model course: BMM, private) Neuruppin Brandenburg
Carl von Ossietzky University of Oldenburg (model course)

Graduated from the Dutch Rijksuniversiteit Groningen

Oldenburg Lower Saxony 40 (WS)
University of Regensburg regensburg Bavaria 224 (WS)
Rostock University Rostock Mecklenburg-Western Pomerania 215 (WS)
University of Saarland Homburg Saarland 278 (WS)
Eberhard Karls University of Tübingen Tübingen Baden-Württemberg 327 = 164 (WS) + 163 (SS)
Ulm University Ulm Baden-Württemberg 300 (WS)
Julius Maximilians University of Würzburg Wurzburg Bavaria 315 = 158 (WS) + 157 (SS)
University of Witten / Herdecke (model course, private) Witten North Rhine-Westphalia

Model and reform courses at German state universities

Deviations from the legally stipulated training course are possible according to § 41 of the license to practice medicine in the form of time-limited, state-approved model courses. The first reform course was launched in the 1999 winter semester at the Charité Berlin . The model course at the University of Witten / Herdecke (since 1983) is characterized primarily by its preclinical training in small study groups according to the POL ( Problem-Oriented Learning ) and by the clinical training with a focus on "bedside teaching" in the clinics. The reform curriculum DIPOL (Dresden integrative problem / practice / patient-oriented learning) at the TU Dresden is also known .

Since the 2005/2006 winter semester, 270 freshmen have been trained exclusively in the model medicine course at the Hannover Medical School (MHH). This has been the case at the Medical Faculty of RWTH Aachen University since the winter semester 2003/2004, where the basic medical examination takes place after the sixth semester and the clinical competence examination after the tenth semester instead of the physics course in the fourth semester. Since the 2003 winter semester, the University of Cologne has also had a model course in which all new students have to take part. Here, however, the general structure of the course was retained insofar as the examinations take place according to the submission of the license to practice medicine, i.e. H. After the fourth semester and the associated equivalence tests (formerly Physikum), you have passed the pre-clinical course and can switch to the standard course of study at other universities relatively easily.

The University of Heidelberg has taught since 2001 at the Medical Faculty of Heidelberg one of the curriculum of Harvard Medical School ajar (Boston / MA, USA) Reformstudiengang called HeiCuMed (Heidelberg Curriculum Medicinale). In contrast to this, the Heidelberg-Mannheim location, where the Mannheim Medical Faculty (also belonging to Heidelberg University) is responsible for teaching, research and the hospital, has its own model course ( MaReCum ). At the Heidelberg-Mannheim location, there is also the option of choosing various additional qualification focuses in the 4th and 5th academic year parallel to studying medicine.

In 2004, the Ludwig Maximilians University in Munich introduced a new “MeCuM” curriculum, which resulted from both the new ÄAppO and the findings from the partnership with Harvard Medical School . The curriculum includes a. the acquisition of clinical competence right from the beginning of the course, the early opportunity for students to work scientifically and the targeted preparation for the medical role and dealing with patients.

The Bochum model enables medical students at the Ruhr University Bochum to complete their clinical training in the hospitals / university clinics in the region. In addition, since the 2003/2004 winter semester it has been possible for a group of 42 students to complete their medical studies in a model course. In Bochum, too, problem-oriented learning (POL) is in the foreground of the pre-clinical-clinical-interlinked medical studies. The physics course was replaced by equivalent internal exams (so-called Objective Structured Clinical Examination and Modified Essay Questions Tests). No new students were admitted to the model course in Medicine (MSM) in Bochum in the winter semester 2012/2013. The 5 years currently studying in the model course should finish the course as planned. In the near future, a "reform course" is to be introduced for everyone in Bochum, which includes elements of the MSM. The model course iMED has existed in Hamburg since 2012. Lessons take place in three learning spirals in 18 modules.

