New university ‘won’t cure’ Germany’s rural doctor shortage

Medical education experts have said plans to spend €2.1 billion (£1.85 billion) on creating a new university will do little to lessen a national shortage of doctors in rural areas in Germany.

The Innovation Center University Medicine Cottbus (IUC), the first publicly run medical university in Brandenburg, is set to become “a model for medical care in rural areas” once it welcomes its first students in 2026, according to the state’s prime minister Dietmar Woidke.

But a major problem with rural care – a lack of doctors – is unlikely to be fixed by building the rural medical university, said Frank Wissing, director of the MFT, an association representing Germany’s medical faculties.

He pointed to the example of Mecklenburg-Western Pomerania, Germany’s most sparsely populated state, which has medical faculties at the ancient University of Greifswald and University of Rostock. “Most students studying medicine up there leave again after they have finished their studies, so the argument of retention is pretty weak,” Dr Wissing said.

He added that evidence from abroad showed that what can work is ensuring local people are given places at such universities but a constitutional requirement for equal access when selecting students prevents geographical preferences being used in Germany.

Laura Schmidt, a fourth-year medical student at the University of Lübeck, said many graduates avoided rural work because of the isolation and cost of getting a public practice licence to establish a clinic, which she said are bought from retiring colleagues for five-figure sums.

Ms Schmidt, who serves as the national officer on medical education at the German Medical Students’ Association, has been speaking to those planning IUC about potential problems with rural medical training, such as the supply of affordable housing and public transport.

In recent years, some states have set aside up to 10 per cent of their free, public medicine places for applicants who promise to go into general practice in rural areas but Dr Wissing said it was too soon to know how many would instead buy their way out by paying their tuition costs, typically about €250,000.

Long-overdue reforms of medical licensing in Germany, due to come into force in October 2025, will aim to address the rural deficit by requiring more training outside classical university clinics, such as in rural hospitals or outpatient clinics.

Brandenburg’s science minister Manja Schüle said that the IUC would add about 200 public medicine places to the approximately 12,000 per year that Germany already offers. They are likely to be snapped up; Dr Wissing said most medical programmes have four to five applicants per place, while the Centre for Higher Education, a think tank, counted more than 8,000 Germans travelling to eastern and central Europe to study medicine. Dr Schüle said that the IUC would also create about 1,300 jobs in research and teaching alone.

But the president of the Brandenburg University of Technology in Cottbus (BTU), Gesine Grande, criticised the “political decision” to build a new university rather than create a medical faculty at BTU, adding that this option would be “much more time-consuming and much more expensive”. “We could lose some good scientists and we could even lose our study programmes to the new university,” she cautioned.

ben.upton@timeshighereducation.com