Medical Continuing Training in Germany - DAAD

1. Introduction
Medical Continuing Training in Germany
Basic medical training in Germany leads to graduation with an Approbation (License to
Practise Medicine). This medical training lasts six years and is done at medical universities.
The final year of studies includes 48 weeks of continuous practical training (Praktisches
Jahr / Practical Year).
The first stage of medical continuing training begins with the process of qualifying as a
Facharzt (Specialist). Building on this foundation, further medical qualifications can be
gained through specialisation in one or more Schwerpunkte (Specialties) or by completing a
Zusatz-Weiterbildung (Extra Qualification) course in addition to the regular Facharzt- und
Schwerpunkt continuing training. Candidates can engage in continuing medical training in
Germany after they have gained their Approbation (Medical Licence).
2. Titles and Designations for Fachärzte (Specialists), Schwerpunkte
(Specialities) and Zusatzbezeichnungen (Extra Qualifications)
The qualification (title or designation) gained through continuing training serves as proof of
the acquired competence. The award of the title Facharzt (Specialist), Schwerpunkt
(Speciality) and/or Zusatzbezeichnung (Extra Qualification) is subject to the conditions as
defined in 2.1-2.3.
Notes:
There is no obligation to engage in continuing training for a Schwerpunkt (Speciality) or an
Zusatz-Weiterbildung (Extra Qualification). When choosing the medical university at which
the continuing training will be offered, please note that not all the Chefärzte (Consultants)
hold the teaching qualifications required for providing advanced continuing training in each
of the Schwerpunkte (Specialities), especially at smaller municipal hospitals.
2.1 Titles for Fachärzte (Specialists)
Candidates who complete their continuing training as a Facharzt (Specialist) in accordance
with the prescribed continuing training syllabuses and periods and are able to document the
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disciplinary competence required for this by passing an examination, will be awarded the title
of Facharzt (Specialist).
2.2 Designations for Schwerpunkte (Specialities)
Candidates who complete their continuing training in a Schwerpunkt (Specialty) in
accordance with the prescribed continuing training syllabuses and periods and are able to
document the disciplinary competence then hold the qualifications required for this Speciality.
2.3 Zusatzbezeichnungen (Extra Qualifications)
Candidates who gain Extra Qualifications in accordance with the prescribed training
syllabuses and periods and are able to document that they have the disciplinary competence
required for this by passing an examination will be awarded a Zusatzbezeichnung (Extra
Qualification).
3. Who can do Medical Continuing Training in Germany?
The Approbation, i.e. the Medical Licence to Practise Medicine, is an absolutely
indispensable requirement for admission to medical continuing training in Germany. Doctors
who hold a basic medical degree awarded in countries outside the European Union (EU), the
European Economic Area (EEA) or Switzerland, may, under certain circumstances, practise
medicine in Germany. However, they must prove that they have completed their medical
training as a doctor or are entitled to practise medicine in their respective home country.
Foreign doctors (for example, scholarship holders) can be admitted to practise medicine if
they wish to engage in continuing medical training or in-service training in Germany within
the scope of scholarship programmes financed from the Federal Budget – as is the case for
the DAAD.
4. How long does Continuing Medical Training last in Germany?
The specified course lengths for continuing medical training as cited in this document are
minimum requirements that may change from case to case, if the continuing training
syllabuses cannot be acquired within the minimum allowed time. The tables below only serve
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as a general overview of the continuing training periods in the various fields, Schwerpunkte
(Specialities) and Zusatz-Weiterbildungen (Extra Qualifications). As mentioned above,
continuing training as a Facharzt (Specialist) on in a Schwerpunkt (Speciality) can be
followed up in many fields of medicine. There is no obligation to engage in any of the latter
courses or in any extra qualification courses.
4.1 Examples
The following examples aim to explain the summary table "Facharzt- und
Schwerpunktkompetenz" (Specialist and Speciality Competence). They specify the minimum
time needed for four different "Facharzt" (Specialist) qualifications. At the end of each
Specialist, Specialty or Extra Qualification course, the trained doctor must document the
required disciplinary competencies by passing an examination in order to gain the relevant
title: Specialist, Speciality or Extra Qualification.
4.1.1 Anaesthesiology
A doctor must complete at least 60 months (5 years) of continuing medical training to qualify
as an Anaesthetist.
