Due to high standards in clinical practice and outstanding research opportunities in the USA, German residents wish to do a part of their surgical education in an American teaching hospital. Currently, German applicants must have an unrestricted license and a valid Standard ECFMG Certificate. For this certificate they must have passed Step I and II of the United States Medical Licensing Examination, which also includes an English test. The examination requirements are about to be changed. A 1-year participation in one of the 267 surgical residency programs is generally not possible. In Germany, American residents have the opportunity to apply for a supervised training year without passing the German medical exams. At present, there are no clinical exchange programs in surgery between Germany and the USA. Therefore, the German and American College of Surgeons should develop an exchange program for residents in surgery.
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