How I passed it: ِAnamnesegespräch für die Fachsprachenprüfung!

# My aim from this video is to share my expereience and help foreign doctors in understanding better what is tested in the Fachsprachenprüfung. Sorry for the mistakes! “Life is too short to learn German!’

**** Language mistakes are tolerated. But it is a huge problem when you use Lateinisch with the patients. It is wrong therefore to ask the patient: “Haben Sie Diabetes/Hypertonie? Haben Sie Appendizektomie gehabt” — Correct is to use the “German words”: Haben Sie Zuckerkrankheit? Bluthochdruck? Haben Sie Blinddarmenfernung gehabt?”

*** The challenging-question I gave of Herr Müller having severe abdominal pain and demanding analgesics: Should one give or withold analgesics in case of acute abdomen until a diagnosis is reached? I thought the answer was “withold the analgesics”. But it seems this was the situation “for decades” (reference: http://www.ncbi.nlm.nih.gov/pubmed/21249672). Now, according to the previous Cochrane review from 2011, “This strategy has been questioned by some studies that have shown that the use of analgesia in the initial evaluation of patients with AAP leads to a significant reduction in pain without affecting diagnostic accuracy.”

Unfortunately, I do not have enough experience neither here in Germany nor in Jordan. So, maybe you can help in answering if Herr Müller could get analgesics at the time of the history-taking or not. I think one can wait until after the physical examination. What do you think?

# Posts in my blog about the Facharztausbildung in Germany: http://amanfrommoab.com/category/doctors-going-to-germany/

# For detailed information about the Fachsprachenprüfung (in der Ärztekammer in Münster), please read this post, which also contains the template history file that I used in the video: http://www.amanfrommoab.com/2015/03/19/my-experience-fachsprachenprufung-in-der-arztekammer-in-munster-medical-german-language-test/

# Or from this link you can download the word file, and please remember: ““There is no correct sequence of the clinial examination. The correct sequence is YOUR SEQUENCE. Just develop your own sequence and always stick to it!””: http://amanfrommoab.com/wp-content/uploads/2015/03/Patientenprofil.docx
# Other useful links and posts:
– Facebook Group Doctors Going to Germany: http://amanfrommoab.com/2014/07/11/facebook-group-sharing-information-doctors-going-germany/

– My Experience and Required Documents: Applying for Approbation in Bezirksregierung Arnsberg: http://amanfrommoab.com/2014/10/21/experience-applying-approbation-bezirksregierung-arnsberg-2014-10-21/

– Do you want to quickly get the Approbation?
http://amanfrommoab.com/2015/02/20/want-quickly-get-approbation-important-advice-graduates-universities-outside-european-union/

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Finally, I do not have any conflict of interest with this company/institute.

 

Medical License Authorities where foreign doctors could apply for Approbation without Einstellungszusage (a promise to work = being accepted to work in a hospital)

You would 99% do a medical knowledge exam in order to get the Approbation. I do not know further details. You can find the further details about the content of the exams and the exact required documents for application in the websites of the medical license authorities in the mentioned authorities.

1) Baden Württemberg: http://www.rp.baden-wuerttemberg.de/servlet/PB/menu/1071540/

2) Köln: http://www.bezreg-koeln.nrw.de/brk_internet/leistungen/abteilung02/24/approbationen_berufserlaubnisse/index.html

3) Berlin: http://www.berlin.de/lageso/gesundheit/akademische-berufe/arzt/approbation.html

If you applied for Approbation in any of the above authorities, then please post your experience as a comment.

If you know of other authorities, then please also write a comment.

 

Read further details about the applying for the Approbation here in Germany (highly recommended):

Do you want to quickly get the Approbation? Where and how? A very important advice for graduates of universities from outside of the European Union

My Experience: Fachsprachenprüfung in der Ärztekammer in Münster (Medical German Language Test)

Like always: Please post any questions or additional information public here in this post (comments boxes are at the end of this page) not in a private message. I really do not have time only to help one person at a time! Here will all to see and participate!

 

Sequence before doing this exam:

– 03.06.2013: I got my meical degree (MBBS) from Mutah University, Karak Jordan.

– 01.07.2013: I began learning the German language in Jordan (My experience in learning the German language here: “Ten months from zero to B2 Goethe Certificate outside Germany”, http://amanfrommoab.com/2014/07/23/experience-ten-months-zero-b2-goethe-certificate-outside-germany.

– 10.07.2013: I began my internship year in Jordan.

– 29.04.214: I got B2 Level from Goethe-Institute in Jordan (77,5) but contined learning German in order to reach the C1 level and to pass Telc’s B2-C1 Medical Exam. But most importantly, to imrpove my language because this is, with Approbation and working experience, the most important factor in getting a job in Germany.

– July 2014: I finished my internship year.

– October 2014:
– – I came to Germany and started a B2-C1 medical German course and C1 courses (One general and the other to prepare for Goethe’s C1-Exam.

— I did a one week Hospitation in psychiatry. Unfortuantely, I could not do more. I was restricted to the language course. Not doing a Hospitation was a great advantage because I spent three months at home not being able to interact with Germans and living with Arab colleagues. Finding accomodation in WGs (Wohnung Gemeinschaften, i.e., shared accomoation) with Germans is very hard if you only plan to stay in a city for less than three months. In addition, finding such accomodation requires a lot of interviews and waiting.

