Wiesbaden. Germany’s healthcare system is relying increasingly on foreign doctors. Figures published by the Federal Statistical Office (Destatis) show that hospitals and practices in many parts of the country depend heavily on medical staff from abroad. As early as 2002 it was clear that Germany could no longer cover its demand for doctors from its own ranks. Poor working conditions in hospitals and practices are also pushing young German physicians to seek work abroad.
In 2024, 13 per cent of doctors – around 64,000 – did not hold German citizenship. Ten years earlier the figure stood at 30,000, or roughly seven per cent. Across the workforce as a whole, the share of foreign nationals reached 15 per cent in 2024, compared with nine per cent a decade earlier. Foreign doctors also account for a disproportionately large share of younger medical staff. In 2024, almost half – 49 per cent – of foreign doctors practising in Germany were younger than 35. Among German doctors, only 18 per cent fell into that age group.
A quarter from abroad
Including both human and dental medicine, doctors who have moved to Germany made up almost a quarter of the profession in 2024. In total, around 121,000 physicians – 24 per cent of the workforce – had a migration background. Some of those doctors have since acquired German citizenship.
Besides completing medical studies and obtaining a licence to practise in Germany, degrees gained abroad may also be recognised as fully equivalent. While that facilitates entry into the profession, it also raises questions about the standard of training. Around 7,000 doctors with foreign degrees received recognition as fully equivalent in Germany. About 1,400 of them were German nationals who had studied abroad. Many German medical students choose to take that route in order to bypass strict admission limits at home.
Light and shadow
The system has brought urgently needed staff into German hospitals and practices, but it also has a darker side. One of the most frequent complaints among patients concerns language barriers.
As early as 2024, a senior doctor at a hospital in North Rhine-Westphalia (NRW) told the newspaper Welt that the employment of foreign doctors in German hospitals was often associated with inadequate language skills and insufficient professional training. The physician insisted on remaining anonymous – a sign of another problem in Germany. Those who voice concerns publicly risk being denounced as far-right.
Yet the criticism itself was entirely legitimate. The issue, the doctor stressed, concerned only the quality of training and language proficiency. If the required standards were not met, he warned at the time, patient care could be put at risk. In simple terms, even a well-trained Syrian doctor is of limited help without the ability to communicate with an 80-year-old patient on the ward. According to the physician from NRW, many doctors come from countries where medical training often does not match German standards.
Careless authorities and employers
Another factor aggravates the situation further. Authorities and hospitals are sometimes surprisingly lax when checking qualifications. In Waldshut, in southern Germany, a case made headlines in which a 43-year-old woman applied for a medical position using a scanned diploma from the University of Salerno in Italy. The forged certificate presented her as a graduate of the programme ‘Medicine and Surgery’. She also submitted what was apparently a forged licence to practise issued by the Stuttgart regional authority. By sheer luck, no patients were harmed.
Perhaps the most serious recent case involved the attacker from Magdeburg, Taleb al-Abdulmohsen, who claimed to be a specialist in psychiatry and psychotherapy and worked as a ward doctor in a forensic psychiatric facility in Bernburg until, on 20 December 2024, he drove a car into the city’s Christmas market, killing six people and injuring more than 300. Reports suggested that the man, originally from Saudi Arabia, had repeatedly drawn attention in the clinic because of serious professional failures. There were even doubts as to whether he had studied medicine at all.
In 2019, the Regional Court in Kassel sentenced a 37-year-old Libyan man to five years in prison after he had worked as a doctor in several hospitals using forged documents and committed serious treatment errors. The man had assembled an extensive collection of falsified certificates and used them to deceive both employers and recruitment agencies. In Libya he appears to have undergone some form of medical training, but he failed the professional knowledge examination in Germany.
Alongside the questions of language proficiency and professional qualifications, the cases reveal a degree of criminal energy for which authorities and employers appear insufficiently prepared. Stricter checks are needed not only of language skills and professional qualifications but also of the authenticity of supporting documents.