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Unlike in other countries, postgraduate training in Germany is not attached to academic centres. Content and duration of postgraduate training are stipulated by the federal medical boards, with the process being unstructured and solely at the responsibility of the trainee. As a model for a structured postgraduate training programme, the Dutch training system for general practitioners is described in detail. The most important difference is the funding of trainees and training facilities within the frame of structured training programmes by the Dutch Ministry of Health. Acquisition of qualifications thus becomes more important than the work performance of the trainee. After reforming graduate medical training, it is now time to rethink postgraduate training in Germany.