Professional Recognition and Licensing in the German Health Sector

As an internationally oriented headhunting agency that recruits for the health care sector, we are frequently asked how foreign professionals and academics can have their medical or nursing training or studies recognised in Germany. This is a major issue in the health sector in particular, as physicians and other academic professions in this field, as well as nurses and health professionals, are not allowed to work in Germany without recognition.

Since many of the candidates from abroad with whom we are in contact do not know what to look out for, we have summarised here how such a licence works.

German Language Skills and Suitability

Basically, all applicants, whether they are physicians, nurses or health professionals and whether they come from the EU or so-called third countries, must prove that they have sufficient knowledge of the German Language and that they are fit and healthy.

In concrete terms, this means that you have to demonstrate language skills at B2 level, present your official certificate of good conduct from Germany, your home country and, if applicable, your country of training and undergo an examination by a German physician. The physician will check whether the applicant is fit and able to exercise the respective profession in the health sector. Among other things, mental and chronic illnesses are examined.

In order to obtain a licence to practise medicine as a physician, applicants must also pass a technical language test at level C1.

Approbation as a Physician from the EU, European Economic Area & Switzerland

When applying for a licence to practise medicine in Germany, candidates from European Union, the European Economic Area and Switzerland have an easier time than their colleagues from third countries, as medical training in these countries is regulated according to uniform standards. This means that it is no longer necessary to check whether the training can be equated with German medical studies - the degree is automatically recognised.

Licensing as a Physician from Third Countries - Equivalence Test Necessary

For applicants from third countries, however, the competent authority must first check whether the curriculum of the college or university can be considered equivalent to the studies in Germany. Another option is a knowledge examination, which medical graduates from third countries can take. This is based on the oral-practical examination of the German state examination and tests knowledge in diagnosis and treatment and focuses on the areas of surgery, internal medicine, emergency medicine, clinical pharmacology, imaging procedures as well as radiation protection and legal issues. The test can be repeated twice.

Temporary Licence to Practise as a Physician and Medical Specialist

During the preparation for the knowledge test, the waiting period for the licence to practise medicine in Germany or if you only want to come to Germany for a limited period of time, it is also possible to apply for a simple professional permit. This is limited to a maximum of two years, during which you may only practise under the supervision of a physician with a licence to practise medicine. The prerequisite for a professional permit is a successfully completed training as a physician, sufficient knowledge of German and personal and health suitability, which must also be proven here.

If, on the other hand, a licence to practise medicine has already been obtained, a medical specialist acquired abroad can also be recognised by the competent state medical association. In most cases, the physician must be a member of the chamber.

Physicians from third countries must also be able to present a visa with a work permit, a visa for seeking employment or for the recognition of foreign professional qualifications. The latter is valid for a maximum of 18 months and is useful, for example, for a temporary professional permit.

Work Permit for Health Care Professionals & Nursing Professionals from Third Countries

In addition to personal and medical suitability and proof of language skills, a permit to use the occupational title is required for admission or a work permit as a health professional or as a nursing professional from third countries. This then entitles the holder to exercise the profession.

Here too, the professional training must be equivalent to the corresponding training in Germany, which can also be achieved through additional relevant professional experience. If this is not sufficient, a knowledge test or an adaptation course is also possible in order to acquire the necessary qualification.

Professionals from third countries also need a residence permit (visa) that allows them to work.

Work Permit for Care Workers from European Union, European Economic Area & Switzerland

For nursing staff from the European Union, the European Economic Area and Switzerland, it is much easier to obtain a work permit, as is the case with physicians from these countries, since their training is automatically recognised. Of course, all other documents concerning fitness and one's own person must still be submitted.

Responsibilities for Admission in Germany

The Central Service Point for Professional Recognition (ZSBA) of the Federal Employment Agency generally provides support in the recognition of foreign training. The actual admission is then granted by the competent authority in the respective federal state. Accordingly, the offices require proof of competence. This can be confirmed in the form of an expression of interest or confirmation of employment from an employer, applications for vacancies or a current main place of residence or proof of habitual residence in the federal state.

You will find a list of the competent authorities in the various German federal states for the granting of the licence to practise medicine and the professional permit for specialists at the end of the article.

Proof of Education and Your Person

In addition, it goes without saying that all requests for Approbation or professional recognition must be accompanied by the certificate of completion of vocational training, proof and work references on all relevant professional experience, as well as a complete curriculum vitae, birth certificate and proof of identity. Sometimes a declaration of no objection from the competent authority in the home country is also required.

Evidence of Training

In the case of a licence to practise as a physician or a licence to practise as a nurse from a third country or a licence to practise as a health professional, a list of subjects and hours with the theoretical and practical teaching hours or the curriculum of the college or university must also be submitted so that the authorities can check the equivalence of the training to German training.

All documents must be submitted in the original language and in German - translated by an official interpreter.

Applicants must also note that vaccination against the covid-19 has been compulsory in Germany since March 2022.

Duration and Costs

If you apply for a work permit, you should expect a processing time of several months in most cases. Especially in the case of applications from non-EU countries, checking all documents can be time-consuming - in individual cases the authorities need more than a year.

Admission is also subject to a fee and costs between 100 and 360 euros. In addition, there may be costs for the official translation of the documents and the visa.

Application from Abroad Possible

Physicians, nurses and health professionals can already apply for their licence to practise or recognition from abroad. In principle, it makes sense to start acquiring the necessary German language skills in good time and to consider what other qualifications might be required. In addition, a visa must be applied for and applicants should think in good time about where in Germany they would like to work and look for appropriate positions. This is the only way to find the competent authority for licensing.

Checklist for Approbation & Professional Recognition of Healthcare Professionals

To give you an overview, we have summarised here what documents you need and must submit for the application for a professional licence in Germany:

• Curriculum vitae with signature
• Birth certificate and, if applicable, certificate of change of name
• Proof of identity (identity card or passport)
• Official certificate of good conduct from Germany.
• Official certificate of good conduct from your home country / country of origin.
• If applicable, official certificate of good conduct from the country of training
• Medical certificate confirming that you are fit to practise your profession
• Documents on your training in original and German (officially translated)

• Certificate of education
• If applicable, overview of subjects and hours
• If applicable, proof of internships completed
• If applicable, proof of professional experience

• References from previous employers (if available)
• Certificate B2 German language skills (can be submitted later)
• for physicians: Certificate of C1-level in medical German Language

If required:

• Proof of responsibility for the state authority (e.g. confirmation of employment, proof of residence, etc.)
• Successful completion of knowledge test
• Additional qualifications acquired in Germany

For skilled workers and academics from non-EU/non-EEA countries: