Medical education

As a study of medicine ( medical degree) is referred to the scientific and practical education of physicians. Similar to other programs (such as the Study ) the scientific principles with practical professional interests are linked. For acting as doctor's license to practice medicine in Germany after graduation required which can be made out directly after the successful completion of the course. In Switzerland, this corresponds to the federal examinations Human-/Zahnmedizin. Then today a development is completed, at which one specializes in a field of medicine ( general medicine, surgery, etc. ) and the specialist title acquires. Formerly a branch was possible as practitioner without this specialization, and at times even without training - today requires the admission to practice as a doctor in these cases as a specialist training.

• 5.1 Offer at the Universities
• 5.2 selection
• 5.3 Structure of the program 5.3.1 preclinical
• 5.3.2 clinic
• 5.3.3 Final exams

History

The medical school has a long tradition. It was in the ancient world for the first time a formal definition, known primarily by the oath and the teachings of Hippocrates. In the middle ages the basics of medical schools were established at universities.

Today goal is the training of doctors "of the scientifically and practically trained in medicine doctor who is capable of autonomous and independent medical profession, to training and continuous training. " (From § 1 of the Licensing Regulations for Physicians on 27 June 2002)

Terms of Use

In the member countries of the European Union, the basic medical training in accordance with Directive 2005/36/EC of the European Parliament and of the Council at least six years and 5,500 hours of theoretical and practical study at a university or under the supervision of a university must include.

When in the context of the Bologna process structured as a bachelor and master degree study only the master's degree allows the practice of medicine in all states of the European Union. The Bachelor of Science will then qualify for medical oriented vocational areas, but not for medical activities. Which activities should the bachelor's degree entitle exactly is unknown as yet. By 2007, only had a few of the countries that have joined the Bologna Declaration, introduced a Bachelor 's / Master's degree program in human medicine. Seven countries, Switzerland, Denmark, the Netherlands, Belgium, Iceland, Armenia and Portugal have their medical schools required such restructuring binding. Four states leave the decision to their universities. 19 countries have their universities the implementation, however, is expressly prohibited, including many Eastern European countries, but also Italy and Spain. Eleven countries had not yet made a final decision until 2007. One of these is according to a study by the Association for Medical Education in Europe ( AMEE ) and Germany.

The International Federation of Medical Students 'Associations ( IFMSA ), the European Medical Students' Association (EMSA ) and Federal Representation of medical students in Germany ( bvmd ) advocate the Europe-wide introduction of a bachelor's / master 's degree program in human medicine. However, associations see both the opportunities that present themselves from it, and risks. To differentiate with other subjects they require, inter alia, the introduction of a Bachelor of Medicine and Master of Medicine.

Medical studies in Germany

The study of medicine is regulated federally by the licensing regulations for physicians ( ÄAppO ). Admission is based on the general higher education or a corresponding creditable education or vocational training degree.

After Licensure Act of 2002 to the training

" Basic knowledge, skills and abilities in all subjects convey, which are necessary for a comprehensive health care for the population. The medical training is conducted on a scientific basis and practice-and patient-related. It should

• The basic knowledge of the functions of the body and the spiritual soul qualities of man,
• Basic knowledge about the disease and the sick people,
• Necessary for the medical practice general knowledge, abilities and skills in diagnosis, therapy, health promotion, disease prevention and rehabilitation,
• Practical experience in dealing with patients, including the cross-curricular approach of diseases and the ability to coordinate the treatment,
• The ability to comply with the health economic impact of medical practice,
• Basic knowledge of the influences of family, society and the environment on health, the organization of health services and the management of illness episodes,
• The intellectual, historical, and ethical foundations of medical behavioral

Mediate based on the current state of research. The training should also include aspects of medical quality and promote a willingness to cooperate with other physicians and with members of other health professions. "

The standard period of study is 12 semesters and 3 months. The average duration of studies in 2003 at German universities was 12.9 semester.

The study is divided into two sections:

• Preclinical part ( first to fourth semester ), at the end of the first part of the medical examination ( former names: medical preliminary examination, Physikum ) is,
• And a clinical part. He concludes in the final year of study a coherent practical training ( practical year ) for 48 weeks and is completed with the second part of the medical examination.

Then the state licensure (approval ) to practice as a physician / health care professional may be requested.

Admission to study

There is a nationwide admissions restrictions ( numerus clausus ), since each semester to apply significantly more applicants for the study of medicine, as the universities can accommodate. Most colleges accept only in the winter semester new students, but some are also for the summer semester.

