Model Specialist Training Regulations 2026 and What the 130th German Medical Assembly Changes
17.09.2026
Who issues the training regulations — and why there is a model version
Medical specialist training in Germany is a matter for the state medical associations. They are public law corporations and each issues its own legally binding training regulations for its own area. The (model) specialist training regulations of the German Medical Association, MWBO for short, are by contrast a template: according to the German Medical Association they are “purely advisory in character” for the state associations.
In practice that means two things. First, what the German Medical Assembly resolves does not apply immediately at the bedside. The changes only become binding once the individual state medical associations adopt them into their own training regulations — a point the German Society for Haematology and Medical Oncology, for instance, makes explicitly. Second, because all 17 associations follow the same model version, the rules remain broadly comparable nationwide, and moving between federal states during training remains plannable.
The MWBO is divided into three sections. Section A contains the general provisions, Section B the fields, specialist and subspecialty competencies, and Section C the additional qualifications. The 130th German Medical Assembly sharpened all three.
The Hanover resolutions at a glance
According to the German Medical Association's announcement of 15 May 2026, the revision covers the following points among others:
- Eight field definitions were revised.
- The minimum training period was shortened in eight disciplines: anatomy, hygiene and environmental medicine, public health, neuropathology, pathology, clinical pharmacology, pharmacology and toxicology, and physiology.
- The specialist title in biochemistry was deleted.
- Training stages were adjusted for 29 specialist titles.
- In the general provisions, the crediting of oral surgery training time towards oral and maxillofacial surgery and the crediting of interruptions were newly regulated.
- In Section C, the headers of the additional qualifications in geriatrics and medical informatics were amended.
This revision does not stand alone. In 2025 in Leipzig, the 129th German Medical Assembly had already re-sorted the then 56 additional qualifications into three categories: those with a minimum training period under an authorised doctor, those taken alongside work without a binding minimum period, and purely course-based ones. Hanover was therefore the second major step in a multi-year overhaul.
Competencies instead of time — the real change of system
The substantive core of the reform is not any single discipline but a way of thinking. The general training content is structured into eight physician roles according to the internationally established CanMEDS model. These replace the previous division into methodological and practical competencies and expressly bring communication, teamwork, leadership, patient advocacy, teaching and learning, professionalism and the handling of digital medicine to the fore alongside specialist knowledge.
The shift in language reported from the debate by the Deutsches Ärzteblatt fits with this: “training period” becomes, consistently, “minimum training period”. The guiding formula of those responsible is “content before time”. Anyone who does not attain the required competencies within the minimum period trains for longer; the stated period is the floor, not the ceiling.
What target numbers are
Target numbers are the quantities attached to individual training items, that is, the number of examinations or procedures a trainee is expected to have carried out themselves. They have not been abolished but embedded: under the training regulations of the Westphalia-Lippe Medical Association, the association's board may adopt and publish target numbers under Section 2(7). What is assessed in the end is the competency — the target number is the indicator that there was sufficient opportunity to practise.
The eLogbook
All of this is documented in the eLogbook, a web application that launched on 1 July 2020 and has since been introduced by every medical association — in some cases as a requirement, in others as a voluntary option. Doctors in training record their content continuously, and the authorised trainers confirm the competencies acquired and target numbers reached. This is anchored in the training regulations: continuous documentation by the trainee, and confirmation by the authorised doctor at least annually.
These disciplines change in concrete terms
The following overview summarises the resolutions reported by the Deutsches Ärzteblatt and the German Medical Association.
| Discipline | Previous rule | Resolution of the 130th Assembly |
|---|---|---|
| Neurology | 12 months of psychiatry and psychotherapy | 6 months of psychiatry, plus 6 months of acute neurological care on a stroke unit |
| Psychiatry and psychotherapy | 12 months of neurology | 6 months of neurology, with an optional further 6 months in neurology, general practice or internal medicine; 24 months of inpatient care compulsory |
| Internal medicine with a subspecialty | 72 months, of which 24 months inpatient in the subspecialty | 72 months remain; within inpatient care at least 18 months in the respective subspecialty, in exchange for more flexible distribution between outpatient and inpatient settings |
| Public health | 60 months, 720 hours of course-based training | 54 months, of which 30 months in public health institutions and 18 months at a public health office; course hours halved to 360 |
| Human genetics | up to 12 months in other fields of patient care compulsory | this time “may” rather than “must” be completed |
| Additional qualification in geriatrics | 18 months, access only for certain disciplines | 24 months, access for all specialists in direct patient care |
| Additional qualification in medical informatics | definition without artificial intelligence | definition extended to include artificial intelligence, access via 24 months of medical practice |
The delegates themselves made clear that real negotiation lies behind these figures. Johannes Albert Gehle, president of the Westphalia-Lippe Medical Association, spoke of a compromise preceded by a tough process and many conversations. Christine Neumann-Grutzeck, president of the German professional association of internists, saw for internal medicine “a balanced compromise between greater flexibility and quality assurance”.