— I applied for Approbation at middle October. My documents had problems with the legalization. I received a mail three weeks later informing me about the mistakes. I corrected them and my papers were then sent to Gutachten (Middle November). My total Approbation experience is here.

– October and November: I had a lot of time because the courses were not intensive enough. I tried to attend conferences, scientific days, and lectures related to my wanted specialty and I suceeded. Most importantly, I attended a conference of the largest German society for psychiatry (DGPPN, official website) and that helped me to make contacts and to tremendously imrpove my knowledge about psychiatry in Germany. I came to know about such events from visiting the websites of univeristies, hospitals and that of the DGPPN.

– Early Dececmber 2014: I did Goethe’s C1 exam. But was distressed that the results need at least six weeks to appear. I waited about two months to get my certificate. I passed with 82.5. The preparation course for the C1 exam helped me a lot. It is really amazing.

– After attending the important psychiatry conference of the DGPPN, I sent seven printed applications for a job in Psychiatry in the District Governemtn of Arnsbeg. I got two interviews. I was accepted to beging working with Berufserlaubnis (i.e., before getting my Approbation).

– January 2015: Due to new laws, and because my medical degree was judged equal to that in Germany, I was then to do the Fachsprachnprüfung in the Ärztekammer in Münster. I could not get a Berufserlaubnis.

– 28.02.2015: I did the Fachsprachenprüfung and passed it. It was not easy. I will get my Approbation in about 10 days.

– 18.03.2015: I did the exam on 28.02.2015 and got my approbation 18 days later. They required from me to send a German Führungszeugnis (This document costs 13 Euro and one can get from the Rat Haus in the place where he is Angemeldet), a new Straffrehit und a new Ärztliche Bescheinigung (These two documents are in the website of the District Government of Arnsberg. Download them. You simply sign the first and the other one needs to be filled by a doctor. The last two documents need to be sent again when they are older than three months at the time of issuing the Approbation. I am in Germany since less than 6 months. However, I was asked to send the Führungszeugnis (Because in their leaflet, it states that this document need to be sent when the doctor is in Germany since at least six months). I politely complained to the responsible employee about this document and the previous two documents because these requiremnts are not present in the published leaflet. After some discussion, the employee thanked me and I think that she said that they would consider adding this information in the website.

More details about the above documents in this post: “My Experience and Required Documents: Applying for Approbation in Bezirksregierung Arnsberg (Updated on 10.02.2015)”, www.amanfrommoab.com/2014/10/21/experience-applying-approbation-bezirksregierung-arnsberg-2014-10-21/.

Less than 10 minutes after passing the Fachsprachenprüfung in front of the building of the Ärztekammer in Münster. Wishing the same for you! - Jameel Hijazeen جميل حجازين

Less than 10 minutes after passing the Fachsprachenprüfung in front of the building of the Ärztekammer in Münster. Wishing the same for you!

 

• The exam:

– This is the official webpage of the exam: www.aekwl.de/index.php?id=5346.

Which doctors do this exam?

– Graduates of the European Union and doctors from outside of the European Union who applied for Approbation in the District Governemnt of Arnsberg, Detmold and Münster and whose medical certificates are judged equal to those of Germany’s medical schools (Gleichwertigkeit bekommen).

– You cannot simply apply to do this exam if you did not apply for Approbation in one of these authorites. See a detailed example for Arnsberg here.

How much does the exam cost?

– 300 Euro. You transfer the money to the account of the Ärztekammer. You can do that with online banking from your PC. I did that with my account at the Deutsche Bank. This takes less than 10 minutes.

How can I register for this exam?

After your meical degree is judged equal (gleich), you will get an E-Mail from the Ärztekammer telling you that you can register the exam and giving you a list of possible appointments, a bank account to transfer the money, and asking you to send them in a reply email: Short CV, a scanned copy of your B2-Certificate, and a proof of the money transfer (I transferred the money online and I sent them a PDF version of the transfer order from my Deutsche Bank online account) and to specify two dates in which you can take the exam.

After sending this email, they will reply telling you of the date of your exam and that they would contact you about 10 days before your exam in order to let you know at what time you will do the exam.

If you have an Einstellungszusage then you can get an earlier appointment (as early as two-three weeks). It is best that the hospital contacts the Ärztekammer with an email.

What happens if you failed this exam?

– You can repeat the exam. A limit for the repetitions is not specified. Simply because about all doctors passed this exam in the last years. Recently, the exam is hard and many now fail in the first time. However, I never heard or read about people who failed more than two times. [Update 21.03.2015: Yesterday, I met an egyptian doctor who failed this exam for a second time! I do not think it is hard now to fail the exam two times!].

How much do you need to wait before you could repeat the exam?

– “Man soll mindestens drei Moanten warten”. A doctor who failed the exam told me that this was written on a paper telling him of his result. But now, because the doctors who need a Berufserlaubnis in Arnsberg are required also to pass this exam, then the waiting list is long. At the end of March, for example, two colleagues of mine were told that they need to wait until early may to do the exam.