But also at other university hospitals, new forms of training are being developed which are intended to reduce the frequently complained practice deficit, e.g. B. Problem-oriented learning (POL), closer integration of theoretical and clinical training, the study hospital with patient acting actors, etc. Also since this semester, the Heinrich-Heine-Universität Düsseldorf has been offering a model course. It usually lasts six years and is divided into three qualification levels. A lot of practice is integrated, especially in the second stage.

Degree programs from foreign universities in Germany

The license to practice medicine takes place in the home country of the home university and in accordance with the national law there, but is recognized by the EU-wide mutual professional recognition directive upon application in all other EU countries. The private courses are all chargeable and outside the German admission restrictions.

  • Oldenburg : The University of Oldenburg has been offering a degree in human medicine since the winter semester 2012/13 following a positive opinion from the Science Council and a funding commitment from the state. For this purpose, a medical faculty is being set up which, in close cooperation with the Rijksuniversiteit Groningen in the Netherlands, offers a continuous 12-semester model course in accordance with the requirements of the medical licensing regulations with the completion of a state examination as part of the "European Medical School Oldenburg-Groningen". Students from Groningen can undertake part of their studies in Oldenburg, students from Oldenburg complete at least one year of their studies in Groningen and also acquire the Dutch Master of Science in genetics from the Rijksuniversiteit Groningen at the "European Medical School" there .
  • Kassel : Since the 2013/2014 winter semester, the Kassel School of Medicine has also been offering a five-year, bilingual course that takes place in cooperation with the University of Southampton , where enrollment and later license to practice medicine take place.
  • Hamburg
    • From the 2019/2020 winter semester, the newly founded UMCH (Universitätsmedizin Neumarkt am Mieresch Campus Hamburg) will be offering six-year studies in human medicine in English. This is a branch of the Romanian Medical University (UMFST) from Târgu Mureș (German also Neumarkt am Mieresch ). The license to practice medicine is based on Romanian law.
    • The Asklepios Campus Hamburg is part of the Semmelweis University Budapest . Since 2008 the clinical part of the course can be taken there.

Degree programs at German private universities

  • Since the summer semester 2015, the newly founded, private Brandenburg Theodor Fontane Medical University (MHB) has been offering a so-called Brandenburger model course in medicine (BMM). In problem-oriented learning, content should be conveyed in small learning groups. The acquisition of theoretical knowledge and its practical application are linked from the first semester through a practical day in a teaching practice and through internships in hospitals. In the TRIK teaching format (teamwork, reflection, interaction, communication), students reflect in practice under supervision . Around 20 clinics and several teaching practices are cooperation partners of the MHB.
  • The Medical School Hamburg (MSH) was accredited in 2017 and offers a degree in human medicine together with the Helios Kliniken Schwerin .

New founding of German state faculties

From the 2019/20 winter semester, the University of Augsburg will also offer a human medicine course, the Augsburg Clinic will be expanded to become a university clinic and will become state sponsored, and a medical campus will also be built. A reform course is planned with a focus on “medical roles and their competencies”. The Science Council approved this in summer 2016.

A medical course is also being prepared at Bielefeld University . There are currently plans to start a model course in the winter semester 2021/22; the capacity is designed for 300 students per year. Similar to Bochum, several public and church-sponsored clinics are to operate under the name of "Universitätsklinikum Ostwestfalen-Lippe".

A course of studies is also to start in Chemnitz from autumn 2020.

In addition, Bavaria is "thinking out loud" about founding another medical faculty in Passau .

Digital studies in Malta

Since November 2018, the private university EDU has been offering an interactive, digital bachelor's and master's degree in human medicine. EDU is operated by Digital Education Holdings Limited (DEH) in Malta . The German partner is the private clinic group Helios Kliniken and chairman of the founding faculty of the Bonn anesthetist Andreas Hoeft. A three-year bachelor's degree can be completed for 19,500 euros per year, which is to be followed by a two-year master's degree from autumn / winter 2021.

