Structure of the medical degree
The following post is supposed to inform you about the structure and the different exams of a medical degree. The system I will be talking about is the normal system as it is applied across Germany. Some universities offer a reformed degree though which is quite different to the normal system.
The structure of the medical degree is set by medical licensing regulations. The first part ranges from the first to the fourth term and ends with the State Examination (which is also called the Preliminary Examination).
The first four terms are labelled „preclinical“. This is the time where students are taught basic knowledge of natural sciences. Subjects such as Biology, Physics, Chemistry, Physiology, Sociology and many more have to be taken and are being examined at the end.
Only after completion of all these subjects, one can register for the Preliminary Examination. There are no grades given for the aforementioned subjects that are of any relevance for the State Examination. It is only important to pass all of them.
Every medical student knows the „magical 60%“ during the preclinical part. Once all preclinical courses have been passed, there are two more absolute preconditions to be able to register for the State Examination. The student has to prove that he/she took part in first aid training and completed a three-month nursing internship.
Students are only allowed to do the nursing internship before starting their degree or during the holidays. It is not possible to do it during term time. I would recommend doing the majority of it before starting your degree so you will have enough time to relax and go on holiday during the breaks.
Once all relevant documentation has reached the Federal State Examination Office, the student will be invited to take the Preliminary Examination.
The examination consists of two parts. Over the course of two days, the student has to sit a written multiple – choice examinations. Everything covered in the previous two years is examinable.
Some days or weeks later there is an oral examination of Anatomy, Physiology and Biochemistry. The two exams can be passed independently of each other.
After this really stressful time, the next part commences. The clinical part which is often just called „clinic“.
The clinic ranges from term five to term ten. Those terms mainly deal with symptoms, diagnosis and therapy. But subjects such as Natural Medicine and Statistics are also part of the syllabus.
In all those subjects, the grades range from 1 to 4. If you get a 5 it means you did not pass and have to repeat the exam. The clinical part ends with the second State Examination.
Until then the student has to work for 4 months, or more accurately 120 days, in a hospital or a doctor’s office. This is called the clinical traineeship.
For this there are certain requirements:
Two months have to be completed in a hospital or a rehabilitation clinic. The specialist area and the hospital can be chosen freely. One month has to be completed at an ambulatory facility. This facility can be both a doctor’s office or the outpatient area of a hospital. The specialist area can be chosen freely here as well.
Contrary to the aforementioned where some form of choice was left to the student, one month at a general practitioner is compulsory now.
Once the clinical traineeships have been completed and all exams have been passed the second State Examination can be attempted.
The second State Examination (STEX) is similar to the Preliminary Examination as it also consists of multiple choice questions. The examination is held over three days. Each day 100 – 120 questions are given to students over the course of 5 hours. Everything covered during the whole degree (the past 5 years) is examinable.
Obviously, the questions will mostly relate to content taught during the clinical part but some question about the preclinical part will be included.
Once the second State Examination has been passed it is time for the practical year.
The practical year consists of a year-long internship at a hospital. The student is given work similarly to a junior doctor ranging from normal work on the ward to assisting at surgeries.
The practical year is split into thirds and each third is spent in a different area.
The areas of surgery and internal medicine are compulsory and only in the last third of the practical year, the student can go into an area of his/her choice. Many students use the practical year to gain experience abroad and/or try to find the right specialist area for their future career. Most universities are indifferent as to where students complete their practical year. The student can freely decide whether to do it abroad or in Germany.
After the practical year, there is one more hurdle between the student and the license to practice medicine. The last part is an oral – practical exam. It covers internal medicine, surgery, the elective subject and one randomly chosen subject. Over two days, questions will be asked to groups of a maximum of four students. This is the final exam of the medical degree and once it has been passed the students can finally call themselves doctor’s and work as such.
Just as a mere formality the license to practice medicine still has to be granted but this is only a further bureaucratic step and should not pose any problems.