Skilled Migrant Workers
How Much German Is Enough?

Communication between doctor and patient
Communication between doctor and patient | © Techniker Krankenkasse

Whether they come as doctors or geriatric nurses, engineers or bricklayers – anyone who works in Germany needs some knowledge of German. In certain sectors particular language skills are required.

Germany is increasingly attracting skilled workers from abroad: in 2012 alone, the number of foreign doctors officially registered in Germany rose by nearly 15 percent, according to the German Medical Association. Nurses, IT specialists, engineers and other skilled professionals also come from Southern Europe, Southeast Asia and other parts of the world to work here. Most take German courses in their home countries until they attain the level of competence they need for entry into Germany and for their professional qualifications to be recognized. This does not always happen, however: “Theoretically, doctors have to prove proficiency at B2 level. In practice, however, the staffing situation is so appalling, especially in rural areas, that hospital managers do not insist on this. People are then for example given a temporary contract and are supposed to learn German within a year by attending evening classes”, says Almut Schön, who for her doctoral thesis researched German courses aimed at doctors: in Bavaria, for instance, skilled workers from abroad can begin working as carers for the elderly before they prove they have the required language skills, but then have six months to achieve B2 level.

After all, anyone who works in Germany needs some knowledge of German: “All employees must have sufficient language skills to understand their employment contract or salary statement and on occasion to make small talk with their colleagues over lunch”, believes Petra Szablewski-Cavus, who offers work-related German courses. According to Bernd Meyer, a professor of intercultural communication at Mainz University, a knowledge of German is also essential when it comes to occupational safety and health: “Many accidents happen on building sites because of linguistic problems and misunderstandings.” While work processes in areas such as manufacturing and production are relatively standardized and Indian engineers can fall back on English when discussing specialist subjects with their customers, insufficient language skills can pose a major problem in other professions, especially those entailing a great deal of communication.

No success without good communication

If doctors or people in the care professions are unable to express themselves in a clearly understandable way or themselves have problems understanding what is said to them, they will often be unable to carry out their duties work properly, however excellent their professional skills may be: “Part of the training of a geriatric nurse in Germany includes the ability to translate their specialist knowledge into more colloquial language when talking to the elderly person’s family. Even for a highly competent nurse from Bulgaria, this places very particular demands in terms of German language skills. It can also be a big problem when it comes to completing paperwork, especially if this requires observing certain formalities”, believes Szablewski-Cavus. The situation for doctors is particularly tricky: they generally find it fairly easy to communicate with their colleagues, because specialist medical communication follows similar structures around the world and because qualified doctors tend to find it easy to learn the requisite medical jargon. Particularly when talking to patients, however, language and communication have an importance that should not be underestimated.

Patients and their relatives do not usually use specialist expressions, after all: they explain in their own words what symptoms and prior medical conditions they have, how they came to have a particular accident and whether they take any regular medication. Not all patients can switch to English, and some speak in dialect or broken German. Some even subsequently take the hospital to court because they feel that they were not given sufficient information from doctors who lacked the necessary knowledge of German.

Tailored to their needs: German courses and exams for skilled workers

For decades, the Goethe-Institut branches around the world have been providing work-related courses in German to prepare skilled workers for employment in Germany. In some sectors it is already standard for skilled migrant workers in Germany to attend German evening classes that are partly financed by their employers or out of the public purse. Some hospitals, like the Charité in Berlin or the University Hospital in Freiburg, get their employees to practise having discussions with simulated patients in role-playing situations. According to the German Hospital Federation, some local authorities have already introduced practical language tests in which for example conversations between the doctor and the patient are simulated. Furthermore, Germany’s federal states agreed at the Conference of Health Ministers that a standardized method of language skill testing should be drawn up – to date different regulations have applied in hospitals around Germany.

What is most important of all is that such courses and tests take into account the language skills that skilled workers actually need in their jobs. Corresponding guidelines and teaching materials have already been developed for some areas such as for geriatric and general care nursing and for medicine. Petra Szablewski-Cavus additionally recommends that teachers of further training courses encourage participants to identify their own language needs and – wherever possible – to obtain an insight into the working environment and the specific requirements that the work entails. Until skilled migrant workers reach the linguistic proficiency needed to cope with their work, they should of course have experienced colleagues by their side to support them in the workplace.