Entstehung und Regelung ärztlicher Fortbildung in Deutschland

Abstract

During the investigation period of 1949 to 1990, the formerly common educational system in Germany was developed in two different political systems. In the Federal Republic of Germany (FRG), professional political structures and a medical self-government system were linked to state medical chambers, while in the German Democratic Republic (GDR) medical and scientific societies had worked without professional organizations. Medical training in the FRG is based on a "voluntary duty" of the doctor for continuing education. In the GDR, there was a further education obligation, namely a medical specialty, as well as a compulsory education, known as obligatory peripheral training (OF).
 The development stages of medical training in the GDR and in the FRG are also linked to a certain extent by political incentives. Four phases can be identified for the GDR: orientation (1949-1960), reform (1961-1970), consolidation (1971-1988) and dissolution of the institutions (1989-1990). For the FRG, two stages can be distinguished: consolidation (1949-1960) and orientation (1961-1990).
 The system-related training factors also play an important role in the common history. The discussion about the distinction between education, Continuing Medical Education (CME) and further education developed in the imperial age on the basis of the idea of offering free medical training and founding academies of CME. These, however, were seen as a competition for the universities and their expansion at this time was repulsed. In the Weimar period, a general definition could be found, which separated further education and training in their function. Continuing education represented a continuous lifelong updating of knowledge and further education served the acquisition of the title for a special medical field. Governmental support for further medical training by the Central Committee for Medical Training in Prussia was also viewed critically, as well as the question of making this medical duty more controllable by requiring proof. This debate ended abruptly with the national socialist rule, which, according to the “Führerprinzip”, introduced a requirement for CME.
 In summary, it can be said that the state, (professional) political and economic impact on continuing medical education is closely linked to the structural conditions of the respective national framework conditions.