Germany

Working as a doctor in Germany: things to know before you start

Despite little activity on my blog these days, I’ve noticed that one old text has been getting an increasing amount of attention since I published it some 3 years ago: Surprising things about being a doctor in Germany.

In addition, I’ve been getting a number of personal e-mails from medical students and junior doctors from around the world asking for more information and advice on the subject of potentially starting out as a doctor here in Germany.

So, here are a few of my personal experiences and tips from the perspective of a British-trained doctor who moved over to Germany in 2009. I have a fair bit of information to share, so I plan to write about it over a series of texts. I hope this helps some of you.

Before you start

1. Have I got a good chance of getting a job as a doctor in Germany?

Short answer is yes. Germany does need doctors at the moment. It of course depends on your speciality of interest and your place of interest. The chances of getting a job in smaller or less attractive cities is obviously higher than for example a renowned university teaching hospital. But it’s a big country and there is a lot of choice at the moment.

2. Is my medical training recognized in Germany? What documents do I need?

Before you start actively looking for a job, it would be best to check with the regulating body here what the requirements are for having your medical degree recognised and subsequently obtaining a license to practice.

Each ‚Bundesland‘ has its own governing body (for example ‚Ärztekammer Nordrhein, Bayerische Ärztekammer etc). I suggest you pick your place of interest in Germany and enquire at the local Ärztekammer there, but bear in mind that there may be differences between the states.

Applying from a member state of the EU

In general, applying from within the EU is more straightforward than from outside and incorporates getting high school/university certificates translated, references from bosses, security checks from your home country and assurances from your governing body that your medical degree is in line with the standards set by the EU. The usual occupation health issues such as HIV status, immune status against hepatitis as well as a medical certificate from a doctor assuring a good bill of health is also required. The Ärztekammer I applied to refused to look at any documents until they were officially translated from English into German to tell me if they were the correct ones (despite the fact that they could clearly read and understand English). This is therefore a costly and time-consuming process (both in terms of money and your nerves). In the end I got my registration one day before I was due to start work.

Applying from outside the EU

For those outside of the EU, things can get a little trickier. Depending on the structure of your medical training, it can require extra (un-paid) placements and a medical viva to check your knowledge and skills, in addition to the above paperwork. I would check all of this out before your decision to move here so that you can plan your finances and expectations appropriately. From what I gather, things seem to be decided on a very individual basis.

3. How good does my German have to be to work here?

Germans institutions often ask for the Goethe-certificate level B2. This is a requirement for university entrance and acquiring citizenship for example and is a good rule of thumb before you start work here, regardless of whether it is an official requirement or not. For your own sake. It is a level which just about gets you by in conversation and in reading and writing although far from ensuring an easy start. I found that whilst doctor colleagues and allied healthcare professionals spoke and understood english at varying levels, patients (especially the older ones) generally did not and furthermore expect, quite naturally, to be communicated with in their native language.

Tips for improving your German language skills

Like all languages, your German will only get better through use. If like me at the time, you are starting from scratch, there is nothing like living in the country, reading local newspaper, watching Germany films and making friends to improve your fluency.

I did a one month intensive language course (level B2) before I started work. It was a brilliant way to start my life in Germany and is a September I look back on with immense fondness. I made some great friends from this course from all over the world and went to some great parties. It was the ERASMUS year I never had. Aside from the social side though, it was a good foundation for my language skills.

Throughout the year, I met weekly with a friend from Argentina who had been living in Germany for a few years and wanted to improve her English. We would talk for 30 minutes in English and then 30 minutes in German. Over the years, this turned into wonderful evenings of drinking red wine over bowls of delicious pasta in favorite local restaurants and a lasting friendship. And of course we improved our language. It’s quite easy to find a so-called ‚Stammtisch‘ through Facebook groups days to achieve something similar.

That’s it for today. I will write about the medical training system in Germany and some practical tips about looking for and applying for jobs in further posts!

On Immunity

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A colleague and I have noticed how paediatricians here appear to be ever so latently and subtly anti-vaccinators. They don’t tell you this outright, but it’s the feeling you are left with when the topic of vaccination is brought up.

Sure, doctors are no longer paternalistic, and that’s a good thing. And parents are increasingly well-informed. But an expert opinion and clear illustration of the main facts are always invaluable. I don’t know if it’s time constraints, but my perception was that the approach was heavy on parental choice with a distinct impression of lack of concern if parents decide not to bring their child along for certain jabs. Disappointingly without really spending the time to explain the benefits of vaccination for that disease, both to your child and the community of children it lives in. Or to mention that we are speaking about standard vaccinations that are recommended by paediatric societies in many parts of the world.

On my reading list this week was therefore ‚On Immunity – An Inoculation‘ by Eula Biss. A book tackling the history of inoculation, the scientific world of immunisation and the ethical and social side to vaccination. What I wasn’t expecting was that these hard issues would be told in a creative journey of stories relating to mythology, metaphors and motherhood. And what a beautifully written journey it is – a journey through hard facts, conflicting opinions, the fascinating history of medicine, a personal narrative of the neurosis and anxieties of new motherhood and with just a little bit of philosophizing along the way.

A highly recommended read for anyone really. And certainly for all mothers. All parents.

Raising a bilingual child

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Before Erik came along, I proudly stated that this wouldn’t become a ‚mommy blog‘. Although I meant it, I was a little naive about the fact that being a mum is currently my ‚full-time job‘ and a lot of the things that I do, things I read, people I meet, places I go, conversations I have, somehow relate to my new status as a mother.

Wracking my brains for a non-baby related theme is currently harder than I had imagined or planned. Thus for today I’m giving up, with a note to myself to try to be broader in future.

A topic I am currently occupied with is bilingualism.

Being a Brit living in Germany, it’s important that Erik learns to speak English as well as German.  The plan was therefore for me to speak to him in English and my husband in German.

This is not as easy as I imagined.  I’ve gotten so used to speaking in German one hundred percent of almost every day, that it feels strange to speak to this little person beside me in English. When we are out and about, in the presence of strangers in shops, park benches etc. it feels almost wrong to speak to him in English rather than the language of the community. Perhaps because I don’t want to be seen as a foreigner who doesn’t speak German.

Thus I am reading a book about bilingualism ‚Be bilingual – Practical ideas for multilingual families‘ by Annika Bourgogne and quizzing every other bilingual family I happen to meet on their experiences.

Our tactic of ‚one parent, one language‘ does seems to be the recommended way for us to go. Here are some of the important facts I have learned:

1.Worldwide, the majority of the population is either bilingual or multi-lingual. So it’s really not that special. And most of these parents are presumably raising their kids bilingually quite naturally without giving it too much thought. It’s more that as a Brit, learning a second language is often seen as a nice extra but never a necessity meaning that it does indeed feel like something special.

2. A child needs to be exposed to the ‚minority language‘ for at least 30% of the time. For the first year at least, Erik has the advantage that he pretty much has no choice but to hang out with me. After that however, the ‚majority language‘ of German is what he will increasingly be exposed to and quickly starts to dominate. That is why for example, a bilingual nursery would be a huge advantage. And engaging an english speaking babysitter. And regular video-calls with family.

3. Being brought up bilingually doesn’t hinder speech development as previously thought. Some kids may start to speak later, but this apparently falls into the normal spectrum of language development, just as there are stark differences to be seen between monolingual kids.

4. Expect some resistance from your kid at some point. I consider English my native language. My other native language is Tamil. Despite the fact that my parents spoke to me in Tamil, at some point after our move to England, I just replied in English. Perhaps due to a need to fit in. The result now is that I am a passive bilingual: though I understand Tamil without a problem, I couldn’t string together one sentence on my own. The fact that I possess no literacy skills in Tamil is another factor which contributes to this.

5. A second language is often referred to as a gift. But apparently it also takes a bit of work. Simple things such as books and multimedia in the second language are important. But also contact with kids the same age who speak the minority language. And regular trips to a place speaking that language.

6.Bilingualism has many advantages for later life. It is said to have a protective effect on cognitive decline, slowing for example the onset of dementia. It also supposedly makes it easier to later master another language.

The fall of the Berlin wall

Today marks the 25th anniversary of the fall of the Berlin wall. The recent history  in my adopted country is dramatic and rich. And such an anniversary provides the opportunity to learn much more about it – with newspapers and websites offering an array of historical accounts, analyses, commentaries and pictures.

25 years ago, I emigrated with my family from India to England. The events in Berlin at the time meant nothing to me as a little girl discovering a new life in the west. Over the years, history classes in Britain explored the events of the World Wars in detail, but little of what happened next.

