On Germany

Discussion in 'Europe' started by NeuroFP, Jun 21, 2008.

  1. NeuroFP

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    I've got a few pertaining to Medicine in Europe...more specifically though, to Germany.
    I'm curious as to whether anyone knows a of a few websites that display physician income in Germany. I'm also interested in knowing this: if I get an MD in Germany, would it be recognized in the US? If not, how is medical practice in Germany? Some sites I've read state that many doctors leave Germany for Norway, Sweden, and the like because 'German medical school uncontrollably admit students.'

    Any help is greatly appreciated.
     
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  3. shreypete

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    Hey that's a great question. I wanted to know that too. Also how do Sweden and Norway pay their doctors? (I heard most of the Swedes are moving to Norway for jobs that pay better incomes). Is this after the tax cuts?
     
  4. Marsupilami

    Marsupilami New Member

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    Hi NeuroFP,

    I don't have any websites with info on incomes at hand right now. I'm currently studying medicine in Germany and am considering leaving Germany after graduation. Thousands of docs have left the country in the past years as incomes in private practices have been sinking. The perspective of owning a private practice is no longer there for most physicians, which means that most will be slaving away in hospitals for the rest of their lives.

    Yes, it's true, some have left Germany for Sweden, Denmark and Norway, others went to Switzerland, France, the Netherlands, UK, Austria, Australia, New Zealand or the US. We are everywhere :D.

    Due to this development, there is a growing shortage of physicians over here without any replacing docs from other countries in sight.

    Your MD will be recognized in the US, although you will have to take the USMLE.

    Hope this helps a bit.
     
  5. Marsupilami

    Marsupilami New Member

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    Again, I have no figures at hand, but I have been in contact with several docs in Norway and Sweden. Generally speaking, you won't get rich in these countries but you can certainly lead a very comfortable life as an MD. Docs rarely work more than 40h a week, have around 10 weeks of paid vacation per year. The major drawback with these countries is that as an IMG you will most likely end up in small villages (forget Stockholm or Oslo). Now combine this with long winters and a rather reserved population, it becomes clear that not every IMG is happy there !
     
  6. prefontaine

    prefontaine Senior Member

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    Doctors in Berlin strike over poor pay and conditions

    German doctors are threatening to abandon their jobs and move to the United Kingdom. The row over poor pay and working conditions began almost two weeks ago. More than 2200 doctors from Charité University Medical Centre in Berlin, Europe�s largest hospital, went on strike after hospital administrators refused to listen to demands for a 30% pay increase.

    Demonstrating in the streets of Berlin, the doctors�including physicians, interns, surgeons, and even heads of department�have been gaining public support with banners saying, "Patients perform your own operations," "Warning! Tired Doctors," and "England, we�re coming."

    Olaf Guckelberger, a surgeon at Charité aged 38, claims that medical staff at the clinic work an average of 36 hours overtime a week, and 90% of overtime is unpaid. He said, "If the doctors are suffering, then the patients suffer too." In many cases, employees work for as little as �3 (�2; $3.50) an hour, he said. Collectively, the medical staff at the hospital put in 85 000 hours of overtime each month, and this does not include time spent on call.

    Intern Katrin Koertner said, "The overtime we do is bad enough but worse is that it often goes unrewarded. We cannot claim money for it because there are work limitation regulations, and time off in lieu has to be taken within a couple of months. Most of the time we are short staffed and cannot take extra time off. If we did it would be detrimental to the patients." She added that it was a "joke" that hospital administrators wanted to cut a further 450 jobs.

    Dr Guckelberger admitted that many doctors would jump at the chance to work abroad; and the UK is one of the most popular destinations. "The average monthly wage for doctors at the hospital is �5500 a month before tax, but this takes into account higher paid staff such as senior consultants and department heads. Younger doctors and those lower down earn far less. The majority could earn double that amount in the UK. I for one would work there if the opportunity arose," he said.

    He and his colleagues also wanted to see a change in salary scales: "I�ve worked here since 1993 and am earning almost the same as when I started. Apart from one major rise after the first five years, salaries more or less stay the same unless you are made head of a department."

    Advice centres have also been set up for doctors, for interns in particular, to find out more about working conditions and pay in other countries. In Switzerland, an intern can earn as much as �6000 gross a month for a 50 hour week and also receive full pay for being on call, unlike in Germany, where they get only 80% of their salary when on call.

    Doctors in Germany are told that in Britain, doctors may only work a maximum of 56 hours a week by law; that medical secretaries are employed to write reports; and that time and a half is paid for weekend and night shifts.

    Since the strike began, the hospital has provided only emergency treatment, and numerous operations have been postponed. Health authorities are worried that the protests in the capital will send a signal to doctors in the rest of the country.