In the years 1986 to 1996, the test for medical courses the candidate has been defined ( " medical test") used for selection. From individual universities he is now again performed (" selection of higher education institutions ", see below).

Today, one-fifth of the available places will be by the Foundation for Higher Education Admission ( SFH ) after high school grade average award ( " Best High School "). Also 20% of the SFH awards to those applicants who wait the longest ( "Wait semester "; than waiting semester, a semester is considered after passing High School, in which one is enrolled at a German university ). The remaining places - 60 % - may award the universities themselves; This is organized by the SFH (so-called " selection of universities "; " HA "). The universities may thereby to a certain extent - it must play a role as the final grade in the selection - choose their candidates themselves.

The Charité Berlin, for example, calculated from the final examination results and individual results in science subjects, a point value. At a certain value you will be invited to selection interviews, there are about three times invited more applicants than spaces available. Exceed the point value a certain level, then one will be allowed directly and without conversation.

Given the much higher than the number of places demand attempt some study place applicants to obtain a place on the prosecution. The lawsuits are there against suspected errors in the capacity calculations of the universities. If they are successful, the universities need to create additional places. The cost per procedure will be about 1,500 to 10,000 euros.

Preclinical part

In pre-clinical training section, the natural and social scientific foundations of medicine are taught. At the end of the pre-clinical phase, the student should have understood scientific principles and know how the human body works in the normal state and is structured. Knowledge of disease and healing follows in the clinical part.

In order to face up to the " first part of the medical examination " at the end of the pre-clinical phase, 14 events must be attended with success, and sufficient presence and the corresponding exams are passed:

Internships in physics, chemistry, biology, physiology, biochemistry / molecular biology, course of the macroscopic and microscopic anatomy, course of medical sociology and psychology, seminar physiology, biology / molecular biology, anatomy, internships for introduction into clinical medicine, medical terminology, career exploration.

In addition an elective. In addition to a nursing internship (90 days, which can be divided into two or three sections of at least 30 days) are proven and the first aid training.

Clinical part

In the clinical section covers the following subjects are taught:

• General Practice
• Anesthesiology
• Health / Social Medicine
• Ophthalmology
• Surgery
• Dermatology / Venerology
• Gynaecology / Obstetrics
• Ear, Nose and Throat
• Human Genetics
• Hygiene / microbiology / virology
• Internal medicine
• Paediatrics
• Clinical Chemistry / Laboratory Diagnostics
• Neurology
• Orthopedics
• Pathology
• Pharmacology / Toxicology
• Psychiatry and Psychotherapy
• Psychosomatic Medicine and Psychotherapy
• Forensic Medicine
• Urology
• As well as an elective.

In addition, performance records are required in the following cross -cutting areas:

These are usually named by their number, eg Q13 - Palliative Care

Clerkship

After successfully completing the first part of the medical examination to the beginning of the practical year (PJ) for four months internship are abzuleisten outside of lesson times. The internship is intended to familiarize the students with the doctor's patient care. It finds

Practical year

The practical year ( PJ) will take place in the last year of medical studies. It is divided into three training sections of 16 weeks:

In this training section, the training is on the patient at the center. Students should have acquired during the previous study medical knowledge, skills and abilities deepen and expand. Lead them according to their level of training under the guidance, supervision and responsibility of the training physician assigned to them by medical chores. To form part of participation in clinical conferences, including the pharmacotherapeutic and clinical pathological conferences.

Medical tests

The medical exams in both sections of the written and oral-practical parts. The written examinations at the end of the pre-clinical stage of study ( written part of the first section of the medical examination, today called because of the historical development of the examination regulations of most medical students as Physikum ) and after the internship year ( written part of the second portion of the medical examination, the term " hammer exam " has now so established that the big publishers have adopted it for their associated testing literature) are elaborated by the Institute for Medical and Pharmaceutical examination questions ( IMPP ).

Synonyms of test names

A section shall be deemed passed if both the written and the oral-practical part have been passed. The earlier possible offset any defective part of the test by a "good" in the other no longer applies. The former first and second state exam, there are no longer under the new licensing regulations. Instead, the faculties must provide all of the knowledge tests after the first section of the medical examination. Each student must as a prerequisite for admission to the second part of the medical examination performance records in 22 majors and twelve cross section compartments provide ( see above).

