Hendrik van den Bussche1, Detlef Niemann2, Bernt-Peter Robra3, Udo Schagen4, Beate Schücking5, Nobert Schmacke6, Claudia Spies7, Alf Trojan8, Uwe Koch-Gromus9. 1. Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland. Bussche@uke.de. 2. , Hamburg, Deutschland. 3. Institut für Sozialmedizin und Gesundheitsökonomie der Medizinischen Fakultät, Universität Magdeburg, Magdeburg, Deutschland. 4. Institut für Geschichte der Medizin und Ethik in der Medizin, Charité Universitätsmedizin Berlin, Berlin, Deutschland. 5. Rektorat, Universität Leipzig, Leipzig, Deutschland. 6. Abteilung Versorgungsforschung, Institut für Public Health und Pflegeforschung , Universität Bremen, Bremen, Deutschland. 7. Schwerpunkt operative Intensivmedizin, Klinik für Anästhesiologie, Berlin, Deutschland. 8. Institut für Medizinische Soziologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland. 9. Dekanat der Medizinischen Fakultät, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
Abstract
BACKGROUND: Undergraduate medical education in Germany takes place in the medical faculties of universities, whereas postgraduate medical education takes place in nearly all hospitals under the aegis of medical associations. Both phases of the medical qualification process live on their own; the communication between the two responsible bodies is negligible. Previous reforms have always tackled undergraduate education only, whereas postgraduate education takes place without public attention. OBJECTIVE: This position paper discusses the origins and consequences of the complete separation between undergraduate and postgraduate medical education in Germany with regard to responsible bodies, learning objectives, and didactical concepts. On the basis of this critical analysis, proposals are presented to narrow the gap between the two phases. MATERIALS AND METHODS: This paper is based on several sources: data from historical documents, information retrieved from the internet on educational concepts in other OECD countries as well as intensive discussions among the authors. RESULTS AND DISCUSSION: The dissociation between under- and postgraduate education has historical reasons. Over a longer period of time the German Federal States reduced their responsibility for postgraduate education in favor of medical associations. The authors propose steps towards a better integration of both sequences, towards seeing the educational process as a continuum. In such a concept, medical associations would have a greater influence on undergraduate education and - vice versa - medical faculties on the postgraduate phase.
BACKGROUND: Undergraduate medical education in Germany takes place in the medical faculties of universities, whereas postgraduate medical education takes place in nearly all hospitals under the aegis of medical associations. Both phases of the medical qualification process live on their own; the communication between the two responsible bodies is negligible. Previous reforms have always tackled undergraduate education only, whereas postgraduate education takes place without public attention. OBJECTIVE: This position paper discusses the origins and consequences of the complete separation between undergraduate and postgraduate medical education in Germany with regard to responsible bodies, learning objectives, and didactical concepts. On the basis of this critical analysis, proposals are presented to narrow the gap between the two phases. MATERIALS AND METHODS: This paper is based on several sources: data from historical documents, information retrieved from the internet on educational concepts in other OECD countries as well as intensive discussions among the authors. RESULTS AND DISCUSSION: The dissociation between under- and postgraduate education has historical reasons. Over a longer period of time the German Federal States reduced their responsibility for postgraduate education in favor of medical associations. The authors propose steps towards a better integration of both sequences, towards seeing the educational process as a continuum. In such a concept, medical associations would have a greater influence on undergraduate education and - vice versa - medical faculties on the postgraduate phase.
Keywords:
Cooperation; Germany; Postgraduate medical education; Undergraduate medical education