Herzchirurgie Training in Germany: A Realistic IMG Route?

Foreign doctors can become Herzchirurgen in Germany, but accept a first job only after confirming how many of the 6 training years that department can certify. Herzchirurgie means cardiac surgery. It is not a combined cardiothoracic specialty where one certificate covers heart, lung and chest surgery.

This distinction changes your applications. A surgeon who wants aortic valves, bypass operations, transplant surgery and mechanical circulatory support should apply to Herzchirurgie departments. A surgeon who wants lung cancer operations, chest-wall surgery and pleural disease should look at Thoraxchirurgie, the separate thoracic surgery specialty.

How long is Herzchirurgie training in Germany?

The model specialist training programme of the Bundesärztekammer sets Herzchirurgie at 72 months. That is 6 years of supervised work in cardiac surgery, including 6 months in intensive care medicine. Your state medical chamber, the Landesärztekammer, applies its own Weiterbildungsordnung, which is the binding training rule in your Bundesland.

Your Logbuch, the training record, follows you through those years. It lists operations, intensive care work, outpatient cases and procedural numbers. Your senior doctor with the Weiterbildungsbefugnis, the training licence, signs the entries that the chamber later reviews.

Do not treat 72 months as a promise from one hospital. A cardiac centre may train junior doctors for only 24 or 36 months. Afterwards, you move to another approved department for the remaining years, with your signed Logbuch and employment certificates.

Is Herzchirurgie a realistic first job for an IMG?

Yes, but it is a narrow first-job market. Germany has cardiac surgery in specialist centres, not in every hospital with a general surgery ward. A department may advertise one junior doctor post while a large general surgery department advertises several across trauma, visceral surgery and emergency work.

The applicant who gets an interview normally brings a German medical licence, clear German communication and surgical ward experience. A CV with admissions, discharge letters, blood draws, drains, central lines, intensive care rounds and night duty gives the chief a picture of the work you can start on Monday.

A new licence holder applying only to university cardiac centres in Berlin, Munich and Hamburg loses time. Those departments receive applications from doctors already working in German surgery. Smaller cardiac centres and cities outside the largest metropolitan areas are the more realistic places to search first.

There is one important exception. If you already have several years of cardiac surgery, a detailed operation list and a strong German reference, a university department may take you directly. Your papers need named procedures, dates, your role in the operation and the consultant who supervised you.

What work fills the first years?

Your first months are not bypass operations. You start with ward rounds, anticoagulation plans, chest-drain checks, discharge letters, emergency admissions and postoperative patients in intensive care. At 3am, you may be reviewing a patient with bleeding, low urine output or new atrial fibrillation after surgery.

Later, the Logbuch moves from assisting to defined procedures and larger operation steps. The chamber wants signed entries, not a broad sentence in a reference letter saying you worked in the operating theatre. Keep operation lists, employment certificates and rotation schedules from every hospital.

Who decides whether your previous years count?

The Landesärztekammer decides. It compares your foreign employment certificates, operation list, rota and supervisor letters with its Weiterbildungsordnung. The chamber normally credits work that matches cardiac surgery tasks under a named supervisor and refuses vague certificates that only say “resident doctor in surgery.”

Years in general surgery can help you get hired, but they do not automatically become Herzchirurgie years. The usual decision is partial credit for work that matches the chamber's required content. A year spent mainly on appendectomies, hernias and gallbladders is useful surgical experience, but it is not the same as a year in a cardiac operating theatre or cardiac intensive care unit.

Ask before you build your life around a number. Send the chamber your certificate, operation list and rotation schedule. Ask for a written answer on whether those months can count towards Facharzt Herzchirurgie, the specialist certificate in cardiac surgery.

The training licence matters more than the hospital name

A famous university hospital is a poor choice if its department can certify only part of your training and cannot tell you where doctors finish the rest. A smaller centre with a clear 36-month or 48-month training licence, regular operating room exposure and signed Logbuch meetings can move you forward faster.

Before signing, ask the department one direct question: “How many months of Herzchirurgie training can your authorised trainer certify for me?” Then ask for the name of that trainer and whether intensive care is completed inside the department. Put the answer beside the employment contract before you accept the Stelle.

What to do before you apply

• Search cardiac surgery vacancies at specialist centres, then send each chief a CV with your licence status, German level, surgical employment certificates and operation list.
• Ask the department in writing: “How many months of cardiac surgery training can your authorised trainer certify?”
• Send your foreign certificates, rotation schedule and operation list to the Landesärztekammer and ask how many months can count toward Facharzt Herzchirurgie.
• Keep every signed Logbuch page, rota and employment certificate from your first German surgical post.

Stand: 2026-09-15. This article is orientation, not legal advice. Rules differ by Bundesland and change — always confirm with your [Landesärztekammer](https://www.bundesaerztekammer.de/aerztekammern) before acting.