德國快篩普及化
聯邦衛生部長Spahn宣布，從3月1日起，民眾可以在診所、藥局、Test center 免費接受快篩，費用由政府承擔。如果想要在家自行測試，目前考慮收取一歐元左右的自負額。
快篩的操作方式比正規的PCR簡單，只要把棉籤插入前鼻腔2-3公分處，旋轉個15秒就可以了。根據Charité 和海德堡醫學大學對150名疑似案例的研究，一般民眾自行操作快篩和醫療人員做測試的準確性差異不大。所以民眾自行在家操作應該是可行的。
有些人把快篩普及化視為疫苗普遍接種前的應急措施，他們認為只要每個快篩陽性的人都乖乖待在家裡，就能大幅減少傳播，但是，另一些人對其持保留態度。如果只是大量提供免費測試，對於防疫是沒有幫助的。政府需要有更加明確的規則。假如有人快篩陽性，他們應該向誰通報?如果父母確診，他們家裡的小孩是否能夠上學?還是全家人都應該要被隔離?政府應該要盡快對上述問題提出明確的措施。
心得:我個人覺得快篩免費比較像是降低大家對於疫苗施打進度落後的怒氣，還有轉移焦點，說明政府有在做事的措施而已。快篩能夠減少疫情傳播的前提是，被驗出陽性的人真的在家裡乖乖自我隔離。德國人做得到嗎?而且就像上面說的，如果一個家人在家隔離，另一個人天天出去上班上學，這樣病毒不是照樣傳播出去嗎?我想真正的希望應該還是應該放在疫苗上。
One year after German Approbation
It’s been more than a year since I got the German medical license. Although compared with many predecessors, I’m still a little rookie, I'd still share some thoughts here. Here I will compare the differences in residency training between Taiwan and Germany and summarize my current feelings.
First, let's talk about the advantages of Germany
1. Freedom to choose specialties.
In Taiwan, due to a strictly regulated capacity limit of each specialty, it is not always possible to train in department you want. To get into a residency training program is very competitive. In Germany, there is no such capacity limit. It depends on whether each hospital / clinic has a mentor Qualifications, if yes, you can be trained there as long as they still have vacancies. In Germany, I have received various offers from dermatology, pathology, family medicine and neurology, and I am currently training in the rehabilitation department.
I think this gives me a chance to think seriously about what I really like, and I won't go with the crowd because of the collective anxiety of my peers.
2. Take the leap whenever you want
In Taiwan, the interviews for residency training program always take place at the end of the year. After all the hustle and bustle, the dust is basically settled. Unless someone quits and releases a job vacancy, the chances of making a change in the middle are small. In Germany, it happens all year round and there are job vacancies everywhere. Because taking maternity leave and parental leave is justified in Germany, if someone takes leave of pregnancy, the hospital must hire another doctor. The amazing thing is that the majority of doctors here are women, so there are really bunches of such vacancies. And after giving birth to children, many of these mothers will also take the chance to quit and find a new job.
In addition, it is not surprising to change or to pursue a second specialty in Germany. As I worked in pathology, there were a ophthalmology attending physician who was training in forensic medicine, and I have also heard of anesthesia attending physician transferred to general practitioner, and among my colleagues, there are also former dermatology residents. In short, what you want to do and what you have done is your own business. No one will say, "Oh, you will be delayed."
3. So many holidays
As everyone knows, the annual leave in all walks of life in Germany should be no less than 26 days.
4. Part-time working mode
Many job vacancies here can be done part-time, like 50%~80%. Of course, the salary will be relatively low, and training years will also be discounted, but it is a good choice for those who want to study at the same time, who need to take care of children, or people who simply don't want to work to much. It would be nice if Taiwan also has such partial working hours.
Then come back to the advantages of Taiwan
1. Solid training
I think the biggest advantage in Taiwan is solid training
I have seen other seniors say that training in Taiwan is better than in Germany. At that time, I was half-believing, but now I totally feel that way.
Taiwan really has very high standards for the training of every doctor, so that after coming to Germany, I was shocked finding out that German doctors can become specialists without having to know this or that.
I personally think that one of the contributing factors is that the structure of the medical system in Germany is very implemented. It is not necessary for everyone to handle everything independently. Sometimes I am full of envy that my colleagues in Taiwan can receive substantial and complete training, but upon thinking of the blood and sweat in the training process, I am fine here.
2. Shorter training period
The working hours in Germany are relatively short, but the corresponding training years are long. Now every residency training (including family doctors) takes at least five years. However, Germany does not have a PGY system, so it saves one to two years.
