Despite coronavirus, foreign doctors struggle to get degrees recognized in Germany

March 31, 2020

In the middle of a pandemic that is threatening to overwhelm Germany’s health care system, Ben, a Berlin-based surgeon from Poland, spends his evenings stitching up cow intestines that he buys from his local supermarket.

“Specialist surgery is like driving a car,” the 34-year-old, who holds medical degrees from universities in Libya and Egypt, explained to DW. “When you don’t drive your car for a while you forget how to drive. So I bought some intestines from the supermarket and I am stitching it in my home.”

Ben, who did not want to give his full name for fear of prejudicing authorities evaluating his application, spent 10 years as a general surgeon before moving to Berlin last year. With his European Union passport, he had no trouble moving to Germany, but endless stress finding a job.

“I am an assistant lecturer,” he added. “I used to teach medical students in Libya. I have a lot of experience in my field, and I am losing my experience.”

Read more: Germany recognizing more foreign degrees

Spahn at a press conference (Reuters/F. Bensch)

Spahn called on a trio of states to reconsider a decision not to recognize Polish medical degrees

The coronavirus outbreak has injected a new urgency into the issue, as Germany’s health care system faces a sharp rise in cases. Last week, Health Minister Jens Spahn wrote to three state governments urging them to reconsider a decision they made last year not to automatically accept Polish medical degrees, following an EU directive that highlighted discrepancies between the two systems.

“Independent of a final European legal assessment of this solution, I would consider a pragmatic approach from the authorities appropriate,” Spahn wrote in the letter, quoted in German media.

Tough exams

But that isn’t much use to Ben, who is working as a medical orderly in a hospital as he bounces between two authorities: The Berlin Health Department and the Berlin Ärztekammer, or Medical Council. At the moment he has been waiting for four months for a paper from the former to take to the latter, who will set him a German medical language exam, one of three he has to pass before he can get his license. “It is very time-consuming and money-consuming,” as he puts it.

The process can take up to 18 months, according to Sameer, a Syrian doctor who came as a refugee, successfully passed and now works as a junior doctor. The long delays cause extra worries about residency and work permits, and applications can cost several thousand euros in administrative fees, language courses and exams, depending on the bureaucracy in the given German state.

“The bureaucracy gets more and more complicated,” said Sameer. “In Germany, for every exam you need an appointment, but it can take a year, because there are a lot of applicants and a limited number of doctors who can do it.”

But Sameer and Ben know several potential doctors who gave up and left the country.

“A friend of mine from Libya went back a month ago — he’s a specialist in intensive care,” said Ben. “These kinds of doctors right now are needed in Germany, but he said, ‘I lost too much money waiting.'”

“Why did I come to Germany?” Ben continued. “I heard it was the best place you can achieve your dreams as a surgeon. I want to improve my skills, and I will give something back to Germany: I will give myself to treat the German people.”

Read more: Opinion: How many deaths can we afford?

Tortuous bureaucracy

There’s one simple reason why the bureaucracy takes so long, said Stephan Schiele, of Tür zu Tür (“Door to Door”), a Bavarian integration project: “The appropriate authorities are hopelessly understaffed.”

But there are also bureaucratic reasons: Each applicant’s qualifications are assessed individually: that is, the authority appoints an assessor who has three months to decide what the foreign qualification entails, and what it might correspond to in the German system.

Read more: Germany to centralize supply chains, set prices on masks, protective gear

There has been some recent effort to expedite the process, at least with nursing: Pilot projects have started vetting entire foreign nursing schools, rather than individual qualifications.

“We’re moving in that direction with the doctors too, but of course it takes a while because you have to look more closely at the courses,” said Schiele.

At the same time, as he acknowledged, “Medical training is a sensitive point: Imagine if we allowed doctors into the clinics without recognition. As soon as there was some kind of problem, people would scream blue murder.”

Doctors in protective gear taking blood samples from patients with COVID-19 symptoms (Getty Images/S. Gallup)

A German state has called for foreign doctor applicants to help — but only with coronavirus tests

Political urgency

Despite the impending shortage of doctors, the bureaucracy can’t simply be expedited, pandemic or no pandemic. In mid-March, the Saxony medical council posted an appeal on Facebook for foreign doctors without a work permit living in the state.

In a statement to DW, the council said that about 200 foreign doctors had responded to the call, but clarified that they would not be deployed to work as doctors. Instead, they would be asked to man the coronavirus hotlines, carry out tests and work as nurses. “This is not associated with an (accelerated) recognition (of qualifications), and that isn’t being planned,” the statement said.

Read more: Rush to develop coronavirus rapid tests

A spokesperson for Berlin’s Medical Council said in an email that the capacities of the council itself were limited because of the current situation, and therefore it was “not realistic” that foreign doctors could suddenly be fast-tracked into hospitals. The Berlin Health Department, the LaGeSo, struck a similar tone, saying that states could not unilaterally change guidelines without consulting other states. But its statement added: “We continue to be making an effort to find all helping hands for the next weeks and months, including the not-yet approved doctors.”

Sameer, for his part, understands the reluctance to throw bodies at the frontline in the current crisis, but still thinks the bureaucracy is painfully slow.

“I have a lot of friends in Berlin who finished the German and are dying to do the exams, and the next appointment is in a year, or even 18 months,” he said.

