[Responsibilities and concepts for undergraduate and postgraduate medical education in Germany : A plea for a reorientation]. / Zuständigkeiten und Konzepte zur ärztlichen Ausbildung und Weiterbildung : Ein Plädoyer für eine Neuorientierung.

BACKGROUND: Undergraduate medical education in Germany takes place in the medical faculties of universities, whereas postgraduate medical education takes place in nearly all hospitals under the aegis of medical associations. Both phases of the medical qualification process live on their own; the communication between the two responsible bodies is negligible. Previous reforms have always tackled undergraduate education only, whereas postgraduate education takes place without public attention. OBJECTIVE: This position paper discusses the origins and consequences of the complete separation between undergraduate and postgraduate medical education in Germany with regard to responsible bodies, learning objectives, and didactical concepts. On the basis of this critical analysis, proposals are presented to narrow the gap between the two phases. MATERIALS AND METHODS: This paper is based on several sources: data from historical documents, information retrieved from the internet on educational concepts in other OECD countries as well as intensive discussions among the authors. RESULTS AND DISCUSSION: The dissociation between under- and postgraduate education has historical reasons. Over a longer period of time the German Federal States reduced their responsibility for postgraduate education in favor of medical associations. The authors propose steps towards a better integration of both sequences, towards seeing the educational process as a continuum. In such a concept, medical associations would have a greater influence on undergraduate education and - vice versa - medical faculties on the postgraduate phase.

["In Stockholm they apparently had some kind of countermovement" - Ferdinand Sauerbruch (1875-1951) and the Nobel prize]. / "In Stockholm hatte man offenbar irgendwelche Gegenbewegung" - Ferdinand Sauerbruch (1875-1951) und der Nobelpreis.

The archive of the Nobel Assembly for Physiology or Medicine in Solna, Sweden, is a remarkable repository that contains reports and dossiers of the Nobel Prize nominations of senior and junior physicians from around the world. Although this archive has begun to be used more by scholars, it has been insufficiently examined by historians of surgery. No other German surgeon was nominated as often as Ferdinand Sauerbruch for the Nobel Prize for Physiology or Medicine in the first half of the 20th century. This contribution reconstructs why and by whom Sauerbruch was nominated, and discusses the Nobel committee evaluations of his work. Political factors did not play an obvious role in the Nobel committee discussions, in spite of the fact that Adolf Hitler in 1937 had prohibited all German citizens to accept the Nobel Prize. The main reasons why Sauerbruch ultimately was not considered prize- worthy were that Sauerbruch's achievements were marked by scientific priority disputes, and that his work was not seen as original enough.

The Limit of a strong Lobby: Why did August Bier and Ferdinand Sauerbruch never receive the Nobel Prize?

August Bier (1861-1949) and Ferdinand Sauerbruch (1875-1951) have remained two of the most influential figures during the first half of the 20th century in German and even in international surgery. They were jointly awarded Adolf Hitler's German Science Prize in 1937, but never the Nobel Prize for Physiology or Medicine, although no other German surgeons were nominated as often as Bier and Sauerbruch for the prestigeful award from 1901 to 1950. This contribution gives an overview of the reasons why and by whom Bier and Sauerbruch were nominated, and discusses the reasons of the Nobel Prize Committee for not awarding them.

Hermann Stieve's clinical-anatomical research on executed women during the "Third Reich".

Hermann Stieve (1886-1952) was Director of the Berlin Institute of Anatomy from 1935 to 1952. His research on the female reproductive system is controversial, as some of his scientific insights derived from histological investigations on the genital organs of executed women. These investigations were made possible by the sharp increase in executions during the "Third Reich." Stieve's research was methodologically accurate and contributed significantly to contemporary scientific debates. Nevertheless, his use of the organs of execution victims, some of them resistance fighters, benefited from the Nazi justice system. He thus indirectly supported this system of injustice. The allegation, however, that Stieve "ordered" the death of prison inmates according to their menstrual cycle, appears to be incorrect. An appraisal of Stieve's research should avoid traditional black-and-white classifications of research during Nazi times. In our opinion, Stieve was neither a murderer nor a fervent Nazi. Nevertheless, his research results were flawed by their ethical and political context. Stieve will remain a somber footnote in the biographies of many execution victims.

Ernst Ferdinand Sauerbruch and his ambiguous role in the period of National Socialism.

The role of German physicians under National Socialism is highly controversial. We show that Ferdinand Sauerbruch, one of twentieth century's most outstanding surgeons and chair of surgery at Berlin's Charité from 1927 to 1949, openly supported National Socialism in his public statements and in his position as head of the medical section of the Reich Research Council. He was appointed state councilor and received the Knight's Cross of the War Merit Cross by the National Socialists. But Sauerbruch also supported victims of Nazi persecution, attempted to use his influence to put a stop to the "Euthanasia Program T4," and in private expressed his criticism of National Socialists. The ambiguous stance of Ferdinand Sauerbruch is probably more typical of the role physicians played during National Socialism than the well-known black-and-white cases.