Compensation · 2025 / 2026
What German doctors actually earn.
An Assistenzarzt Year 1 earns €5,609.85 per month gross at a municipal hospital under TV-Ärzte/VKA — the most common starting point for foreign doctors. Universities (TdL) €5,626.91, Asklepios €5,735.00, Helios €5,842.13. On-call adds 20–30% on top.
Verified · Source: Marburger Bund Entgelttabellen
TV-Ärzte/VKA — currently in force
1 August 2025 – 31 May 2026 (+2% step).
Next step 1 June 2026 (+2%). Agreement ends 31 December 2026.
Year 1 comparison
Public-sector pay clusters within 0.3%.
The gap opens with private operators — Helios pays the highest base, but VKA and TdL often catch up or pull ahead once Bereitschaftsdienst and overtime are added. If you expect heavy on-call load, compare total compensation, not table values.
Moves to 40h/week from 1 Jan 2026 — effective ~5% raise via fewer hours. (MB TdL, 28 Mar 2024)
Includes Strukturzulage for Arzt. Covers former Rhön-Kliniken. (MB TV-Ärzte RKA, 23 Oct 2025)
Hamburg Asklepios hospitals pay under TV-Ärzte/VKA, not the Asklepios contract. (MB Asklepios, 31 Mar 2025)
Largest private operator (~10,000 doctors). Facharzt scale 12 Stufen vs 6 elsewhere. (MB HELIOS, in force 1 Nov 2025 – 30 Sep 2026)
TV-Ärzte/VKA
The municipal-hospital benchmark.
Covers most non-university public hospitals. Stufen are years of qualifying service in the role — for EG II Facharzt that's years 1, 4, 7, 9, 11, 13.
| Grade | Stufe 1 | Stufe 2 | Stufe 3 | Stufe 4 | Stufe 5 | Stufe 6 |
|---|---|---|---|---|---|---|
| EG I — Arzt | €5,609.85 | €5,927.86 | €6,154.97 | €6,548.61 | €7,018.01 | €7,211.07 |
| EG II — Facharzt | €7,404.11 | €8,024.90 | €8,570.00 | €8,887.98 | €9,198.36 | €9,508.74 |
| EG III — Oberarzt | €9,274.08 | €9,819.15 | €10,598.97 | — | — | — |
| EG IV — CA-Vertreter | €10,909.31 | €11,689.17 | — | — | — | — |
In force 1 Aug 2025 – 31 May 2026. Source: Marburger Bund VKA Entgelttabellen, 13 Jan 2025.
PreviewNext step: 1 June 2026 – 31 December 2026+2%+
| Grade | Stufe 1 | Stufe 2 | Stufe 3 | Stufe 4 | Stufe 5 | Stufe 6 |
|---|---|---|---|---|---|---|
| EG I — Arzt | €5,722.05 | €6,046.42 | €6,278.07 | €6,679.58 | €7,158.37 | €7,355.29 |
| EG II — Facharzt | €7,552.19 | €8,185.40 | €8,741.40 | €9,065.74 | €9,382.33 | €9,698.91 |
| EG III — Oberarzt | €9,459.56 | €10,015.53 | €10,810.95 | — | — | — |
| EG IV — CA-Vertreter | €11,127.50 | €11,922.95 | — | — | — | — |
10. ÄnderungsTV: +4.0% from 1 Jul 2024, +2.0% from 1 Aug 2025 (current), +2.0% from 1 Jun 2026. Contract ends 31 Dec 2026. Night-shift premium raised from 15% to 20% effective Jul 2025.
TV-Ärzte/TdL
University hospitals, 40h/week from January.
Covers state-owned Unikliniken — but not Charité (Berlin), UKE (Hamburg), TV Ärzte Hessen, or TV-UK Baden-Württemberg, which run separate state-level deals. Working hours drop from 42h to 40h per week from 1 January 2026 with the same table values — an effective ~5% raise.
| Grade | Stufe 1 | Stufe 2 | Stufe 3 | Stufe 4 | Stufe 5 | Stufe 6 |
|---|---|---|---|---|---|---|
| Ä1 — Arzt | €5,626.91 | €5,945.86 | €6,173.67 | €6,568.57 | €7,039.34 | €7,222.97 |
| Ä2 — Facharzt | €7,426.63 | €8,049.32 | €8,596.06 | €8,903.30 | €9,070.79 | €9,302.27 |
| Ä3 — Oberarzt | €9,302.27 | €9,849.02 | €10,631.15 | €10,942.53 | — | — |
| Ä4 — CA-Vertreter | €10,942.53 | €11,724.64 | €12,347.33 | — | — | — |
Source: Marburger Bund TdL Entgelttabellen, 28 Mar 2024. Tarifrunde 2026 still being negotiated as of 12 May 2026.
Helios
The largest private operator.
~10,000 employed doctors across Helios facilities. Note Helios has 12 Stufen for Facharzt vs 6 elsewhere — table below shows the first 6. Yr 7 Facharzt: €8,837.82, Yr 8: €9,212.27, Yr 13: €9,586.73.
| Grade | Yr 1 | Yr 2 | Yr 3 | Yr 4 | Yr 5 | Yr 6 |
|---|---|---|---|---|---|---|
| Arzt | €5,842.13 | €5,991.36 | €6,216.61 | €6,665.65 | €6,889.46 | €7,189.33 |
| Facharzt | €7,534.54 | €7,609.15 | €7,758.32 | €8,163.51 | €8,387.31 | €8,537.96 |
| Oberarzt | €9,616.00 | — | €9,675.94 | — | €10,045.12 | — |
| CA-Vertreter | €11,159.16 | — | — | — | — | — |
In force 1 Nov 2025 – 30 Sep 2026. Source: Marburger Bund HELIOS. Next step from 1 Oct 2026: ~+2% (Arzt Yr 1 → €5,958.97).
