How to Practice Medicine as a Specialist in Germany

An American doctor hoping to practice medicine as a specialist in Germany will need to be fluent in German and have Approbation (the full German Medical License). Then you can apply for Specialty recognition, Facharztdiplom, which we detail here.

For more information on how to practice medicine in Germany check out Everything You Need to Know About Practicing Medicine in Germany and Eight Steps to German Medical Licensure.

Applying for Specialty Recognition

The State Chambers of Physicians, (Landesärztekammer) assess the content and duration of specialty training and then award the specialist diploma,Facharztdiplom. You must be a member of your State’s Chambers of Physicians and only then will the Chamber evaluate your American specialty training and compare it with your specialty’s German standards.

In general, a physician needs to provide a detailed certificate listing the size of their training hospital, the activities of the department, and other information as dictated by the State Chamber of Physicians for your specialty. More specifically, the North Rhine State Chambers of Physicians, one of the largest State Chambers of Physicians, requires applicants to provide amongst other things, training diplomas, proof of work experience, and an active US state medical license. These documents are submitted in duplicate in a certified German translation.  

After reviewing an application, the State Chambers of Physicians may advise an applicant to complete additional years of training, gain procedural experience, or take the Facharztprüfung,. The Facharztprüfung is an oral board-certification exam conducted by three physicians, two of whom are specialists in the area of examination. Overall, these exams are rather benign.

The Challenge of Demonstrating Training Equivalency  

German residency training is often 5-6 years long while American training is often shorter. This makes it harder for US trained specialists to demonstrate training equivalency.

For example, General Internal Medicine residency in Germany is 5 years compared to 3 years in the US. A US-trained Internal Medicine physician who completed 3 years of Residency, and who did not pursue fellowship training, will need to complete an additional 2 years of residency training in Germany, for a total of five years of training, to be recognized as an Internal Medicine specialist. Work experience as an attending is taken into consideration and  depending on the level of experience, the requirement for additional training in Germany might be waived.

On the other hand, a US-trained cardiologist who completed 3 years of IM training and 3 years of cardiology fellowship, amassing 6 years of training experience, meets Germany’s requirements for Internal Medicine training. In the case of a cardiologist, the State Chamber of Physicians would then examine the procedure log. An applicant falling short of any procedural requirements, such as the 300 catheterizations required for a German cardiologist, may be advised to obtain additional procedural training in Germany.

The Medical Specialty That Does Not Exist in Germany

Emergency medicine, as a distinct specialty, does not exist in Germany nor does it exist in several other European nations. The time spent in an American Emergency Medicine training program could partially count towards training in Anesthesiology, Internal Medicine or Surgery. Here is a list of recognized German medical specialties.  

Bottom Line

Practicing medicine as a specialist in Germany is doable by obtaining Facharztdiplom (specialty certification). The number of years spent in training, inclusive or residency and fellowship, and work experience could help you meet the German training requirements.

Dr. Shana Alexandra Greven (Shosky) is an Osteopathic Neuromusculoskeletal Medicine specialist, an American doctor living in Germany who recently received Approbation (a German Medical License).  She works part-time as an Assistant Professor at ATSU Kirksville College of Osteopathic Medicine in Kirksville, MO as well as at Liberty Mountain Medical Group in Lynchburg, VA.  Dr. Greven enjoys spiritual and contemplative studies, meditation, yoga, running, fitness, nutrition, nature, equality, and believes in supporting the physical, spiritual, and mental Health of her patients. She is the author of the Ultimate Guide to Practicing Medicine in Germany.

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