My first ever trip to Germany was at the turn of the year in 2004-2005. A good friend made through the ERASMUS program at university invited a group of us to spend new year’s eve with her in her beloved Berlin. After hearing so much about the place during her year in the UK, I remember how excited we were as we made the long road-trip from Birmingham to Berlin. Arriving on a typically cold and grey (but still somehow never dreary) winter evening in Berlin we celebrated the turn of the year watching the fireworks from a rooftop terrace and the following day visiting Potsdamer Platz (a central point left divided after the erection of the wall) , Checkpoint Charlie (the most well-known crossing point across the wall)  and marveling at the graffiti-covered remains of the Berlin Wall itself- all the classic tourist spots – before heading to a quintessentially cool Berlin bar.

Over the last decade, I’ve seen and learnt more about the post-war time in Germany little by little through visits to Berlin, film culture (if you haven’t seen them,  ‚Goodbye Lenin‘ and ‚The Life of Others‘ are a must) and stories told by friends and family. I’m looking forward to pouring over the Sunday papers today and reading more stories about the historic events in 1989 and it’s impact on modern day Germany.

The Secret German Customer Service Code of Conduct

After nearly 5 years of regular stamp buying, sorting out parcels on a Saturday morning and several emergency photocopying trips, I’ve finally broken the ladies who work at the local post office on my street. On my escapade there this week, I was met with a faint smile of recognition. Furthermore, an off-subject comment was thrown my way during the transaction, which could only be construed as an attempt to show humour. And finally, as I was seen struggling to cut up cellotape with my teeth, I was offered a pair of scissors (completely unsolicited) to make the job easier. On my last trip to the post office, I had an inkling that the ladies were warming up to me. And now it’s confirmed. Never – after 5 years of being a loyal customer – have I had such pleasant, friendly and helpful service.

Because German customer service is not the same as British customer service. They seem to follow some sort of special code, which is contrary to everything I know from Britain. And the ladies at my post office are exemplary in their adherence to this code of conduct (although from what I have experienced, the same code is clearly in use in the citizens advice bureau, passport offices, registry offices, and in several shops). From what I can decipher, the steps to following this code go something like this:

Step 1

Whenever possible, exude the impression that you are doing something very important and technically difficult when the customer arrives. If possible, carry on this pretense for a few minutes while the customer waits. Do not at any point attempt to make any eye contact with the customer or in any way seek to acknowledge her presence during this period.

Step 2

At some point, you will have to acknowledge the customer. Acknowledge the customer with an expression which suggests that she is bothering you and that you actually have far more important things that you could be doing. As you become more practiced, you should be able to convey this impression in conjunction with an overt smile and a passably polite greeting.

Step 3

Regardless of the request the customer makes, make her feel like that she is making a particularly tiresome request.

Step 4

Sometimes a customer may change her mind during the transaction. This indecisiveness will inevitable prolong the transaction. However small or large your inconvenience due to this, do not immediately show your willingness or your ability to accomodate to this changed request. The customer is henceforth to be treated as a „difficult customer“. If she blushes with embarassment/apologises profusely, you have carried out this step successful.

Step 5

If something does not go right for your customer eg. the package she has come to collect was sent back to the sorting office 2 days ago and she is noticeable disappointed, do not offer any sign of sympathy or understanding. You may however choose to offer a helpful smirk. This is left to your discretion.

Step 6

Never go out of your way to be extra helpful. That is outside your job description. If you can instead brandish some sort of rule or regulation which makes the request of your customer that little bit less likely to be successful, then do it now. Does your customer look confused by this unheard of rule and is unsure of how to proceed? Mission accomplished. Remember, it is not your job to sort out her problems.

Step 7

Finally, don’t get personal. The customer is your customer, not your accquaintance. If at all possible, avoid all small talk. This formality and distance will stand you in good stead for carrying out the previous 3 steps with ease time after time.


Which makes me realise that the key to breaking the code as a customer  is to always get personal. And as I am on the brink of leaving the widely acknowledged ‘friendly’ Nordrhein-Westfalen for the cooler manners of Bayern, I’m ready to go on the charm offensive. Buoyant in the knowledge that my local post officer worker expressed a vague hint of regret in her voice on hearing that I will soon be in need of postal redirection services. 

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