Asklepios
Private hospitals — except Hamburg.
Important exception: Asklepios hospitals in Hamburg pay under TV-Ärzte/VKA, not the Asklepios private contract. If you accept a Hamburg position from Asklepios, check which Tarifvertrag applies — the difference is meaningful at higher Stufen.
| Grade | Stufe 1 | Stufe 2 | Stufe 3 | Stufe 4 | Stufe 5 | Stufe 6 |
|---|---|---|---|---|---|---|
| Arzt | €5,735.00 | €6,070.00 | €6,305.00 | €6,685.00 | €7,165.00 | €7,350.00 |
| Facharzt | €7,560.00 | €8,190.00 | €8,735.00 | €9,065.00 | €9,370.00 | €9,565.00 |
| Oberarzt | €9,475.00 | €10,010.00 | €10,510.00 | — | — | — |
| CA-Vertreter | €11,125.00 | — | — | — | — | — |
In force 1 Jan 2026 – 31 Dec 2026 (+2.5% step). Source: Marburger Bund Asklepios, 31 Mar 2025.
Bereitschaftsdienst
On-call pay adds 20–30% gross.
Bereitschaftsdienst is presence-on-site overnight or weekend duty. Under TV-Ärzte/VKA it has three components — none of which behave like the popular "Stufe A/B/C/D hourly rate" tables that float around the internet, which conflate older TVöD-K with current TV-Ärzte rules.
(a)
Hourly BD-Entgelt
Per-hour rate by Entgeltgruppe and Stufe. EG I Stufe 1: €36.14/h. EG IV: €50.49/h.
(b)
15% Zeitzuschlag
Time surcharge added on top of the hourly BD-Entgelt for the duration of the duty. Paid in money — not convertible to time off.
(c)
Escalation rule
More than 4 duties per month: BD compensation rises by 10 percentage points, with further increments per additional duty. Designed to discourage thin rosters.
Hourly BD-Entgelt by grade and Stufe
| Grade | Yr 1 | Yr 2 | Yr 3 | Yr 4 | Yr 5 | Yr 6 |
|---|---|---|---|---|---|---|
| EG I | €36.14 | €36.14 | €37.51 | €37.51 | €38.88 | €38.88 |
| EG II | €42.97 | €42.97 | €44.34 | €44.34 | €45.73 | €45.73 |
| EG III | €46.40 | €46.40 | €47.76 | — | — | — |
| EG IV | €50.49 | €50.49 | — | — | — | — |
In force 1 Aug 2025 – 31 May 2026. Hourly Bereitschaftsdienst rate by Entgeltgruppe and Stufe.
Rufbereitschaft (stand-by from home)
Daily flat rate: €33.29 until 31 May 2026, rising to €33.96 from 1 June 2026.
Actual call-ins are paid as overtime with each call rounded up to a full hour.
Worked example
Ä1 Year 2 with typical on-call load.
Worked example only. Actual BD load varies by department — intensive care and surgery run heavier, psychiatry and lab specialities lighter. With four BD duties triggering the escalation rule, total monthly gross often clears the base by 30%+ — sometimes 45%+ on intensive specialities.
Labels
EG vs Ä — what the codes mean.
| VKA | TdL | Role |
|---|---|---|
| EG I | Ä1 | Arzt — Assistenzarzt (in specialist training) |
| EG II | Ä2 | Facharzt (board-certified specialist) |
| EG III | Ä3 | Oberarzt (consultant / senior physician) |
| EG IV | Ä4 | CA-Vertreter (deputy chief physician) |
If you trained abroad
Almost everyone starts at Ä1.
Almost all foreign-trained doctors entering the German system start at EG I / Ä1 (Assistenzarzt) regardless of prior experience. Stufen advancement is based on qualifying service time within the German role, not on years practised abroad.
Specialist qualifications obtained abroad are generally not automatically recognised. To enter at EG II / Ä2 (Facharzt), you go through a separate Facharztanerkennung procedure with the relevant Fachgesellschaft — distinct from Approbation itself. Most apply for Approbation first, work as Assistenzarzt, then pursue Facharztanerkennung in parallel.
Caritas/Diakonie hospitals use AVR Caritas / AVR Diakonie wage schedules — typically slightly below TV-Ärzte/TdL. We have not pulled the 2026 physician rates from primary AVR documents; treat third-party citations of these with caution.
Caveats — what isn't in this dataset
- ·Caritas / Diakonie AVR — described as "häufig leicht unter TdL-Niveau" in trade press, but not pulled from primary AVR documents.
- ·TV-Ärzte/TdL post-31-March-2026 — Tarifrunde 2026 in progress; existing table continues under Nachwirkung until signed.
- ·Helios BD rates current window — the new MB Helios PDF exists but didn't extract cleanly in this round.
- ·Charité, TV Ärzte Hessen, TV-UK Baden-Württemberg — separate state-level deals not pulled for this update.
Number formatting note: German payslips display amounts as "5.609,85 €" — the comma is the decimal separator. €5,609.85 here means the same number.
Earn this, but where?
Salaries are nearly identical across the country.
What varies is how long you wait for Approbation in each state. Compare processing times and pick where to apply.