For foreign-trained doctors

Your step-by-step guide to
German Approbation

10,857 doctors applied for recognition of a foreign medical qualification in Germany in 2024 (Destatis / BIBB-Anerkennungsmonitoring). Each of the 17 Bundesländer runs its own procedure, with its own fees, processing times, and exam. This site compares all of them.

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Law change · 1 Nov 2026Bundestag has voted to make Kenntnisprüfung the default route for Drittstaat applicants — replacing the case-by-case equivalence check.Read the analysis →

10,857

Applications filed in 2024

State procedures compared

4 wk – 20+ mo

Processing time range

B2 + C1

German required

Last updated 12 May 2026. Sources are cited inline on each page.

The 6-step Approbation process

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.

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.

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 — eligible for full Bildungsgutschein funding through the Bundesagentur für Arbeit.

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.

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.

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.

Fastest states to Approbation

Choose strategically — location flexibility can save 12+ months.

Compare all 17 states →

Mecklenburg-Vorpommern

LAGuS — Landesamt für Gesundheit und Soziales, Landesprüfungsamt für Heilberufe

2–5 months

MV publishes the most specific processing-time data of any German state: Eingangsbestätigung ~4–6 we…

Sachsen-Anhalt

Landesverwaltungsamt — Landesprüfungsamt für Gesundheitsberufe, Referat 507, Halle (Saale)

2–4 months

Sachsen-Anhalt is among the fastest Approbation authorities in Germany — the LPA states the 3-month …

Language exam

FSP Exam Guide

Per-state fees (€350–€700) and pass rates (43.7%–74%), the 3-part oral format, and which prep courses are worth paying for.

Medical exam

Kenntnisprüfung

The M3-equivalent oral exam: § 37 ÄApprO format, pass rates by state, slot-wait times, and the 3-attempt federal limit.

Finance

Doctor Salaries

TV-Ärzte VKA/TdL tables, on-call structure, and how Helios, Asklepios, and Rhön compare to the public collective agreement.

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