Healthcare Institutions in Germany

If you’re planning to work as a doctor in Germany, it’s not enough to simply understand the healthcare system. It’s just as important to know about the different types of healthcare institutions — because they can vary significantly in terms of structure, work culture, resources, and training opportunities. These differences can have a real impact on your specialist training, career options, and even your path to full medical licensing.

Inpatient care includes all medical services where patients stay in the hospital overnight or for several days and receive continuous, around-the-clock care. Facilities such as university hospitals or public clinics are primarily designed for inpatient treatment, but many also offer outpatient services — like specialist clinics or hospital-based outpatient departments — where patients can be treated without needing to stay overnight.

University hospitals (often called “Unikliniken”) are closely linked with medical schools and play a key role in research, teaching, and the treatment of complex medical cases. These hospitals typically offer the full spectrum of medical specialties, including highly specialized departments. If you’re interested in research or want to focus on rare and complex conditions, a university hospital could be the right fit for you. Their training programs are usually well-structured, include rotations, and often provide protected time for research or independent projects. On the flip side, the work environment is typically high-pressure, with strong hierarchies and limited individual supervision. University hospitals are also among the largest in Germany — some have more than 1,000 beds.

Public hospitals are operated by cities, counties, or federal states. They focus on basic and general care for the population in a specific region, often include emergency departments, and offer training in many core medical specialties. If you’re looking for a long-term role within the regional healthcare system, public hospitals might be a great choice. You’ll benefit from high levels of patient contact, strong team structures, and hands-on experience. Research opportunities are usually more limited, and the structure can vary from state to state. These hospitals typically have 100 to 500 beds.

Private hospitals are run by companies or large healthcare groups like Helios, Asklepios, or Sana. They range from general hospitals to highly specialized or luxury clinics catering to international patients. These settings often operate under a performance- and efficiency-driven business model. The quality and structure of training programs can vary widely and depend heavily on the specific site, so it’s important to check in advance whether the hospital has official training authorization. Some locations offer structured programs, while others may not have strong teaching or research infrastructure. Their size can range from small private clinics to large hospitals with several hundred beds.

Non-profit and church-affiliated hospitals are run by organizations like Caritas, Diakonie, or religious foundations. These institutions often take a values-based approach to care, with a strong focus on teamwork, empathy, and human connection. If you’re looking for a socially driven and supportive work environment, you may feel especially comfortable here. These hospitals also offer specialist training, although often in a more limited range of disciplines. In return, you’ll usually receive more personal guidance and enjoy a strong sense of team spirit. Most of these hospitals have between 100 and 300 beds.

Outpatient care refers to medical services where patients receive treatment without being admitted to a hospital — typically in private practices or Multispecialty Outpatient Clinic (Medizinische Versorgungszentren, or MVZs). Outpatient care plays an increasingly important role in specialist training in Germany.

In many specialties, it’s common to spend part of your training in an outpatient setting. In general practice, for example, two of the five required training years must be completed in outpatient care. Other specialties also include outpatient rotations in private practices or MVZs.

Outpatient care offers several attractive working conditions:

• Working hours: Regular daytime schedules with no night or weekend shifts
• Compensation: Monthly salary subsidies from regional medical associations (Kassenärztliche Vereinigungen)
• Demand: There’s a high demand for trainees, especially in rural or underserved areas

If you’re looking for structured working hours, a stable setting, and long-term patient relationships, outpatient training could be a great fit for you.

One thing you should always check: Not every facility is authorized to offer full specialist training. Whether it’s a hospital, multispecialty outpatient clinic, or private practice, the training must be led by a physician who holds official authorization from the relevant State Medical Association (Landesärztekammer).

This authorization is often limited — either by time or to specific stages of training. Some facilities may only be allowed to supervise certain years or parts of the training program (for example, only the outpatient component). So before applying, make sure to check which parts of your training can actually be completed at the facility — ideally on their website or by contacting the regional medical board.

Working with patients isn’t your only option. Many doctors in Germany also pursue careers in medical research, public health institutions, health insurance companies, pharmaceutical firms, or digital health startups. While these roles generally don’t count toward specialist training, they can offer fulfilling, impactful careers — especially if you’re interested in science, policy, or systems-level healthcare.

As you can see, your German medical license opens the door to many different paths — whether in hospitals, private practices, or medical centers. Let’s explore together what fits you best!

The information provided in this article is for general guidance only and does not replace legal advice or official sources. We strive for accuracy, but we recommend consulting the responsible authorities for the most up-to-date requirements.

All information provided without guarantee.