Two years decide whether you are Specialist or Consultant.

Specialist requires the primary medical degree and a recognised specialty qualification, with no experience after the main specialty. Consultant requires the same, plus two years following the main specialty qualification and one year following a subspecialty. There is no examination for Tier 1 holders.

Compare that with Tier 2, where Consultant demands five years, and Tier 3, where the Consultant title is closed altogether. The difference between arriving as a Specialist and arriving as a Consultant is a salary band, a scope of practice and, in many houses, whether you can lead.

The Tier 1 table lists Germany as: specialty certificate with Oberarzt title. For non-nationals both are required. If your senior post was short, or your current senior post is in Austria rather than Germany, the file needs a written confirmation from the German employer — or the Austrian route, which is also Tier 1 and asks for the Facharztdiplom plus specialist registration, without an Oberarzt requirement.

• Base salary, paid monthly and free of income tax.
• Housing, either as an allowance or as provided accommodation.
• Schooling, per child — and often capped at two children. If you have three, this is negotiated at the beginning or not at all.
• Annual flights for the family, health cover, malpractice cover, and an end-of-service gratuity.
• Mobilisation support and the cost of licensing and verification.

Surgical and interventional specialties submit an operative logbook every two years at licence renewal. Start keeping the numbers now if you are not already: case volumes as primary operator, by procedure. They will be asked for during credentialing long before renewal, and a profile with volumes behind it is a different document from a profile with procedure names in it.