The decadence of German medical doctorate

Germany is a country where a doctorate still invites respect and even deference, in certain circles at least. Here, the prefix “Dr.” even becomes official part of your name, while your professorial thesis advisor is reverentially called “Doktorvater”- doctoral father (there is no appropriate term for female supervisors, which makes the concept even more embarrassing these days). There is a whole zoo of German doctorate degrees, biologists and other natural scientists are generally “Dr. rer. nat.” and medical doctors are “Dr. med”. Unlike in the Anglo-Saxon model, German physicians do not receive a default MD title with graduation, they can only call themselves Herr or Frau Doktor once they wrote and defended a dissertation at their university.

The thing which angers German life scientists (and others) about this peculiar German medical doctorate, is that it is relatively easy to get, while providing equal, if not better, academic advantage as their own PhD-like Dr. rer. nat. Biologists need between 3 and 5 years to have enough material for a thesis, while their medical colleagues invest often less than a year, and even this in-between their university lectures, courses and exams. The medical dissertations themselves accordingly often contain little (if any) own research and are much shorter, occasionally just a couple of pages describing the attached co-authored publications (doctors publish a lot, often the sheer quantity counts). This lightweight model is exactly what generally prevents German medical doctors from having their titles recognized in the US or elsewhere as a PhD degree. In Germany however, both Dr. rer. nat. and Dr. med. have an equal value when academic jobs are distributed.

Importantly, this Dr. med. title is not at all required for doctors to practice medicine in hospitals or in order to open their own  private praxis. Outside of the academia, the doctorate is solely about the prestige. In hospitals or medical faculties, junior doctors will rather bite own tongue than address their superiors informally, as “Herr Müller” instead of “Herr Professor Doktor Müller”. And in case this Herr Müller also wrote an additional thesis out of the available doctorate zoo, he is to be addressed as Herr Professor Doktor Doktor Müller (no, this is not a typo). On the other hand, a fully certified physician who left university without adding a Dr. med. to his or her name, will have difficulties to be taken seriously.

This is why many physicians do all they can to get a Dr. (or even a Prof.) in front of their names to boost their careers. Some employ ghostwriters, others even buy titles from corrupt or phony universities. Plagiarism is extremely rife, whole labs occasionally submit the same thesis all over, including the boss, who then uses it for his or her “habilitation”, a German academic degree of “Privatdozent”, designed as a qualification for a professorship. Even the German defence minister and close ally of the Chancellor Merkel, Ursula von der Leyen, was caught plagiarizing heavily in her 1990 dissertation on obstetrics (analysis is available on Vroniplag Wiki). However, she was acquitted of misconduct (and thus retained her title) by her alma mater, the Hanover Medical School.

Debora Weber-Wulff, professor at the University of Applied Sciences in Berlin, is specialist for plagiarism detection and one of the contributors of VroniPlag Wiki anti-plagiarism platform. She published a case study about the widespread plagiarism in German medical dissertations and explained this problem in a RetractionWatch interview. Yet as Weber-Wulff is fully aware of, this rampant plagiarism is not the only problem. Some of German medical dissertations are of outrageously substandard quality. Weber-Wulff shared with me some examples, which I present below.

Four examples of horrendously bad German medical doctorate theses

 1. “If I were head physician, than I would… : Requests for changes in a psychiatric clinic“. 61 pages, University of Heidelberg, 2000

Usually, a doctorate thesis has one author. It is after all supposed to be evidence of a personal independent research effort of an academic scientist. This one had two authors:  Leonie Maischein (now resident psychotherapist in the Protestant Hospital Bielefeld) and  Birgit Tebbe. Their “Doktorvater” was the psychologist  Priv.-Doz. Dr. rer. soc. Dipl.-Psych. Jochen Schweitzer.

The two authors asked between 22. 02 till 31.03.1999 30 employees and 55 patients of a nearby psychiatric clinic for suggestions of improvement in the management. The German-language abstract is available here.

2. “Craters on the Earth-facing side of the Moon, named after doctors”. 113 pages, University of Cologne, 1983.

The author of this medically highly-relevant opus was Siegmund Domin, now general practitioner in Cologne. His patients are surely impressed by his medical doctorate, and probably assume his doctorate research saved many lives. Remarkably, Domin’s stroke of genius had a sequel:

 “Craters on the Earth-averted side of the Moon, named after doctors”. 100 pages,  University of Cologne, 1985.

This time it was Domin’s wife Lidia Domin, whose medical investigation revolutionized medicine and patient care the second time, after her husband. Frau Dr. Domin also has her own GP practice in Cologne. The two doctors later on published a book, “Moon craters named after doctors”, it is really a pity it was overlooked by the Nobel Prize Committees for Medicine or Literature. Maybe at least some newly found craters on the Moon could be named after the Domins?

 3. “Natural remedies for impotence in medieval Persia”, University of Münster, 2006

The peculiarity of this medical dissertaion by Dr. med. Maryam Khalegi Ghadiri is its length, or rather shortness: 3 pages. Yes, just three. It is probable that the dissertation text is similar to this short and equally named “Review of Impotence” which Khalegi Ghadiri published in 2004 together with her “Doktorvater” Ali Gorji in the journal International Journal of Impotence Research. Gorji is neurophysiologist at the University of Münster, according to Weber-Wulff, he was also responsible for the supervision of a number of apparently plagiarised doctorate theses. Khalegi Ghadiri is still employed in Münster and keeps publishing with Gorji.

4. “Results of phage typing and analysis of chemotherapeutics resistance of Staphylococcus-aureus strains from clinics of Federal Republic of Germany”. University of Bonn, 1982-2002

There is a whole family of these medical doctorate thesis, the only difference in title is the year for which the analysis was performed. The earliest dissertation is from 1982 and concerns the analysis from 1977; the doctorate recipient was Wolfgang Micansky, now general practitioner in a small German town in Niederrhein area, not far from the Dutch border. To make sure this 1977 dataset was properly analysed, it was re-examined in 1983 by another Dr.med. candidate, Thomas Herting (now apparently GP and specialist for acupuncture in Lübeck).  Another of the follow-ups, the dissertation from 1985, was submitted in Bonn by Peter Schreckenberg (now established pediatrician in a town near Bonn), who analysed the dataset from 1979. His wife and praxis-partner Lioba Schreckenberg defended her thesis in Bonn in 1985, by analysing the dataset from 1980.

There are around 20 doctorate theses of this kind. The farce (almost) concluded in 1993, with the two theses by Monika Raussen (now dermatologist in small town 50 km away from Bonn), and Marie-Luise Thomas, who bravely shouldered the bacterial datasets from 1986 and 1987, respectively. Their “Doktorvater” apparently retired from his academic post by then. Yet the concept was revived, just once in 2002: the dataset from 1992 needed urgent medical attention. This medical thesis was defended by Anusha Patchava, who currently works in a GP praxis in Frankfurt. Since then, the dissertation churn-out completely stopped on “phage typing and analysis of chemotherapeutics resistance of Staphylococcus-aureus strains from clinics of Federal Republic of Germany”.

My brief internet search showed that it is unlikely to be revived. The “Doktorvater” died in 2004, at the age of 88. In his obituary, the microbiology professor Henning Brandis is described as the discoverer of the phage typing method and “an experienced teacher to his many doctorate students”. The only problem is: Brandis apparently never taught them the most important aspect of the doctorate research: originality. However, knowing how many German MD theses are plagiarized, communally performed or simply academically abysmal, all with full knowledge, approval and even active participation of the “Doktorvater”, this is hardly surprising.