Residency (medicine)

The aim of further medical training is to acquire in-depth knowledge, experience and skills for defined medical activities within the framework of several years of professional activity under the guidance of doctors authorised or empowered to provide further training on the basis of the Further Training Ordinance (WBO) after licensing as a doctor (or after being granted permission to practise as a doctor). This also includes diagnostic and therapeutic interventions defined in terms of number.

The further training regulations are drawn up by the respective state medical association. However, these are usually closely based on the (model) further training regulations adopted by the German Medical Council (Deutscher Ärztetag). According to the 2003 revision, continuing medical education distinguishes between three types of qualification:

• Specialist: The Medical Association awards the title of specialist to authorised doctors in a specialist field after examination of the further training, for example specialist in general medicine, specialist in neurology, specialist in urology or specialist in anaesthesiology. In some fields, different specialist titles can be acquired, for example in surgery (specialist in vascular surgery, specialist in general surgery, etc.).

• Focus: A focus indicates a specialisation within a field, example: specialist in paediatrics and adolescent medicine with a focus on paediatric cardiology. "Focus" does not mean that the specialist spends most of his time on this activity. He or she may also work in the "speciality" as a sideline, as is often the case with a specialist in psychiatry with the speciality designation forensic psychiatry.

• Additional designation: The additional designations can be acquired by physicians from different fields. They differ significantly from one another in terms of the scope of further training and prerequisites. Examples are the additional titles of emergency medicine, acupuncture, diabetology, etc. The additional title replaces the previous specialist qualification and other further training titles. Depending on the additional title, the prior acquisition of a specialist title may be required.

The WBO for doctors also includes examination regulations. According to the 2003 revision, oral examinations must be held at all three levels to determine the success of further training. At least one member of the examination board, which is usually made up of four doctors, must hold the title whose qualification is being examined.

The currently valid (model) further training regulations (in force since 15 November 2018) require staff appraisals to be held at least once a year and a logbook to be kept. This is intended to create a uniform national standard that not only improves teaching, but also makes it easier for doctors in further training to move from one federal state to another. The (sample) logbooks published by the German Medical Association have since been further elaborated by some specialist societies. It is important to note that the (model) further training regulations are not legally binding for the individual medical associations.

Earlier further training regulations additionally provided for the acquisition of a specialist qualification for certain examination methods (X-ray, bronchoscopy, laboratory examinations, duplex sonography, etc.). Optional further training was carried out and certified, for example, in internal medicine for clinical geriatrics and intensive care medicine. In a sense, these are "small specialties". Specialty certificates and facultative continuing education courses are still valid, but are no longer reissued. In part, they have been merged into additional advanced training courses.

See also

• List of medical specialties