Solidarity and humor in the coronavirus crisis

Bear hunt

With schools and kindergartens closed for weeks, kids can get bored. To keep them amused, thousands of Belgians and Dutch have put cute teddy bears in their windows — it’s bear-spotting time! Many bears are registered on interactive maps so parents can plan their family outings along the route that has the most teddy bears.

Solidarity and humor in the coronavirus crisis

The most vulnerable

Elderly people are often hit harder by an infection with SARS-CoV-2 than younger people. To protect them, supermarkets in many countries are offering special times for senior citizens, allowing them to shop in relative safety.

Solidarity and humor in the coronavirus crisis

Brightening everyday life

Turkey has taken a different tack, imposing a curfew for people older than 65 or chronically ill — for their own protection. In the city of Mersin, 25-year-old Zulkif Cengiz has been playing a few tunes to pass the time for elderly people staying at home. In other countries, people sing in front of nursing homes, where residents are not allowed to have visitors to avoid infection.

Solidarity and humor in the coronavirus crisis

Positive approach

Many Italians have been confined to their apartments for weeks. Emergency measures are to remain in place until at least mid-April. But they haven’t lost heart. Posters with a colorful rainbow and the slogan: “Andra tutto bene” (“Everything will be fine”) are hanging in windows and from balconies across the nation.

Solidarity and humor in the coronavirus crisis

‘Italy, we are with you’

Solidarity still exists. In Beslan in southwestern Russia, people lit candles (above photo) to show their solidarity with Italy, one of the nations worst-hit by the coronavirus pandemic. In Paraguay, Poland and Bosnia-Herzegovina, buildings were lit in green, white and red. In China, a tricolored bus has taken to the streets whose handholds and seatbacks bear the words “Cheer up, Italy.”

Solidarity and humor in the coronavirus crisis

Hope on the horizon

Switzerland is also sending a message of solidarity. True to the motto “light is hope,” bright messages beam from the Matterhorn, that highly symbolic Swiss mountain. But “#hope” alternates with “#stayathome” — the call to take the pandemic seriously and not go out.

Solidarity and humor in the coronavirus crisis

Let’s pretend we are on holiday

The pandemic cost Adas Vasiliauskas his regular job. Don’t despair, the Lithuanian photographer thought. Instead, he used a drone to take snapshots of how Lithuanians are spending their time at home during the curfew. Looks like fun: sunbathing on the roof, exercising on the balcony, dressing up or dreaming of the next holiday.

Solidarity and humor in the coronavirus crisis

Animals suffer, too

Public life has also come to a halt in Bangladesh. For animals that feed on garbage and leftover food, it is a problem when people no longer go out to eat. Volunteers in the capital, Dhaka, have taken to feeding stray dogs. In Germany, the Animal Welfare Association has warned that pigeons in the cities face starvation.

Solidarity and humor in the coronavirus crisis

Show appreciation

Medical staff in many countries have been working at the absolute limit for weeks. Some Europeans stand at open windows and on balconies in the evening to applaud the doctors and nurses. Pakistanis wave white flags to pay tribute to the medical staff. But there is a more effective way of showing appreciation and that is by staying at home to slow down the pandemic.

Solidarity and humor in the coronavirus crisis

DIY face masks

All over the world, volunteers are sewing simple face masks. They may not necessarily protect the wearer from infection, but if tied properly over mouth and nose, they can help to prevent the virus from spreading. The masks these Armenian-Syrian women produce are distributed among the poor in Aleppo.

Solidarity and humor in the coronavirus crisis

Fighting infection through art

Helping by doing what you do best definitely applies to the RBS Crew graffiti collective in Senegal. With their works of art on walls in Dakar, they are showing the population how they can stem the spread of the coronavirus. Sneezing into the crook of your arm is one of the important rules for protecting others.

Solidarity and humor in the coronavirus crisis

A sense of humor

Reuben Ward sauntered around the US capital, Washington D.C., dressed up as a huge, scary Tyrannosaurus Rex. “It was an entertaining way to distract people a little from the coronavirus and cheer them up,” the 29-year-old said. His message: Even if the situation is serious, you need to keep a sense of humor.

Solidarity and humor in the coronavirus crisis

Sweet distraction

In Germany, coronavirus-related humor tends to be linked to food. Check out the “antibody” coronavirus chocolates, cakes shaped like rolls of toilet paper and chocolate Easter bunnies complete with face masks. But it wouldn’t be Germany if there wasn’t something to complain about: Critics argue that the merchandise is in bad taste.

Solidarity and humor in the coronavirus crisis

Toilet paper bonus

Toilet paper is in great demand in many countries. A restaurant in a town in the US state of Minnesota adds a roll of the precious product to every take-out order over $25 (€22). “When the customers get their order, you hear a genuine laugh and that’s the best thing right now,” the owner told FOX 9. It’s also a clever marketing strategy.

Solidarity and humor in the coronavirus crisis

Clown or president?

Reactions to the crisis are also satirical. Aira Ocrespo is not the only one to criticize Brazilian President Jair Bolsonaro for his lax approach to the pandemic. As the artist sees it, a red clown nose is the only facial protection the president wears against the coronavirus.

Author: Uta Steinwehr