Training periods, part-time work and interruptions
How long training lasts is set out for each discipline in Section B. Sixty months, that is five years full-time, is typical: the training regulations of the Westphalia-Lippe Medical Association provide for this in general practice, among others. Disciplines with a subspecialty competency run longer, with internal medicine with a subspecialty at 72 months.
The general provisions set the framework: the periods laid down are minimum requirements; training is in principle completed full-time in a substantive post; in part-time work at least 50 per cent of weekly working hours must be reached, which extends the overall duration accordingly. Sections of less than three months generally do not count.
New, and significant for life planning, is the crediting of interruptions: under the revision, absences of up to six weeks a year — for instance through illness, pregnancy, parental leave or military service — should no longer extend the training period. The Rheinisches Ärzteblatt described this point as one of the most tangible reliefs in the reform.
The specialist examination
At the end comes the examination before the state medical association. The training regulations of the Westphalia-Lippe Medical Association show how tightly this is regulated: the association forms examination boards of at least three doctors, of whom at least two hold the title being sought; the examination lasts at least 30 minutes and is not open to the public; candidates' impairments must be taken into account.
Failing is not final. The examination board may set an extension of the training period of up to two years, and a resit is possible no earlier than three months after a failed examination. The German Medical Association's physician statistics show how many take this route: in 2025, 16,195 doctors received specialist recognition, after 15,378 the year before. The largest groups were internal medicine with 2,283, general practice with 2,147 and anaesthesiology with 1,524 recognitions.
How other countries organise specialist training
A look across the border shows that competency orientation, logbooks and annual progress review are not a German peculiarity but an international standard — only the routes there differ considerably.
| Country | Entry after the degree | Duration (examples) | Governance and documentation |
|---|---|---|---|
| Germany | German medical licence (Approbation), then a direct application for a post with a doctor authorised to train | general practice 60 months, internal medicine with a subspecialty 72 months | state medical association, eLogbook since 1 July 2020, oral specialist examination of at least 30 minutes |
| United Kingdom | Two-year Foundation Programme (F1 with provisional, F2 with full GMC registration), then specialty training | GP CCT three years; anaesthesia around seven years in three stages (CT1–CT3, ST4–ST5, ST6–ST7) | the General Medical Council approves the curricula produced by the royal colleges: the foundation curriculum, 65 specialties and 30 sub-specialties; annual Review of Competence Progression (ARCP) |
| United States | Central allocation procedure (the NRMP Main Residency Match) | internal medicine 36 months under the ACGME requirements; other disciplines longer | the ACGME accredits the programmes, a clinical competency committee assesses progress against the milestones |
| Switzerland | Federal medical diploma, then a post at a recognised training institution | general internal medicine five years, of which three years basic and two years advanced training | SIWF as an autonomous body of the FMH, 45 federally accredited training programmes plus general practitioner, compulsory e-logbook, written specialist examination |
United Kingdom
After the degree, the two-year Foundation Programme is compulsory for all graduates before specialty training begins. In the first year only provisional registration with the General Medical Council exists; in the second, full registration. Progress is reviewed annually in the ARCP, based on reports from clinical and educational supervisors. The Royal College of Anaesthetists states the principle for its roughly seven-year training unambiguously: it is “outcome-based rather than time-based”. Those who reach the required outcomes faster can finish earlier; part-time work extends things accordingly. The GP route ends after three years with the Certificate of Completion of Training, assessed through the MRCGP components AKT, SCA and workplace-based assessments.
United States
In the United States a central algorithm decides access to residency. The National Resident Matching Program's 2026 Main Residency Match was the largest in history: 53,373 registrants, 48,050 active applicants, 6,809 certified programme tracks and 44,344 positions offered; 38,354 applicants received a PGY-1 position, and the fill rate was 93.5 per cent. Match rates differ sharply by background: US MD graduates reached 93.5 per cent, international graduates without US citizenship 56.4 per cent. On content, the Accreditation Council for Graduate Medical Education sets the direction: its programme requirements for internal medicine call for 36 months of supervised training, and a clinical competency committee assesses development against the milestones.
