Examination: Insufficient medical school slots to address the scarcity of physicians
In the academic landscape of Germany, medical education and advanced care facilities are primarily concentrated in major urban university hospitals, such as those in Berlin, Munich, Hamburg, Bonn, Aachen, Frankfurt, Cologne, and Tuebingen [1][2]. These institutions serve as teaching, research, and clinical excellence centres, integrating advanced medical research with patient care.
This distribution of medical education and cutting-edge clinical services tends to cluster in urban and economically affluent states, where large universities and research hospitals exist. For instance, Munich and Berlin boast major university hospitals with multidisciplinary teams and extensive research facilities, attracting top medical professionals and advanced treatments [1].
The concentration of medical expertise and innovation in these metropolitan university centers provides patients with greater access to experimental treatments, the newest technologies, and highly specialized care, including participation in clinical trials [1]. However, this distribution also contributes to regional disparities. More rural or less populous states, which host fewer or no major university hospitals, may experience limited access to highly specialized medical care and slower diffusion of innovative treatments, potentially leading to uneven healthcare quality across Germany [1][2].
Germany’s decentralized healthcare structure adds complexity, with updating hospital technologies and infrastructure varying regionally, affecting how quickly care improvements reach less served states [3]. Recent efforts, such as policy incentives to increase Germany’s role in global clinical trials, are pushing to expand clinical research sites beyond traditional centers, which could improve care availability in more regions over time [5].
Another significant trend in Germany's medical education is the increasing proportion of women among first-year students. The states of Saarland and Mecklenburg-Western Pomerania, with 29 and 26 medical study places per 100,000 inhabitants, respectively, for first-year students, hold top positions in this regard [4]. This corresponds to a medium position, with 13 medical study places per 100,000 inhabitants, shared by Baden-Württemberg and Thuringia.
Despite the growing number of female students, securing a place in medical studies remains challenging. Moreover, the annual running costs per person in the field of human medicine/health sciences are around 25,000 euros, according to the Federal Statistical Office [6]. It is worth noting that Brandenburg and Bremen currently have no state-funded medical study program.
The part-time rate for men in hospitals has risen from 20 to 29 percent in the last ten years, and for women from 33 to 42 percent [7]. In the winter semester 2024/25, approximately 10,000 first-year students were able to secure a medical study place, while around 20,000 applicants were unsuccessful [4].
Looking ahead, the Medical University of Lausitz is scheduled to start operations in the winter semester 2026/27 in Brandenburg, aiming to address the current scarcity of medical study places in that state. The Social Association SoVD has warned that the lack of medical study places threatens local healthcare in many regions [8].
In conclusion, while medical education and advanced care facilities in Germany are concentrated in major urban university hospitals, efforts are being made to address regional disparities and improve access to medical care for all citizens.
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