Research needs innovative ideas, time for design, performance and discussion of projects, and freedom in the daily routine. Integrating the individual working concepts in the given profile of the university hospital and the national research system requires a suitable institutional framework and individual academic mentoring. German university medicine is shaped by a steep hierarchy and high economic pressure - factors that are justified by the medical care system, but which are counterproductive in research. There is a lack of scientific education, time, incentives, and adequate infrastructure - conditions which do not motivate for a scientific career. The increasing interdisciplinary cooperation between medicine and natural sciences, however, has had a positive impact on medical research. Wissenschaftsrat (German Council of Science and Humanities) and DFG (German Research Foundation) analyzed German university medicine and published forward-looking recommendations, which emphasize that university hospitals have to be structurally adjusted to satisfy the needs of medical research and education. Only after the implementation of the recommendations can it be assessed whether the proposed changes solve the designated problems.