4.1.2 Surgery
To gain the specialist competencies listed in the table for the field of "Surgery", a doctor must
initially complete at least 24 months (2 years) of basic continuing training. This is then
followed by specialist continuing surgical training in the desired field. The choice of specialist
competencies in the field of surgery are: General Surgery; Vascular Surgery; Cardiac
Surgery; Paediatric Surgery; Orthopaedics and Trauma Surgery; Plastic and Aesthetic
Surgery; Thorax Surgery and Visceral Surgery.
In other words: A doctor wishing to gain qualification as a Facharzt (Specialist) in the field of
thorax surgery must, for example, complete at least 24 months of basic continuing training
plus at least 48 months of subsequent specialist continuing training in thorax surgery. This
means 24 months + 48 months = a minimum of at least 72 months (6 years).
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4.1.3 Internal Medicine and General Medicine
Continuing training in the fields of "Internal and General Medicine" lasts (a total of) at least:
- 60 months (5 years) for disciplinary competence (Fachkompetenz) as a "General
Practitioner" 12.1,
- 72 months (6 years) for specialist competence (Facharztkompetenz) as an "Internist" 12.2,
and
- 72 months (6 years) for specialist competence (Facharztkompetenz) as an "Internist +
additional disciplinary competencies (e.g. Internist and Pneumologist)" 12.3.
4.1.4. Paediatrics
Continuing training in the field of Paediatrics lasts at least 60 months. After passing the final
examination, the qualified doctor is given the title: "Facharzt für Kinder- und Jugendmedizin"
"Paediatrician". Subsequent specialisation, for example in the field of "Neuropaediatrics /
Child Neurology", takes at least 36 months and is completed with a further examination.
4.2 Summary Table of Specialist and Speciality Competence
The following table lists the minimum times required for medical continuing training in the
various medical fields and Specialty Competencies.
Remarks: The figures listed in this table are based on the Model Continuing Education Rules
of the Bundesärztekammer (German Medical Association). The study regulations of the
respective Landesärztekammern (State Medical Associations) may differ slightly.
Field Specialist and Speciality Competence
Number of
Months
1. Anaesthesiology Anaesthetist 60
2. Anatomy Anatomist 48
3. Industrial Medicine
Occupational Medicine
Specialist in Industrial Medicine
Specialist in Occupational Medicine 60
4. Ophthalmology Ophthalmologist 60
5. Biochemistry Biochemist 48
6. Surgery 6.1 Specialist in General Surgery 24 Basis+48
6.2 Vascular Surgeon 24 Basis+48
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6.3 Cardiac Surgeon 24 Basis+48

6.4 Paediatric Surgeon 24 Basis+48
6.5 Orthopaedic and Trauma Surgeon 24 Basis+48
6.6 Plastic and Aesthetic Surgeon 24 Basis+48
6.7 Thorax Surgeon 24 Basis+48
6.8 Visceral Surgeon 24 Basis+48
7. Gynaecology and Obstetrics Gynaecologist and Obstetrician 60
Specialities:
– Gynaecological Endocrinology and
Reproductive Medicine 60 Basis+36
– Gynaecological Oncology 60 Basis+36
– Special Obstetrics and Perinatal Medicine 60 Basis+36
8. Ear-Nose-Throat Medicine 8.1 Ear-Nose-Throat Specialist 24 Basis+36
8.2 Speech, Voice and Paediatric Hearing
Disorders – Phoniatrician 24 Basis+36
9. Dermatological and Venereal
Diseases Dermatologist and Venereologist 60
10. Human Genetics Human Geneticist 60
11. Hygiene and Environmental
Hygiene and Environmental
Medicine
Medicine Specialist
12.1 Internist
60
12. Internal and General Medicine
(General Practitioner) 60
12.2 Internist: 60
12.3.1– Internist and Angiologist 72
12.3.2–Internist and Endocrinologist and
Diabetologist 72
12.3.3– Internist and
Gastroenterologist 72
12.3.4– Internist and Haematologist and
Oncologist 72
12.3.5– Internist and Cardiologist 72
12.3.6– Internist and Nephrologist 72
12.3.7– Internist and Pneumologist 72
12.3.8 – Internist and Rheumatologist 72
13. Paediatrics Paediatrician 60
