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Medical profession in Germany
To practice medicine in Germany, a state license called Approbation is required. German medicine students obtain this license after the successful completion of their studies by passing the third and last state examination (so-called M3-Prüfung).
A medical degree or a professional permit from a foreign country does not automatically suffice to practice medicine in Germany.
You find general information for foreign physicians with the wish to work in Germany on the website of the Arbeitsagentur (employment agency): https://www.arbeitsagentur.de/vor-ort/zav/download/1533755031373.pdf.
Your way to a German medical license
There are two ways to obtain a German medical license and be allowed to practice medicine in Germany as a foreign physician without restrictions: The Gleichwertigkeitsprüfung (equivalence assessment) and the Kenntnisprüfung (knowledge test).
No matter which way you choose, you need to hand in your application documents (diploma, certificates etc.) translated into German. And you must pass the Fachsprachenprüfung (language test) prior to any application.
While you wait for the results of the Gleichwertigkeitsprüfung or your date for the Kenntnisprüfung, you can practice medicine with a preliminary professional permit (vorläufige Berufserlaubnis) under certain restrictions.
Overview of the procedures
Beside medical knowledge, you are required to be proficient in the German medical terminology (Fachsprache) in order to obtain a preliminary permit to work as a physician. With the language certificate you can either apply for the recognition of the medical degree you obtained in your home country (Gleichwertigkeitsprüfung) or for an examination in medicine (so-called Kenntnisprüfung). In this diagram, procedures handled by examination offices have a gray background while tasks which you must fulfill yourself are shaded or framed in red.
Counselling offices
You find general information about the recognition procedure as well as counselling offices in your work location on the website of the German government: https://www.anerkennung-in-deutschland.de/html/de/2688.php.
This website is available in English too, so make sure to check it out – you will probably find it useful!
To apply for the Gleichwertigkeitsprüfung or the Kenntnisprüfung can be quite complicated – not least because a lot of documents are required. Therefore, you should visit a counselling office prior to any application. They will help you on your way, and consulting an official office is usually free of charge. More information about the counselling offices in the federal states in Germany are accessible here: https://www.anerkennung-in-deutschland.de/de/interest/finder/location?arrangement=Nein&nationality=Drittstaat&profession=412&success=Ja&whereabouts=Deutschland.
Each federal state is responsible for the implementation of the Gleichwertigkeitsprüfung, the enrollment for the Kenntnisprüfung and for issuing the medical license to successful applicants in their state. Therefore, different counselling offices are to be contacted depending on where in Germany you wish to work. Relevant contact points are listed below:
| Federal state | Contact data | Website |
Baden-Württemberg | Landesprüfungsamt und Anerkennungsstelle für Gesundheitsberufe | https://rp.baden-wuerttemberg.de/themen/gesundheit/seiten/arzt-ausland/ |
Bayern | Regierung von Oberbayern | https://www.regierung.oberbayern.bayern.de/aufgaben/37198/244210/leistung/leistung_33391/index.html |
Berlin | Landesamt für Gesundheit und Soziales (LAGeSo) | |
Brandenburg | Landesamt für Arbeitsschutz, Verbraucherschutz und Gesundheit (LAVG) Landesärztekammer Brandenburg | https://www.laekb.de/www/website/PublicNavigation/arzt/qualifikationen/kenntnispruefung/ |
Bremen | Die Senatorin für Gesundheit, Frauen und Verbraucherschutz | https://www.aekhb.de/aerzte/auslaendische_rzte/2/57/index.html |
Hamburg | Landesprüfungsamt für Heilberufe Billstraße 80 | |
Hessen | Landesärztekammer Hessen | https://www.laekh.de/fuer-aerztinnen-und-aerzte/fachsprach-und-kenntnisstandpruefungen |
Mecklenburg-Vorpommern | Landesamt für Gesundheit und Soziales Mecklenburg-Vorpommern | |
Niedersachsen | Ärztekammer Niedersachsen | |
Nordrhein-Westfalen | Zentrale Anerkennungsstelle für approbierte Heilberufe (ZAG-aH) der Bezirksregierung Münster | |
Rheinland-Pfalz | Landesamt für Soziales, Jugend und Versorgung (Dienstort Koblenz) | |
Saarland | Landesamt für Soziales, Abteilung E (Referate E1/E2), Zentralstelle und Landesprüfungsamt für nichtakademische Gesundheitsberufe und akademische Heilberufe | https://www.saarland.de/las/DE/themen/gesundheitsberufe/gesundheitsberufe_node.html |
Sachsen | Landesdirektion Sachsen - Dienststelle Dresden | |
Sachsen-Anhalt | Landesverwaltungsamt Sachsen-Anhalt - Landesprüfungsamt für Gesundheitsberufe | https://lvwa.sachsen-anhalt.de/das-lvwa/landespruefungsamt-fuer-gesundheitsberufe/approbation/ |
Schleswig-Holstein | Landesamt für Soziale Dienste Schleswig-Holstein – Gesundheitsberufe | |
Thüringen | Thüringer Landesverwaltungsamt |
Fachsprachenprüfung (language exam)
In order to apply for a preliminary profession permit, the Gleichwertigkeitsprüfung or the Kenntnisprüfung, you are required to be proficient in the German medical terminology beside your professional aptitude. Therefore, you have to pass a Fachsprachenprüfung (language exam).