Switzerland
Switzerland combines state oversight with self-governance: the legal basis is the Medical Professions Act, and responsibility lies with the Swiss Institute for Postgraduate and Continuing Medical Education (SIWF), an autonomous body of the FMH. Forty-five training programmes are accredited, plus the title of general practitioner. Take general internal medicine: five years, of which at least two years inpatient and six months outpatient in the basic stage, three months of emergency medicine, plus a written specialist examination with 120 multiple-choice questions in English, a scientific publication and evidence of point-of-care ultrasound. Everything runs through the e-logbook, through which the application for the title is finally submitted as well. Specialists from the EU benefit from mutual automatic recognition under the free movement agreement.
What this means for prospective students
Anyone considering a medical degree today will experience these training regulations in a few years' time — regardless of which EU state the qualification was obtained in. For basic medical training, Directive 2005/36/EC sets a Europe-wide minimum of five years of study and at least 5,500 hours of theoretical and practical training at a university. Anyone meeting these requirements falls under the principle of automatic recognition set out in Article 21 of the directive.
In German law this is mirrored in Section 3 of the Federal Medical Practitioners Act: medical training completed in another EU or EEA state counts as equivalent once the corresponding evidence of training is presented — no separate equivalence assessment is provided for. After licensing, the route into specialist training is just as open as it is for graduates of German faculties: an application for a post with a doctor authorised to train, the eLogbook, and the specialist examination at the responsible state medical association.
Specialist training itself also rests on European foundations. Article 25 of the directive requires full-time training at recognised institutions with appropriate remuneration and minimum durations under Annex V; Article 28 sets at least three years for general practice, including at least six months each in a hospital and in an approved practice. With 60 months for general practice, Germany is well above that — an indication that German requirements sit towards the upper end by European standards.
New doctors are needed: according to the German Medical Association's physician statistics, around 437,000 doctors were in practice at the end of 2024, a good 15 per cent of them foreign nationals, and about 23 per cent of those working were over 60. Anyone starting now enters a labour market glad of every well-trained doctor. Which place of study elsewhere in Europe fits your profile is something we are happy to look at together — without obligation, in the free advisory session.
This article reflects the position as of 14 August 2026 and presents the state of the resolutions journalistically. It does not replace legal advice; only the training regulations of the responsible state medical association in force at the time are binding.
The author's view
I studied dentistry in Sofia and am today a Swiss-licensed dentist; I run Medschool Experts from Bern. Two legal systems, two frameworks, one degree that worked in both. That is exactly why I read the Hanover resolutions with a certain calm: what the 130th German Medical Assembly changed is, for young colleagues, largely an improvement, and it affects everyone equally — regardless of whether the degree was taken in Berlin, Sofia or Zagreb.
Three points strike me as notable. First, the consistent talk of the minimum training period. Anyone who realises in their fourth year that a competency is still missing should be allowed to practise for longer without it being seen as a blemish. That is more honest than any fiction in which everyone is equally far along after exactly 60 months. Second, the crediting of interruptions of up to six weeks a year. That sounds technical, but for young families, for longer illnesses or for a pregnancy it is real relief — and it removes part of the guilty conscience from a phase of life in which a great deal is happening at once anyway. Third, the eight physician roles under the CanMEDS model. Communication, teamwork and the handling of digital tools have long been decisive in daily practice; that they are now explicitly part of the assessment matches what I experience every day in practice.
What matters particularly to me here: looking at Switzerland, the United Kingdom and the United States shows how good the European solution actually is for students. In the United States, access to specialist training hangs on a central match in which international applicants fare considerably worse than domestic ones. In the United Kingdom, a two-year compulsory programme sits between the degree and specialty training. In the EU, by contrast, automatic recognition applies: a degree from Bulgaria, Hungary, Poland or Croatia leads in Germany, without a detour and without a knowledge examination, into the same specialist training as a degree from Munich. Many of the families I speak to underestimate that advantage.
At Medschool Experts we have supported young people on this route for years and were the first agency to show, free of charge and in near-daily YouTube videos and interviews with real medical students abroad, what this everyday life actually looks like. My conclusion from it: the route through the rest of Europe is not a detour but an equivalent path to the same destination — the specialist title, which since the 130th Assembly is surrounded by somewhat more modern rules.
Summary
- Meeting in Hanover from 12 to 15 May 2026, the 130th German Medical Assembly amended all three sections of the (model) specialist training regulations: the general provisions, the catalogue of specialist titles and the additional qualifications.
- Under the 2026 revision, the minimum training period falls in eight disciplines, training stages change for 29 specialist titles, and the specialist title in biochemistry is discontinued.
- In neurology and psychiatry, the compulsory time in the other discipline falls from 12 to 6 months; in neurology, 6 months of acute care on a stroke unit are added.
- The resolutions of the 130th German Medical Assembly only become binding once the state medical associations adopt them into their own training regulations.
- A medical degree completed in an EU member state leads, under Article 21 of Directive 2005/36/EC, straight into the same German specialist training without a detour.
