My Experiences and Challenges in Germany as A Clinical Physician ~ Acquire Theory and Skill of Chronic Total Occlusion Percutaneous Coronary Intervention and a German Doctor’s License ~

Abstract

　Treatment of chronic total coronary occlusions (CTOs) is the most challenging field of percutaneous coronary intervention (PCI) because of the historically low procedural success and high recurrence rate. The success of CTO-PCI depends mainly on operator experience. Therefore I studied abroad at Darmstadt Hospital in Germany, which is a high volume center in Europe for CTO-PCI, to acquire the theory and skill of CTO-PCI. Another experiment is to struggle to get the German doctor’s license. Foreign physicians who want to train or work in Germany need a permanent medical license (Approbation) or a temporary medical license (Berufserlaubnis). In this report we will describe the CTO PCI, my experiences in the heart catheter laboratory at Darmstadt Hospital, and how to get the German doctor’s license.