After a "detailed examination" by the Central Office for Foreign Education (ZAB) in the Secretariat of the Conference of Ministers of Education , the master's degree does not fall under the automatic professional recognition within the European Union according to the EU Professional Recognition Directive 2005/36 / EC, since the DEH is not classified as a "university" , and a practical service required in Malta is not completed. In addition, the German Medical Association and the Medical Faculty Conference (MFT) consider the quality of the course and the qualifications of the teachers and examiners to be "questionable". The Secretary General of the MFT, Frank Wissing, warned that this course of study "does not offer sufficient preparation for practical work".

statistics

First semester in human medicine in Germany from 1993 to 2002
Human medicine students in Germany in 2002
  • The proportion of women among new students in human medicine in Germany has risen significantly above the proportion of men in recent years.
  • The proportion of women among graduates in Germany is slightly lower than among new students, but it is still higher than the proportion of men. In 2002, there were 4630 female medical students who had completed their medical exams, compared to 4222 male fellow students.
  • The SfH in Germany received 40,387 applications for 8,629 study places for the 2010/2011 winter semester.
  • In the 2011/2012 winter semester, around 73,500 Germans studied human medicine in Germany. According to a survey of 372 medical students, which was carried out in the winter semester 2012/13 on behalf of the Federal Ministry of Education and Research , the average time spent studying was 38.9 hours per week. 68 percent of the students were female. Human medicine students achieved the highest values ​​in a number of criteria: 62 percent had at least one parent with a university degree, 68 percent rated the area of ​​“university and studies” as “very important” for their lives. 89 percent would choose to study again. 71 percent do not expect any difficulties in finding a job that suits them. With an Abitur grade point average of 1.71, the students also had the best grade point average of all study programs considered.
  • Failure rates for the written part of the physics are currently 8.6% and for the written part of the second exam 0.9%.

criticism

  • Due to the shortage of so-called country doctors often forecast in the media , the public and politicians are calling for a rethink when it comes to admission to medical studies, with proposals such as family doctor contingents or the abolition of the numerus clausus.
  • On March 31, 2017, the reform paper “Master Plan Medical Studies 2020” was published. It was decided by "Federal Health Minister Hermann Gröhe and Federal Research Minister Professor Johanna Wanka as well as representatives of the health and education ministers' conference of the federal states and the coalition factions of the German Bundestag [...]."
  • The main aim of the so-called master plan is to promote or reorganize the admission to studies, the practical relevance of the university education and, in view of the dwindling number of general practitioners' practices in rural regions, the strengthening of general medicine during the studies. In addition, among other things, a reorganization of the examinations and a stronger focus on skills are proposed, and in future, "social and communicative skills as well as relevant work experience [...] should also have greater weight" in the selection process. Various actors in the field of medical education criticize the fact that the reform paper was drawn up in a non-transparent process solely by federal and state politicians, without the students (e.g. via the bvmd ), the faculties (e.g. via the MFT ) To involve representatives of medical didactics or specialist societies. In addition, many questions about the implementation of the proposed measures and their funding remain unanswered.

Medical studies in Austria

State universities are the Medical University of Innsbruck , the Medical University of Vienna , the Medical University of Graz and the University of Linz . Since 2013, the Karl Landsteiner Private University for Health Sciences has been offering future medical professionals a Bologna-compliant medical course, consisting of BA Health Sciences & MA Human Medicine, with 70 places per year. There is also a private university in Salzburg, the Paracelsus Medical Private University , with 75 places per year. Since August 2014, a second location of the Salzburg private university has existed on the grounds of the Nuremberg Clinic. 50 study places are available at the German location every year. In addition, the Sigmund Freud University of Vienna (SFU) started its own course in 2015 , which is also Bologna-compliant and consists of 6 semesters each for the B.Sc. in Medical Science and the subsequent Master in Human Medicine or Dentistry.