    The doctors� association, the Marburger Bund, has already called for nationwide strikes and warns, "If there is no reaction, then we�ll just carry on."
     
  7. shreypete

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    I heard that Sweden isn't paying it's doctors very well either which is the main reason why most of them are moving to Norway. What about Norway? As an IMG, you can't work in cities like Oslo or Bergen or Tromso?
     
  8. Marsupilami

    Marsupilami New Member

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    Cost of living is markedly higher in Norway than in Sweden ( Oslo e.g. has been voted as the most expensive city in the world a numerous times!). The only way of really profiting from the higher Norwegian salaries is to work in Norway and live in Sweden, which some doctors I know do, or do locums in Norway for a certain time period, imho.

    It is certainly not forbidden to work in Oslo as an IMG once you obtain a residence permit :D The problem is...everyone and their uncle wants to work there, as an IMG you will simply be at a major disadvantage when competing for jobs.
     
  9. shreypete

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    I don't get it. I didn't really think that in these countries, the term IMG carries a lot of weight because one of the primary requirements to work in these countries (or even to do an apprenticeship program there) is that we need to have an excellent command of the language. So how can they make such a distinction once we've learned the language up to a native language level and obtained a residence permit?

    What do "locums" mean?

    and what do you think is the best country in Europe to practice in? in terms of financial benefit as well as workplace satisfaction?
     
  10. prefontaine

    prefontaine Senior Member

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  11. shreypete

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    Why Malta? Could you please elaborate your opinion?
     
  12. Marsupilami

    Marsupilami New Member

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    Hello Pete,

    just look at it this way...why should the situation for IMGs in Norway, Sweden etc. be any different than in the US ? An IMG wanting to work in the US usually has to overcome many more obstacles in order to get a job. A British trained,(UK) board certified Anesthesiologist with say 10 years of experience on the job is required to pass the USMLE despite of having gone through rigorous testing in his home country, and, what is even worse imho, to start from scratch by going through residency again, even if he was an experienced attending (consultant) in his home country. In addition to that, he will usually need better Step I+II scores than his American competitors and will less likely match at competitive programs. Now, I'm not complaining, that's just the way it is.

    So coming back to Norway as an example, employers will usually prefer a native applicant who has been educated in the system over an IMG. Once you have worked in the country for some years though, know the system, it will be much easier to relocate to more attractive regions. But let's not forget that even a lot of Norwegian docs are having a hard time getting jobs in Oslo. Same is true for London, Paris etc...
     
  13. shreypete

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    That makes sense. I was just under the impression that medical graduates who've received a degree from an EU country wouldn't have much of a hard time to practice anywhere in the EU...I guess it only applies for the EU citizens.

    So in your opinion Marsupilami, which country in Europe do you think is most ideal for doctors to practice in? I'm pretty much set on giving the USLMEs and return back home but I just want to have another back-up too.

    Thanks for you reply.
     
  14. Marsupilami

    Marsupilami New Member

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    Hello Pete,

    not even for EU citizens is it that easy to get jobs in another country. Legally, of course, yes...but convincing the employer that he should choose a foreign MD over e.g. 5 local competitors won't be easy. Especially, if you are coming directly out of med school. With some work experience, however, it becomes easier to apply since you will be more attractive.

    Which country to chose ? I know some ( board certified) MDs who went to France, and they love it there. Pretty good salaries and excellent €/h relationship, they work about 40h/week at maximum. Hard though to get a residency training spot as you will be required to pass an additional test, even with EU diploma. ( "Concours something").
    Other good places for MDs are Belgium and the Netherlands. Getting residency spots is supposed to be tough in the Netherlands. Other countries I would rank high are Sweden and Norway.

    I don't know where you are studying, but have you considered the UK or Ireland ? Some time ago I had plans of going to the UK after med school, but all I hear now is what a mess the job market is for med school graduates and how many British MDs are leaving for Australia.

    Best regards,
    Mars
     
  15. shreypete

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    Hey Maruspilami, I study in Prague, Czech Republic and yes I've considered UK but the system is just getting harder and harder for non-EU citizens and for those who've studied in other EU countries. I'll do a bit more research on France, Netherlands, and Belgium (I did read somewhere that Netherlands is a very good country for doctors but I've heard better things about Norway).
     
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  17. This should give you an idea...

    valid for employed physicians at municipal hospitals from January 1st, 2009 (salaries differ if it's a private or a university hospital)

    Resident (residency takes between 4 and 6 years in Germany):
    1st year: 3662€
    2nd year:
    3870€
    3rd year: 4018€
    4th year: 4275€
    6th year: 4582€

    specialist:
    1st year:
    4834€
    4th year: 5239€
    7th year: 5595€
    9th year: 5802€

    assistant medical directors:
    1st year:
    6055 €
    4th year: 6410 €

    deputy of the chief physician:
    1st year:
    7122 €

    To give you numbers of medical pratices is difficult, as they depend on the town on the specialty.
     