To repeat the exam, the doctor who failed need to contact firstly the District Government in order that they in their turn notify the Ärztekammer to allow for the doctor to register again for the exam. The employees sometimes make this slow so that the doctor who failed would learn more German. For example, an employee in Arnsberg told a doctor who failed the exam that she would not allow him to do the exam again before he sends her a proof that he took a German medical language course.  As a result, the whole process is slow and according to what I read and heard, at least three months would pass before being able to do the exam again.

Where and when is the exam held?

– In the Ärztekammer Westfalen-Lippe. Website and location on Google Maps. The exam is most often held on a Saturday.

There is a train station that is at a walking distance of about 8-10 minutes from the Ärztekammer. It is called “Münster Zentrum Nord“. Taking a Taxi from the Hauptbahnhof in Münster costs about 8-10 Euros. Taking the train from Münster Hauptbahnhof to this station costs around 2,5 Euro.

Duration of the exam?

– The exam lasts officially one hour. But for some, it lasted about 70 Minutes and for others 1.5 hours. The last happened with a colleague of mine from my hospital who did not do so good in the history taking part. The examining doctors then told him that they would ask him medical information in order to give him a second chance. According to my friend, the questions about mediccal knowledge lasted about 30 minutes and then they told him: “For the history that you took, you do not deserve to pass the exam. But because you medical knowledge is good, we will give you the Approbation!”.

The exam:

Fachsprachenprüfung Münster

– It is divided into three parts. The first part is history taking for 20 Minutes. There is a committe of three doctors, or two doctors and a secretary. One doctor plays the role of a patient. You write the history on blank papers. You are all comfortablly sitting in a room and you are offered some thing to drink!

After you take the histroy, you are taken to another room to write it. You have the options either to type if on PC or on a specific paper. Here is the paper:

For those who would like to type, you will type on a similar form like the paper above. It is an interactive PDF file. I chose to type because I type quickly (in German around 65 words per minute) and on PC you can correct mistakes. The doctor warned me that not many doctors do that and that I do not have a lot of time. I chose that nonetheless and later I think that the doctor liked it because he told the others in a little bit impressed way: “Yes, he typed it. Not many doctors do that!”. Yes, does the interactive PDF file shows you mistakes in grammar and spelling? No! It is not like Microsoft Word and I can easily imaging that are certainly not allowed to use Microsoft Word in the exam to check what you wrote.

Writing about the physical examination after writing the history is not required because you simply do not do a physical examination in the exam.

After writing/typing the history, you go back to the committee to discuss the history. You are asked questions like:

– “Can you summarize the history”

– “The patient is the hospital since yesterday, what did you do to him?”

– “What is your differential diagnoses and provisional diagnosis”

– “What is the treatment?”

– “What investigations do you want to do?”

– Not for all doctors, but many are asked to do Aufklärung, i.e., explanation of a medical procedure or operation to the patient. For example, endoskopie, koloskopie, appenziktomie, etc. You can find a lot of resouces in Google. For example, “Aufklärung Koloskopie“. Also see a document below by a Jordanian doctor which also contains Aufkärungen (they are a little bit short but they can give you an idea about what is important to say in the exam).

Now, medical information is asked about. Although this exam  is not a knowledge exam, but such information are asked about in general. Details not required. Not all committees do so but many doctors are now faced with knowledge questions. Some say, this would not determine of you fail or pass and that the most important part of the exam is history-taking. If the history taking is excellent, and you answered more than half of the Lateinsisch-Deutsch words translation at the end of the exam, then you can pass.

Most often asked about cases:

Recently, they are not being restricts to these. One important thing to note is that your case is most likely a part of your specialty or in which specialty you did a Hospitation.

  • Kopf: Schlaganfall + Kopfschmerzen (D.Dx. Migräne & Meningitis)
  • Hals: Halsschmerzen (Halswirbelsäule Syndrome)
  • Brustkorb: Brustschmerzen (MI) + Bronchial Karzinom + Husten und Fieber
  • Bauch:
    • o Oberbauchschmerzen (Gastritis, Ulcus, akute Appendizitis, akute Cholezystitis
    • o Unterbauchschmerzen rechts (akute Appendizitis)
    • o Unterbauchschmerzen links (akut Divertikulitis)
  • Rücken: Rückenschmerzen
  • Untere Extremität: (Beinschmerzen bzw. –schwellung) tiefe Venenthrombose + Peripherele Arterielle Verschlusskrankheit.
  • Kniegelenkschmerzen oder Gelenkschmerzen oder Sprunggelenkfraktur oder -torsion.

 

Challenging questions:

An important skill in the histroy-taking is answering challenging questions (Like in the USMLE). For example:

– A patient has pain in chest. His father died because of lung cancer. He asks you, “Docotor, I will die! My father had this pain and he had cancer and died!”. The following is an example of a patient who has right upper abdominal pain and tells you suddenly in the exam that she thinks that she has liver cancer.

– Ich habe Angst, weil ich denke, dass ich Leberkrebs habe.
– Warum denken Sie so? (Haben Sie die Ergebnisse von Untersuchungen? Hat ein Arzt solche Diagnose Ihnen gegeben?)
– Nur so… Mein Vater hat auch rechte Überbauchschmerzen. – Ich verstehe Ihre Angste Frau Müller. Es ist eine Mögichkeit, dass rechtsüberbauch schmerzen durch Lieberkrebs verursacht können. Aber das ist sehr selten. Auf hand des Anamnesegeprch so weit, das ist sehr unwahrscheinlich und ich habe andere Diagnosen im Kopf. Aber ich werde Ihre Sorge sehr ernst nehmen. Wir machen jezt das Anamnesegespräch und danch die körperliche Untersuchung fertig und danach verornene ich ein paar Untershcuhng um die Ursache Ihrer Schmerzen zu finden und Lieberkrebs auszuschließen.

