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How foreign and non-EU doctors get licensed to practise medicine in Germany: the Approbation, Berufserlaubnis, equivalence check, and German language exams.
Canonical: https://www.prezumi.com/blog/how-to-practice-medicine-in-germany-as-a-foreign-doctor
To work as a doctor in Germany with a foreign medical degree you need your qualification recognised and a licence from the authority of the federal state (Bundesland) where you want to practise. There are two licences: the Approbation, a full and permanent licence to practise without restriction, and the Berufserlaubnis, a temporary permission that is limited in time, place, and often to a single employer. Doctors trained in the EU, the EEA, or Switzerland generally have their qualification recognised automatically and move straight to Approbation. Doctors trained outside the EU (in a "third country") go through an individual equivalence check, and if their training is judged not equivalent they sit a medical knowledge exam called the Kenntnisprüfung. On top of that you must prove German at roughly B2 level plus pass a medical-language exam (the Fachsprachprüfung) at about C1. This guide walks the whole path. Every fact was checked against the German recognition portal (recognition-in-germany.de / anerkennung-in-deutschland.de), make-it-in-germany.de, and the Bundesärztekammer; the details are set by each state, so confirm yours with the responsible authority before you plan around them. Last reviewed: August 2026.
This is medical-licensing (YMYL) information and it varies by federal state. Recognition of foreign medical qualifications in Germany is decided by each Bundesland's licensing authority (Approbationsbehörde), and the language exam is run by the state medical chamber (Landesärztekammer). Fees, processing times, required documents, and even the exact language level can differ between states and change over time. Use this as orientation and verify each step with the authority of the state where you intend to work, plus the official portal anerkennung-in-deutschland.de. Last reviewed: August 2026.
Medicine is a regulated profession in Germany, so you cannot work as a doctor without a licence. There are two, and they are not the same thing.
Many international doctors start work on a Berufserlaubnis and convert to an Approbation once they have passed the language exam and either had their training recognised as equivalent or passed the Kenntnisprüfung.
You apply to the Approbationsbehörde of the Bundesland where you want to work, since recognition and licensing are handled at state level, not nationally. Which office this is depends on the state, and where you apply matters because processing times, fees, and some requirements vary between states. You submit your medical diploma, transcripts and curriculum, proof of identity, a certificate of good standing from your home regulator, health and reliability certificates, and certified German translations of foreign documents. The official portal anerkennung-in-deutschland.de has a finder that points you to the correct authority for your target state and profession.
The core of recognition is whether your training is equivalent to the German medical degree. This is where EU and non-EU qualifications diverge sharply. Doctors who hold a qualification from an EU or EEA member state or Switzerland that is covered by the EU's automatic-recognition rules generally have it recognised directly and receive the Approbation without a knowledge exam, once the other conditions (language, good standing) are met. Doctors with a qualification from a third country outside the EU go through an individual equivalence assessment (Gleichwertigkeitsprüfung), in which the authority compares the content and duration of your training against the German standard. The anabin database of the Central Office for Foreign Education and formal evaluations help the authority judge your degree and university.
If the equivalence check finds substantial differences between your training and the German standard that cannot be offset by professional experience, you take the Kenntnisprüfung to still obtain the Approbation. It is a state medical knowledge examination pitched at the level of the German final medical state examination (Staatsexamen). It is typically an oral-practical exam covering internal medicine, surgery, and other core areas, plus law relevant to practising in Germany. Passing it satisfies the equivalence requirement and opens the door to the full licence. In some cases an adaptation period under supervision is offered as an alternative, but the Kenntnisprüfung is the common route for third-country doctors.
| Where you trained | Equivalence route | Usual outcome |
|---|---|---|
| EU / EEA / Switzerland (automatic-recognition qualification) | Recognised directly | Approbation, no knowledge exam |
| Third country, training judged equivalent | Individual equivalence check (documents, anabin) | Approbation once language is proven |
| Third country, substantial differences | Kenntnisprüfung (or adaptation period) | Approbation after passing the exam |
You must prove you can communicate with patients and colleagues in German, and this is two separate hurdles. First, general German language skills, for which most states require at least B2 on the Common European Framework (CEFR). Second, a specialist medical-language examination, the Fachsprachprüfung, usually set at C1 level for medical communication. The Fachsprachprüfung is run by the state medical chamber (Landesärztekammer) and tests a simulated patient conversation, documentation, and a doctor-to-doctor handover in medical German. Both the general level and the medical exam are required before the Approbation is granted, so budget time for structured language learning; medical German is a real barrier even for fluent everyday speakers.
