Studying

My medicine studies – a small inside view

on
August 16, 2019

When I was a small child in primary school and someone used to ask me what I wanted to become one day, I always answered: “I will become a doctor to help other people.” At that time, I was also thinking about becoming a pop star, but I knew that it was more unlikely to reach this goal. Through the years continuing the dream to study medicine and to be a doctor one day remained. I completed several work experiences in the medical and therapeutical field but always returned to the thought of studying medicine. And nowadays, here I am: at the beginning of the fourth semester of human medicine at my desired university.

I collected some questions via Instagram and now I am going to address them to give you an understanding of my excitement about medicine and also to inform about medical studies. Here I am going to share my current level of knowledge and my own experiences, that I collected during my studies so far.
This means I am writing about my specific university in Germany. Some aspects might be different to other universities in different cities here in Germany and I am quite sure that there are big differences in comparison to studying medicine in different countries. But since I am also writing about my (pre)med school experiences on my Instagram Blog, these insights might be interesting to you. Maybe, you even think about studying medicine in Germany.

How is your medicine studies structured?

In general the study programme “human medicine” lasts six years in Germany. This means it contains 12 semesters and is structured in three big parts. Since I don’t know much about studying medicine in other countries, I am going to translate proper names analogously. This is not about comparison, but just to provide information. Therefore, the three big parts are called “Pre-clinic / Pre-med school”, “Clinic / Med school” and “practical year”.

Pre-clinic. During the Pre-clinic-sections, you will learn the detailed principles about the structure and functions of a humans body. This part lasts four semesters. Context-related the goal is to learn how a “healthy” body is working. Therefore the students follow up with science subjects like biology, chemistry and physics. During this time, anatomy classes might be especially interesting. Here, you learn the structure of the human body on the basis of a preparation course. Therefore people allowed that their bodies will be donated to the institution of medicine after their deads. That’s the same principle of the CNS-course (Learning about the brain with the aid of real brains). Next, also histology is a section of the pre-clinic part. During this class you will look at different organ- and cell types under the microscope. Moreover, the functions and mechanisms of a humans body are taught in physiology and biological chemistry. Beside anatomy, these two classes build the biggest part of the pre-clinic-section. Also, here you also learn about principles of imaging processes (X-Ray, MRI, CT…), terminology (Latin and Greek, the languages of physicians) and psycho-sociology.
At the very beginning of the studies, there is one course which is called “Introduction to clinical medicine”. Here you choose a clinical course, where you attend seminars. I personally chose orthopaedics, which I thought was really interesting. During these first two years, you also need to take an “elective subject”. I decided to attend the course “Neuro-ethics”, which I just passed during the last semester holiday.
Another duty that needs to be completed during the semester holidays is a three-month-long nursing internship in a hospital. These three months could be accomplished at once or split into two times six weeks of work experience or three times 30 days. If you have already accomplished a voluntary social year, a one-year internship at a hospital or a vocational education in the medical field, you don’t need to do the three-month work experience anymore. If you want to start studying in Germany, there are opportunities to recognize an already complete vocational education, e.g. in form of a probationary year.

At my university, the students of human medicine and dental medicine study together until their first state exam, the preliminary examination – the “Physikum”.

Physikum, M1. The “Physikum” is the first out of three state exams. Over the period of three days, the students get examined in written exams in all the different subjects of the pre-clinic section (except for the elective subjects). At another day, the students also need to pass an oral examination in the same subjects.
Clinic. They say the clinic section is the most fun part about studying medicine. This mainly includes clinical science, which contains courses about medical specialities, practice classes with “patient actors” and medical dummies. Moreover, the students take courses about the right interactions and handling with a patient, about emergency and crisis situations and courses about emotion-regulation. The clinic section lasts six semesters, which means three years. Beside passing exams and courses, the students also need to accomplish “Formulaturen” and “block placements”, which are work experiences alongside doctors in hospitals and located doctors practices.
Hammerexamen, M2. After the clinic section, the next state exam follows. So the “Hammerexamen” is the second part of the medical exam. Therefore the students need to pass a written exam about all the courses of the clinic section.
Practical year = PY (GER: PJ). This is a phase, which lasts two semesters long. Therefore the students work in a hospital in the Departments of internal medicine, surgery and a Department of choice.
M3. The last part of the medical examination is an oral exam. Afterwards, the students receive their medical degree and their license to practice medicine. Now they are doctors.

