Germany: Medical Training – Health Systems Facts

Medical Graduates Per 100,000 Population (2017): 12.0
Nursing Graduates Per 100,000 Population (2017): 54.5
Percent Share of Foreign-Trained Doctors (2017): 11.9%
Percent Share of Foreign-Trained Nurses (2017): 7.9%

Source: OECD (2019), Health at a Glance 2019: OECD Indicators, OECD Publishing, Paris, https://doi.org/10.1787/4dd50c09-en.
https://www.oecd.org/health/health-systems/health-at-a-glance-19991312.htm

“The major criterion for a successful application and matching in one of the medical programs is the grade point average, or GPA (Abiturschnitt), after leaving high school (Gymnasium). It is calculated based on a student’s performance during 11th and 12th grade of school, a brief research paper, and their final school examinations. 1.0 is considered best while 4.0 is the minimum GPA required to graduate from high school. In addition to that, a large number of universities provide bonuses for participating and passing an exam called TMS (Test für Medizinische Studiengänge) [17], which is similar to the American Medical College Admission Test (MCAT) and can improve a GPA up to 0.8 points depending on a student’s percentile. Furthermore, minor GPA improvements can be achieved for prior military/civil service or completion of a nursing degree apprenticeship. Certain faculties even provide additional GPA credit for superior performance in scientific classes during high school. During the application process, the high school graduates need to choose up to 6 universities they are planning to apply for and rank them in order of preference. Moving on, the Stiftung fuer Hochschulzulassung distributes the available over 9,000 spots in German medical schools threefold [18]: 20% of all spots are given to those with the highest GPAs in state rankings. 60% are accepted via the internal process of medical faculties which is based on the final GPA including bonuses and occasional personal interviews. The final 20% are admitted by the number of “waiting semesters” (Wartesemester), meaning those who have waited the longest since high school graduation, without enrolling in a public university, have the greatest chance for sucessful application to medical school. For the medical year of 2016/17, the GPA cutoff for the first 20% via state rankings was either 1.0 or 1.1 depending on the home state. Cutoffs for GPA with bonuses via the internal distribution process were around 1.3. Acceptance for the last group (20% of spots) via waiting list required a minimum wait of 14 semesters (7 years) since high school graduation [19]. Defining ideal admission criteria will remain a subject of ongoing debate between students, medical faculties, and politics [14].

“Overall, the process is not without some intricacies. Three rounds of ranking and matching are typically needed to assign all the available spots and the last students are informed about their successful acceptance as late as October – at which point most universities have already begun orientation and first lectures.”

Source: Zavlin D, Jubbal KT, Noé JG, Gansbacher B. A comparison of medical education in Germany and the United States: from applying to medical school to the beginnings of residency. GMS Ger Med Sci.
2017;15:Doc15. DOI: 10.3205/000256, URN: urn:nbn:de:0183-0002568
https://www.egms.de/static/en/journals/gms/2017-15/000256.shtml

“The public universities and their respective medical faculties discussed in this report are predominantly government- and thus tax-funded, as it has been the norm for many decades in Germany. After a short period of tuition charges of 500 Euros per semester (1,000 Euros per year) [28] starting around 2005 in various German states, these fees were all abolished again by the winter semester of 2014/15 [29] due to massive protests from students and the general public and shifts in the political atmosphere. Today, merely administrative fees exist ranging around 50–90 Euros per semester as well as discounted tickets provided by the universities for unlimited use of public transportation ranging from 50 to 200 Euros per semester. Generally, cost of living, particularly housing [30] in the more expensive cities, has been the major financial burden for students in Germany. For these reasons, many scholarship offers are more focused on specific student groups, such as political parties or religious communities rather than reaching out to the general student body [31]. The largest providers of collegiate financial support are the so-called Deutschlandstipendium, which reached merely 0.84% of all students [32] in Germany, the Studienstiftung des deutschen Volkes with similar scholarship figures [33], and the national Bundesausbildungsförderungsgesetz (BAföG) [34], that provides monetary aids up to 670 Euros per month to qualifying low-income students – half as a scholarship, half as a student loan. Altogether, only 4% of all German students received scholarships according to a recent survey [35].”