3. Training program
The training of German resident doctors is quite different from that in Taiwan. And often the same specialties have different regulations in different states. The trouble is that not every hospital are able to provide a complete five-year training, especially those specialized hospitals or clinics. Therefore, after completing a certain part of the training, you need to find another job yourself. In Taiwan, it is usually guaranteed to be completed after recruiting, and the insufficient parts can also be sent to substitute training, which saves a lot of trouble.
4. Novice friendly
Because itis relatively rare in Germany in terms of one-stop training, and job-hopping is also very common, so many hospitals will like to hire people who already have experience. In Taiwan, job seekers are usually at the same age, and there is not much difference between them.
On the whole, if you want to learn the most advanced medical techniques and receive solid training, Taiwan or the United States is definitely a better choice. If you still want to come to Germany, I think you might consider coming out after completing training in Taiwan, because unlike the United States, it is in Germany possible that a foreign residency training be recognized.
In summary, if you have a free heart and an unruly soul, coming to Europe is still very suitable.
Zhuge Grilled Fish "Three kingdoms" - Düsseldorf
Last week, thanks to the Leben App promo, we in Berlin also had the opportunity to enjoy this "Zhuge Grilled Fish" from Düsseldorf.
In fact, I didn't know what Zhuge grilled fish was before, but after some research, I realized that it belongs to Sichuan cuisine, similar to the concept of putting grilled fish on a spicy pot. Out of curiosity, I placed an order.
This grilled fish hot pot costs 45 euros and there are two fish in it!
Then there is a box of spicy soup base and a packet of vegetables. There are fungus, lotus root, noodles, and various vegetables. We only add half a packet.
We also ordered two cold dishes, and the store also gave a pack of Luwei (braised dishes), which should be braised duck gizzards.
Overall, I would say it's a good bargain, and the store has prepared the food quite well. We only had to pour the soup and vegetables into the pot and put the fish on top of it. I only put one fish at first.
The owner also very considerately packs a small packet of sesame, peanut and coriander, and put it on top is the finishing touch.
In fact, after I came to Germany, I came into contact with a lot of Chinese dishes that I have never had before, and found many Sichuan dishes especially super delicious.
Delivery App Reviews in Germany
The biggest impact of Lockdown on life might be that we cannot visit the restaurants anymore. This wave of regulations has instead promoted more stores to enter the delivery market. Following are some delivery apps that I use recently, if you know any other apps, you are more than welcomed to share with me.
Leben:
This is an app created by Chinese. The advantage is that the interface is all in (Simplified) Chinese, and there are basically all Chinese restaurants. If you are in a large German city, it should be covered in the scope of delivery. You can use Paypal payment in the app . In short, is very convenient. Most of them deliver starting from 12 Euros, so even one person can easily place an order.
Eataround
It is a new delivery app recently. The Chinese in the interface is actually not OK, but I can't find how to shift into English. There are vegan Tianfuzi and Hage Ramen on it. The advantage is that there are many restaurants to choose from, like Thai, Greek, German and other dishes are available. The obvious disadvantage is that the delivery starts at 40 Euros, and extar service fee is charged for by orders less than 40 Euros.
Lieferando
Before Lockdown, it dominated the German delivery app market for more than a year. There are many restaurants in cooperation, but not many that suit our taste. The advantage is that no matter where you are in Germany, there should be at least two or three pizza or spaghetti you can order; the disadvantage is that they see themselves an intermediary platform instead of a delivery service. If there is a dispute with food delivery, they will not be responsible.
Deliveroo
When talking about delivery apps, you must mention Deliveroo, which is a thing of the past. When I first came to Germany, Deliveroo was still operating in Germany. At that time, many of my favorite stores could be delivered by their apps, such as Tianfu (Sichuan cuisine), Cooking Papa (Korean cuisine), and their delivery staff are driving delivery, unlike Lieferando, who always ride bicycles. Unfortunately, it seems that they quit due to high labor costs and other reasons. I hope they can come back someday!
The above is my current delivery app, welcome to share experience :)
德國 C&A 驚喜福袋 Überraschungstüte
大家有聽說C&A推出的驚喜福袋Überraschungstüte嗎?
一個福袋只要15歐，裡面有七件單品，包含一條長褲、兩件毛衣或長袖T，再加上四樣冬季商品(Winter-Kollektion)，還可以用十歐加購一件風衣或外套。昨天看到的時候覺得：也太超值了吧!很想直接打電話下單，但男友問說那裏面的東西好嗎?讓我瞬間冷靜，決定先觀望一下，今天看到德國Youtuber 發的開箱影片，大家覺得怎麼樣呢?
