ENA neurosurgeon in Germany is a doctor with the title Facharzt für Neurochirurgie who operates on the brain, spinal cord, spine and nerves, and nobody sees one «just in case». Usually there is already a scan with a finding and a local doctor saying surgery is needed, so the first question is not which hospital but who exactly will operate.
This page is about the surgeon rather than the department: what the German title stands for, what different neurosurgeons do and how to compare two of them. The conditions treated and the operations themselves are covered in the overview of neurosurgery in Germany.
What the title Facharzt für Neurochirurgie means
The title means that after six years of medical school the doctor has completed specialist training in neurosurgery and passed an examination at the medical chamber of his federal state. The training takes at least six years, half a year of it in neurosurgical intensive care, under a specialist authorised to train. Six years is the minimum: if the required range has not been covered, training lasts longer. The rules are set out in the model training regulations of the German Medical Association; each state chamber’s version is the binding one.
Over those years the doctor works through a compulsory catalogue: set numbers of operations on the brain, spine and peripheral nerves, emergency care for head injuries, brain haemorrhage and acute spinal cord damage, and a part in vascular brain surgery and in drug treatment of tumours. It all goes into a training logbook; the supervisor confirms the entries and the numbers reached, and the chamber admits a doctor to the examination only when everything is documented. Without that recognition nobody may call himself a neurosurgeon.
The paperwork shows a hierarchy: an Assistenzarzt is a doctor in training, a Facharzt a qualified specialist, an Oberarzt a senior consultant, and the Chefarzt or Direktor heads the department. The head’s name on the letterhead does not mean he will operate; that is a separate question, best asked in advance.
Neurosurgeons are not interchangeable
Neurosurgeons are not interchangeable, because the specialty has settled into clear strands: brain tumour surgery, skull base surgery, vascular neurosurgery (aneurysms, malformations), spine surgery, functional neurosurgery such as deep brain stimulation in Parkinson’s disease and epilepsy surgery, and paediatric neurosurgery. Most of them, along with peripheral nerve surgery, are separate parts of the training regulations too.
This matters more than any ranking. A surgeon who removes acoustic neuromas several times a week and one who operates on the lumbar spine just as often are both neurosurgeons, but for a given diagnosis the choice between them is not neutral.
A surgeon’s strand shows in the Schwerpunkte section of the profile, the name of the department and the publications. For example, Prof. Bernhard Meyer is director of the department and outpatient clinic of neurosurgery at the Rechts der Isar hospital of the Technical University of Munich; the department’s website lists its clinical focus areas: neurotechnology, brain tumour surgery and neuro-oncology, vascular neurosurgery and spine surgery. Prof. Marcos Tatagiba is medical director and chief physician of the University Department of Neurosurgery in Tübingen.
An online opinion from a German neurosurgeon
An online opinion from a German neurosurgeon is often the right first step: in many situations an MRI or CT on a disc and the reports are enough for him to say whether he confirms the indication for surgery, with no need to travel first.
For a substantive answer the package needs the original study files in DICOM format, as the scanner stores them, not photographs of a screen, plus the radiologist’s report, discharge summaries and histology after any operation or biopsy. A remote opinion does not replace a neurological examination or the talk about risks before consent. Under Section 630e of the German Civil Code that explanation must be given orally and early enough for a considered decision, by the doctor or someone trained for the procedure, in words the patient understands.
A second opinion from a German neurosurgeon is a written document, not a verbal comment: the doctor sets out what he agrees with in the proposed plan, what he does not and what he would do instead. It may also say that these images are not enough and new tests are needed. See the page on a second opinion from a German doctor.
Checking a surgeon before you travel
More can be checked in advance than many expect: where the surgeon trained, how many years he has been operating independently, which procedures his profile lists as the main ones, whether the department belongs to a certified centre for its field, such as a neuro-oncology centre, and whether he or his team speak the patient’s language.
At the first conversation the questions are simple. Who will operate, and who will assist? What happens if the situation changes during surgery? How many days in hospital, and who follows the patient after discharge? Specialists in other fields are listed in the directory of doctors in Germany.
Where a neurosurgeon sees patients and operates
A neurosurgeon may see patients in a hospital outpatient clinic or in private rooms, but he operates in a hospital department, most often at a university or large hospital with round-the-clock neuro-intensive care and neuroradiology. Brain and spinal cord surgery is tied to a department with an operating microscope, navigation and intensive care, not to a consulting room.
For an international patient, choosing the surgeon means choosing the hospital and the other way round; keeping one while dropping the other rarely works, because the surgeon operates where his team works. Where such departments are and how to match them to a diagnosis is covered on the page about neurosurgery clinics in Germany.
Frequently asked questions
Who are the best neurosurgeons in Germany?
There is no single best neurosurgeon: Germany has no official ranking of doctors, and magazine lists use their own methods. Three criteria matter more. Profile: does the surgeon operate on exactly your diagnosis? Volume: how often do he and his department perform this operation? Hospital: are intensive care, neuroradiology and the right team on hand? The right surgeon meets all three.
What language will I speak with a German neurosurgeon?
Whichever language you understand without effort: German law requires the explanation before surgery to be understandable to the patient. Whether the surgeon speaks English is worth checking, but risks and options are safer discussed in your own language, so an interpreter joins the consent conversation. The discharge letter is translated too, because your doctor at home will need it.
What if the German neurosurgeon disagrees with my local doctor?
Compare the arguments, not the reputations. The written opinion states what the German surgeon disagrees with and why: a different approach, observation instead of surgery, or an extra test. These arguments can go back to your local doctor. If the disagreement remains, a further opinion or a case conference helps, and the final decision is yours, made with the surgeon who will operate.
How AlenMed matches a neurosurgeon in Germany
AlenMed matches a neurosurgeon to the diagnosis and the scans: we collect the imaging and reports, have them translated and put them in front of a surgeon in the right strand. The patient receives a written opinion and, if he goes ahead, the hospital’s estimate, a date and a visa invitation.
An interpreter comes with the trip, so that nothing at the consent conversation is signed unread. We help obtain the discharge letter and the imaging for the journey home, and afterwards pass questions and new scans on to the surgeon.
This material is for information only and is not an offer. The indication for surgery is decided by a doctor at an in-person consultation.