Your route to the full licence to practise medicine (Approbation) and to a suitable post

If you live in Germany, the authority of the federal state (Bundesland) where you have your habitual residence decides on the full licence to practise (Approbation). The federal state where you are to work decides on a temporary licence to practise (Berufserlaubnis) (§ 12 BÄO). These can be two different authorities.

In your application you declare that you are not involved in a procedure for an Approbation or Berufserlaubnis in any other federal state (§ 39c ÄApprO).

Among other things, you are required to provide proof of identity, a CV, proof of your training and a certificate showing that you are entitled to practise the profession in the country where you obtained your degree (§ 39c ÄApprO).

The certificate of good conduct (Führungszeugnis), the corresponding documents from the state where you obtained your degree and the medical certificate may be at most three months old when submitted (§ 39e ÄApprO).

For documents not issued in German or English, a translation into German or English by publicly appointed or sworn translators is required. The authority may admit other translators and, in justified exceptional cases, may require a translation into German (§ 33a ÄApprO).

In practice, the federal states (Länder) require general German at level B2 and a medical German test (Fachsprachprüfung) that is based on level C1 (basis: § 3 Abs. 1 Satz 1 Nr. 5 BÄO and the key points of the Conference of Health Ministers of 2014). Each federal state regulates registration and timing itself.

This is an oral and practical examination in German, held on one day, preceded by taking a patient's medical history, a physical examination and a written report. The content covers internal medicine and surgery, as well as emergency medicine, clinical pharmacology, imaging procedures, radiation protection, the legal framework and communication skills. It lasts 60 to 90 minutes per person and can be repeated twice (§ 37 ÄApprO).

The federal states (Länder) must ensure that you can take the test within six months: in the standard route from the date of application, and after an equivalence assessment (Gleichwertigkeitsprüfung) from the formal notice (Bescheid) on the substantial differences (§ 37 Abs. 9 ÄApprO). The authority must issue this notice no later than four months after all documents have been received (§ 38 Abs. 3 ÄApprO). No measured processing times are available for this yet.

The authority may grant a licence under § 10 BÄO, but there is no entitlement to one. It is revocable, as a general rule applies only up to a total duration of medical work of no more than two years, and may be restricted to certain activities and places of employment. A decision on the application is to be made no later than three months after the documents have been submitted, and enquiries to other bodies may suspend the deadline (§ 34 ÄApprO).

Some federal states (Länder) impose further requirements. Some of their published information still describes the position before November 2026 and mentions, for example, a passed medical German test (Fachsprachprüfung) (Lower Saxony, Berlin) or proof of an employer for medical work (Hesse). Ask your competent authority about the current position. Your state medical association (Landesärztekammer) can clarify whether periods under a Berufserlaubnis count towards specialist training.