Sara was born in Wiesbaden, Germany, but with dual German/American citizenship, moved to the USA at the age of 12. After completing high school and gaining an undergraduate degree in anthropology and art in Tacoma, Washington, she spent a year interning on a women’s studies program in Namibia. It was there that Sara decided she wanted to become a doctor and on her return to the USA, she began applying to medical schools.
“Since German medical courses incorporate modules in basic sciences, I didn’t need to already have credits in biology or chemistry,” she explains, “It was enough just to have a good grade point average.”
Sara’s high school grades and Bachelor’s degree were accepted as an equivalent to the German Abitur; and she had proven German language skills as confirmed by her German school records. Where today university applications are made on an individual basis, at that time they were managed by a central organization, and Sara had no trouble getting a place in a medicine course in Mainz. She moved back to Germany and began her studies.
The program was a six-year course comprising two years of basic sciences followed by four years of medical studies that included practical work and compulsory rotations. This latter stage, Sara says, was hard work, but it gave her the opportunity to travel.
“As well as choosing a local placement for my compulsory month-long rotation in obstetrics and gynecology, I returned to the US for general practice and surgery and went to Ethiopia for internal medicine. I found the rotations really useful for narrowing my interests and deciding what areas to focus on.”
Sara continued to travel in the final year of her studies, completing rotations not only in the German teaching hospital she was assigned to in Koblenz as well as in nearby Andernach, but also in the United States. Back in Germany, she passed her Staatsexamen and gained her Approbation, thus becoming a licensed doctor.
“Without your Approbation it’s not possible to practice medicine on humans,” Sara explains, “You can carry out medical research or lecture in the subject, but you’re not legally able to work as a doctor.”
She decided against writing a thesis in order to acquire a ‘Dr. med’ title, saying “there aren’t enough doctors in Germany at the moment, so a ‘Dr’ title is sufficient if you want to work in a clinic or hospital.” She adds, however, that a “Dr. med” is almost certainly necessary if you want to enter a competitive field such as ophthalmology or plastic surgery.
Having qualified as a doctor, Sara found a position at a hospital in Mainz and began her five-year residency. The specialization process was very straightforward: “You have to join your local Ärztekammer (medical association), providing them with copies of all your certificates and proof that you have no criminal record, and then pay them an annual fee,” she said.
Sara is enjoying her residency, but her career plan has evolved along the way. She started out working in geriatrics, but after taking time away from work to have children, opted to change her focus to internal medicine.
“I decided that hospital work was not a good option with kids”, she says, “and decided to switch my specialization.”
It wasn’t a problem, since the two fields are similar and the skills she had logged during her time in geriatrics also count toward the requirements for internal medicine. Sara and her family moved back to her home town of Wiesbaden at around the same time, meaning she had to register with a new Ärztekammer, but this was a straightforward process and one that worked out well: the federal state of Hessen is much in need of doctors, she says, and there were lots of jobs available in major fields such as hers. She is doing the final three years of her residency in a clinic in Wiesbaden and aims to become a general practitioner.
Prior to having children, Sara had been planning to return to the USA. She says that studying medicine in Germany before relocating abroad to work is not uncommon, and with a medical qualification from Germany it’s possible to work anywhere in Europe without any additional training. As there is no obligation to remain in Germany after qualifying, many foreign students come to Germany just to complete their studies. “There are lots of Norwegian medical students here,” says Sara, “There just aren’t enough medical schools in Norway.”
There are also plenty of foreign doctors in Germany who qualified in another country and came here to find jobs. “There are a lot of doctors here from Eastern Europe, particularly Poland, but also from all over the world.” Yet she’s observed during her years of study, training and employment here that for foreign doctors in Germany, it can be tricky to find work.
“It can be much harder to find jobs in urban areas”, she admits, “since foreign workers can be discriminated against because of their non-German qualifications and language skills. Employers worry that you may find it difficult to communicate with patients”. So, in addition to good medical qualifications, fluency in German is now also a requirement when applying to work as a doctor. “The Germans are very strict about that”, Sara says, “It’s critical to be able to communicate with your patients.”