Due to the large number of applicants (not least from Germany), selection procedures were introduced. The "MedAT" has been used in Vienna, Graz and Innsbruck since July 2013. A two-stage application process is carried out in Krems, consisting of a written test and an interview. In Salzburg and at the SFU, a three-stage application process with a written test and an interview is used.

Medical studies in Switzerland

In general, the subjects of human medicine , dentistry and veterinary medicine are summarized in Switzerland under the umbrella term medical studies . The first two years of study were identical for human medicine and dentistry, more and more theoretical and practical parts of dentistry are now also being transferred to the first two years in order to increase the specificity.

After completing the degree, there will be five to six years of assistantship in human medicine, after which an FMH specialist title can be acquired.

The study of veterinary medicine is specific from the first year.

Offer at the universities

The Bologna system has been in effect at all universities since the year that began in 2007 , in which, after the third year, the Bachelor of Medicine (B Med) or Bachelor of Dental Medicine (B Dent Med) or Bachelor of Veterinary Medicine (B Vet Med) is awarded. Before that, there were courses that were comparable to the diploma courses in Germany.

In the subsequent three years of the master’s degree (human medicine) or two years (both others), a master’s thesis must be written, and after passing the final exams, one receives the title Master of Medicine (M Med) or Master of Dental Medicine (M Dent Med ) or Master of Veterinary Medicine (M Vet Med). The federal examination (federal diploma of the respective subject) is then taken by all courses of study after the master’s degree; the master’s degree is the admission requirement.

The University of Zurich offers a degree in chiropractic medicine (20 places). The bachelor's degree is identical to the human medicine degree. In addition, chiropractic lessons are used to cover the basics of chiropractic medicine. The master’s program is run as an independent chiropractic medicine. All subjects of the human medicine course and the additional chiropractic course must be taken. The master’s degree leads to a Master of Chiropractic Medicine (M Chiro med). The master’s degree entitles you to register for the federal examination in chiropractic.

After completing the master’s degree, the doctorate (Dr. med., Dr. med. Chiro., Dr. med. Dent., Dr. med. Vet.) Can be obtained in a further year by submitting a doctoral thesis.

The Swiss University Conference provides information about the registration situation and annual capacities as well as the recommendation of a numerus clausus at the end of February. The following table describes the situation in 2019 (B = Bachelor; M = Master; x = is offered).

university NC 2019? B Med human medicine M Med human medicine B / M dentistry B / M veterinary medicine
University of Basel Yes x x x
University of Bern Yes x x x x
University of Freiburg Yes x x
University of Zurich Yes x x (also chiropractic) x x
ETH Zurich Yes x (parts with Univ. Zurich) Change Univ. Zurich, Basel or USI (guaranteed)
University of St. Gallen Yes (to University of Zurich) x
University of Lucerne Yes (to University of Zurich) x
USI Yes (to Univ. Basel) x
University of Geneva No x x x
University of Lausanne No x x
University of Neuchâtel No Year 1, then change from Geneva / Lausanne

In Switzerland you can complete a degree in human medicine and dentistry at the following universities: in German at the University of Basel , University of Bern , University of Zurich and in French at the University of Geneva

Master's degrees (bilingual) at the University of Friborg and (French) at the University of Lausanne are only possible in human medicine . The University of Lucerne , the University of St. Gallen and the Università della Svizzera italiana are now also offering Master’s degrees in human medicine; the Bachelor’s degrees are offered in Zurich or Basel, although admission has already been made for these locations and contact has been made.

The University of Neuchâtel offers the first year of human medicine training, after which you have to switch to Lausanne or Neuchâtel (as you did not take part in the numerus clausus ).

A Bachelor of Medicine degree can be obtained at ETH Zurich . A subsequent master’s degree is guaranteed in Zurich, Basel or at the USI. However, the aim is to appeal to people who are particularly interested in research, who may then also take up other master’s degrees in more modern basic medical disciplines - based on basic medical training.

