The Approbation Process for Non-EU Doctors in Germany: Step by Step

The Approbation is the full, unrestricted licence to practise medicine in Germany. For international doctors — especially those from outside the EU — obtaining it involves a multi-step process that varies by federal state, country of qualification and specialty. This guide walks you through every step, in the order things actually happen.

Step 1: Understand your recognition pathway

Before anything else, you need to know whether your medical degree will be recognised directly (Gleichwertigkeit) or whether you will need to pass an additional examination. For EU/EEA graduates, recognition is usually automatic under EU directives. For non-EU graduates, the Landesprüfungsamt (state examination office) of the Bundesland where you want to work will assess your qualification.

If your degree is deemed equivalent, you may proceed directly to the FSP. If it is not deemed equivalent, you will be directed to the Kenntnisprüfung — a subject-knowledge examination in medicine, conducted in German. Some candidates need both exams. This determination is made by the state authority, and it varies: the same degree from the same university may be assessed differently in Bavaria than in Berlin.

Step 2: Gather and translate your documents

You will need certified translations of your medical degree, transcripts, internship certificates, good-standing certificates and, in some states, a detailed curriculum comparison (Curriculum-Vergleich). Apostilles may be required depending on your country. Start this early — translations take time, and some documents need to come from authorities in your home country.

Step 3: Apply to the Landesprüfungsamt

Submit your application to the examination office of the state where you intend to work. Processing times vary wildly — Berlin can take three to six months; some smaller states are faster. During this time, you can apply for a Berufserlaubnis (temporary practice permit) in some states, which allows you to work under supervision while your Approbation is being processed.

Step 4: Pass the FSP (and/or Kenntnisprüfung)

The Fachsprachprüfung tests your ability to communicate in medical German. The Kenntnisprüfung tests your medical knowledge in German. Prepare specifically for whichever exam(s) you are required to take. Generic German courses are not sufficient — these are specialised exams that require specialised preparation.

Step 5: Receive your Approbation

Once you have passed your exam(s) and your documents are approved, the Landesprüfungsamt issues the Approbation. This is a federal licence valid across all of Germany — you are not tied to the state that issued it.

What nobody tells you

The process is not linear. Documents get lost. States request additional paperwork months after your application. The Berufserlaubnis has its own application process and is not automatic. Some hospitals will hire you with a Berufserlaubnis and FSP date; others will not consider you until the Approbation is in hand. You need a strategy, not just a checklist.

How Medlingua helps

We have guided hundreds of doctors through this process. We help you identify your recognition pathway, prepare your documents, choose the right Bundesland, prepare for the FSP and/or Kenntnisprüfung, and navigate the bureaucracy. We know which states are faster, which Ärztekammern are tougher, and which mistakes to avoid.