Oder:

Pat: Herr Doktor. Ich werde sterben. Ich glaube, ich habe Lieberkrebs!

Dr: Krebs? Warum denken Sie so Fr./Hr.?

Pat.: Ich habe im Internet gelesen und meine Symptome sind ähnliche wie die Symptome von Lieberkrebs.

Dr: Ich verstehe. Es ist richtig, dass Krebs Symptome wie Ihrer verursachen könnte, aber auf Grund was sie bis jetzt zu mir beschildert haben, das ist eher unwahrscheinlich Aber danke das Sie das zu mir erwähnt haben. Ich werde das bestimmt in Betracht ziehn. In der Anamnese jetzt und später in der körperlichen Untersuchung und Untersuchungen werde ich sicher diese Diagnose aus- oder einschließen.Wenn nötigt werde ich eben nach der Meinung des Chefs fragen. Aber beruhigen Sie sich bitte und machen Sie sich keine Sorge! Jetzt können wir vielleicht das Anamnesegespräch weiter führen um die richtige Diagnose zu erreichen. OK? Also … Wo sind wir stehen geblieben (Where did we stop/Arabic: WEEN KONA?)

– A patient has a strong abdominal pain. He does not want to allow you to continue the history before your giving him an analgesic. Suggested answer from me (it is a little bite long):

Es tut mir sehr Leid Fau Müller. Ich verstehe, dass Sie viele Schmerzen haben. Das ist bestimmt unangenehm. Aber haben Sie bitte ein bisschen Geduld. Wir können nicht Bauchschmerzen behandeln, bevor wir die Ursache Schmerzen wissen. Das heißt, wir stellen zuerst eine Diagnose und gemäß dieser Diagnose können wir Sie behandeln. Damit wir die richtige Diagnose erreichen können, müssen wir jetzt das Anamnesegesprächt weiter machen. Es dauert nicht lnage. Danach mache ich eine körperliche Untersuchung und verordne ein paar Untersuchung und bildgebende Verfahren. Alles in Ordnung? Wo waren wir stehen geblieben? Also… Die Schmerzen sind nicht dauerhaft da… uzw.

 

– A patient starts telling you that he is afraid of his disease and that he cannot concentrate. He does not allow you to take the history.

– A patient starts talking excessively about things not related to his disease. You need to bring him back to the topic.

– A patient is afraid to start taking Warfarin and asks you: “I heard that this medication has a lot of side effects. I do not want to take this drug” or “does it really have a lot of side effects?”. A german medical language teacher of mine told us that a doctor faile the exam as a result of the above question. The doctor began her answer with: “Yes, this medication has a lot of side effects” and then certainly went on to explain about the “nice” complications of Warfarin. The examining doctors told her that she failed because she caused the patient a lot of stress and fears.

I could not find resources in German to prepare myself for that. There are materials in Englisch for the USMLE CS exam.

– Flash cards – Step 2 CS difficult patients

– You can dig more in Google… Google search for “answering challenging questions usmle“.

A little material that I prepared about the above:

 

• During taking the history, never ever use latin terms with the patient. Use only the german translation. And during presenting the case to the doctor, never ever use German words, use lateinsich terms. See the explanation about the last part of the exam at the end of this post.

 

A short template that I prepared for taking the history: 

Ask only these questions and you will cover everything. Repeat the sequence in this template, or simply modify it or develop your own. The idea is that you always take the history in a certain sequence so that with time you would never forget to ask about a part of the histroy (e.g., forget to ask about allergies, vaccinations, fever, weight, apetite, etc.). In Macleod’s Book of Clinical Examination, I think I once read about a beautiful idea regarding the correct sequence of the clinical examination. Should one examine the hands firstly or the head? Or maybe the lower limb firstly?

“There is no correct sequence of the clinial examination. The correct sequence is YOUR SEQUENCE. Just develop your own sequence and always stick to it!”

 

 

A video explaining taking the history in German as required by the Ärztekammer in Münster (also applies to most other authorities): Click here please!

 

• Last part of the exam: Translating from Lateinisch to Deutsch

You are giving a list of 10-12 Words which are in lateinisch and you are to give the German equivalents. For example:

– Appendiziktomie – Blinddarmentfernung (oder genauer: Wurmfortsatzentfernung)

– Thyroid – Schilddrüse

– Diabetes – Zuckerkrnakheit

– Extension – strecken

– Antiemetic – Medikamment geggen Übelkeit

– Myokardium – Herzmuskel

– Endometritis – Gebäremutterschlemihautentzündung

– Endoskopie – Magenspiegelung

– Abdomensongorafie – Bauchultraschalluntersuchung

– CT – Computertomografie – Querschnitttomografie

– MRT – Magneticresonancetomografie – Kirnspintomografie

– Basiloma – weißter Hautumor

– Herzinssufiziene – Herzschawche

– Thromobztopenia, spinal kanal, Hematom, Hemoptysis, Antazid, Thrombus, Lungenembolie, Nullipara, etc.