Selection process

You have to register to study at Swissuniversities, the rectors' conference of Swiss universities, by around mid-February each year. There are precise criteria for the admission of foreign students. The basic requirement for studying in Switzerland is: a. the main residence in the country or Swiss citizenship. If the capacity is clearly exceeded and this cannot be solved by diversion between the universities, the Swiss University Conference can recommend a numerus clausus (NC), which has always been the case in recent years. The decision is then taken by the university cantons. An NC was previously valid for the Universities of Basel, Bern, Freiburg and Zurich and now ETH, St. Gallen, Lucerne and USI for human medicine (since 1998), for veterinary medicine (since 1999) and since 2005 also for dentistry. Since 2008, applications for chiropractic in Zurich have also been subject to an NC, whereby admission takes place jointly with human medicine.

Admission takes place with the aptitude test for medical studies (EMS), which decides both on general admission and on the choice of the desired university or any necessary diversion. The universities form a common pool for this purpose, each candidate can specify a desired order of study locations, according to the order of the test results, these wishes are taken into account for admission.

Structure of the course

The entire human medicine curriculum is designed for 6 years of study and ends with the federal examination in human medicine. In dentistry there are 5 years (3 years Bachelor and 2 years Master).

Bachelor

The bachelor's degree lasts three years. The exact distribution of the lectures and clinical courses as well as the exams are somewhat different at each university. The first semester includes lectures in anatomy, chemistry and physics. There are also internships in subjects such as chemistry, physics, physiology and psychosocial medicine. In the second semester, the basics of biochemistry, human sciences, molecular cell biology, embryology, histology and genetics are taught. Internships are primarily concerned with anatomy lessons, in which corpses are dissected in groups . In addition, biochemistry, physiology and histology are taught. At the end of each semester there are multiple choice exams and at the end oral exams in anatomy, histology, biochemistry and physiology. Each academic year can be repeated once (certain years also twice).

master

The master’s degree in human medicine also takes three years. The lectures in the clinical section are divided into thematic blocks in which the various diseases are taught. Clinical courses are held in various hospitals in the afternoons. In the "classic" courses in the various specialist areas, the students go to the bedside with a doctor and examine the patients. But there are also internships in subjects such as ethics, biostatistics and pathology. At the end of each semester, a multiple choir exam is held. The failure rate in these exams is very low. The fifth year is the elective year. During this year the prospective doctors work as sub-assistants in various hospitals. The sixth year of study serves to prepare for the state examination. In particular, it includes refresher courses and clinical courses. Some universities deviate somewhat from this scheme in that the elective year of study sometimes extends to the 6th year of study and the clinical courses sometimes take place as block internships on a weekly basis. The 10-month internship, the content of which corresponds to the German PJ, takes place in the master’s degree depending on the university.

In dentistry, it takes 2 years.

particularities

All universities that offer entire courses have university hospitals or animal stations for practical training.

The medical course is considered a learning-intensive university course and is very clearly structured. The students' freedom of choice is therefore very limited.

The four-week nursing internship (so-called "Häfeli internship") has not been compulsory at all universities since 2007.

Medical studies in other non-German speaking countries

Medical studies in Bulgaria

The medical schools are distributed in Bulgaria over the country, with six universities in five locations: Medical University of Pleven , Medical University, Sofia , Sofia University "St. Kliment Ohridski", Medical University of Varna , Medical University of Plovdiv and the Trakia University Stara Zagora . In Bulgaria, completing a medical degree is linked to a professional doctorate , which is awarded after completing the degree without a doctoral degree.

Medical degree in Lithuania

In Lithuania , the largest Baltic state, there are 6-year Lithuanian-language and English-language medical courses in the Lithuanian capital Vilnius and in the second largest Lithuanian city Kaunas . The degree is Master in Health Sciences . Both courses are available at Vilnius University (founded in 1579) and at the Medical Academy of the Lithuanian University of Health Sciences (founded in 1922). The English-language course in Vilnius (with 360 ECTS ) is carried out in small student groups (up to 10–12 students). The course begins on September 1st (the application deadline is August) in the so-called autumn semester. In the spring semester there is no admission of freshmen.

