The German medical doctorate system is not the only element that needs changing to overcome the ills that you discuss (see Nature 527, 7; 2015). In our view, a European approach offers the best cure.

We suggest that Germany's medical degree should be modified to lead to a common European medical qualification: the vocational degree of Doctor of Medicine. Postgraduate medical research should be part of a different common European qualification: the academic degree of Doctor of Philosophy.

Scientific quality would be guaranteed if the criteria for attaining degrees were to be standardized across Europe, and if specialist postgraduate medical colleges were widely set up. Students and clinicians would then also be able to pursue their divergent scientific interests more easily.

A European core curriculum devised along these lines would reduce excessive pressure on students, enhance the mobility of students and graduates, and foster the growth of excellent health care and science. The International Federation of Medical Students' Associations and the European Medical Students' Association have already laid the foundations for such a curriculum (see J. Hilgers et al. Med. Teach. 29, 270–275; 2007).