Medical subspeciality training in Germany

[zoo1985]

Hi

I'm a graduate of an Irish medical school and am currently training in Internal Medicine in Ireland.

I was wondering if I wanted to do medical subspeciality training in Germany, say in Endocrinology and get Facharzt, do I have to retrain in Germany for a Facharzt in Internal Medicine or can I directly start in Endocrine training?
Is completion of the MRCP exam required?

Also, how long is Endocrine training in Germany (without Internal Medicine). I understand that a good grasp of the language is required.

Thanks for your help.

[Fino]

As far as I can tell it depends on how far you are in your training. If you have completed your training in Ireland then you can get the German "Facharzt" as Ireland is a EU-country. You would have to get some paperwork done, of course...
You could then - if I am not mistaken - add on your subspecialty training in let's say endocrinology.
However, if you are still training you would have to get your training recognised in Germany, i.e. you would have get in touch with the pertinent Landesaerzetkammer and discuss with them what documentation they want to consider your training as equivalent. They might recognise all your training or only parts of it. Then you would continue your training in Germany and try to get the desired subspecialty training.
MRCP - again, I am not 100% sure - will not matter to the Landesaerztekammer as it is not an exit exam but an exam taken DURING your training. If you are lucky, though, your German consultant might be familiar with the UK / Irish system and appreciate the value of the MRCP which would then give you a brownie point when you apply for jobs.

And last but not least:
you will need a decent grasp of German if you want to train in Germany. Do not expect any of your patients to be fluent in English (nor all of your medical and nursing colleagues)

May I ask : why do wish to do your training in Germany?

[zoo1985]

Thanks Fino for your helpful post.

I would not consider undergoing training in Endocrinology in Germany until I have completed my Internal Medicine training in Ireland (1 more year to go).

I am thinking of completing subspeciality training in Germany for personal reasons as my spouse is looking to do a fellowship somewhere in Europe and in Ireland subspeciality training takes a very long time (5 years after Internal Medicine). Also the weather in Germany is much better of course! And my final destination is hopefully the Middle East (where I am from) so it does not matter if I complete here or in another EU country.

Do you know how long Endocrine training is in Germany? Is it 3 years roughly?

[zoo1985]

Just an extra note about the training system in Ireland:

-1 year of internship to be completed after graduating from medical school (6 months internal medicine, 6 months surgery)
-2 years of basic specialist training in Internal Medicine (if that's the chosen field) during which you have to complete 3 steps of the MRCP exam.
-5 years of higher specialist training in Endocrinology and internal medicine which includes 1 year of research only and 1 year of internal medicine and another speciality which is not Endocrinology.

After this you are awarded a Certificate of Completion of Specialist Training (CCST) which means you can be a consultant.

A lot of doctors don't pass all 3 steps of their MRCP by the time they complete the 2 years of basic training in internal medicine so they might need to do an extra year as a registrar which does not count in their 5 years of specialist training.

Does the German Facharzt in Internal Medicine compare with a person who has completed the Basic Specialist Training in Internal Medicine?

[Muriel]

Does the German Facharzt in Internal Medicine compare with a person who has completed the Basic Specialist Training in Internal Medicine?

No, it does not. The German Facharzt in Internal Medicine (without any subspecialty) takes 5 years of training. If you decide to become a specialist, e.g. endocrinologist, you have to pass 6 years of training (3 years of basic specialist training and 3 other years in the chosen subspecialty)

[Fino]

Does the German Facharzt in Internal Medicine compare with a person who has completed the Basic Specialist Training in Internal Medicine?

No, it does not. After completing BST you are fairly experienced but not as much as a Facharzt. Facharzt level is comparable to an experienced registrar.

[zoo1985]

So basically Facharzt is an exit certificate for Internal Medicine rather than a qualification that people get on their way to subspeciality qualification.

I assume the German system isn't like an American residency where the internship year is counted as part of the training (i.e. 3 years internal medicine residency with year 1 being an intern and then doing the American Board in Internal Medicine).

So if I have 1 year of internship, 2 years of internal medicine BST and 1 year as an Endocrinology/Internal Medicine registrar in Ireland - would that roughly convert to 3 years medical BST in Germany meaning I would need 3 more years for Facharzt Endocrinology.. or am I wrong?

[Fino]

that is exactly the question you need to pose to the Landesaerztekammer. I personally think that your level of training equals "3. Weiterbildungsjahr Innere Medizin" but as I said, this is what I think. You would need to clarify with the Landesaerztekammer, you know how bureaucrats can sometimes have very different ideas...