Lithuanian universities do not require a numerus clausus for studying medicine. A written admission test is compulsory in the subjects biology and chemistry (30 questions per subject), at the LSMU University Kaunas also in physics . In addition, there are personal interviews with the applicants. The multiple choice tests and interviews are held in English. The basic requirement for studying in English in Vilnius is the SAT Subject Test in Biology E / M or the MCAT test.

Studies in Lithuanian are generally free of charge. The fees are charged for the English-language course. The Lithuanian language courses are offered alongside your studies. The internships or clinical traineeships, other practical training and education are carried out in the university hospitals (such as Kaunas University Clinics with 7,200 employees and Santaros clinics in Vilnius with 9,000 employees).

A medical course at the University of Klaipėda is planned. In Klaipėda , the Lithuanian port city on the Baltic Sea , there is a Faculty of Health Sciences with 1,300 students and 120 teachers in 8 chairs. It is hoped that the course will be accredited around 2021. So far there have been English-language courses such as Nursing Science (BA) and Physical Education and Sport (BA) as well as Health Care Management , in Lithuanian also health management , kinesiotherapy, public health and public health education etc.

Medical degree in Sweden

In Sweden, medical studies last 5.5 years (11 semesters); The theoretical training is followed by an AiP (AT) phase of at least 18 (often 21) months. During this time, the AT receives a provisional permit to practice medicine, but this can only be applied for by the employer. You can study medicine in Sweden at the universities of Umeå, Uppsala, Stockholm, Linköping, Gothenburg, Malmö / Lund and, since January 2011, also in Örebro. The training was gradually converted to PBL (problem-based learning), with Linköping and Örebro introducing this model most consistently. At some of these universities it is possible to obtain a bachelor's degree in the subject, for example in Örebro. There is currently a discussion about extending medical studies in Sweden to six years and abolishing the AT phase. A state investigation is currently being carried out by the Social Department, but it has sparked many protests, especially among students.

Medical studies in Spain

The aim of the degree in human medicine is to treat, heal and prevent diseases in humans. In the first two years ("pre-clinical section") the students learn the anatomy and physiology of humans in a normal state. The students learn, among other things, the morphology of the human body, the structure of the human organs as well as their composition and function. The students also take part in laboratory internships and familiarize themselves with basic clinical knowledge (taking anamnesis, physical examination, etc.). The first two years are mostly divided into the areas of anatomy, biochemistry, statistics, cellular biology, physiology and psychology.

In the following four years ("clinical section") the focus is on learning pathologies, their physiopathology and treatment. Clinical internships are continuously completed in teaching hospitals alongside the lectures . On the basis of this knowledge, the students learn which functional anomalies belong to certain clinical pictures. This in turn enables them to learn systematic and coordinated therapeutic approaches and to classify disease progression / prognosis. In the Spanish medical course 360 ​​European Credit Points are awarded, whereby each of these Credit Points corresponds to an effort of 25 hours. The course therefore comprises a total of 9,000 hours and the standard time is 6 years. The degree is the 'Grado en medicina'. The course takes place in the European higher education area. Many universities have introduced the obligation to follow one or more lectures in English in the human medicine course. Many universities require sufficient oral and written knowledge of a foreign language, mostly English, as a qualification requirement.

After graduation, registration for the state examination (known as "MIR" = Médico Interno Residente) takes place in order to begin the specialist training. The exam takes place once a year at the beginning of a calendar year in Madrid. The subsequent nationwide allocation of training places is carried out centrally by the Federal Ministry of Health in Madrid in a strict sequence of exam grades. The graduate selects from 47 subjects to specialize as a specialist. In Spain, a graduate of the medical faculty acquires the title of specialist doctor through the postgraduate course “Médico Interno Residente”, or “MIR” for short, which is up to five years long.