A special medical training over other programs is the medical Promotion: In contrast to the generally three - to five-year doctoral program in other subjects the duration of a medical doctorate is usually about one or two semesters at a full-time PhD or three to four semesters, if the promotion is conducted in parallel with the current study. A doctoral thesis (dissertation) is not made ​​mandatory within and after graduation from medical school in Germany. It is the study of medicine with the second section to complete the medical examination and work on receipt of the license to practice medicine. It is then, however, no doctorate, the way to a later Habilitation in Germany is only after a successful promotion, which can then be obtained at a clinic, for example, in a scientific part-time position, possible.

Medical schools in Germany

Model and reform programs

Deviations from the statutory training course are possible, according to § 41 of the Licensing Regulations in the form of a temporary, state law approved model programs. The first reformed curriculum was written for winter semester 1999 at the Charité Berlin. The model program at the University of Witten / Herdecke (since 2000) is mainly characterized by its pre-clinical training in small groups after the POL ( Problem Based Learning ) and by the clinical education focused on "Bedside teaching" in the clinics. It is also known the reform curriculum DIPOLE ( Dresden Integrative Problem / practice / patient - oriented learning ) at the TU Dresden.

Since the winter semester 2005/2006 270 first-year students at the Medical School of Hannover are (MHH ) formed exclusively in the model course of study medicine. This is since the winter semester 2003/2004, the case where instead of Physikum in the fourth semester takes place the medical exam after the sixth semester and the Clinical Competence Examination after the tenth semester at the Medical Faculty of the RWTH Aachen. At the University of Cologne has been around since the winter semester 2003 model also has a degree program in which all students must attend. Here, however, the general structure of the program has been maintained so far that the tests after the submission of the Licensing Regulations expire, that is, after the fourth semester and the corresponding equivalence tests (formerly Physikum ) one has the preclinical behind and can relatively easily in the control course Change other universities.

The University of Heidelberg has taught since 2001 at the Medical Faculty of Heidelberg will be modeled after the curriculum at Harvard Medical School (Boston / MA, USA) Reformstudiengang called HeiCuMed ( Heidelberg Curriculum Medicinale ). In contrast to this, a separate model studies ( MaReCuM ) is in Heidelberg - Mannheim, where the ( related also to the University of Heidelberg), Mannheim Medical Faculty is responsible for teaching, research and the clinic operated. At the site of Heidelberg -Mannheim, the possibility exists, to set various additional qualification focuses of the 4th and 5th year of training in parallel to study medicine.

The Ludwig- Maximilians- University in Munich in 2004 led a new curriculum " MeCuM " one, which resulted both from the new ÄAppO as well as the insights gained from the partnership with Harvard Medical School. The curriculum includes, inter alia, the acquisition of clinical competence from the beginning of the study at that early opportunity for students to work scientifically and specifically prepare for the medical role and dealing with patients.

The Bochum model allows students of medicine at the Ruhr- University Bochum, to complete their clinical training in the past in the region hospitals / teaching hospitals, a special case in Germany. It is also possible since the winter semester 2003/2004 for a small group of 42 students to complete their medical studies in a model study. In Bochum, the problem -oriented learning ( POL) in the foreground of preclinical - clinical- toothed medical studies. The Physikum was replaced by equivalent, faculty internal ( so-called Objective Structured Clinical Examination and Modified Essay Questions tests). In the model study program Medicine ( MSM) in Bochum no new students were admitted for the winter semester 2012 /2013. 5 vintages who are currently studying in the model degree program should terminate as planned the study. In the near future a " reform program" for all is to be introduced in Bochum, the elements of the MSM contains.

But also in other university hospitals new forms of training are being developed to reduce the often lamented practice deficit, such as Problem Based Learning (PBL ), closer integration of theoretical and clinical training, the study hospital with patients performing actors, etc.

The University of Oldenburg will offer after a positive opinion of the Scientific Council and a financing commitment of the country in the winter semester 2012/13, a study of human medicine. For a medical school is built, the one continuous 12 -semester model course of study according to the guidelines of the medical licensing regulations will establish the completion of a state examination in close cooperation with the University of Groningen in the Netherlands under the European Medical School Oldenburg- Groningen. Students from Groningen to perform a part of the studies in Oldenburg; Students from Oldenburg will spend at least one year of studies in Groningen. In the European Medical School, also the Dutch Master of Science Geneeskunde be purchased in the University of Groningen, the right in all States of the European Union under European law for the practice of medicine.