Since I just started my fourth semester, you can see that there is still so much in front of me until I will be a doctor one day. That’s why I can’t provide so much information about all the different fields and sections yet. However, I am looking forward to everything that will be in this way.
Moreover, I want to point out something important:
Studying 12 semesters long, which are six years, that’s really a lot! However, you should complete your studies in a tempo that is okay for yourself. It is not a big deal to take fewer classes during a semester and need more semesters in the long term. Moreover, you can also take off a semester because of a disease, pregnancy or parenting leave, something that happened in your private life, when you are way too stressed or when you want to study one semester abroad.  There are many reasons why people aren’t able to complete their studies in the standard period. So don’t get too stressed about that!


Has it been too difficult to get accepted at a university?


Depending whether you want to start med school in the summer term or the winter term and also depending on which university you want to study in Germany, a good final grade certificate (“Abiturzeugnis”, Abitur = German high school finals to be allowed to study at a college/university) might be very important. Every semester, the universities determine a certain mark average, which you need to achieve at least (= NC, Numerus Clausus). In the winter semester, this often is 1,0, which means, all your marks need to be 1, which is the equivalent to A.
Next, you need to pass a certain “selection procedure”, which is different from one university to another. At my local university, first of all, the best Abitur graduates will be determined in a draw. This is possible for all the candidates who achieved at least the chosen NC. The other candidates will be invited to a “Test for students of medicine”. Here they need to pass different tests: written, orally, practically. The candidates are tested in disciplines like general knowledge, logical thinking, dexterity, communications with patients, medicine in English and many more. The best who pass all these tests also receive a university place.
However, there are also some opportunities for how you can study medicine without 1,0 in your final grades.

  • waiting time. If you wait long enough, your chances to be accepted are getting higher, Every semester the universities give information about the Abitur grades that you need to achieve at least and a maximum time that you need to wait.
  • TMS = “Test for medical study programmes”. This is a test, which some universities offer to students who want to improve their Abitur marks. You are allowed to do this test once in your life.
  • Voluntary social year / one-year-work experience in the medical field completed an apprenticeship (Nurse, Paramedic). On one hand side, this is a great way how you can bridge your waiting time and on the other hand side, you don’t need to complete the three-month nursing internship anymore.
  • Foreign students. This might be interesting to you since you read this article in English. As a student from another country, you have different options on how to get a place to study at a German medical university. One requirement is that you have to pass a language test in a language school with the language level of C1 or more in German. Moreover, some language schools offer a test to improve your Abitur grades. Every university just offers a very small percentage of study places for foreign students (around 5%). These places are awarded through the “ratio of foreign”. You can directly apply to a certain university or with the help of international study programmes,
  • Hardship case. If you have a disabled persons pass with the degree of disability of at least 50%, you can be accepted to some universities as a student with a disability. For the application, you need some specific forms about your personal medical situation. Here your Abitur marks don’t matter at all.
    Not every university offers all these different options for application and the application procedure is different from one university to another and also for every new semester. So here I highly recommend that you also do some research.

I personally got my study place because I made a hardship case application because – as you might know – I am chronically ill. And now I am just so thankful that I can study medicine with my disability. Studying with a disability is also a topic that I want to address in the future on this blog.
!Warning! As from 2020, there will be new application procedures, which will be offered next to the given procedures.
In the German version of this article, I also addressed these in more detail.
All the factors, that I mentioned will add up to a score that will be calculated for every Student. The study places will be awarded after the points on this scale.
Probably there will be more rules about in the future. So I hope that you aren’t mad with me if I won’t update this article as soon as there will be a new rule. But you can have a look at the websites of the universities and of the application portals for medical students, where you will find all the new conditions for every new semester.

Are you happy with your studies and is it very time-consuming?

