German medical students must conduct a research project and write a dissertation in order to receive the title “Doctor.” However, the dissertation is not required to graduate, enter a residency, or practice medicine. About 90% of practicing physicians hold the title “Doctor”; a career in academic medicine almost always requires it.
The student then produces the dissertation as a piece of independent research, which serves to demonstrate the new academic knowledge gained during the doctoral project. A dissertation may be prepared either in the form of an individually supervised project or within the framework of a structured doctoral program. Promotion (website in German).