You can only register for a doctorate in medicine after obtaining a medical degree at a university. The universities offer specialized doctoral courses for this purpose. Most universities now require several publications in international journals from the doctoral candidate in the sense of a cumulative doctoral thesis for a successful doctorate. The average time to complete a PhD in Human Medicine in Spain is 3-4 years full-time.

German-language medical studies in Hungary

At the Semmelweis University in Budapest , the University of Pécs and the University of Szeged there is the possibility of completing a medical degree in German in six years. Due to the extremely high numerus clausus of German universities, studying medicine in Hungary is an attractive alternative for students with a very good to good Abitur. This is supported by the high number of applications. The high tuition fees don't seem to stop this trend either. In 2008, Semmelweis University opened a branch in Hamburg under the name Asklepios Medical School . For 6900 euros per semester, the clinical semesters of medical studies can be completed there in German according to Hungarian law

Medical degree in the USA

Medical training in the United States is divided into two parts. After four years of undergraduate studies , the Bachelor of Science or Bachelor of Arts is acquired. This is followed by a four-year course that leads to the "Medical Doctor" (MD). In contrast to Germany, the title “Doktor” is awarded without completing a doctoral thesis (so-called professional doctorate ). Access to MD studies is not easy in the USA either. Admission is granted to less than half of American and typically less than 3 percent of international applicants, most of whom have already earned a bachelor's degree in the United States. Medical studies, especially at state universities, are largely financed from taxes levied in the respective states. Therefore, priority is given to the residents of this state. Some state-sponsored universities only accept American citizens and residents with permanent residences in the United States.

As a prerequisite for studying medicine, degrees from almost every bachelor's degree are recognized if the students have completed a prescribed minimum number of compulsory courses in biology , chemistry , mathematics , as well as behavioral, social and human sciences. Additional requirements are outstanding university performance, very good English skills, non-university activities such as internships or social commitment as well as a sufficient result in an admission test, the Medical College Admission Test (MCAT), a standardized test that can be taken online worldwide.

The course consists of instruction with supervision and work in the hospital . It graduates with a doctor of medicine (MD).

For foreign doctors, passing the United States Medical Licensing Examination is a prerequisite for practicing medicine in the USA.

Stress and stress in studying

It is assumed that the study effort, the emotional burden, the pressure to perform within the students due to competition, the prospect of unregulated working hours in the medical profession and a poor work-life balance are among the main stressors. This often leads to a significant general reduction in quality of life. A frequently mentioned stressor is the high learning curve in a short time for exams and certificates. The overload of information often leads to a feeling of disappointment due to the inability to retain and reproduce the entire material during the examination period.

A meta-analysis by the American JAMA magazine shows that the prevalence of depressive symptoms is between 21 and 43%. While some studies have found depressive symptoms more common in female students than males, several studies contradict these findings. Dahlin et al. shows in a study of Swedish medical students that stress occurs particularly in the first year of study and leads to stress within the course.

German foreign students show a similar prevalence. 23.5% of German students show clinically relevant depressive symptoms. It is questionable whether these symptoms existed before the degree or only developed during the course of the degree. In addition, it is not clear whether medical students have a higher prevalence of mental symptoms than students from other disciplines.

See also

Magazines

literature

  • H. Sorg, R. Krämer, C. Grieswald, CGG Schwab, FJ Paprottka, AE Steiert, DJ Tilkorn and J. Hauser: The medical doctoral thesis in Germany. A quantitative analysis of the doctoral regulations of medical faculties . Der Chirurg 87 (2016), pp. 775-784.

Web links

Wikibooks: The Medical Dissertation  - Learning and Teaching Materials
Wikiversity: Teaching Materials Human Medicine  - Course Materials
Wiktionary: Medical studies  - explanations of meanings, word origins, synonyms, translations

Individual evidence

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