2:30開始是男裝開箱，女裝從7:30開始。其實全部看下來，除了毛衣我覺得還不錯看，其他的都恩...德國人好像覺得穿上面有英文字樣的衣服很酷或很可愛?但我覺得很尬。女裝部分看到那件黑色豹紋內搭褲我直接尖叫
憑良心說15歐真的很便宜，只要裡面有一件還不錯的衣服，應該就划算了，但是要把其他挑戰我審美的單品放進我衣櫃裡，我要先認真考慮一下
諸葛烤魚-杜塞
上禮拜因為樂本App的活動，讓在柏林的我們也有機會吃到杜賽的這家”諸葛烤魚”。
其實之前不知道諸葛烤魚是甚麼東西，研究一下才知道原來是屬於川菜 系，類似把烤魚放在麻辣鍋上的概念。因為沒吃過覺得很新奇，就也下單了。
這份烤魚火鍋要45歐元，裡面有兩條魚!
然後一盒麻辣湯底和一包蔬菜，裡面有木耳、蓮藕、寬粉，還有各式各樣的蔬菜，我們只加半包就覺得分量差不多了。
照片裡只有半包。我們還另外點了兩個涼菜，店家還送了一包滷味，應該是滷鴨胗。
整體來說覺得很超值，而且店家把食物都調理好了，我們只需要把湯底和蔬菜倒進鍋裡，把魚放最上面就好了。我只先放了一條。
老闆還很貼心的另外包了一小包芝麻、花生米和香菜，放在最上面是畫龍點睛
其實來德國以後，反而才接觸到很多沒吃過的中菜，尤其很多川菜都超好吃呢
德國執照一年心得
距離我拿到德國執照也一年多了，雖然跟眾多前輩比起來，我還是小小菜鳥，還是來比較一下台灣跟德國住院醫師訓練的差異，總結一下我目前的感想
先講德國優點
1. 選科自由。
在臺灣，因為各專科有容額限制，不是想走甚麼科就能去受訓，考住院醫師是非常競爭的，而在德國沒有這樣的容額限制，而是看每一家醫院/診所是否有導師資格，如果有的話，只要他們還有職缺，就能在那裏受訓。在德國，皮膚科、病理科、家醫科、神經內科的Offer 我都拿過，目前則是在復健科受訓。在臺灣，我根本沒有肖想過皮膚科
我覺得這讓我有機會認真思考，到底自己真正喜歡的是甚麼，也不會因為同儕的集體焦慮而隨波逐流。
2. 隨時想換就換
臺灣的住院醫師考試好像都是集中在年末的時候，一波東奔西跑放榜之後，基本上就塵埃落定，除非中間有人離職而釋出職缺，不然中途想轉職的機會不太大? 在德國則是一年到頭，到處都有職缺。因為在德國請產假、育嬰假是天經地義，如果有人懷孕請假，醫院就要另外聘人來代替她。奇妙的是，醫師群體也是女性居多，所以這種職缺真的超級多。而且這些媽媽們生完小孩，很多也會順便跳槽了。
另外，在德國換專科或雙專科也不是甚麼奇怪的事。之前在病理，就有眼科VS來訓練要轉法醫，也有聽過麻醉VS轉家醫，而我現在同事裡面，也有皮膚科R換過來的。總之就是你想做甚麼、做了甚麼是你自己的事，不會有人說「蛤那你就delay一年了」之類的話。
3.放假多
這就不用贅述了，在德國各行各業的年休應該都是26天起跳。
4. 部分工時模式
這邊很多職缺可以是Teilzeit部分工時，50%~80% 之類的都看過，當然這樣薪水就會相對應的比較少，訓練年資同樣要打折計算，但對於想同時讀博、需要照顧小孩，或是單純不想太累的人來說，就是不錯的選擇。我覺得如果臺灣也有這種部分工時的話應該也滿好的。
5. 不用看病人家屬臉色
這個真的就是民情差異。在這裡，如果病人不守規矩，例如在醫院偷抽菸，我們是可以直接請他滾的。最近因為疫情關係，就限制病人不能偷跑出去或是跟外人親密接觸，好幾個病人真的就因為違規被趕走。
之前也一個病人在周末跟值班醫師起衝突，說要找律師，還要跟Bild (類似德國的蘋果日報)爆料，那位學姊就很強硬的堅持立場，到最後病人妥協說他只是一時情緒不好說的氣話，承諾不會真的去搞那些動作。不過德國也是有很愛投訴院長信箱的人。
然後說回來臺灣的優點
1. 訓練扎實
我覺得在臺灣最大的優點就是訓練扎實
之前就曾經看過其他前輩說臺灣訓練比德國好，當時我還半信半疑，現在我完全覺得就是這樣。
臺灣真的對每個醫師的養成要求都很高，以至於來德國以後發現，原來德國醫生可以這個不用做、那個不用會，一樣可以當上專科醫師的時候整個震驚了。例如我們醫院急救訓練不需要會 on Endo，有緊急狀況就叫救護車。是的，我們是醫院，但還是可以叫救護車，我也叫過。