Medical studies in Austria

State universities are the Medical University of Innsbruck, Medical University of Vienna and the Medical University Graz. In Salzburg, is a private university, the Paracelsus Medical University, with 50 study places per year.

Because of the strong candidates rush on them ( not least for Germany ) competitions were introduced. In Vienna, Graz and Innsbruck are used, since July 2013, " MEDAT ". In Salzburg, a three-stage application process with a written test and interview will be applied.

Studying medicine in Switzerland

In general, the study subjects human medicine, dentistry and veterinary medicine are summarized in Switzerland under the umbrella of medical studies. The first two years of study are identical for human and dentists. The study of veterinary medicine, however, differs in the first semester significantly from the other two directions.

The pre-clinical phase lasts two years, the clinical training for another four years, is being carried out in the fifth and partly in the sixth year ( election year) in the hospital. The course is concluded with the Master's degree, which is a prerequisite for admission to the Federal State Examination. After the study is followed by five to six years time as an assistant under which a FMH specialist title can be purchased.

The Structure of the program differs in part from university to university strong. In particular, the internships and the sub assistantship varies widely.

Offer at the Universities

In Switzerland, you can complete a degree in Human Medicine and Dentistry at the following universities: In German Language University of Basel, University of Bern, University of Zurich; in French University of Lausanne and University of Geneva. In Zurich, a Master's degree program for chiropractic care is offered - a prerequisite of B. Med 's degree is in human medicine ( with a specialization ). At the University of Freiburg and the termination ( first three years) can be purchased for a Bachelor of Medicine - for dentistry training the first two years can be completed in Freiburg (what all was before the expansion of the Department of Medicine, 2010 ), at the University of Neuchâtel only the first year - the students must then proceed to one of the other universities. Veterinary medicine can only be studied at the University of Bern or Zurich University. Since the year of study beginning in 2007 applies to all universities in the Bologna system, in which awarded after the third year of the Bachelor. In the three years of the master's program, a master's thesis must be written, and after passing their final exams the title is obtained "Master in Human Medicine " or " Master of Medicine ". Then ( MD ) can be purchased in another year of the doctorate.

Selection

Until about the middle of February each year, you have to register to study at the Rectors' Conference of the Swiss Universities. For the admission of foreign students there exist exact criteria. The basic premise of studying in Switzerland, among others, the principal place of residence in the country or Swiss nationality. If the capacity significantly exceeded and this can not be solved by diversions between the universities, the Swiss University Conference may recommend a numerus clausus (NC ), which in recent years has always been the case. The decision is then taken by the university cantons. An NC was previously in the universities of Basel, Bern, Fribourg and Zurich for human medicine (since 1998), for Veterinary Medicine ( since 1999) and since 2005 also for dentistry. Since 2008, applications were received for chiropractic in Zurich are subject to a NC, where admission is common with human medicine.

The number of registrations increased especially since 2001 at very continuously. For the year 2009 1120 people have been alone in Zurich registered for the course of study of human medicine, with a capacity of 220 study places. Admission is with the aptitude test for medical studies (EMS ), which determines both the general admission and on the choice of the desired university or a pos- needed diversion. The universities are turning to a common pool, each candidate will be able to specify a desired order of places to study, according to the order of the test result, these requests will be considered in the approval. When obligate exchange after the second year of Freiburg students may change with the best results of the tests of the second year to the university of choice.

Structure of the program

Preclinical

The preclinical study lasts two years. The exact distribution of lectures and clinical courses and the exams are slightly different at each university. The first semester includes courses in anatomy, chemistry and physics. There are also internships in subjects such as chemistry, physics, physiology and psychosocial medicine. In the second semester the fundamentals of biochemistry, life sciences, molecular cell biology, embryology, histology and genetics are taught. Internships in the second year deal primarily with the anatomy lessons, is dissected in the in groups. To this end, among other things, taught biochemistry, physiology and histology. At the end of each semester, there are multiple-choice tests and at the end of pre-clinical studies, four oral examinations in anatomy, histology, biochemistry and physiology. In the pre-clinical phase, the current failure rates are about 25 % per year. Each academic year shall once ( some years even twice ) are repeated.

