Approbation for foreign doctors in Germany
The license to practice medicine is a prerequisite for doctors to work in Germany. Doctors who have studied in Germany receive their license to practice medicine directly after completing their medical studies. For doctors from abroad, the Approbation process usually takes about one to two years, as various bureaucratic steps have to be gone through.
Here you will find the most important information about how to become a doctor in Germany as an foreign physician. For example, you can find out where to apply for the license or which requirements must be met.
Table of contents
Why foreign doctors need the license to practice
In order for a doctor to be allowed to practice medicine in Germany, he or she must have a license to practice medicine. The license is also a prerequisite for foreign doctors to be allowed to use the professional title „doctor“ and to practice. According to the statistics of the German Medical Association as of December 31, 2020, there were approximately 409,121 licensed physicians in Germany. Approximately 56,107 foreign physicians were practicing in Germany by that date.
German license to practice for foreign doctors
In order for foreign physicians to be able to practice in Germany, they must apply for a license to practice medicine at one of the responsible state or district governments. However, the application for the German license to practice medicine is usually not directly recognized for foreign doctors. The decisive factor for this is the different study contents between Germany and the foreign country. Accordingly, for the recognition of the license to practice medicine, the equivalence test for foreign doctors (also called equivalency review) must be successfully completed. In this regard, two groups of procedures are distinguished in the application for licensure:
- Physicians, with a medical degree in the EU/EWR or Switzerland.
- Physicians with a medical degree in a third country.
1. License to practice for doctors from other EU countries
EU citizens automatically have a work and residence permit for Germany. Accordingly, physicians from the EU/EEA or Switzerland can apply for a German license to practice medicine at the responsible state or district government without any problems. Provided that the equivalence of the training content with German standards is established in the equivalence examination and all necessary documents are available (e.g. B2 language certificate for general language and C1 specialist language certificate for medicine), the applicant is granted the license to practice medicine. Unlike foreign physicians from a third country, physicians from the EU, EEA or Switzerland usually only have to pass the Fachsprachprüfung. The licensing process for doctors from other EU countries is as follows:
2. Licensure for doctors outside the EU
In order for foreign doctors from a third country to apply for a license to practice medicine in Germany, they must have studied medicine in their home country and be in possession of a work and residence permit. Furthermore, foreign doctors must be in possession of a language certificate (GER-B2) and a Fachsprachzertifikat (C1) (these are obtained through the Fachsprachprüfung), which confirms their knowledge of German. In addition to these formalities, further documents are required for the application for the license to practice medicine, which can be found in detail on the homepage of the individual state or district governments. In contrast to doctors who have studied medicine in the EU, EEA or Switzerland, doctors from third countries usually have to pass a Kenntnisprüfung.
Approbation for foreign doctors – An overview of the required documents
The requirements for the granting of the German license to practice medicine for foreign physicians is regulated by the medical licensing regulations. In essence, the applicant for licensure must submit the following documents or evidence:
|Benötigte Unterlagen||EU, EWR, Schweiz||Drittstaat|
|Antrag auf Erteilung der Approbation||✓||✓|
|Nachweise über die abgeschlossene Ausbildung:|
b) detaillierte Fächerauflistung, mit Angabe der pro Fach gelehrten Stundenzahl,
c) Fächer- und Notenübersicht,
d) Nachweis über die Ableistung der praktischen Ausbildung
|Approbation aus dem Heimatland||✓||✓|
|Identitätsnachweis (z. B. Reisepass oder Ausweis)||✓||✓|
|Geburtsurkunde / Auszug aus dem Familienbuch||✓||✓|
|Bei Namensänderung: Nachweis / Urkunde über die Änderung des Namens (z. B. Heiratsurkunde)||✓||✓|
|Ärztliche Bescheinigung über die gesundheitliche Eignung zur Ausübung des Arztberufes||✓||✓|
|Amtliches Führungszeugnis – Belegart 0 – (Inland)||✓||✓|
|Strafregisterauszüge aus dem Heimatland||✓||✓|
|Certificate of Good Standing||✓||✓|
|Sprachzertifikat, welches die Deutschkenntnisse mit mindestens B2 bescheinigt||✓||✓|
|Fachsprachzertifikat für Medizin Niveau C1 (GER)||✓||✓|
|Einstellungszusage oder Absichtserklärung im Bundesland zu arbeiten (Aufgepasst: Je nach Bundesland gelten andere Auflagen)||✘||✓|
7 steps to licensure for foreign doctors
The path to German licensure for foreign physicians is a multi-step process. Among other things, you must pass language tests and submit documents that meet certain requirements. For example, some documents must be notarized. With our 7 steps to the license to practice medicine for foreigners, we give you a procedural overview.
