The pathway to residency in Germany: a survey study to identify factors that impact an international medical graduate from Syria

Abstract Background The German health care system has recently become an attractive destination for international medical graduates, particularly from developing countries such as Syria. However, there are no studies about the factors that influence the successful entry into the German healthcare system at trainee level.  Method  An anonymous cross-sectional survey was distributed electronically to Syrian medical graduates who successfully entered residency training in Germany. Collected data included demographics and factors that influence entering the residency, such as proven German proficiency and clinical experience in the home country. Hypothesis testing was used to assess the difference between the variables. Results A total of 109 participants responded to the survey. Twenty-three (21.1%) subjects completed a medical residency in Syria before moving to Germany, and 46 (42.2%) had no previous clinical experience before moving to Germany. The proven German proficiency of the participants upon arrival in Germany was less than B1 in 39 (35.8%), B1 in 37 (33.9%), and B2 in 33 (30.3%) cases. None of the participants had a language level beyond B2, and 18 (16.5%) had no German knowledge. The median of months spent in Germany till residency for those with B1 or B2 certificates before moving to Germany (10.5 (6.25–16) months and 8 (5–11) months, respectively) differed significantly from those with German-language skills belowB1 ((21 (14–29) months, p < .001). Residency in the home country was not associated with a difference in the median of the months in Germany till entering residency, p = 0.84. Conclusion A crucial factor influencing the successful entry to the German medical system at the trainee level is the ability to speak German, measured in levels based on the Common European Framework of Reference for languages. A high language skill level is a crucial factor associated with a decrease in time in Germany till entering residency for an international medical applicant. In contrast, previous work experience is not influencing the entry into the German labor market.