Start the language track early and in parallel. The Fachsprachprüfung at C1 medical German is the step most international doctors underestimate, and exam slots at the Landesärztekammer can be scarce. Begin general German (aiming for B2) while your documents are being gathered, then move to medical-German preparation, so the language requirement isn't what holds up your licence.
For a third-country doctor, the full path from starting the application to holding an Approbation commonly takes one to two years, driven by document gathering and translation, the equivalence assessment, language learning, and waiting for exam dates for the Fachsprachprüfung and, where required, the Kenntnisprüfung. EU-trained doctors who qualify for automatic recognition are usually much faster. Costs are spread across several items and vary by state: the recognition and Approbation application fees, certified translations, the fees for the language and knowledge exams, and language courses, which are often the largest expense. Because every figure depends on your state and situation, price your own path from the responsible state authority and the Landesärztekammer rather than a single headline number.
Once you hold the Approbation you can be employed as a physician and begin specialty training. Becoming a specialist (Facharzt) means completing a structured postgraduate training programme (Weiterbildung) in a hospital or approved practice, supervised and certified by the state medical chamber, which runs roughly five to six years depending on the specialty and ends with the specialist examination (Facharztprüfung). Germany has a persistent demand for doctors, especially outside the big cities and in fields such as internal medicine, general practice, anaesthesiology, and psychiatry, which is why the recognition route exists and why hospitals often help international doctors through it. If you are still choosing where to train rather than converting an existing degree, our guide on studying medicine in Germany covers the university route from the start.
German hospitals expect a clear, structured CV (Lebenslauf) that leads with your medical qualification, licence status (Approbation or Berufserlaubnis), clinical experience, and language levels, usually alongside a short cover letter. A credentialing office and a chief physician will both read it, so it needs to be clean and easy to verify. Our doctor resume examples show how a physician CV should look at each career stage, with a copyable template and the sections reviewers check first, and you can adapt the same profile for other countries covered in our guides to becoming a doctor in the USA, Australia, and Canada.
You can build that CV in Prezumi: enter your training, licence status, and clinical record once, render it into an ATS-friendly template, and export a text-based PDF for free. When you apply to a specific hospital or department, the AI editor rewords your real entries to match the posting without inventing anything you didn't enter.
The Approbation is the full German medical licence: permanent, valid nationwide, and unrestricted, and it is required before you can complete specialty (Facharzt) training. The Berufserlaubnis is a temporary permission to practise, usually granted for up to two years and tied to a specific employer, region, and supervision. Many international doctors work on a Berufserlaubnis while their Approbation is still being processed, then convert once they pass the language exam and have their training recognised or pass the Kenntnisprüfung.
No. Doctors who hold a qualification from an EU or EEA state or Switzerland that is covered by the EU's automatic-recognition rules generally have it recognised directly and receive the Approbation without a knowledge exam. Doctors trained outside the EU go through an individual equivalence check comparing their training to the German standard, and if substantial differences are found they must pass the Kenntnisprüfung to obtain the licence. Both groups must still prove German language ability.
The Kenntnisprüfung is a state medical knowledge examination for doctors whose foreign training is judged not equivalent to the German medical degree. It is set at the level of the German final medical state examination and is usually an oral-practical exam covering internal medicine, surgery, and other core areas plus German medical law. Passing it satisfies the equivalence requirement so you can be granted the full Approbation. In some cases an adaptation period under supervision is offered as an alternative.
Two things. General German language skills at roughly B2 on the CEFR, and a specialist medical-language examination, the Fachsprachprüfung, usually at about C1 level. The Fachsprachprüfung is run by the state medical chamber and tests a simulated patient consultation, medical documentation, and a doctor-to-doctor handover in German. Both are required before the Approbation is granted, and medical German is a real hurdle even for otherwise fluent speakers, so start language learning early.
Recognition and licensing are handled at the level of the federal state (Bundesland), by that state's licensing authority (Approbationsbehörde), and the medical-language exam is run by the state medical chamber (Landesärztekammer). This means requirements, fees, and processing times vary between the 16 states, so you apply in the state where you want to work and confirm the details there. The official portal anerkennung-in-deutschland.de has a finder that identifies the correct authority for your case.
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