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Background The German healthcare system is facing a serious shortage of healthcare professionals and is therefore dependent of foreign staff to ensure adequate healthcare. 14 % of the physicians and 17 % of the nurses working in Germany have foreign citizenship. The variety of cultural backgrounds and language skills raises the question for advantages and challenges when it comes to human resource policies in hospitals and outpatient care services. Methods The findings are based on 16 expert interviews with physicians, nurses, and managers in leading positions of two hospitals and two outpatient care services. These institutions differ in the extent to which they treat migrant patients and hire foreign healthcare workers. Results From the experts' perspective, the biggest advantage in foreign health workers are their language skills. Foreign language skills are a huge advantage provided that their knowledge matches the patients' languages and their German skills are adequate as well. Additionally, their knowledge about other medical cultures are very much appreciated. The experts see challenges in different qualifications that the professionals have gained in their home countries as well as diverse working cultures, which often leads to frustration among the teams. Therefore, too much ethnic diversity is difficult for everyday working life. Ethnic discrimination is the case in hospitals with less migrant staff and patients. Conclusions To ensure adequate healthcare, healthcare professionals should get a special training, which enables them to work in diverse teams with colleagues from other countries. Meanwhile, foreign staff need time to get used to new hospital structures and should feel strengthened to bring their skills in. This is a process, which the institutions must moderate and accompany constructively. Key messages Immigration of foreign healthcare professionals leads to multicultural teams in healthcare, which are characterized by differences in cultures and qualifications. Therefore, leading professionals should support and encourage multicultural teams to learn how to deal with this diversity in everyday working life.

Integration of migrant healthcare workforce from the perspective of leading hospital staff in Germany