For this part of the exam, there is a book by Dr. Nabeel Farhan, the founder of the Patientenkommunikationtest und head of the Freiburg International Academy. This book contains at the beginning very useful information related to histroy taking and then contains more than 70 pages of translations of German-English words. It is very useful and most doctors I know read it. The book is titled: “Medizinische Fachsprachenfortbildung für ausländische Ärzte“. I would also suggest simplzy reading German health news and using Google Chrome Add-Ons for immediate translattions (see the full details and instructions in this post of mine: “The Most Interesting and Quiskest Way to Learn a Lot of German Vocabulay and Pass Goethe’s B2 Exam“). This is a slower method for learning but is more intersting and the information learnt are certainly better understood than simply memorizing translations like in a dictionary. I think that the best method is combining the two methods and Farhan’s book is certainly a must.

 

Fianally, the following post in the Facebook Group “Egyptian Doctors for Germany” contains the written experiences of at least 10 doctors. This include the histories and the Begriffe. I totally recommend reading it. It would help you extremely, especially if you knowa Arabic:
https://www.facebook.com/groups/377408505663230/permalink/800039526733457/ 

 

Update 04.07.2016:

In this post is a great summary of the needed material for the Fachsprachenprüfung! It is really amazing! It contains almost all things! If I am to do the exam, then I would probably would not need a lot more than to read this summary. Of course, the more you learn, the better, but this summary really contains everything. It is prepared by an Egyptian doctor called “Muhamad  Jamal  Ataya”. I do not know him personally. I found a link to this great summary in a post in the group “Egyptian Doctors for Germany”.

https://www.facebook.com/groups/FIA.Egyptian/1121646134568321/

Will you do a Kenntnisseprüfung* in order to get the Approbation in Germany? Follow this great new service from the Freiburg International Academy (FIA)

Will you do a Kenntnisseprüfung* in order to get the Approbation in Germany? Follow this great service from the FIA Freiburg International Academy.

*Kenntnisseprüfung: Medical Knowledge Exam in internal medicine, surgery and a third subject, like orthopedics, that doctors who got their medical degrees from countries outside of the European Union need to pass in most German states. More details and rules about getting the Approbaiton in Germany here:

“Do you want to quickly get the Approbation? Where and how? A very important advice for graduates of universities from outside of the European Union”
amanfrommoab.com/…/want-quickly-get-approbation-important-…/
—————————–
Nach Abklärung der rechtlichen Grundlage der Veröffentlichung der Fragen der Kenntnisprüfungen (vor allem in BW, NRW, Hessen) werde ich täglich eine Frage veröffentlichen und auf Ihre Antworten warten. Am Abend werde ich die richtige Antwort veröffentlichen*.

Source: https://www.facebook.com/pages/FIA-Freiburg-International-Academy/674063622680689

 

Du hast B2-Zertifikat aber keine Approbation und kannst nicht eine Stelle finden? Vorschläge!

Fast 90% der ausländischen Ärzte haben ähnliche Lebensläufe: Nur B2-Zertifikat, keine Approbation, und keine Erfahrung in Deutschland oder dem Ausland.

Deswegen ist folgendes meine Meinung nach, um Geld und Zeit zu sparen und den Lebenslauf zu verstärken. Ich habe das selbst gemacht und eine Stelle gefunden mit wenig Bewerbungen und wenig Einstellungsgespräche:

1. C1-Zertifikat von Goethe- oder Telc-Institut: Am wichtigsten weil fast 95% der Bewerber nur B2-haben). Das C1-Zertifikat wirst dir helfen ein Vorstellunggespräch zu haben. Im Vorstellunggespräch ist deine Sprache was entscheidet! Wenn du schlecht sprichst, dann sogar C2 ist nicht wichtig! Es geht um was der Chefarzt hört!

C1-Niveau in Telc B2-C1-Medizin-Prüfung wäre auch nützlich. Aber ich bin mir nicht sicher, ob es als gut als C1 ist. Aber sicher: C1-Zertifikat von Goehte- oder Telc-Institut ist AM BESTEN!

2. Sich um eine Hospitation bewerben: Telefonisch oder schriftlich. Aber telefonisch funktioniert einfach, wenn du gut Deutsch sprichst.
3. Konferenzen und Tagungen in deiner Zielfachrichtung besuchen: Suchst du die Gesellschaft für die Fachrichtung, z.B., Deutsche Gesellschaft für Neurologie. Diese sind gut für Lebenslauf und du kannst direkt mit Chefärzte sprechen und nicht nur eine Hospitation haben, sondern auch eine Stelle!

4. Ein bis zwei Empfehlungsschreiben von deutschen Ärzten, mit denen du gearbeitet hast.

Mit C1-Zertifikat und Hospiationerfahrung kannst du sicher eine Stelle finden. Aber dann brauchst auch viele Bewerbungen zu schicken. Deine Bewerbung auch soll Fehler-frei und professionell.

