Oral and maxillofacial surgery (OMFS) in Germany is a dual-degree specialty, titled Dental, Oral and Maxillofacial Surgery (DOMFS) in Annex V of Directive 2005/36 that defines professional qualifications in Europe. Overall, 19 countries in Europe offer a dual degree in OMFS (Dental, Oral and Maxillofacial Surgery - DOMFS) and nine offer a single medical degree, maxillofacial surgery (MFS). Challenges facing the medical profession in Europe include generational shifts in priorities [1], changes in the gender ratio [2], trend toward part- time work [3], changes in the age profile of the workforce [4], and immigration and emigration alongside the integral stresses of workload and external pressures from national and European authorities. Awareness of these changes enables planning to mitigate their impact. This paper presents an example of when an amendment to the Delegated Act enabled French oral surgeons with solely a dental degree to gain access to DOMFS, stressing the need for vigilance regarding the legislative framework in which DOMFS specialists practice. Currently, specialists with both dental and medical degrees who completed their training in countries with a single medical degree (MFS) must apply on a case-by-case basis if they wish to practice in a DOMFS specialty. Germany could explore whether general processing rules may be established for this group and other OMFS specialists. German authorities are currently considering how to handle doctors with medical qualifications and/or board certification from third countries, i.e., outside the European Union. The OMFS specialty in Germany should decide whether to issue a statement on this matter; other medical specialties have already expressed concerns. There are risks associated with European examinations that have been adopted as national assessments of specialist skills or knowledge. Collaboration with organizations such as the European Union of Medical Specialists (UEMS) is recommended. If German OMFS wishes to maintain its leadership role in Germany and in Europe, it must continue to engage in dialogue with all stakeholders.
