Principles and Legal Framework

Responsibility for specialist training lies with an authorized training physician for the specialty. By law, the training must be personally supervised by the authorized training physician.

Authorization constitutes the delegation of a public function by the Medical Association in its capacity as a corporation under public law. 

The Specialty Training Regulations provide legal protection for physicians in training.

 

This results in the following obligations for authorized training physicians:

The authorized training physician must ensure that physicians in training are able to acquire the required competencies within the designated training period. The authorized training physician bears liability for this under private law! (Not primarily under employment or public service law).

The authorized training physician must implement the requirements of the Specialty Training Regulations (WBO) and personally provide the elements of specialist training or ensure that they are provided under their personal authority.

Individual training components may, for example, be delegated to institutes or other institutions. These then act solely on behalf of the authorized training physician. As a rule, institutes themselves do not hold authorization to provide specialist training in the specialty but merely act as commissioned providers. If problems arise there, they must be resolved by the authorized training physician.

The authorized training physician cannot simply delegate decisions concerning the progression of specialist training to committees or conferences without being personally involved in the decisions made there or assuming personal responsibility for them.

The following applies to contractual arrangements:

Specialist training may only be undertaken as a primary professional occupation within an employment relationship subject to social security contributions.

Secondary employment arrangements or fee-based contracts are not provided for.

This means that all required specialist training content must be made available within the framework of this employment contract. This also applies to any training components delegated to commissioned institutions.

Self-experience has a special status (see relevant section).

Entering into additional contracts with institutions that require compliance with conditions under association regulations is always voluntary and applies only to the association's own regulations.

In particular, elements such as an “intermediate examination” and “authorization to treat,” which are frequently found in such arrangements, are not part of the medical Specialty Training Regulations. Licensed physicians are authorized to treat patients by virtue of their medical license. The scope and supervision of treatment within the specialty during specialist training are the sole responsibility of the authorized training physician under whose personal direction the training is conducted.

The authorized training physician remains fully responsible for ensuring that the required training content can be acquired within the designated training period. This also applies to individual components commissioned from other providers. Additional contracts cannot override this responsibility.

The applicable Working Hours Act must be observed in all cases. The reasonableness of travel times must also be taken into account when individual training components are delegated.