Oder kannst du gehen, wo man nur mit Hospitation die Approbation beantragen kann. Aber die Verfahren dauern mindestens drei-vier Monaten und man ist nicht 100% sicher, dass er Gleichwertigkeit kriegen wird. Mehr Details in meinem Beitrag hier: http://amanfrommoab.com/2015/02/20/want-quickly-get-approbation-important-advice-graduates-universities-outside-european-union/

 

Haben Sie eine Andere Meinung? Haben Sie andere Vorschläge? Bitte schreiben Sie einen Kommentar in dieser Seite meines Blogs unten. 

N.B. Bitte keine private Nachricht. Alles veröffentlicht für alle teilzunehmen und profitieren. Danke.

Do you want to quickly get the Approbation? Where and how? A very important advice for graduates of universities from outside of the European Union

Logo of the Facebook Group: Doctors Going to Germany

Logo of my Facebook group “Doctors Going to Germany: A group for sharing information for and by doctors going to Germany“.

• A link to the group on Facebook: https://www.facebook.com/groups/DoctorsLearningGermanTogether.
• More about this group here: “Our Facebook Group for Sharing Information for and by Doctors Going to Germany”, http://amanfrommoab.com/2014/07/11/facebook-group-sharing-information-doctors-going-germany.

 

*** If you have corrections, comments, or questions, then please post a comment to this post using the Facebook comment box or using the other comment box below. PLEASE DO NOT SEND ME A PRIVATE MESSAGE. Keep the discussions public in this post here in English or German for all to participate and benefit ***

 


Terms:

# Hospitation: Clinical attachment or externship. This is a training period in a hospital in which you are allowed to attend rotations, talk with patients, take history, withdraw blood, among other things. In some hospitals, you are allowed to participate as an assistant in operations during the Hospitation in surgery departments. 

How to get a Hospitation in a German hospital? You can read the following article:

• “How to apply for a clinical attachment (Eine Hospitation) in Germany”, http://amanfrommoab.com/2014/07/24/applying-clinical-attachment-eine-hospitation-germany/

# Approbation: German Medical License: Allowance to work as doctor in all Germany. If you get this from any Approbationbehörde (see the next definition) in Germany, then this is valid in all German states. After three years of working experience in Germany, this license is also valid in all European Union (Not sure though of how many years of working experience in Germany are required)

# Approbationbehörde: Medical Licensing Authority. There are 16 German states but there are 23 Medical Licensing Authorities. An authority could be responsbile for certain regions of a German state or a for a whole German state. For example, in the German State of North Rhine-Westphalia (Population at the end of the year of 2013 of 17.6 Million, source: Wikipedia), there are five medical licensing authorities.

• A list of the German Medical Licensing Authorities is here: http://amanfrommoab.com/2014/07/06/list-approbation-medical-license-authorities-approbationsbehorden-germany/

 

# Approbation for graduates of European Union: It is granted very easy. They need only to prove knowledge of the German Language in B2 level. Some authorities are now requiring a proof of the knowledge of both the general german language in level of B2 and a level of knowledge of C1 in Medical German. For this, there is a certificate called Telc B2-C1 (More about this certificate in the next point). In other authorities, B2 is enough to apply for Approbation but the graduate of the European Union need to do a medical German language test.

# Graduates from universities outside of the European Union (The so-called third-countried – sogenannt Drittstaaten): In other words, doctors who got their medical degrees NOT from universities in Germany (1) or in the European Union (2) but from any other country. This has nothing to do if the country is a third-world (developing) country or not and the nationality of the applicant does not play a role. What plays a role is the country of graduation if in Germany or the European Union or not.

Knowledge of the German Langauge as explained in the point above apply to them. However, their medical degrees are not recognized. They need therefore to do by most Medical License Authorities a German medical knoweldge Test (Kenntnisseprüfung oder Gleichwertigkeitsprüfung) (difficulty is differnt from one authority to another and the topics of the exam are differnt too but in general Internal Medicine and Surgery). 

– Topics of the Kenntnisprüfung in the German States of Rheinland-Pfalz: Themen zu Lernen für Gleichwetrigkeitsprüfung – Unten steht alle letzte Examprotokollen in Rheinland-Pfalz in den letzten Monaten.pdf

– The Largest Collection of written experiences about GleichwertigkeitprüfungenApprobation exams of 14 German approbation authorities (Facebook – Doctors Going to Germany).rar

However, by few Approbationbehörden, grdautes from univeristies outside of the European Union do not need to do a Medical Knowledge Test.  The following article discusses that.

This article is translated from a post written by Dr. Abdelrahman Ashour. He is an Egyptain doctor working in Germany and a co-administrator of a gropu called (The German Residency ” Facharztausbildung “).

The post was post published on 19.02.2015. Link: https://www.facebook.com/groups/502617799842684/permalink/63951830615263.

The articles of this doctor and his group are great and I recommend them but the problem is that most posts are in Arabic.

N.B. I added my opinion (text colored green) where I thought I have some experience and all the links in the translation are from me so as to help the understanding. Otherwise, I think that what the author worte is accurate (colored in blue). However, please keep in mind that the laws always change and that many times there are exceptions and some employee in the same authority might accept something and others might not accept it.

And in gerneral, the competition is now increasing and thousands of foreign doctors are now flowing to Germany.