Clinic

The lectures in the clinical section are divided into thematic blocks, in which the various diseases are taught. In the afternoons, clinical courses are conducted in various hospitals. For the "classic " courses in the various fields of the students go to a doctor to the bedside and examine the patient. There are also internships in subjects such as ethics, biostatistics, and pathology. End of each semester, a multiple choice test is performed. The failure rate in these tests is very low. The fifth year is the election year of study. During this year, the budding doctors work as a wizard in different hospitals. The sixth year of study serves as preparation for the state exam. It includes in particular refresher courses and clinical courses. Some universities are slightly different from this scheme by the elective year ranges partly to the 6th year of study and take place the clinical courses as part of practical training on a weekly basis.

Final exams

During the sixth academic year university exams take place, which you must pass in order to be admitted to the state exam. These were designed very differently by different universities. The federal examinations human medicine according to new MedBG was restructured. Since Graduation year 2011 Switzerland there are a state exam with a two half -day written multiple choice exam called with 150 questions and a standardized course test items for checking the medical skills and abilities, OSCE, give.

Special

All universities that offer entire degree programs, have university hospitals and veterinary stations for practical training.

The medical school is considered to be more learning-intensive university degree, and is very clearly structured. The freedom of choice of the students are thus very limited.

Since 2007, the training in chiropractic medicine is integrated into the study.

This four-week internship care (so-called " Häfeli internship " ) is mandatory since 2007 no longer at all universities.

The elective year, which corresponds to the content of the German PJ, takes place from one university in the fifth or the fifth and sixth year. Students seek the job itself is only one condition that each body must take a full calendar month at least. The compartments can be combined freely with few exceptions.

German -language study medicine in Hungary

At the Semmelweis University in Budapest, the University of Pécs and Szeged University, there is the opportunity to complete in German language in six years studying medicine. The study of medicine in Hungary is attractive as a " last resort " for students willing to moderate High School due to the extremely high numerus clausus German universities. This is supported by the high application numbers. Also, the high tuition fees do not seem to stop this trend. 2008 Semmelweis University opened under the name Asklepios Medical School has a branch in Hamburg. For 15,000 euros a year, the clinical semesters of medical studies can be completed under Hungarian law in German language there.

Study medicine in the U.S.

The medical training is organized in the United States in two parts. After four years of undergraduate studies of the Bachelor of Science or Bachelor of Arts degree is earned. This is followed by a four year degree course also connects that leads to the "Doctor of Medicine" (MD). In contrast to Germany, the title "doctor" usually also awarded without making a dissertation. Access to the MD degree is not easy in the United States. An authorization receive less than half of the American and usually less than three percent of international applicants who have usually already obtained a bachelor's degree in the United States. The study of medicine is particularly financed at state universities for the most part collected from the respective states taxes. Therefore, the inhabitants of this State shall be granted priority access. Some state-supported universities accept only U.S. citizens and residents to permanent residents of the United States.

As a prerequisite for the study of medicine degrees are recognized almost every bachelor's degree program, if students who enroll for a prescribed minimum number of required courses in biology, chemistry, mathematics, and behavioral and social sciences and the humanities. Additional requirements are outstanding academic achievements, excellent English language skills, non-academic activities such as internships or social engagement and a satisfactory result in an admission test, the Medical College Admission Test ( MCAT ), a standardized test that can be completed online world.

The course consists of lessons with supervision and work in the hospital. It ends with the Doctor of Medicine ( MD).

Medical studies in Sweden

In Sweden, the medical school 5.5 years (11 semesters) takes; to the theoretical training is followed by a minimum of 18 ( but often 21) month AiP ( AT ) phase. In this time, the AT receives a provisional license to practice the art of healing, but which can be requested only by the employer. A medical degree is possible in Sweden at the Universities of Umeå, Uppsala, Stockholm, Linköping, Gothenburg, Malmö / Lund and since January 2011, in Örebro. The training gradually to PBL ( problem based learning ) were converted, this model was introduced most consistently in Linköping and Örebro. Some of these universities in the acquisition of a bachelor title is possible in the art, for example in Örebro. Currently there is a discussion, the study of medicine in Sweden to extend to six years and abolish the AT phase. A state investigation this is currently the Social Department, however, has aroused many protests, especially among students.

Statistics

• The proportion of women among new students in human medicine in Germany has increased in recent years, significantly higher than the proportion of men.
• Among the graduates of the proportion of women in Germany is slightly lower than among the freshmen, but it is still higher than the share of men. So were the years 2002 4630 medical students who have completed medical examination over 4222 male counterparts.
• In SFH in Germany went for the winter semester 2010/2011 40 387 applications for 8629 places a.