The Common European Framework of Reference for Languages (Gemeinsamer europäischer Referenzrahmen für Sprachen = GER) defines the standards of (foreign) language proficiency in six reference levels. To be allowed to work as a foreign physician in Germany, you are required to have general knowledge of the German language on level B2 in addition to technical language skills on level C1. Further information about the reference levels of the GER are available here: https://www.europaeischer-referenzrahmen.de.
The exam is conducted by approved institutions. Which institution is responsible for your Fachsprachenprüfung depends on the federal state where you take the exam.
Various companies offer courses to prepare for this exam. With a via medici license, you get access to a PDF version of the workbook ’Fachsprache Medizin im Schnellkurs’ by Axel Karenberg to improve your German medical terminology. In your study plan for the Kenntnisprüfung, we included suitable chapters of this book for you to refresh your technical language skills topic-related.
Crash course in medical terminology
Preliminary professional permit
While you wait for your results of the Gleichwertigkeitsprüfung or prepare for the Kenntnisprüfung, you can work as a physician in Germany with a preliminary professional permit (vorläufige Berufserlaubnis). With this permit, you are allowed to work under the supervision of a licensed physician and perform tasks in a non-leading position outside of the emergency service.
The permit is issued by the same institutions that are responsible for German medical licenses and the recognition of foreign medical degrees and diplomas (for details see table above ). It is limited to a period of 2 years and loses its validity in case you fail the Gleichwertigkeitsprüfung or Kenntnisprüfung.
Gleichwertigkeitsprüfung (equivalence assessment)
As a foreign physician with the wish to work in Germany, you can get your foreign medical degree(s)/diploma(s)/work permit(s) checked. This procedure is called Gleichwertigkeitsprüfung and verifies whether your certificates and your level of knowledge and skills in medicine meet the necessary requirements and standards in Germany.
Gleichwertigkeitsprüfung or Kenntnisprüfung?
Personal experience show that the Gleichwertigkeitsprüfung usually requires a longer waiting period compared to the Kenntnisprüfung. Since passing the Kenntnisprüfung is your only way to obtain a medical license in case you fail the Gleichwertigkeitsprüfung, we advise you to consider carefully the examination you apply at first.
Kenntnisprüfung (knowledge test)
In case the Gleichwertigkeitsprüfung comes to the result that the medical degree from your home country is not equivalent to a German medical license, you have to proof that you have the necessary knowledge and skills to practice medicine in Germany. You do this by passing the Kenntnisprüfung. The Approbationsordnung für Ärzte (ÄAppO, German medical licensure laws) determines the legal foundations for the Kenntnisprüfung. You find the legal text passages here: https://www.gesetze-im-internet.de/_appro_2002/__37.html.
Peer exchange
The exchange with other foreign physicians who passed the Kenntnisprüfung might help you to get an impression of the examination and gives you the opportunity to ask your questions on a more personal level. There are online groups for this purpose, for example on Facebook, where experiences, but also test protocols are shared. Take time to check whether such a group exist in the location where you live and/or wish to work.
Please pay attention to the type of examination that is discussed in your group of choice. Often the term Gleichwertigkeitsprüfung is used for both Gleichwertigkeitsprüfung and Kenntnisprüfung!
In many federal states you need to send your application for the Kenntnisprüfung to the respective Landesprüfungsamt (examination office) by mail. Beside the completed request form, the application requires various documents, many of which need to be officially certified. Those documents include:
birth certificate
proof of identity (for example passport)
curriculum vitae (CV)
proof of impunity abroad (extracts from criminal records from respective states)
criminal record certificate from Germany (Führungszeugnis Belegart O)
certificate of completed medical studies including license to practice medicine from your home country
certificate of good standing (if applicable)
language certificate (Fachsprachenprüfung)
medical certificate (ärztliches Attest).
Please be aware of the requirements of individual federal states!
Waiting times
The conduct of the Gleichwertigkeitsprüfung as well as the application for the Kenntnisprüfung are often associated with long waiting periods. Don’t lose heart! Get information about all necessary steps to apply and take care of obtaining, translating and submitting the required documents in time. Meanwhile, with a preliminary professional permit you can already work as a physician under certain restrictions.
Usually, the Kenntnisprüfung is organized and conducted by the responsible Landesärztekammer (state chamber of medicine). It is an oral and practical exam and takes between 60 and 90 minutes. The first part is based on a clinical case including the enquiry of the medical history (Anamnese), the physical examination of the patient (körperliche Untersuchung) and the drafting of a physician’s letter (Arztbrief). The second part is an oral group exam in which the questions not only relate to the clinical case but expand to all relevant topics.