Germany was opened for foreign doctors in the last 4-5 years and Arab doctors were among the first know that. Mostly, Syrians, Egyptians, Libyans and Jordanians. What is very interesting for me, is that I think that Indian and Paktistani doctors do not seem to know a lot about this route of residency and they are not seen in the scene although they represent at least one fifth of the world population. In the statistics of the year 2013 about foreign docotrs in Germany (link), there are only 202 Indian doctors working in Germany and Pakistani doctors are not mentioned and included under “other nationalities from Asia”. Through the messages and comments that I get in my Blog and my group, the majority of those who ask are from those two countries in addition to Nigeria. A small poll that I published in my group a few days ago confirms that (13 out of 25 doctors who answered the pull come from India and Pakistan) (Link to the pull in Doctors Going to Germanyl). Of course, there is a selection bias in this poll as Arab doctors and Greek doctors, for example, have their very large groups and are little represented in my group.

• For more details, see this post: “Statistics of Arab Doctors in Germany by 31.12.2013”, amanfrommoab.com/2014/07/24/statistics-arab-doctors-germany-31-12-2013/

• This post is also useful: “Exact numbers and nationalities of foreign doctors in Germany in the years 2012 and 2013 by the German Medical Association”, http://amanfrommoab.com/2014/07/24/exact-numbers-nationalites-foreign-doctors-germany-years-2012-2013-german-medical-association/

 

Before 2-3 years, Jordanian doctors used to get jobs in Germany in less than three months with only B2 level (that is to say, with a modest German language level) and after sending few job applications. Moreover, back then some doctors sent applications for Hospitations and they got offers for contracts instead because of the low number of applicants. Now, getting a Hospitation is very hard and my colleagues in Jordan send hundreds of E-Mails to get a Hospitation.

• You can read the following post for more inofrmation and to konw how to apply for a Hospitation: “How to apply for a clinical attachment (Eine Hospitation) in Germany”, amanfrommoab.com/2014/07/24/applying-clinical-attachment-eine-hospitation-germany/

============================

Dr. Ashour’s article (What he wrote is in blue. My comments are in green):

 

Please do not apply in no way to get your Approbation in the following regions:
1. The German state of Baden-Wütumberg.
2. The District Government (Bezirksregierung) of Düsseldurf
3. The Distric Government (Bezirksregierung) of Köln

These three do no give equivalence of the medical degrees (=Gleichwertigkeit) and when the result is “not equal (nicht gleich)” you will be stuck with them and you must do a Medical Knowledge Exam in order to be given the Approbation. This exam is very hard and the possibility of not succeeding in it is very high. Moreover, when you apply in another Approbationbehörde, this will affect you negatively.

The easiest two Approbationbehörden to get approbation without any exams are Leipzig and Dresden in the German State of Sachsen BUT YOU NEED TO HAVE EINSTELLUNGSZUSAGE (A paper from a hospital that they accepted you as a residence to work in it) from a hospital in an area that is part of these regions. The advatages of these two are:
1. Only B2 is enough to apply for Approbation.
2. After the result is gleich (equivalent), you do not have to do a medical german language test (Fachsprachenprüfung) like in [the Distric Governments of] Arnsberg, Detmold, or Münster (What is this exam? It is carried out by the Doctors Chamber (Ärztekammer) in Münster and its official website is here: www.aekwl.de/index.php?id=5346). This exam is necessary to get Approbation or Berufserlaubnis in these distric governments. You will get equivalence of your studies in these distric governemnts but you need to have Einstellungszusage to apply for Approbation.
[[[I disagree with the author in two points:

A. The equivalence of studies is not 100% guaranteed. I would say that 80% get equivalence of the studies when talking about graduates of Jordan, Egypt and Syria. However, I was told that the rate of non-equivalence is now increasing. Moreover, the Fachsprachenprüfung is now becoming harder and the failure rates are increasing. Questions are now asked about investigations and mangement and it is not only simply taking a histroy then writing and presenting it.

B. In the District Government of Arnsberg, a proof of Hospitation of at least two months is enough to apply for Approbation. See the full requirements here: amanfrommoab.com/2014/10/21/experience-applying-approbation-bezirksregierung-arnsberg-2014-10-21 ]]]
But for the colleague who have Egyptian or Iranian Master, then the best palce is the German States of Türingen. There they will receive the Approbation in one month at most after applying for it. But to apply for Approbation they need a medical language certiface of any kind (B2-Medizin-Telc or Patientenkommunikationtest). They also need an Einstellungszusage.

 

[[[More about these exams: 

• “How to and how easy is it to get C1 level in Telc B2-C1 Medical exam? Be the judge yourself!”, http://amanfrommoab.com/2014/08/30/easy-pass-telc-b2-c1-medical-exam-judge/.

• “To improve your CV and get more job interviews: Telc Deutsch B2-C1 Medizin Test & “Patientkommunkationtest” von Freiberung International Academy, Universität Klinikum Freiburg”, http://amanfrommoab.com/2014/07/05/telc-deutsch-b2-c1-medizin-improve-cv-get-job-interviews/ ]]]

The procedures of obtaining the Approbation in Thüringen is about 1 Month while in the rest of regions is about 3 Months.

 

[[[My personal experience and that of at least 10 Jordanian doctors who applied in Arnsberg since last June: The procedures now lasts at least 4-5 Months. Or in average 5 +/- 1 Month. The procedures were fast in the past and before about 15 months they even lasted about two months]]]

And for those who ask if there are availabe jobs? Yes, the jobs are available and everyday I see Ads for all specialties but of course more in certain specialties. What matters in the acceptance for the job is your proficiency of the German language (How good you speak German) better than previous experience and any Approbation.

