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Dear Prof. Werfel,

As you know UEMS aims to harmonize the European Training Requirements to promote free movement of Specialists and to guarantee the quality of training at a sufficient level. 22 European Countries have the full specialty of Allergology today. Estonia 2014, France 2017 and Slovenia 2018 were last added on this list. Existing European training requirements for Allergists (UEMS proposal European Charter Chapter 6, 2003) demand 5 years of training for Allergology (2 years in Common trunk, 3 years Allergology). Only 5 European countries still have a subspecialty and Germany is one of them. Now we hear with great concern that Germany wants to cut down the time trainees have to spent in training to become an allergist. That means Germany does not even follow the minimum requirements for the subspecialty laid out in the European Position-Paper published in Allergy 2018;73:540-548. And this paper was heavily influenced by the German proposal of the DGAKI from 2013 for the German MWBO.

From an European view, we fear that the development in Germany leads to a massive loss in education quality of German allergists. lf we consider the European development, Germany is on the wrong track. Most life-threatening allergies are being treated in hospitals. How will Germany ensure that the training of serious and complex allergies are being treated according to international guidelines when there is no proper in hospital training? Cutting down the training requirements is an underestimation of the complexity of allergies and the immunology behind this. 17 European Countries have the combined Specialty or Subspecialty of Allergology and lmmunology. Allergology is not separable from lmmunology, because the test results have to be understood and integrated in the clinical context. This needs to be supervised and therefore there is considerable need for training.

We ask you therefore urgently to reconsider and alter the new proposal of training for allergists in Germany. Germany will become isolated in Europe and will lose the connection to the European development. 18 months of training for the subspecialty and 5 years for the full specialty is the European way. Germany is at the brink of an history mistake.

Best regards