For foreign-trained doctors
The operational guide
to German Approbation.
10,857 doctors applied to have a foreign medical qualification recognised in Germany in 2024 (Destatis / BIBB-Anerkennungsmonitoring). Each of the 17 chambers runs its own process, with its own fees, processing times, and exam. This site compares all of them. Sourced, dated, no marketing copy.
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State comparison
17 chambers.
4 weeks to 20+ months.
Approbation processing time is the single biggest variable in your timeline. The fastest states approve within 6 weeks; the slowest average over 16 months. The law on where you can apply changes 1 November 2026.
10,857
Applications filed in 2024
Source: Destatis
17
Chamber procedures compared
4w – 20mo
Processing time range
€130 – €600
Approbation fee by state
The path
Six steps from foreign degree to German Approbation.
01
Check your eligibility
EU, EEA, and Swiss medical degrees are recognised automatically under Article 24 of Directive 2005/36/EC. Drittstaat (non-EU) doctors undergo a case-by-case equivalence review (Gleichwertigkeitsprüfung). From 1 November 2026 the federal default flips to direct Kenntnisprüfung instead.
02
Choose your state
Processing times range from about 4 weeks officially (Mecklenburg-Vorpommern) to 20+ months in practice (Bayern, FOIA average 16.5 months). Approbation fees run €130–€600 and FSP fees €350–€700 by Land. Picking strategically can save you a year.
03
Reach German B2/C1
All states require a B2 general-German certificate (telc, Goethe, ÖSD) before opening an FSP file. Most candidates target C1 medical German via Lingoda or AMBOSS, both eligible for full Bildungsgutschein funding through the Bundesagentur für Arbeit.
04
Submit documents
Degree, transcript, home-country licence, police clearance, health certificate. Non-German documents need sworn translations and apostilles. Each state runs its own intake: Berlin via LAGeSo, Bayern via ZAABY, NRW via Bezirksregierung Münster.
05
Pass the FSP
A 60-minute oral exam in three ~20-min parts: Anamnese (history-taking with a trained actor), Arztbrief (written physician letter), Arzt-Arzt-Gespräch (case handover). Where chambers publish, pass rates range from 43.7% (Niedersachsen) to 74% (Thüringen). There is no national figure.
06
Receive Approbation
Once approved, you receive lifelong federal authorisation to practise medicine anywhere in Germany. No renewal required. If the equivalence assessment finds wesentliche Unterschiede, you sit the Kenntnisprüfung (M3-level oral-practical exam, 3-attempt federal limit) before Approbation is issued.
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Which state should you apply in?
Ranks all 17 states for your country, German level, and priorities. Processing runs from ~4 weeks (Mecklenburg-Vorpommern) to 16.5 months (Bayern, FOIA average) — the choice matters more than anything else you'll decide.
Open toolCost & timeline calculatorWhat will it really cost — and how long?
Itemized fees for your exact path: Approbation €200–€430, FSP €350–€700, translations, legalization, language courses. Plus a realistic timeline from your current German level to licence.
Open toolDeep guides
Sourced, dated, no marketing.
Language Exam (FSP)
Per-state fees €350–€700 and pass rates 44–74%. The 3-part oral format, what to expect, and which prep courses are worth paying for.
Read guideKenntnisprüfungKnowledge Exam (KP)
The M3-equivalent oral exam. § 37 ÄApprO format, pass rates by state, slot-wait times from 6 weeks to 18 months, 3-attempt federal limit.
Read guideFinanceDoctor salaries
TV-Ärzte VKA and TdL tables, on-call structure, and how Helios, Asklepios and Rhön compare to the public collective agreement.
Read guideFirst-mover1 Nov 2026 reform
The Bundestag-passed law that makes Kenntnisprüfung the default. 4-week opt-out window, decision tree by scenario, what changes and what doesn't.
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Your Approbation,
tracked end-to-end.
A personalised tracker and document checklist built on the same sourced data as this site — tailored to your country, your target state, and where you are in the process.
Progress tracker
Step-by-step, personalised to your state
Every step from first document to Approbation, with real processing times and fees from your target Ärztekammer — not a generic template.
Document checklist
Every document, every status
Track obtained, translated, and apostilled status per document. Legalization routes differ by country; yours are pre-filled based on your source country.
State-specific data
Your numbers, not averages
Approbation fee, FSP fee, and processing time for the exact chamber you chose — the same FOIA and official data published on this site.
By country of training
Syria, India, Egypt, Turkey, Ukraine, Iran — each country has its own legalization route, document quirks, and Kenntnisprüfung likelihood.
Sourced from primary authorities
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Country-specific document checklist.
Routing exceptions, apostille rules, and the exact documents your target chamber will demand — sent once, no spam.