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Salary & Pay2 min read

Why Small German Hospitals Pay Doctors Less

Same grade, same title, different pay. In Germany your hospital's owner decides your pay table, not just your years of training.

Ahmed Quteishat

Assistenzarzt, Innere Medizin (Berlin) · Founder of Klaro

Private German Hospitals Can Pay Doctors Less: Same grade, same job title, different base pay depending on who owns the hospital in Germany.

Two junior doctors (Assistenzarzt) with the same grade can be paid differently in Germany. The reason is not experience. It is who owns the hospital.

Why does hospital size change pay?

Because not every hospital pays from the same table. Public and university hospitals follow a shared, negotiated pay table. Many private and church-run hospitals write their own.

Which pay table applies where?

Public hospitals run by a city or county usually pay under TV-Ärzte/VKA. University hospitals run by a state usually pay under TV-Ärzte/TdL. Both are collective pay tables, negotiated by the doctors' union (Marburger Bund).

Private hospital groups often use an in-house pay scale instead, called a Haustarif. Church-run hospitals, run by Caritas or Diakonie, often use their own church pay rules (AVR). Neither is bound to the public table.

A compare chart: public and university hospitals use one shared pay table, private and church hospitals often use their own lower one.

What actually differs at the same grade?

  • Your base monthly pay for your exact step can be lower
  • On-call pay (Bereitschaftsdienst) is often set by the hospital, not a shared table
  • A Christmas or holiday bonus may be smaller or missing
  • Your yearly raise is a board decision, not a fixed schedule

How do I find out before I sign?

Ask the hospital's HR office directly which pay table applies to your contract. A public or university hospital will name TV-Ärzte/VKA or TV-Ärzte/TdL without hesitation. A private or church hospital may answer with a house name you have never heard of.

That answer tells you more about your real income than the job title does. Two contracts can say Assistenzarzt and still pay very differently.

What to do before you sign

  1. Ask HR in writing: which pay table applies here, TV-Ärzte or an in-house scale?
  2. Ask for the exact table name and your grade's step, in euros, not a range.
  3. Compare the on-call pay (Bereitschaftsdienst) per shift, not just the monthly base pay.

Stand: 2026-10-26. This is a guide, not legal advice. Every German state has its own rules, and rules change. Check with your state's [medical chamber (Landesärztekammer)](https://www.bundesaerztekammer.de/aerztekammern) before you act.

See doctor jobs in Germany

Ahmed Quteishat — Assistenzarzt, Innere Medizin (Berlin) · Founder of Klaro

Ahmed built Klaro after watching how much of a doctor's move to Germany gets lost in paperwork rather than medicine.

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