• Hendrik van den Bussche, Detlef Niemann, Bernt-Peter Robra, Udo Schagen, Beate Schücking, Nobert Schmacke, Claudia Spies, Alf Trojan, and Uwe Koch-Gromus.
• Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland. Bussche@uke.de.
• Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2018 Feb 1; 61 (2): 163-169.

BackgroundUndergraduate medical education in Germany takes place in the medical faculties of universities, whereas postgraduate medical education takes place in nearly all hospitals under the aegis of medical associations. Both phases of the medical qualification process live on their own; the communication between the two responsible bodies is negligible. Previous reforms have always tackled undergraduate education only, whereas postgraduate education takes place without public attention.ObjectiveThis position paper discusses the origins and consequences of the complete separation between undergraduate and postgraduate medical education in Germany with regard to responsible bodies, learning objectives, and didactical concepts. On the basis of this critical analysis, proposals are presented to narrow the gap between the two phases.Materials And MethodsThis paper is based on several sources: data from historical documents, information retrieved from the internet on educational concepts in other OECD countries as well as intensive discussions among the authors.Results And DiscussionThe dissociation between under- and postgraduate education has historical reasons. Over a longer period of time the German Federal States reduced their responsibility for postgraduate education in favor of medical associations. The authors propose steps towards a better integration of both sequences, towards seeing the educational process as a continuum. In such a concept, medical associations would have a greater influence on undergraduate education and - vice versa - medical faculties on the postgraduate phase.

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