我個人覺得其中一個因素是德國的分級醫療非常落實，甚麼東西在基層做，甚麼狀況屬於急性醫療，那些東西可以留給其他人做都劃分很清楚，不需要每個人都會獨立處理所有事情，不過老實說，在德國當病人很多時候真的要命很硬，自求多福。有時候還是滿羨慕在國內的同仁可以接受充實完整的訓練，但想到訓練過程付出的血汗，我又佛系了。
2. 訓練年限短
德國工時比較短，但相對應的訓練年限長，現在每個專科訓練(包括家醫)都要五年起跳，甚至病理科之類的總共要六年。不過德國是沒有PGY制度的，也是省了一兩年。
3. 訓練包套
德國住院醫師訓練還滿奇葩的，有點類似集點制度，比如說復健科五年，其中需要包含一年內科(或神內)以及一年外科(或骨科)訓練。而且往往同一個專科在不同邦的規定又不一樣。麻煩的是，不是每個醫院都有辦法提供完整的五年訓練，尤其專科醫院或是診所更是不可能，所以完成某部分訓練之後需要自己再去找下一個工作。而臺灣通常是招進去就可以保證做完，不足的部分也可以送去代訓，就省了很多煩惱。
3. 新手友善
因為德國比較少這種一站養成的情況，跳槽也很常見，所以很多醫院就會喜歡聘已經有經驗的人，萬一是無經驗者，面試的時候就要想辦法彌補這部分。而在臺灣，通常求職者都是在同樣的人生階段，彼此差異不會太大。
整體來說，如果想學習最先進的醫術，接受紮實的訓練，台灣或美國絕對是比較好的選擇。如果還是想來德國，我覺得或許可以考慮在臺灣當完R再出來，因為不同於美國，德國是有機會承認外國的住院醫師訓練的。
至於很多人都一直說出國就會被歧視、低人一等什麼的，我認真覺得這是看運氣和個別環境。以前在台灣醫院工作的時候，遇到更多不友善的同事或其他職類人員，醫院裡的階級制度也非常明顯，讓我覺得很壓迫；而在德國，同事之間都比較疏離，和上司、前輩的關係也比較平等。而且話說難聽一點，德國那麼大、醫師職缺那麼多，老子不爽就依照合約辭職換下一家，也不需要為了訓練看誰的臉色，不用像在台灣，動不動就被恐嚇「台灣醫界很小」甚麼的 所以我覺得在德國執業比在臺灣的時候快樂多了。而且現在德國已經吸引非常多外籍醫師過來，我現在和以前待的醫院，都有一半左右的醫生不是德國人，對外國人也是見怪不怪了
總結來說，如果你有一顆閒散的心和不羈的靈魂，同時對物質沒有太大追求的話，來歐洲還是很適合的
德國外送App 點評
現在正值沒什麼用的 Lockdown light 期間，對生活影響最大的，應該就是餐廳不能內用，不過我們早就很久都不內用了，這一波規定反而促進更多店家投入外送市場，下面是幾個我最近常用的外送app，如果還有其他app也歡迎跟我分享哦
樂本Leben:
這是一個中國人創的app，好處是介面都是(簡體)中文，裡面基本上也都是中餐館，如果你所在的是德國大城市，應該都有涵蓋在外送範圍，在app裡可以透過 Paypal 支付，總之就是滿方便的。柏林宴遇、新陽光、美食屋我們都常點，大部分店家12歐起送，就算只有一個人也能輕鬆下單。
Eataround
應該是最近新出的外送 app，介面中文化的很不OK，但我找不到怎麼改成英文。上面有純素食的天府子，還有Hage Ramen。優點是餐廳選擇多，泰式、希臘、德式等等各種料理都有，比較明顯的缺點是40歐起送，不滿40歐要外加服務費。
Lieferando
在 Lockdown 之前獨霸了德國外送app市場一年多，是我心目中萬惡的app，所以我把它擺最後。合作的餐廳很多，但合我們口味的不多。優點是不管你在德國多麼鄉村的地方，上面應該都有兩三家Pizza或義大利麵可以點；缺點是他們以仲介平台而非外送服務自居，如果送餐有糾紛，他們不太會負責。
Deliveroo
如果講到外送App一定要提已成往事的 Deliveroo. 剛來德國的那時候，Deliveroo 還有在德國營運，那時候我的很多愛店都可以用他們家app叫到，像是天府川菜、Cooking Papa 韓式料理，而且他們外送員都是開車外送，不像 Lieferando 都是騎腳踏車送，可惜後來好像因為勞動成本太高等原因退出，希望他們總有一天能再回來啊!
以上就是我目前常用的外送app，歡迎交流心得 :)
@Dr.Vanessa