  18. MSHell

    MSHell Deranged User

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    I assume these are monthly salaries?
     
  19. Yes, monthly gross salaries, in Germany you'll be paid monthly.
     
  20. shreypete

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    I think these salaries are better than what an American gets but are these the salaries after tax cuts...?
     
  21. MSHell

    MSHell Deranged User

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    Gross, not net.
     
  22. Marsupilami

    Marsupilami New Member

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    Hi Pete,

    I've been to Prague several times and also drank a few pivos there...a beautiful city :thumbup:
    Yes, it is hard to get into the British system, unfortunately. Regarding Norway, it is certainly a very good country to both work and live in, and Sweden is worth a look as well.
     
  23. NeuroFP

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    Thank you all so much for your priceless statements.

    All of those numbers, percentages, and words help a great deal.

    However, one proposition that I've found to be rather interesting is this: it seems as though doctors or medical students from almost every nation want to leave there home land and go to another. For example, the British are going to Australia, Germans is going to the UK, so on and so fourth.
     
  24. Dr.Millisevert

    Dr.Millisevert Senior Member

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    agreed. Basically from what I can tell.. all the eastern european docs are moving to the UK.. and actual UK medical grads are all moving to Australia and New Zealand to train and work now.
     
  25. Marsupilami

    Marsupilami New Member

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    Yep, it's crazy. Around 20k German docs are currently supposed to be practicing abroad.
     
  26. Carter0891

    Carter0891 Watching from Afar
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    I hate to bring current politics into the mix, but I am very curios to know; As medical professionals examining foriegn employment opportunities, do any of you guys see a correlation between countries with universal healthcare systems and poor MD compensation?

    I lived in Germany and I found that the standard of care was relatively lower, in my opinion due to over worked, under paid doctors and hospitals so desperate for income, they prioritized people with private insurance over those who had none. A friend of mine presented with levine's and chest pain, with a hx of heart cond. and waited for 6 hours in the ED half naked.

    Just curious as to what your opinions may be, especially as the US moves towards a universal system.
     
  27. Freibi

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    That is by no means more than you would get in the US, especially if you subtract about 50% for taxes!
     
  28. shreypete

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    But nevertheless, despite the tax cuts, American specialist doctors do make more than their European counterparts. This is a known fact.
     
  29. Marsupilami

    Marsupilami New Member

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    Most German docs pursuing their residency in the US say that they end up having less in the States due to cost of living being higher. Comparing raw numbers can be very misleading.

    However, what counts in the end is the salary you can expect after residency imho...which is almost always higher in the US.
     
  30. Nurseneely

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    you must not have been to germany lately, i have lived there several years, and travel at least 2x/yr there. Since the introduction of the Euro, the cost of living has increased dramatically!! I am 28 and most of my peers and friends either have to live with family or with roommates, you just cannot afford to live alone.
    German doctors get paid squat during residency AND after in Germany compared to the US. It would be rare for a Germany doc to make 200-500,000+/year like many do here.
    Doctors have been on strike several times over the past few years.

    The problem is Socialized medicine and providing healthcare for any and everybody in the country, when the government is left to foot the bill, they are going to cut costs where ever they can, this leads to ~50% tax of all wages and decreased wages for healthcare workers.
    Even though Medical school costs basically nothing in Germany, even with the new fees of 1000 Euro/year, this is nothing compared to the cost of a US Med education, it is still an outrage what docs are paid in Germany.
    Same for nurses. I have a friend who has to work all shifts as a nurse and makes ~2000 Euros, takes home about 1000 Euros right now that's $1500/mo.
    i worked as a nurse only 32 hours/week and made close to double that..

    i hope people realize this and don't vote for socialized medicine in the US!
     
  31. Marsupilami

    Marsupilami New Member

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    I have talked to several German residents on my last clerkship about finances...a resident in his third year told me he was making 3k EUR/ month after taxes. Of course, this is only possible due to the massive overtime he does ( works around 70hours per week). If you are lucky and train in the right hospital, overtime is paid ( still not the norm in Germany, though). Resident salaries have improved in the last few years as the shortage of physicians is increasing steadily. While the salary during residency can vary quite a bit in Germany, I am very certain that on average it isn't less than in the States.

    You are right though in that the cost of living in Germany has gone through the roof since the inception of the Euro. However, I believe that some things are still cheaper over here, such as rents.

    As far as salaries of attendings are concerned...you will never get close to US levels...only as a family physician, perhaps.
     
  32. koustubha

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    thanks every one
     
    #30 koustubha, Nov 10, 2008
    Last edited: Nov 13, 2008

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