NHS attracts German doctors
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《英国医生杂志》
More than 2000 German doctors are registered to work in the United Kingdom, despite nearly 5000 vacancies in Germany.
Around 350 partial and full registrations are being granted every year to German doctors, although a third of hospitals in Germany are considering introducing waiting lists because of a shortage of medical staff.
A report in Clinical Medicine (2004;4:57-9) says that German doctors are attracted by a range of factors, including systematic postgraduate training, better working conditions and pay, and opportunities for professional development.
"Such qualities are easily overlooked amid the near universal criticism of the NHS as an employer," says the report, by Dr Marcus Simmgen, a Wellcome Trust research fellow at Imperial College, London, who came to work in the United Kingdom from Germany.
"Criticism of the NHS is commonplace in the UK. Yet, 2350 German doctors are currently registered with the GMC, the largest group of European doctors in the UK. In Germany, with a third of hospitals actively considering introducing waiting lists because of a shortage of medical staff, much could be learned from the British approach," he writes.
The report says that while most UK doctors strive to be memorable teachers to the next generation, the hospital environment in Germany is more competitive. "Asking for help in Germany tends to be considered an admission of lack of knowledge and thus creates barriers. In the UK, advice from even very distinguished doctors is easy to obtain and there is rarely any hesitation in engaging in an educative conversation."
And it says that in the United Kingdom clinical practice comes much sooner, while German medical training focuses mainly on theory.
Rotation in the United Kingdom gives an opportunity to try out different specialties, but in Germany specialisation can begin immediately after qualification. "Most doctors will only ever have worked in a few hospitals and have limited exposure to different case mixes and styles of work," writes Dr Simmgen.
Another advantage of the UK system, says the report, is that a major part of doctors?routine workload has been transferred to nurses and other staff, while German doctors spend a large proportion of their time doing phlebotomy, cannulation, first administration of intravenous drugs, blood transfusion, and electrocardiography recording.
However, the report also points out that years of comparative underinvestment in the NHS have taken their toll. "Many hospitals are in some state of disrepair and as a result the environment appeals to neither patients nor the workforce." Limited use of information technology, a frailty of other types of infrastructure, and an adherence to the nine to five working day often contribute to inefficiencies in the system, it says, while long waits for inpatient investigations that are readily available in German hospitals "can be disheartening."
A spokesman for Bundesarztekammer, the German medical association, said that 184 UK doctors were registered in Germany at the end of 2003, an increase of 10 on the previous year. He said that 83 were working as hospital doctors and 47 in general practice. The remainder were in public health and other areas.(Abergavenny Roger Dobson)
Around 350 partial and full registrations are being granted every year to German doctors, although a third of hospitals in Germany are considering introducing waiting lists because of a shortage of medical staff.
A report in Clinical Medicine (2004;4:57-9) says that German doctors are attracted by a range of factors, including systematic postgraduate training, better working conditions and pay, and opportunities for professional development.
"Such qualities are easily overlooked amid the near universal criticism of the NHS as an employer," says the report, by Dr Marcus Simmgen, a Wellcome Trust research fellow at Imperial College, London, who came to work in the United Kingdom from Germany.
"Criticism of the NHS is commonplace in the UK. Yet, 2350 German doctors are currently registered with the GMC, the largest group of European doctors in the UK. In Germany, with a third of hospitals actively considering introducing waiting lists because of a shortage of medical staff, much could be learned from the British approach," he writes.
The report says that while most UK doctors strive to be memorable teachers to the next generation, the hospital environment in Germany is more competitive. "Asking for help in Germany tends to be considered an admission of lack of knowledge and thus creates barriers. In the UK, advice from even very distinguished doctors is easy to obtain and there is rarely any hesitation in engaging in an educative conversation."
And it says that in the United Kingdom clinical practice comes much sooner, while German medical training focuses mainly on theory.
Rotation in the United Kingdom gives an opportunity to try out different specialties, but in Germany specialisation can begin immediately after qualification. "Most doctors will only ever have worked in a few hospitals and have limited exposure to different case mixes and styles of work," writes Dr Simmgen.
Another advantage of the UK system, says the report, is that a major part of doctors?routine workload has been transferred to nurses and other staff, while German doctors spend a large proportion of their time doing phlebotomy, cannulation, first administration of intravenous drugs, blood transfusion, and electrocardiography recording.
However, the report also points out that years of comparative underinvestment in the NHS have taken their toll. "Many hospitals are in some state of disrepair and as a result the environment appeals to neither patients nor the workforce." Limited use of information technology, a frailty of other types of infrastructure, and an adherence to the nine to five working day often contribute to inefficiencies in the system, it says, while long waits for inpatient investigations that are readily available in German hospitals "can be disheartening."
A spokesman for Bundesarztekammer, the German medical association, said that 184 UK doctors were registered in Germany at the end of 2003, an increase of 10 on the previous year. He said that 83 were working as hospital doctors and 47 in general practice. The remainder were in public health and other areas.(Abergavenny Roger Dobson)