DGIM calls for greater inclusion of general practitioner internists and university outpatient clinics in medical training

14.08.2023 13:48

In mid-June, the Federal Ministry of Health (BMG) presented a revised draft bill as a template for legislation on medical licensing regulations, which is expected to come into force in 2027. Even though the draft now addresses previous criticisms regarding the design of medical studies, the German Society for Internal Medicine (DGIM) still sees a need for improvement. This would continue to inadequately reflect the reality of primary care provided by internists in Germany. The DGIM has summarized all of the suggestions in a current statement and made them available to those responsible for politics.

With the “Master Plan for Medical Studies 2020”, the BMG started a process in 2017, as part of which, among other things, the medical licensing regulations are to be modernized. The revised draft bill published in mid-June is an important step on this path. “The submitted revision addresses key points of criticism of the previous draft, which speaks for a constructive and goal-oriented process,” says DGIM General Secretary Professor Dr. med. Georg Ertl, internist and cardiologist from Würzburg. Overall, medical studies in the future will increasingly focus on acquiring skills in the areas of science, digitalization and interprofessionalism. In addition, basic medical knowledge should be more closely linked to clinical content from the first semester onwards. “The connection of the scientific basis to the clinic and daily care practice makes its importance for science-oriented medicine clearer,” continues Ertl.

Need for clarification: General medicine is not the same as primary care

At the same time, however, the DGIM still sees a need for improvement. “The current draft still speaks of general medicine in many places and means primary care,” criticizes Professor Dr. med. Andreas Stallmach from Jena, who co-authored the statement as chairman of the DGIM's Training and Further Education Commission. “Today, 30 percent of primary care is provided by internists working as primary care physicians,” says the Jena expert. In order to correctly reflect the reality of care, it must be ensured that block internships in the area of primary care can also be carried out in internal medicine practices. Ultimately, compulsory training in practices poses numerical challenges to the healthcare system that can hardly be overcome even with the inclusion of internal general practitioner practices, adds Ertl.

Incorporate university outpatient clinics more into training

The current draft bill also stipulates that university outpatient clinics can take part in student training, but limits the proportion of training places to 10 out of 100 and to two years. “Here, in accordance with the AWMF and the Medical Faculty Association, we are calling for an increase to 30 percent in order to have sufficient outpatient capacity for student training,” says DGIM expert Stallmach. “University outpatient clinics make an important contribution to standard care and are characterized by their close proximity to research and science,” explains DGIM General Secretary Ertl. These are benefits that students can only benefit from, as they can acquire up-to-date specialist knowledge in university outpatient clinics.

In addition to the points mentioned, the DGIM sees further need for improvement, which it has outlined in its current statement. “The new regulation of medical training has long been an important concern in health policy. We are glad that the Federal Minister of Health is now addressing this and want to contribute to the success of the project with our statement,” says DGIM General Secretary Ertl in conclusion.

The full statement can be found here: https://www.dgim.de/fileadmin/user_upload/PDF/Publikationen/Stellungnahmen/20230719_Stellungnahme_Aerztliche_Approbationsordnung.pdf