• Introduction
In this article, we explain the differences in medical residency in Germany vs USA. Moreover, we explain in detail the advantages and disadvantages of working in Germany and in the USA.
• Medical residency in Germany vs USA: Short comparison
Firstly, we wrote a small table containing a summary of the differences in medical residency in Germany vs USA. For details about each point, please read the table that follows.
| 🇩🇪 Germany | 🇺🇸 USA | |
|---|---|---|
| ✅ Rather go to it, if: | You want minors (e. g. Spinal surgery, ophthalmology, ENT, radiology, interventional radiology, etc) Your marks are not that good in medical school and you do not want to learn a lot of medicine You do not want to take the risk of studying for one to two years for the USMLE and then at the end getting bad marks (regardless of the cause). If your marks are bad, you can forget about getting a residency place in the USA in the first place! Not to mention getting into highly competitive specialties. You are totally NOT interested in research You have a small budget before being able to start working and earning your first salary. | You want to earn a lot of money later in your life You want to do a lot of research |
| ❌ Rahter NOT go to it, if: | You hate languages and do not want to waste at least 1,5 years of your life studying a language instead of medicine | You have a phobia of guns and you are an anxious person. For Arab doctors: You hate air traveling and want to live near family |
• Medical residency in Germany vs USA: Detailed comparison
| 🇩🇪 Germany | 🇺🇸 USA | |
| Changing specialties | Changing is very easy. If you are a person who does not know what to specialize in, you can start, for example, in internal medicine, and after two months you can switch to neurology, then after three months to surgery. Of course, it is not a good thing for a CV to quickly change specialties and hospitals 😅 | Very hard process. You need to wait for the match, which takes place only one time a year. |
| Exams for medical license | In most cases, you only need a medical language exam and this is nothing compared to the USMLE exams. Other times, a Kentnisseprüfung (medical knowledge exam) must be taken, and in most states, it is much easier than the American exams, and it is only an oral exam. It is about 95% a clinical exam. • If you got bad marks in the USMLE, you can forget about getting many specialties, not to mention, that you might not get a residency position in the first place! In Germany, no marks. 😊 You either have the medical license or do not have it. | USMLE is harder and much more complex. You need to study basic specialties again. |
| Exams to enter into residency programs | There are no exams. You simply send your application to a certain job offer in a certain specialty and a certain hospital. Then you are invited to an oral interview (usually lasts around 10-20 minutes). Then based on the interview, sometimes too, based on a short day in the department, they decide if you are going to be accepted or not. The interviews are very seldom testing medical knowledge. All details about job interviews for doctors in Germany are here: article. | No, exams, but of course, many specialties are highly competitive. |
| Getting directly to internal medical subspecialties | Yes, possible. You can start for example directly a cardiology residency (duration 6 years). Durations of all medical residencies in Germany are all here: article. | No. |
| Age | Not a big deal how old you are for you to start doing a new medical residency. | Older candidates have relatively a big disadvantage in the matching process. |
| How clear is the way for specialization | Examinations and getting an approbation are sometimes according to the mood of an employee who is discontented with himself and with society. Unfortunately, sometimes there is no clear path. But in Germany, the most important thing is that you get your medical degrees recognized to be equal to a German one. If you achieved that (like all EU graduates), then you just need to do a simple medical language exam. More details are in the following article. Nonetheless, there are a lot of active and large Facebook communities that can answer your questions. Ask what you want in our main group on Facebook and Telegram. | Extremely clear! |
| Costs before getting your first salary | I would think like 5-20 Thousand Euros, depending on how quickly you get your approbation. If you did only one job interview, then you can immediately, or within a few days know, that you have a job. You do not need to keep doing interviews like in the match in the USA. | About 2-5 times as much as in Germany. Doing the interviews for the match alone, you would be traveling to many hospitals across the USA. Or to improve your CV, you need to do one year of (unpaid/bad paid) research. Moreover, having clinical US experience is important. |
| How to be a good doctor? | The most important factor for you to be a great doctor is not doing research (indeed, it is almost not important at all in most hospitals), but the language, your interest in your work, how you deal with patients, and how good you are a team player!!! I mean, you don’t have to be a memorizer of large textbooks to become a successful and popular doctor in Germany. Germany is practical! Show me how well you work! | Doing research is important to improve your CV |
| Research opportunity | In unviersity hospitals, it is easy to do research (List of all university hospitals, currently 38 ones out of about 1900+ hospitals). In other hospitals, you could organize that you do research, mostly in cooperation with university hospitals. But it is mostly in your free time and is not paid. | The best in the world |