I can clearly say: I love it on some days more than on other days. But in general: yes. I am very thankful that I am able to study at the University of my choice and medicine has always been the field, I was interested in the most. To me, it’s fun to understand all the different processes of the body and the human being. However, I need to say that there are times when holding on and pushing through is hard. Because No matter how much I am interested in medicine, the reality is that it could be pretty frustrating and laborious to learn all this different and still the same formula, to not notice a fast learning process and you still know, there is still so much to learn. I guess the biggest problem is to learn a huge amount of subject matter in a short amount of time.
However, I think every student discovers their own learning strategy, daily structure and favourite and not-favourite subjects. Every single student has their own problems during the study and I think there will always be some students who never experience difficulties during the studies in terms of time pressure or understanding of contents – But to be honest: I didn’t meet anyone like this yet.
So yes, studying medicine is time consuming – at least in the pre-clinic section, because this is everything I can tell about so far.

But the study is also what you make out of it. It’s all about organisation. There are people who love to study from morning to evening to pass all their exams with 90%. And then there are people who don’t learn at all until a few weeks before the exams. For me personally. it’s important that I still have time for myself besides the studies. Time to actively care for myself, my family and friends and no matter how much I am interested in medicine, this studies is very hard work for me, physically and mentally and I need to balance it out. During the exam phases, I don’t have a lot of free time. But this mostly lasts for three weeks. I do believe that because of my cardiovascular disease I started studying with different basic prerequisites than other students. And that’s the reason why I just can underline that I am just able to write about my own experiences. And I am quite sure that other (healthy) students might gain totally different experiences. I still want to write a blog post about how I handle studying and caring for myself because of my disease at the same time. Therefore you can leave your questions in the comments below. But there is one aspect, that I already want to highlight: If the studies are too exhausting for you, you might need to think about studying fewer subjects in one semester, than to directly thinking about quitting your whole study.
It is hard sometimes, but even small successes pay off! Maybe it is just accomplishing the practical course in chemistry or biochemistry or even the end term exams. We, as the students that we are, achieve the big and small goals to build up to our long-term goal: the Physikum and later the other big exams to be doctors one day.
I would not recommend studying medicine just because your Abitur grades are what med school requests or because you want to earn a lot of money. But to everyone who is interested in medicine and who found their passion within it, I highly recommend this study to. I guess one big advantage of studying medicine is, that the exams will be written at the beginning or at the end of a semester, so you actually have vacation time. However, this often is filled with internships and preparation for the next exams. And you won’t be able to avoid studying for multiple subjects at the same time.
Studying medicine demands a lot of discipline and persistence. But it is also a lot of fun.

How did you come to medicine and which subject are you interested in the most?

I do believe that my own disease is the reason why I got in touch with medicine pretty early and pretty intense. Maybe even one question guided my way: “Why do diseases originate and why are there so many different variations of one disease?” So it’s more than the classic question “Why me? Why do I have this disease?”I am rather interested in the biochemical mechanisms behind a disease. Also, I always wanted to help other people. And these are the reasons why I really like Anatomy, Biology and Physiology. Actually, every subject has topics which really catch my interest, as soon as I understand what makes this topic so special and where I will be confronted with this topic in the clinic section and later as a doctor in my daily work. However, I think it takes a lot of work to understand Biochemistry and chemistry.
If you’d ask me what medical specialty I am interested in, I would answer Paediatrics and youth medicine. In my opinion, doctors don’t just heal or treat symptoms and don’t see patients as case numbers. But they see humans as the individuals that they are. And that’s why I would love to work with children, Teenagers and young adults because you still can teach them a lot and help them to become a healthier person. There are many specialities I didn’t receive insights into. Maybe I will change my “medical speciality of favour” ten more times until I really need to decide what kind of doctor I want to become. But until I need to make this decision, there is still a long way to go.

I hope that these few topics were able to give you a little inside view into my medical studies.
If you have any questions or suggestions, I would love to read it down in the comments.

Only love,
Sabrina

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Sabrina
Münster, DE

My name is Sabrina and I am living with half a heart. Living with chronic illness can be challenging. That's why I share my experiences, my learnings and moments full of real emotions, love and vulnerability. In this way, I want to encourage other people with and without chronic illness to live a life they love. I am a student, a blogger and public speaker.