14. Paediatric Psychiatry and
Psychotherapy
Specialities
– Paediatric Haematology and Oncology 60 Basis+36
– Paediatric Cardiology 60 Basis+36
– Neonatology 60 Basis+36
– Neuropaediatrics / Child Neurology
Paediatric Psychiatrist and
60 Basis+36
Psychotherapist 60
15. Laboratory Medicine Laboratory Medicine Specialist 60
16. Microbiology, Virology and
Infection Epidemiology
Microbiologist, Virologist and Infection
Epidemiologist 60
17. Oral and Maxillofacial Surgery Oral and Maxillofacial Surgeon 60
18. Neurosurgery Neurosurgeon 72
19. Neurology Neurologist 60
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20. Nuclear Medicine Nuclear Medicine Specialist 60
21. Public Health Public Health Specialist 60
22. Pathology 22.1 Neuropathologist 24 Basis+48
22.2 Pathologist 24 Basis+48
23. Pharmacology 23.1 Clinical Pharmacologist 24 Basis+36
24. Physical Medicine and
Rehabilitation
23.2 Pharmacologist and Toxicologist 24 Basis+36
Physical Medicine and
Rehabilitation Specialist
(Physiatrist) 60
25. Physiology Physiologist 48
26. Psychiatry and Psychotherapy Psychiatrist and Psychotherapist 60
27. Psychosomatic Medicine and
Psychotherapy
– Forensic Psychiatrist
Psychosomatic Medicine Specialist
60 Basis+36
and Psychotherapist 60
28. Radiology Radiologist 60
Specialities:
– Paediatric Radiology 60 Basis+36
– Neuroradiology 60 Basis+36
29. Forensic Pathology Forensic Pathologist
Radiation Therapist
60
30. Radiation Therapy
Radiation Oncologist 60
31. Transfusion Medicine Transfusion Medicine Specialist 60
32. Urology Urologist 60
4.3 Summary Table of Extra Qualifications
In addition to medical continuing training and qualification in the Schwerpunkte
(Specialities), doctors wishing to further specialise can gain a Zusatz-Weiterbildung (Extra
Qualification). The minimum time needed for the individual disciplinary competencies is as
follows:
As already mentioned above, such Extra Qualification is not counted as part of the time
prescribed for training as a specialist. The following special competencies are gained, in
particular, by completing an Extra Qualification course.
Extra Qualifications Number of Months (m) / Hours (h)
Medical Quality Management 200 h
Acupuncture 120 h + 60 h +20 h
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Allergology 18 m
Andrology 18 m
Occupational Health 36 h + 360 h
Dermatological Histology 24 m
Diabetology 18 m
Aviation Medicine 6 m + 180 h
Geriatric Medicine 18 m
Gynaecological Exfoliative Cytology No proof of minimal continuing training hrs required
Haemostaseology 12 m
Hand Surgery 36 m
Homeopathy 6 m +160 h
Infectology 12 m
Intensive Care 24 m
Paediatric Endocrinology and Diabetology 36 m
Paediatric Gastroenterology 18 m
Paediatric Nephrology 36 m
Paediatric Orthopaedics 18 m
Paediatric Pneumology 36 m
Paediatric Rheumatology 18 m
Laboratory Diagnosis– subject specific – 6 m
Magnetic Resonance Imaging (MRI) – subject
specific – 24 m
Manual Medicine/Chirotherapy 120 h +200 h
Pharmacological tumour therapy 12 m
Medical Information Systems 12 m +360 h +480 h
Naturopathy 3 m / or 80 h + 160 h
6 m + 80 h + proof of 50 emergency
Emergency (Trauma) Medicine
(trauma) care assignments
Orthopaedic Rheumatology 36 m
Palliative Medicine 12 m + 40 h
Phlebology 18 m
Physical Therapy and Balneology 12 m + 240 h
Plastic Operations 24 m
Proctology 12 m
Psychoanalysis 250 h + 240 +600 h
100 h + 16 double hr + 15 double hr + 15 double hr +
120 h +100 h + 120 h + 16 double + 15 double hr +15
Psychotherapy – subject specific –
double hr +15 double +120 h + 100 h.
Rehabilitation Medicine 12 +160 h + 160 h
X-ray Diagnostics – subject specific – 18 m and/or 12 m (depending on the subject)
Sleep Medicine 18 m
Social Medicine 12 m +160 h +160 h
Special Orthopaedic Surgery 36 m
Special Pain Therapy 12 m + 80 h
Special Trauma Surgery 36 m
Sports Medicine 12 m +240 h +120 h
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Addiction Medicine 50 h
Tropical Medicine 12 h +12 h +3 m
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