Tens of thousands of Syrian war refugees are currently being trapped between Turkey and Greece or interned in deplorable and dramatic conditions on Greek islands[1]。This drama painfully reminds us that the conflict in Syria continues to be the biggest driver of migration. Since 2015, hundreds of thousands of Syrian migrants have crossed into Europe. Syrians are now the third-largest group of people with a foreign nationality in Germany, and among Syrian immigrants, there are comparatively many well-educated and trained health care professionals, e.g. some 3,000-4,000 medical doctors[2]。并非所有人都逃离了自己的国家。由于德国主要欢迎叙利亚医生，许多人被授予签证。

为什么德国需要叙利亚医生

原因很简单：在德国，近年来医生的相对短缺已经出现。工作时间法规的变化和对兼职工作的需求不断增长，这增加了对更多医生的需求。像许多其他发达国家一样，德国依靠国际医学毕业生或医生来补充其当地培训的员工，以维持其医疗保健系统。此外，随着叙利亚移民数量的增加，在医院和医生办公室接受治疗的叙利亚患者人数也会增加，这导致了对讲阿拉伯语的医务人员的新需求。因此，叙利亚医生能够履行双重功能。

Given this background, it may seem paramount to make the licensure process for Syrian immigrant doctors as straightforward and as swift as possible, actively supporting and advising applicants through the relevant processes. But in fact, the act of obtaining a permanent license to be allowed to practice medicine in Germany is onerous, lengthy, and can bring about many negative experiences. These can include feelings of humiliation, lack of transparency, arbitrariness, and helplessness. This is what many of the 20 Syrian doctors told us in an interview study we performed from 2016-2017.

Syrian doctors in Germany and their stories: the basis of our study

这个想法这项研究arose when a recently immigrated Syrian dentist, began working with us while waiting for his German dental license to be approved.

He told our team about his experiences with a “bureaucratic”, slow and confusing application procedure to secure his license. We were intrigued by his experiences and wanted to seek out other Syrian health care professionals’ experiences of the system. A qualitative study was designed and we received an overwhelming response to our call for interviewees on a Facebook page for Syrian Doctors in Germany. Within a few days, twenty Syrian health professionals were prepared to share their stories through face-to-face interviews.

在不透明和任意的官僚程序中迷失了：这就是作为叙利亚医生在德国申请医疗许可证的感觉

Syrian doctors are highly motivated to apply their skills and expertise in clinical patient care. However, they are confronted with a time-consuming, ever-changing and non-transparent application procedure lasting months, even years.

我们发现，到达德国后，叙利亚医生很有动力将其技能和专业知识应用于临床患者护理。但是，他们面临着耗时，不断变化的和非透明的应用程序，甚至数年。

One physician explained: “当我开始申请临时许可证时……一些规则更改，当局现在要求获得医疗德语的C1课程才能获得临时许可！在我开始C1语言课程后，他们需要检查医学条款。当我们完成一步时，他们要求另一步骤……这里没有稳定。透明

Interviewees describe a Kafkaesque system where they feel at the mercy of Government employees and reviewers who ask for absurd and impossible accomplishments, refuse to give information and act at random. This is shown in the quote of another interview partner: “没有明确的步骤。您可以有两名在同一所大学学习，在同年完成学业的医生，然后其中一个可以在没有任何考试的情况下获得认可，而另一个则需要参加另一次考试。归根结底，只有一个人就您做出决定。…当然，我们无法与这个人见面或与他们交谈。我们甚至都不知道他们的名字。”

因此，受访者报告说感到沮丧，烦恼甚至绝望。由于官方机构的信息和实际支持很少，因此叙利亚医生依靠个人网络和同行来了解要求并找到工作。

Where next?

为了获得对许可过程和所涉及的互动的平衡观点，未来的研究也应探讨德国医师或工作中心会议厅的行政人员的观点。自然，这些监管机构没有为申请许可证的大量移民医生做好准备，并且对许可程序数量的突然增加感到惊讶。记者报告说，批准叙利亚文凭可能很困难，因为在某些情况下，已提供欺诈文件[3，，，，4]。特别是对于医学界，应仔细检查凭证和证书。尽管如此，德国可能会向加拿大，澳大利亚或新西兰等其他国家学习，这些国家对受到海外培训的医生进行了协调，简化的评估程序，并在其申请流程的不同阶段实施了特定的资源指导和支持外国卫生专业人员[5，，，，6]。

欢迎叙利亚医生在德国进口ant than ever – especially as the current COVID-19 pandemic has highlighted the dire need for skilled medical staff in hospitals. While German authorities claim to be making an effort to find as many helping hands as possible to cope with the impending shortage of health care professionals, there are no signs that the accreditation process of foreign doctors – Syrian doctors among them – may be accelerated, or handled in a more pragmatic way[7]。

参考：

[1]Kingsley P. ‘Better to Drown’: A Greek Refugee Camp’s Epidemic of Misery. New York Times, Oct 2nd, 2018.

[2]Bundesaerztekammer (German Chamber of Physicians）。Aerztestatistik Zum 31. 2018年Dezember，Bundesgebiet Gesamt。2019年德国柏林Bundesaerztekammerhttps://www.bundesaerztekammer.de/ueber-uns/aerztestatistik/aerztestatistik-2018/on April 15^th，2020年。

[3] Hinz L. Innenministerium warnt – Falsche Zeugnisse und Diplome: Flüchtlinge kommen mit gekauften „Antragspaketen“ [内政部警告 - 虚假证书和文凭：难民带有购买的“申请套餐”]。2011年11月6日在线重点在线。https://www.focus.de/politik/deutschland/innenministerium-warnt-falsche-zeugnisse-und-diplome-fluechtlinge-koennen-im-libanon-antragspakete-kaufen_id_5066196.html2020年4月15日。

[4] Karam Eddy MS。逃离叙利亚前往德国的医生找到了避难所，障碍和延误。在：《纽约时报》。2018年9月8日。

[5] McLean R, Bennett J. Nationally consistent assessment of international medical graduates. Med J Aust. 2008 Apr 21;188(8):464-8.

[6] Covell CL, Neiterman E, Bourgeault IL. Scoping review about the professional integration of internationally educated health professionals. Human Resources for Health. 2016;14(1):38-. doi: 10.1186/s12960-016-0135-6.

[7]骑士B.尽管冠状病毒，外国医生仍在努力获得德国认可的学位。Deutsche Welle 2020年3月31日。https://www.dw.com/en/despite-coronavirus-foreign-doctors-truggtor-trugg-to-get-get-get-rendized-in-germany/a-5296666742020年4月15日