| Competition for specialties | There is a huge shortage of doctors in many specialties. This means, you can easily find a job or change your hospital. More importantly, your supervisors will in most hospitals deal very respectfully with you, because they know, that you can easily find another job. | |
| Getting the specialty you like | No specialty is theoretically not possible for foreign doctors. In one year (or directly from the beginning), you can start in neurosurgery, ENT, or ophthalmology. Some specialties are not less hard to get, like dermatology. – Article: Which specialties are easiest or hardest to get? – Article: How to get almost any medical specialty in Germany: Improve your CV! Here is how 😊 | Many specialties are hard to get for foreign medical doctors |
| How hard is the work in the residency period | Much easier than in America. There are now laws prohibiting working for more than 12,5 hours (particularly in large hospitals), working more than two weekends in the month or working more than 50 hours a week. Because of the doctors shortage, your supervisors deal in most hospitals nicely with you as a beginner. | Much harder |
| Documentation of work | Doctors spend a lot of time documenting what they do. But starting from 2024, electronic patient records will be a must. | No information. Can you write something? |
| Racism | Racism against foreigners is rare, and even if it exists, you can file a complaint and obtain financial compensation. For example, an Egyptian doctor I know, a female specialist raised her hand, wanting to hit him, but she did not do so, so he received a salary for 3 months without working so that he would not file a case against the hospital. Or another specialist made bad comments about a Palestinian doctor and foreigners, so the hospital dismissed her for 6 months without pay, and she had to attend a course on dealing with foreigners. | Probably less than Germany. |
| Nationalities of doctors | At least one-third of the residents in German hospitals are foreign doctors. Currently, many doctors are from Arab countries. Official statistics at least 18 thousand. | No information. Can you write something? |
| Getting the Nationality | Three years; but the processing time might take an extra year. Currently, one of the strongest passports in the whole world (you can enter 190+ countries without a visa) (Source) | Nationally, it’s harder to get. Passport number 7 in the world (186 countries without a visa). |
| Salaries | – During the residency period: almost like in the USA – After the residency period: Unfortunately, the USA is much more. You can read the following article about the salaries of doctors in Germany | One of the most important and biggest advantages for the USA is much more salaries after the residency period 🥳🥳🥳 In the long run, much more money than in Germany. The salary of a German specialist without extra shifts is about 4,000 euros. With shifts around 5 to 8 thousand euros, you can earn more… see the article the article on the right. |
| Life expenses | Relatively cheaper life than America. Free universities and schools. I mean, if you have 3 children and you want them to study medicine. If they get good marks in school, then they will get a free seat in the university (at least 16 thousand seats per year). The study fees are about 700 Euro per student per year, including transportation costs. Students can also work easily when they are students. | Sending your son/daughter to medical school in America costs around 100 Thousand (or more?). I met once a German lady whose daughter studied something related to the economy in the USA. Fees were like 30 Thousand US Dollars. Her other daughter studied in Germany, fees were only ca. 3 thousand USD. |
| Language barrier | You will waste time learning a new language. Science is in English! To master the German language, anyone needs one and a half to two years. Even after that, learning a new language as an adult is not easy as when a child does. Most have accents and cannot talk comfortably about all topics. | Do not waste time! Invest the time in doing the USMLE instead of learning a new language! |
| Recognition of your specialty worldwide | Well-respected of course but not like the American boards. This article explains exactly where the German board is recognized and where you get immediately a consultant status: Link. | The best specialty in the whole world without dispute. The specialty is recognized in most countries of the world without exams. In the event of transfer to the Gulf countries, you will be recognized faster as a consultant. |
| Geographical location | Germany is in the middle of Europe. Within flights of 2-3 hours, you reach Spain, France, England, Italy, Greece, and many Eastern European countries. Probably you can reach all of the 26 EU countries within 3 hours of the flight. Moreover, Germany is close to the Arab countries, India and Pakistan; as many doctors come to these countries. | Very huge! Air traveling from one state to another can take 9 hours |
| Retirement system | A crumbling retirement system. The retirement age for men is 67 years and for women is 65 years. These age limits are expected to be “raised”. | No information. Can you write something? |
| Criminality | A gradual rise in theft and poverty. | Mass gun shootings are not rare in the USA. But in Germany, they are extremely rare. |
| War in Ukraine | Since the beginning of the Ukrainian-Russian war, the economy has been getting worse. The future is not known. We hope the war will end. | No information. Can you write something? |
• Medical residency in Germany vs USA vs UK vs Canada vs Australia
We explained the differences in the following article:
🇩🇪 Germany vs 🇺🇸 US vs 🇬🇧 UK vs 🇨🇦 Canada vs 🇦🇺 Australia: Working as doctor & medical specialization
Now, we would love to know about your experience:
What is better for medical doctors: The USA or Germany?
Want to learn more? Questions?
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