Medicine International: Dealing with Immigrant Doctors in German Hospitals as an Organizational Ethical Challenge

In 2017, 45,370 doctors with foreign citizenship were practicing in Germany, which is about 12% of all working doctors in Germany. The number of foreign doctors has more than doubled in the last decade, not least due to the increasing shortage of doctors. In many countries with high immigration rates, research has long been conducted - in contrast to Germany - on the integration of migrated health care personnel. The international literature describes that migrated physicians or their colleagues are confronted with various barriers to integration. However, the findings from other countries cannot be transferred to the German context without further ado, since, among other things, the health and training systems are structured differently and this results in different problem constellations for which other approaches can prove to be effective. When this work was started, no empirical studies were available for the German context on challenges in the integration of migrant doctors in Germany and on the experiences of those involved in the integration. The present dissertation aimed to close this research gap in order to lay the foundation for the development of adequate integration measures.
The aim of the research project on which this dissertation is based was to gain a better understanding of how the integration of migrant physicians in Germany presents itself and what makes integration more difficult in the German context. Specifically, the overarching question was: What are the challenges of integrating migrant medical staff in German hospitals? Integration must always be realized from two sides - the migrated physician himself, but also relevant actors of the receiving health care system. Accordingly, both perspectives must be included if the challenges are to be understood and appropriate integration measures developed. This research project should therefore reflect both perspectives. Accordingly, the doctoral project is divided into two partial studies. An interview study with migrated physicians was conducted to understand the challenges they face if they (want to) practice in German hospitals. The second study dealt with the perspective of relevant actors of the receiving system on migrated physicians and their integration. Relevant actors were considered to be persons who either work directly with migrated physicians or who are familiar with the situation of migrated physicians in Germany due to their political activities and can indirectly influence their experiences through structural changes.
Both studies have been published in open access. References and links can be found below:

Klingler C, Marckmann G. Difficulties experienced by migrant physicians working in German hospitals: a qualitative interview study. Human Resources for Health. 2016;14:57.

Klingler C, Ismail F, Marckmann G, Kuehlmeyer K. Medical professionalism of foreign-born and foreign-trained physicians under close scrutiny: A qualitative study with stakeholders in Germany. PLoS ONE. 2018;13(2):e0193010.

In addition, a summary of the interview study with migrant doctors was published in the Ärzteblatt. The article can be found under the following references/links:

Klingler C, Marckmann G. Integration im Gesundheitswesen: Ärzte fühlen sich oft allein gelassen. Deutsches Ärzteblatt 2017;114(7):267-268.