January 31-2014
Germany is relying more on foreign doctors to fix a crunch in its healthcare system but a notoriously daunting language barrier is complicating matters.
State authorities and industry groups are pushing for stricter language tests for new arrivals to ensure that doctors can adequately communicate with Germans in their care.
Germany is streamlining immigration and certification rules to attract foreign doctors. But critics say the language requirements in most of Germany’s states do not guarantee this influx of foreign doctors can talk with and understand patients.
“It’s a problem, a growing problem in Germany,” Hartwig Meyer, a lawyer and head of the German Patient Protection Association, told Agence France Presse (AFP). “There are many doctors who come from abroad, and they speak only very poor German.”
The percentage of foreign-born doctors practicing in Germany has tripled in five years to about 15 percent in 2012 from just five percent in 2007, according to the German Medical Association
Many foreigners learning German complain of the devilish complexity of its grammar and vocabulary, with language a key obstacle for Germany in trying to fill a critical skilled labor shortage.
Iranian-born doctor Hengameh Bigdeli, 45, took a six-month intensive German course before starting work near Nuremberg, but still found the language’s structure frustrating.
“When I first started working, I was really worried that there would be an emergency and I wouldn’t be able to understand the patient,” Bigdeli said. “But when I had a problem, I asked the patient to repeat, to speak clearly and slowly, and they repeated and repeated until I could understand.”
After two months working, Bigdeli said she no longer had any communication problems.
But because of licensing differences between Iran and Germany, Bigdeli, who immigrated to Germany three years ago, must work as an assistant doctor.
“After 14 years of working independently, having my own practice in Iran, it was hard to be like a student again, working under a supervising doctor, never being able to make decisions alone. It’s hard, but better than nothing.”
Germany has a particularly acute need for doctors from abroad as their local counterparts age and retire, but “it’s hard for patients, because they worry that their doctor doesn’t understand them,” said Armin Ehl, managing director of the doctors’ union, Marburger Bund.
“There are some medical departments in rural areas, where besides the head doctor, there are only foreign doctors,” Ehl, whose organization is lobbying for a standardized, nationwide language test for immigrant doctors, told AFP.
Fluid European Union borders mean migration among doctors from the 28 member states has become commonplace. Fears of quality of care are growing.
In Britain, a patient died in 2008 after a German doctor, Daniel Ubani, administered an overdose of painkiller on his first shift there. Following the accident, British officials announced last year they plan to require English tests for immigrant doctors.
Sweden’s medical association is asking for a review of its language policies, which currently only require proof of proficiency for those educated outside the EU.
Austria requires mock-patient interviews for immigrating doctors.
In Germany, language requirements for foreign-trained doctors are set by each of its 16 states. Most require a certificate proving German ability at least at the common European “B2” or “upper intermediate” level, according to Ehl, but not a separate test of medical terminology.
“Someone who has a B2 certificate can certainly buy a sausage, or a train or plane ticket in Germany, but there is no guarantee that he can communicate with a patient,” said Juergen Hoffart, head of the medical association for Rhineland-Palatinate, which last year became the first state to require German tests with mock patients.
Meanwhile, Germany’s state health ministers agreed last summer that a uniform review process for language skills should be developed.