1. Choose a state
Before you apply for a license to practice medicine as a foreign doctor, you must consider in which of the 16 federal states of Germany you want to apply. In your considerations, you should take into account where you have the best chances of quickly obtaining the license to practice medicine, where you want to live. Since the requirements can differ from state to state, you should definitely compare them. For example, in some states you must submit a confirmation of employment.
2. Collect required documents
Before you can apply for a German license to practice medicine as a physician from abroad, you must gather the necessary documents. You must bear in mind that all your foreign-language documents require a German translation by a translator who is publicly appointed or sworn in Germany. It must be evident that the translator has produced a translation of the original document in the language of the country. The following documents are required:
German curriculum vitae
The curriculum vitae for the application for the license to practice medicine must be written in the German language. It is important to ensure that it is up to date and contains all information. It is mandatory to list the educational and professional background. The structure of the curriculum vitae must be tabular. Furthermore, the resume must be provided with the current date and a signature.
In exchange for a small fee, we will translate your resume from English to German and check if your resume meets the requirements. If you wish, you can also receive a modern design.
Evidence of completed education
The application must be accompanied by evidence of completed medical training from the home country. This evidence includes the diploma as well as a detailed list of subjects with details of the number of hours taught per subject, subjects and overview of grades. Furthermore, proof of completion of practical training must be attached. Practical training can be evidenced, for example, by internship, ordination, specialized practical training, etc. In addition, the license to practice medicine from the home country or a license certifying the license to practice medicine in the home country must be submitted.
The diploma/certificate of completion of medical training as well as the professional license, if applicable, must be provided with a Hague Apostille or legalized by the German Embassy in the country of training (substitute legalizations cannot be used for the procedure), if this is generally possible in your country of training.
Proof of identity
When applying for a license to practice medicine for foreign doctors, personal identity must be proven. For this purpose, an officially certified copy of the passport or identity card as well as the birth certificate or an extract from the family register must be enclosed with the application. In the event of a change of name, this must be proven, for example, by the marriage certificate.
A medical certificate is required for the issuance of the license to practice. This medical certificate must state that the applicant is not unfit to practice the profession from a health point of view. The medical certificate can be issued by a family doctor, among others.
In order to be able to work as a doctor in Germany, you must prove that you have the necessary language skills. Although in the later course the language certificate C1 Medicine must be proven by the professional language examination, it is sufficient if you only present a B2 certificate from a recognized language school (according to the European Framework of Reference – CEFR) at the time of application.
Credible evidence of the intention to start the work
Most state offices require proof that you intend to work in the state where you are applying for licensure. The type of proof varies depending on the state. In some states you only have to state that you intend to work in the state or prove that you have a permanent residence in the state. In many other states, however, you must provide proof of employment. If necessary, the confirmation of employment can also be submitted at the very end (shortly before the license to practice medicine is issued).
3. Submit an application for the granting of the license to practice medicine
Once you have collected the required documents, you must send them to the relevant state office by mail. However, before you send the documents, you should check your documents for completeness and whether you have correctly followed the instructions of the relevant state government. You can find the instructions on the homepage State Government.
4. State office checks the documents
After you have submitted your documents to the relevant state office, your application for licensure will be reviewed by a clerk. It will be determined that you still lack the language certificate C1 Medicine and that you must pass the Fachsprachprüfung. Furthermore, the equivalence of your training content with the German qualification standards will be checked (equivalence test). If you have studied medicine as a doctor in a third country, elementary differences in the training are almost always determined. These deficits can be compensated with relevant professional experience. If the licensing authority does not assess the equivalence as sufficient, you will be asked to take a Kenntnisprüfung.
If the state office determines that you do not have the required knowledge of the German language for medical practice, you must successfully pass the specialist language examination. As a rule, you will be automatically registered for this exam through your application for licensure. You can find further information here: Fachsprachprüfung.
