In the German health care system, 5.6 million people are employed in various occupational groups (cf. Federal Statistical Office 2019). Some of these professions require an academic degree as a prerequisite for admission (e.g. medicine and pharmacy); others require dual vocational training according to the Vocational Training Act (e.g. dental assistant). However, the training of the so-called health professions (e.g. health and nursing care, physiotherapy, midwifery), which with over one million represents the largest occupational group in the health sector, is regulated by federal law and has so far been carried out in special vocational schools of the health sector. Thus, the non-academic training of health professions is a special case within the occupational groups in the health sector. At the same time, this form also sets it apart from almost all other European countries, where the training of health professions was already transferred to a degree programme a long time ago.
Although it has been proven several times that non-academic training for health professions no longer meets the requirements of their work activities, corresponding structures are only being established very hesitantly. Until 2019, German occupational laws only allowed higher education to replace vocational schools in exceptional cases via a model clause. This is now changing for the fields of nursing and midwifery. From 2020, primary qualification via a degree course will be added to the existing training options for health care and nursing, and in the case of midwifery, the degree course will completely replace vocational school training.
The path taken towards the academisation of the health professions is accordingly accompanied by a professionalisation of the teaching staff at special health care schools. Since this does not necessarily have to correspond to the standards of teacher training for vocational education, there are opportunities here to rethink and conceptually incorporate requirements.
Parallel to the development of professionalisation structures, the acute shortage of skilled workers in the health professions represents a major challenge. The integration of international health professionals appears to be one of the possible solutions. This requires, beyond answers to questions about the recognition of international degrees, the development of new concepts for teaching competence in the structures of German health care. The view of job satisfaction, cultural and social integration are also relevant perspectives that need to be taken into account conceptually.
This situation gives rise to a number of interesting perspectives for the research area of professional development and qualification. These include, for example, questions about the professionally required competences, how they are acquired and how acquired competences can be credited to each other in the heterogeneity of training paths; about the advantages and disadvantages of training paths and their consequences for the cooperation of professional groups in the health care system and for the quality of health care; about possibilities of mobility in the European work and knowledge space; about opportunities and obstacles of professional development or about questions of curricular development, didactics and methodology."