[[[Regarding the factors that help in getting a job, I totally agree that the proficiency in the German langauge is extremely important. However, now it is extremely hard to get a job interview without Approbation. Even all recruiting companies that I saw do not accept to work with doctors who do not have Approbation no matter how good German they speak. I was told that Approbation is always required. In another point, workign experience, especially in surgical speciatlies, and even if this experience is outside of Germany, is a great advanatage and it will greatly help favor your application. In addition, Hospitation experinece in Germany is important in terms that you had learnt how to take history, do physical examination, do Aufklärung (explaination of procedures), knowing the German Health system. Finally, your personality and your dealing with the patients and your supervisors is extremely important and if the patients and your workign colleagues, nurses and colelagues, loved you, then your supervisors would stick to you and recruit you. In University hosptials, research is important but would not be useful if your German is not good and you cannot do the work recuired from a resident. Many German medical students do research in medical school, in order to get the MD title, and it is not very hard that doctors with no research experience to learn to do that. More importantly, how significant and useful is a research experience in third world countries? What is the percentages of reearches that could be done there and are published in famous journals with high Impact Factors? Also most researches from third world countreis, as the situation is in some countries I know, and I have the right to generalize, then are limited mostly to cross-sectioanls studies and have very limited funding. From my experience, I looked into researchce that are done in Neurogoly and Psychiatry in Germany, and the greatest majority are related to Molecular Biolgoy and/or use MRI or PET and other famous investigations]]]

The translated article and my comments to it end here.
=========================

 

The required documetns for Approbation are different from one authority to another. However, there are a lot of similarities in the required documents. If you do not know in which authority you will apply for Approbation, then you can read the following required documents as examples so as to help guide you in preparing your documents:

• The German state of Sachsen from their official website in English: http://www.aerzte-fuer-sachsen.de/english/basic-information/
N.B. This page is great. It contains a lot of information about medical specialization in Germany)

• The Medical Licensing Authority of Arnsberg, “My Experience and Required Documents: Applying for Approbation in Bezirksregierung Arnsberg (Updated on 10.02.2015)”, amanfrommoab.com/2014/10/21/experience-applying-approbation-bezirksregierung-arnsberg-2014-10-21/

 

Finally, I think that the situation of granting the Approbation in Germany is unfair. Firstly, one need to have an Einstellungzusage (being accepted as residence) in order to apply for Approbation in all but two or three medical licensing authorities. Cannot the doctors apply without that especially that it is very hard  to get a job without Approbation? Moreover, some doctos get the Approbation very quickly and easily and others need to do hard Medical Knoweldge Exams. Even the Medical Knowledge Exams are harder in some authorities and very easy in others. I think that it would be best for the German health system if a German version of the medical licensing exams of the United States (USMLE) was developed for whole Germany!

 

• What is the USMLE? “United States Medical Licensing Examination”,  http://en.wikipedia.org/wiki/United_States_Medical_Licensing_Examination

 

In case of a unified exam, the application procedures would be easier and graduates from the universiteis outside of the European Union would not waste their time trying to solve the mystery of the required docuements to apply for Approbation, or if what for exams they will to have to do, or what are the required topics to be studied for exams. Instead, they would invest their time studying medicine in German because they know that the topics to be studied and they would know that no excpetions would be made and all need to do a medical knowledge test. Moreover, foreign doctors would not be exploited by Agents who take thousands of Euros promising them of false job offers. For example, I was contacted by an Agent from a developing country who wanted to advertise in my Blog for his services for doctors from his country. He wanted more than 10,000 Euros in return for few medical German courses, help in applying for Approbation, Hospitation for one or two months,  in addition to minorities (e.g., networking activities with German doctors!!!). This is crazy! The foreign doctor, if he knew all of the information about the German Residencz route, then he can do such things and would not cost him more than 1000 Euro but of course more time to search. But 10,000+ Euro?!

I think that such a unified exam might be decided upon in the future… but not the near one! I never heard or read about a discussion about a unified exam. Another reason is that the decisions in Germany regarding issues of forieng doctors in the German health system seem seem to take a lot of time. For example, in June of 2013, the German Health Ministers decided that all foreign doctors who want to work in Germany need to prove their knowledge of the German Medical Lanaguge (For example, like in Telc B2-C1 Medical Certificate).

• More details in this translated article, German Health Ministers decide: Exams tourism by doctors with poor German language will be stopped! (27.06.2014), http://amanfrommoab.com/2014/07/24/german-health-ministers-decide-exams-tourism-doctors-poor-german-language-will-stopped-27-06-2014/

 

Until now, I never heard or read of medical licensing authorities that applied that other than in Baden-Wüttumberg. In Arnsberg and Munster, this certificate was required for a period of less than a month last October then they were back to the old rule that B2 alone is enough to apply for Approbation.

Medical License Authorities where forieght octors could apply for Approbation without Einstellungszusage (a promise to work = being accepted to work in a hospital).

 

*** To explore all the articles in my Blog about medical specailty in Germany:  ***

http://amanfrommoab.com/category/doctors-going-to-germany/