Background: In the medical care of people who have been driven out of or have flown from their country to Germany, most of the challenges are not associated with technical–medical aspects but more with intercultural and organizational aspects. Starting situation: In 2015, more than a million people are said to have fled to the Federal Republic of Germany. They must be registered, receive an initial medical examination, and it must be ensured that they have access to medical care within the framework of the integration process. Challenges: Coping with the sheer numbers and the provision of translation services are prerequisite to successfully provide medical care. Solutions: Creation of large capacities in the framework of the official registration system, the initial medical examination, and the use of web-based translating tools are locally adapted solutions for the care of refugees that has helped transform what was initially unorganized medical care. Perspectives: The consequences of demographic change with a shortage of qualified workers and the threat of substandard medical services can in part be solved by immigration. The prerequisite for this is the will to create structures that make long-term integration possible. © 2016, Springer-Verlag Berlin Heidelberg.

Clinical Care Population dynamics communication Medical education Emigration and immigration Community integration Refugee

Germany refugee language medical education medical examination registration Population Dynamics medical service human experiment human community integration migration worker