WRITTEN QUESTION E-1941/96 by Martina Gredler (ELDR) to the Commission (16 July 1996)

Subject: Registration of an Austrian as a medical practitioner in Germany

Pursuant to section 3 of the Federal Medical Code a licence to practise independently as a medical practitioner is issued in Germany after 18 months of practical training as a medical practitioner. In Austria 36 months of training as a general practitioner is required.

A specific training structure is not prescribed in Germany. The rules merely state that, where possible, nine months should be spent in the non-surgical sphere and at least six months in the surgical sphere. Section 34a(4) of the Registration Code for Medical Practitioners requires a period of professional activity outside Germany to be taken into account provided that it is deemed to be of equal value.

In this specific case, an Austrian applicant, who had had a total of 18 months of practical training in Austria, comprising nine months on an internal medicine ward, four months on a surgical ward, two months on an accident surgery ward and three months in the teaching practice of a general practitioner, was refused a German licence by the District of Lüneburg in the Land of Lower Saxony on the grounds that he had not completed his practical training in Austria.

As Austrian and German practical medical training are deemed to be equivalent, should not both German and Austrian doctors who have completed 18 months of practical training in Austria be granted licences to practise as doctors in Germany?

Is this not a case of discrimination on grounds of nationality, which is prohibited by Articles 6 and 48 of the EC Treaty, or of disregard of the freedom of establishment?

What are this young doctor's prospects, after this rejection, of obtaining in Germany the training he wants in order to become a specialist, for which registration is normally required?

Answer given by Mr Monti on behalf of the Commission (5 September 1996)

The question put by the Honourable Member is actually concerned with the duration of specific training in general medical practice.

Council Directive 93/16/EEC of 5 April 1993 to facilitate the free movement of doctors and the mutual recognition of their diplomas, certificates and other evidence of formal qualifications ((OJ L 165, 7.7.1993. )) stipulates, in Article 31(1), that entry to such training is conditional on the successful completion of at least six years' study within the framework of the basic training course and that such training is to last at least two years.

Member States therefore organize basic medical training and specific training in general medical practice in accordance with their own concepts and criteria, provided that they meet the minimum requirements laid down in Directive 93/16/EEC. In the event, while satisfying those minimum requirements, the duration of the two types of training in question differs between Austria and Germany.

In order to benefit under the Directive, the migrant doctor must have completed his training in a Member State. The Directive provides for mutual recognition of diplomas, certificates and other evidence of formal qualifications awarded by Member States. Where the migrant doctor is unable to provide the authorities in the host Member State with evidence that he has completed his training in the Member State of origin or provenance, he does not qualify for automatic recognition or for direct access to the activities of doctor, such access also being denied him in his Member State of origin or provenance. However, the authorities in the host Member State are required, in accordance with the principles enshrined in the Treaty and in the case law of the Court of Justice, to examine the content of his training and, where appropriate, to impose compensatory measures.

In the case referred to by the Honourable Member, the person concerned must either complete his training in the Member State of origin or provenance, or comply with the compensatory measures proposed by the authorities in the host Member State.