The 130th German Medical Assembly developed the (model) specialist training regulations in all three sections: eight disciplines with a shorter minimum training period, 29 adjusted specialist titles, reorganised rotations between neurology and psychiatry, a re-cut public health discipline, and an additional qualification in geriatrics now open to all specialists in direct patient care. The real core, however, is the competency model with its eight physician roles and the principle of “content before time”.
This only becomes binding once the state medical associations adopt the resolutions into their own training regulations. Anyone interested in studying medicine today should take away one thing above all: access to this training does not depend on which EU state issued the diploma. Automatic recognition under Directive 2005/36/EC and Section 3 of the Federal Medical Practitioners Act leads EU graduates into exactly the same system without a detour — and into a labour market that urgently needs new doctors. If you would like to know which European place of study fits, you can get free advice from us.
Further reading
- The German medical licence (Approbation) and recognition of a medical degree from elsewhere in the EU — the legal framework behind direct entry into specialist training.
- The final practical year in 2026 and the state of the reform — the last stage before licensing and therefore before specialist training.
- Studying medicine without a numerus clausus abroad — what the route to an EU degree without waiting semesters looks like.
- One in eleven German medical students is enrolled abroad — how widespread this route has become.
- The allocation of medical study places with quotas, deadlines and the TMS — admission within Germany, for comparison.
Frequently Asked Questions about the model specialist training regulations 2026
Who issues the specialist training regulations in Germany?
The 17 state medical associations. They are public law corporations and each adopts its own legally binding training regulations. The German Medical Association's (model) specialist training regulations are, by its own account, purely advisory for them.
Do the resolutions of the 130th Assembly apply immediately?
No. They only become binding once the individual state medical associations adopt them into their own training regulations. Until then, the version adopted in each association's area applies.
What changes between neurology and psychiatry?
In neurology, the compulsory time in psychiatry and psychotherapy falls from 12 to 6 months, while 6 months of acute neurological care on a stroke unit become compulsory. In psychiatry, the compulsory neurology time likewise falls from 12 to 6 months; 24 months of inpatient care remain compulsory.
What does “competency-based” mean in specialist training?
What is assessed is whether a competency is actually mastered, not merely whether a period has been served. The general content is structured into eight physician roles according to the CanMEDS model, and “training period” becomes, in consistent usage, “minimum training period”.
Have target numbers been abolished?
No. Target numbers still indicate how many examinations or procedures a trainee is expected to have carried out themselves. Under the training regulations of the Westphalia-Lippe Medical Association, the association's board may adopt and publish them under Section 2(7).
What is the eLogbook for?
It is the electronic documentation of specialist training. It launched on 1 July 2020 and has since been introduced by every medical association, in some cases as a requirement and in others voluntarily. Trainees record their content continuously, and authorised trainers confirm competencies and target numbers at least once a year.
How long does specialist training take?
It varies by discipline. Sixty months full-time is common, for instance in general practice; internal medicine with a subspecialty runs to 72 months. Part-time work is possible from 50 per cent of weekly working hours and extends the overall duration accordingly.
Do parental leave or illness extend specialist training?
Under the new rule adopted in Hanover, interruptions of up to six weeks a year — for instance through illness, pregnancy, parental leave or military service — should no longer lead to an extension.
How does the specialist examination work?
It takes place before an examination board of the state medical association. Under the training regulations of the Westphalia-Lippe Medical Association it consists of at least three doctors, at least two of whom hold the title being sought; the examination lasts at least 30 minutes and is not open to the public.
What happens if you fail the examination?
The board may set an extension of the training period of up to two years. A resit is possible no earlier than three months after a failed examination.
Can I become a specialist in Germany with a medical degree from elsewhere in the EU?
Yes. Under Article 21 of Directive 2005/36/EC the principle of automatic recognition applies, and Section 3 of the Federal Medical Practitioners Act treats medical training completed in another EU or EEA state as equivalent. After licensing, specialist training is open without a detour.
How does entry differ in the United Kingdom and the United States?
In the United Kingdom the two-year Foundation Programme must first be completed after the degree, before specialty training begins; progress is reviewed annually in the ARCP. In the United States access runs through the central match: in 2026, 44,344 positions were available and 38,354 applicants received a PGY-1 position.
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About the author
Marcel Kloos
Swiss-licensed dentist and founder of Medschool Experts
Marcel Kloos founded Medschool Experts while studying abroad; since then, over 500 study places have been secured. The Stuttgart-born dentist studied dentistry from 2015 to 2021 in Sofia and holds a Swiss dental licence.
Today he lives in Bern and runs Medschool Experts full-time as its owner.
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