6. Kenntnisprüfung / Equivalence via the legal path
In the case of physicians who have studied medicine in a third country, it is usually determined that their training content does not correspond to the German qualification standards. The training content of physicians who have studied in the EU, EWR or Switzerland is usually considered equivalent. Accordingly, physicians from the EU, EWR or Switzerland often do not have to prove that they have the required knowledge and skills to practice medicine in Germany. If you are found to have equivalence deficits, then you have two options:
Pass the Kenntnisprüfung
The knowledge examination ensures that the applicant has the necessary knowledge and skills to practice as a physician in Germany. Accordingly, the entire knowledge of the German final examination is relevant to the examination. The subjects tested are internal medicine and surgery. Further information is available here: Kenntnisprüfung.
Equivalency via the legal route
If the state government’s equivalency assessment concludes that you have deficiencies in equivalency, you can legally challenge the ruling as an alternative to the knowledge assessment. For this, it is recommended that you work with an attorney. After being commissioned, the lawyer tries to identify errors or inaccuracies in the equivalence assessment and tries to determine whether any deficits identified can be compensated for by professional experience, special knowledge and qualifications (which may have been acquired, for example, through participation in further training courses or work shadowing in a practice or clinic), in order to persuade the licensing authority to vote in favor of equivalence after all on this basis and, if necessary, with reference to the relevant case law, and thus to grant the license to practice medicine.
7. Granting of the license to practice medicine
If you have successfully completed all the steps and the state office has all the necessary documents from you, there is nothing standing in the way of you being granted your license to practice medicine. As a rule, your German license to practice medicine will be sent to you by mail. From now on, you may use the professional title „doctor“ and may practice as a doctor in Germany.
Apply for the license to practice medicine for foreign doctors
To apply for a license to practice medicine, physicians from abroad must apply to a competent district or state government. In doing so, physicians are free to choose in which federal state they apply for the license to practice medicine for foreign physicians. However, the processing time for the Approbation for foreign doctors can differ from state to state. On the one hand, this has to do with whether the documents submitted with the application for the license to practice medicine are complete and in order. On the other hand, the issuance of the Approbation is protracted if many physicians have applied for the Approbation in the federal state. Below is a list of the correct contacts for applying for the license to practice medicine for foreign physicians:
Die Approbation in Baden-Württemberg beantragen Sie hier:
→ Landesprüfungsamt für Medizin und Pharmazie
Die Approbation in Bayern/ Oberbayern beantragen Sie hier:
→ Regierung von Oberbayern
Die Approbation in Bayern/ Unterfranken beantragen hier Sie:
→ Regierung von Unterfranken
Die Approbation in Berlin beantragen Sie hier:
→ Landesamt für Gesundheit und Soziales
Die Approbation in Brandenburg beantragen Sie hier:
→ Landesamt für Arbeitsschutz, Verbraucherschutz und Gesundheit
Die Approbation in Bremen beantragen Sie hier:
→ Die Senatorin für Wissenschaft, Gesundheit und Verbraucherschutz
Die Approbation in Hamburg beantragen Sie hier:
→ Behörde für Gesundheit und Verbraucherschutz
Die Approbation in Hessen beantragen Sie hier:
Die Approbation in Mecklenburg-Vorpommern beantragen Sie hier:
→ Landesamt für Gesundheit und Soziales
Die Approbation in NRW beantragen Sie hier:
→ Bezirksregierung Münster
Die Approbation in Niedersachsen beantragen Sie hier:
→ Niedersächsischer Zweckverband zur Approbationserteilung (NiZza)
Die Approbation in Rheinland-Pfalz beantragen Sie hier:
→ Landesamt für Soziales, Jugend und Versorgung
Die Approbation in Saarland beantragen Sie hier:
→ Landesamt für Soziales Zentralstelle für Gesundheitsberufe und Landesprüfungsamt
Work permit for foreign doctors
In addition to the license to practice medicine, physicians from a third country can apply for a work permit in order to be able to work as a physician in Germany. However, the professional permit is only valid for two years. The professional permit is available for physicians from a third country as soon as they have passed the professional language examination and meet all other requirements.
Managing Director of Approbatio
Personnel Psychologist (M.Sc.)
Mr. Pobuda studied psychology in Göttingen with a focus on personnel psychology and health and sports psychology. Within his scientific work he researches the leadership behavior of physicians. Mr. Pobuda’s main occupation is managing director of the personnel consultancy for physicians „Approbatio“.
Ärztestatistik zum 31. Dezember 2020. Bundesärztekammer.