Medical students across Germany are calling for better pay and more structured teaching during the Practical Year, the final 12 months of medical school, when students work in clinics under supervision. They also want a wider reform of medical education, including an updated training framework that places more emphasis on practical skills.
Experiences during the Practical Year vary by hospital, department and supervising doctors, student representative Marius Moniak said. Students often face financial hardship, limited involvement in medical work and little time for teaching, he said. The Federal Association of Medical Students in Germany held a week of actions last week under the slogan “SOS – Stagnation or Top-Level Medicine?”
At Frankfurt University Hospital, students receive a monthly allowance of €399 for full-time work. Medical student Marlene Wenzl said the amount was not enough to live on. A study by the Moses Mendelssohn Institute and WG-Gesucht puts the average monthly cost of a room in a shared flat in Frankfurt at €630.
Wenzl said some students take weekend shifts or night duties, while others take out loans during their final year. This leaves them with less mental capacity to learn clinical skills and subject knowledge, she said. Students want the allowance to be at least equivalent to the current maximum BAföG student-support rate of €992 a month. Wenzl said some university hospitals already pay that amount.
Goethe University’s medical faculty said it understood students’ financial concerns, but the allowance is paid by the teaching hospitals, which receive no reimbursement for it. The faculty also cautioned that an increase could reduce BAföG support or lead to the loss of family health insurance for students with limited means. Any solution, it said, should ensure that those needing the most financial support are not disadvantaged.
The students’ demands have support from some clinical teachers. Björn Steffen, a senior physician and teaching coordinator in internal medicine, called on the university hospital to provide the space, time and resources needed for good teaching. It should not depend on staff volunteering after patient care or research duties, he said. Steffen also backed fairer pay, arguing that students often take on tasks similar to those of student assistants and that compensation closer to €1,000 would be more appropriate than €399.
Students say the problems extend beyond the Practical Year. They want a new medical licensing framework, which sets the structure and content of medical studies, to give greater weight to practical training. The last major reform of the degree was adopted in 2002, said Márk Möller, the association’s Practical Year coordinator. Students also want more competency-based teaching instead of a focus on memorised facts, structured instruction during the Practical Year and joint classes with nursing and other health professions, association vice-president Aljoscha Lorentz said.
A draft reform has been delayed by financing questions. The Health Ministry published an initial draft in 2020 and a revised version in 2023, based on the 2017 “Master Plan for Medical Studies 2020.” The student association says it has been pressing for an update for around a decade.
A regulation that took effect on November 1 allows up to ten days of absence from the Practical Year due to illness and is intended to make higher allowances possible. Lorentz said, however, that many problems remain, and students will continue their protests. The association says a fairer Practical Year would benefit current students, while a new licensing framework would also help future cohorts and the patients they will treat.
Sources: FAZ.