Career Steps in German Academic Plastic Surgery (2011)

Sir: Academic plastic surgery is essential for the future of our surgical expertise. However, from a transatlantic perspective, career steps in academic plastic surgery in Germany are substantially different from those in North America. Depending on the medical university, requirements have been instituted to obtain the next academic degree after medical doctor, the “privatdozent (P.D.)” in Germany, which usually takes approximately 6 to 8 years of publishing. After successful initiation as a privatdozent, one might apply as “professor” 2 to 6 years later, again depending on the performance in terms of publications, research, and education. On the basis of Humboldt's triad (clinic, research, education), the applicant has to fulfill several requirements which, notably, differ substantially throughout the German medical universities for both privatdozent and professor. We have analyzed the current requirements for obtaining the academic degree privatdozent at German medical universities with plastic surgical departments or subdepartments. To date, among 46 university hospitals in Germany, there are only nine independent plastic reconstructive surgical departments and four additional plastic surgical subdepartments in trauma surgery departments (one plastic surgical university department for each 6.3 million citizens).1 This analysis revealed that within the past 5 years, 24.8 million was received from federal grants by academic plastic surgical departments in Germany. Notably, there are no uniform requirements in Germany to obtain the career steps privatdozent or professor. As far as publication requirements for privatdozent are concerned (Table 1), 33 percent of the independent departments and 25 percent of the subdepartments for plastic reconstructive surgery give clear requirements, such as eight or more first authorships, whereas others are not clear in this regard. One university (Aachen) requires a cumulative impact factor of 15, with eight first authorships. Currently, no medical university with a plastic surgical department requests a certain amount of nonindustrial or industrial funding. However, especially nonindustrial funding from the German authorities (German Research Foundation, German Federal Ministry for Education and Research) is key in this regard. As far as education is concerned, lectures are requested regularly by all universities. The range of education requires most often 2 to 24 years of continuous education, partly with 2 hours per week. Some universities such as Hannover Medical School have started initiatives to endorse education by programs such as “active in education,” a 200-hour program to promote educational techniques. All universities require that a mandatory thesis (Habilitationsschrift) accompany the application. As far as the minimum required time interval from doctoral thesis to application for privatdozent is concerned, 54 percent require a completed residency as plastic and aesthetic surgeon, which takes at least 6 years in Germany. In Erlangen, one may apply 4 years after the doctoral thesis during residency, whereas the others are not explicit in this regard.Table 1: German University Requirements to Obtain the Academic Degree Privatdozent Based on Habilitation at Nine Independent Departments and Four Subdepartments for Plastic and Reconstructive SurgeryThus, given the aforementioned differences in the academic career steps in Germany, one might consider a more uniform career planning in academic plastic surgery in Germany. Karsten Knobloch, M.D. Heiko Sorg, M.D. Peter M. Vogt, M.D., Ph.D. Plastic, Hand, and Reconstructive Surgery Hannover Medical School Hannover, Germany