The examination board normally consists of three fully certified physicians with a specialist qualification (Facharzt/Fachärztin). The topics usually focus on internal medicine and surgery as well as emergency medicine, pharmacology/pharmacotherapy, radiology (imaging techniques, radiation protection) and legal aspects about medical practice in Germany. The examination office can decide on an additional medical discipline or cross-sectional field in case the respective contents in your home country differ from German standards.
You will be informed about your examiners 2 weeks in advance.
Exam topics
To prepare for the exam topics more specifically, it might be helpful to find out the medical disciplines in which your examiners are specialized (for example by looking them up on Google). Often their questions focus on topics of their specialty. Besides, exam protocols (so-called Altprotokolle) from the university where the examiners give lectures may enable you to narrow topics down.
In the Kenntnisprüfung you will be judged on your professional aptitude as well as your German technical language skills. You can re-take the examination twice, meaning you have 3 attempts in total.
Comprehension and language problems
In case you have difficulties to understand a question or give an answer in German during the examination, there are ways to handle these situations. For example, you could ask the examiner to rephrase the question and/or whether you can give your answer (or at least parts of your answer) in English. In any case, do not remain silent! Although your use of German medical terminology will be assessed, don’t forget that in this examination you will be mainly judged on your medical knowledge.
There are numerous courses offered by a variety of institutions to prepare for the Kenntnisprüfung. Make sure the provider has a certification because in this case, the employment agencies can bear the expenses based on the program for the support of professional development (Programm zur Förderung beruflicher Weiterbildung, also called Bildungsgutschein). Contact your local employment agency (Arbeitsagentur) for further information. For details about the support program see here: https://www.arbeitsagentur.de/karriere-und-weiterbildung/foerderung-berufliche-weiterbildung.
In case you fail
In case you fail the Kenntnisprüfung, don’t lose heart! This can happen to anyone, and you have two attempts to re-take you examination. It is most important that you apply for a re-examination immediately, not least because a considerable waiting period is to be expected. You can use this time to revise topics in your study plan that caused you difficulties (language- or content-wise) in your first attempt. This way, you will most certainly pass next time. Good luck!
To provide you with optimal preparation for the Kenntnisprüfung and to make sure you pass on your first attempt, we developed a study plan.
Study plan for your Kenntnisprüfung
How to find your study plan on via medici
For your optimal preparation we developed a study plan (curriculum). To find the study plan, please click on the widget “ALLE LERNMODULE“ on the via medici homepage. There you have different options to access the learning modules. For your study plan, please choose “Kenntnisprüfung” under “Universität”.
This way, please!
Study plan concept
This 40-day study plan will prepare you on your way to the Kenntnisprüfung.
How this can succeed, we discussed and developed with various physicians among which some have obtained their German medical license by passing the Kenntnisprüfung.
From the entire clinical content on via medici, we selected the topics which will be important in the Kenntnisprüfung. Those include internal medicine and surgery as well as emergency medicine, pharmacology/pharmacotherapy, radiology (imaging techniques, radiation protection) and legal aspects about medical practice in Germany. In addition, we included certain diseases/modules from other medical fields which will most definitely be relevant in your daily work.
We sorted those topics into 40 days, while making sure that the amount of content remains balanced, and that you study them in a sensible context. The study days (apart from the mock exam days) are set up as follows:
Each day is divided into blocks of related subtopics.
Each topic starts with a clinical case. Those case modules have question-and-answer elements. This way, you can actively type in your solutions and practice with a high practical orientation.
The case is followed by the respective learning modules.
At the end of each day, we included more clinical cases and visual diagnoses for you to check and consolidate what you have learned.
Efficient practice with cases
Case practice
Since the Kenntnisprüfung is an oral and practical examination based on a real patient, studying with reference to clinical cases is the ideal preparation. This way, you learn the content with a practical orientation and exercise to answer medical questions. Therefore, we included as many different case modules as possible into your study plan.
In case you want to refresh your language skills in relation to specific organ systems, you find suitable PDF chapters from Axel Karenberg’s book on German medical terminology (’Fachsprache Medizin im Schnellkurs‘) at the beginning of the respective study days (days 3, 5, 13, 16, 22, 24, 33 and 35).
You have three days of clinical cases and visual diagnoses only – 1 in the middle (Zwischencheck) and 2 at the end (Schlussspurt) of your study plan. You can take those days as a kind of mock exam since they offer you practice material regarding topics you have already studied and help you to check whether you remember all the important facts.
In contrast to the study plan for German medical students in preparation for their second state examination (so-called 100-Tage-Lernplan), your study plan does not include past questions from the IMPP. The IMPP is the institution that puts together written medical and pharmaceutical exam questions. However, the Kenntnisprüfung is not a written but an oral examination with a different type of questions.
