Differences between American and German medical students and physicians in knowledge of infectious diseases

Unlike in the USA and many other countries, the discipline of infectious diseases is not established as a specialty or a subspecialty in Germany. In order to assess the impact of this structural difference, the knowledge of clinical infectious diseases was compared among 64 German and 82 American physicians and medical students using a 33-question, multiple-choice questionnaire. Participants in the USA had significantly better scores, and, among them, the number of correct answers increased steadily along with clinical experience. In contrast, among the German participants only a minor increase in knowledge was observed after the first 2 years of postgraduate training. The superior knowledge of infectious diseases demonstrated by physicians and medical students in the USA is presumably due to better training in this field during medical school and residency. Additionally, repeated exposure to infectious disease consultation in daily practice is likely to provide continuous medical education. The results of this study may provide a rationale for establishing infectious diseases as a recognized medical subspecialty in Germany.