Welcome to the most detailed article on the internet on how to start a medical residency in Germany and get a German permanent medical license. In German, the word for the permanent medical license is called 🇩🇪 Approbation. A temporary medical license is called in German 🇩🇪 Berufserlaubnis (BE). To be able to start working as a medical doctor and start a medical residency in Germany, you need to have one of these licenses (Article: Differences between the two in detail).
• General notes
▪ The exams required from International Medical Graduates (IMG) do not depend on their nationality (e.g., if EU or not EU), but depend on in which country they studied medicine (more explained in step number 9).
▪ The steps should not always be followed in the same chronological order to start a medical residency in Germany.
For example, you can start learning, German (step 2), before finishing medical school (step 1), or you can apply for the visa (step 7). If you are going to study German in Germany and then later on send the application for the permanent medical license(step 6). Moreover, in some German states, to apply for a medical license (step 6), you need to apply for a job(step 10) and get a job offer first.
▪ This article was written with a help from Mr. Teddy Kabel, admin of the largest English group for foreign doctors in Germany. Vielen Dank 🙂
• The ten steps to start a medical residency in Germany:
1. Finish medical school
Logically, in order to start medical residency in Germany, you need to have received your medical degree. In most countries of the world, medical school lasts six years. In a few countries, like Germany itself or China, medical school lasts five years. The duration of medical school does not play a role in Germany.
For those who failed a year or more in medical school…
If I failed a year or more in medical school and had to repeat them, do I still have a chance to get a German medical license and work in Germany?
Certainly yes! You just need to have a recognized bachelor’s degree from a recognized university, regardless of how long you studied medicine. So, failing a year or more is not a problem. 🥳
– Are your university and faculty recognized in Germany?
Use “Anabin” website to see if your university and your medical degree are recognized in Germany. If your university and faculty have the status “H+/+”, then they are recognized in Germany. 🥳😊 This YouTube video shows you how to find this out using Anabin.
– Stop & think: Is a medical residency in Germany the best option in “your” case?
Before deciding to come to Germany and start medical residency, please read a lot about the advantages and disadvantages of medical specialization in Germany and other countries. If you want to start on a specific pathway, then you should only concentrate on it. Therefore, we wrote many articles to help you with your decision: “Thinking about coming to Germany?”
An important point in helping you in your decision is knowing if your bachelor’s degree will be considered equivalent to a German one (🇩🇪 gleich/Gleichwertigkeit). This is critical because it will save you from doing the medical knowledge exam (step 9). We explained this in the following article:
By the way, if you find the above route complicated and particularly if you do not like to work with patients, there is an academic route:
If you still cannot decide. Read as much as possible about this route of specialization. Look in our main Facebook group and main Telegram group, and see what doctors are discussing and what problems they are facing. You are welcome to post as many questions as you like.
2. Learn the German language & improve your CV to start medical residency in Germany
During your internship year, or already before that, start learning the German language until at least the B2 level. We recommend learning at least until the C1 level. The language is very essential later on during interviews and working with patients, and even for the board exams. Besides having German Approbation, language proficiency is the most critical criterion for the selection process.
The following are articles related to doctors learning German:
Should the language certificate be from a particular testing authority/institute?
Yes, for sure, certificates are accepted from Goethe-Institut and Telc. Both are good, but Goethe-Institut is more famous among the Germans. When you are in Germany, some might ask you: “How did you learn German in your home country, Goethe?”.
Some say, that certificates from ÖSD might be accepted, too. This is an Austrian exam provider.
Should I get an official certificate for each language level I finish, from A1 to B2?
Certainly No! To apply for the Approbation, only a B2 certificate is enough. To apply for the Visa, a B1 certificate is required at least.
Even before you arrive in Germany, enhance your chances of securing your dream medical specialty in a renowned German hospital by not only focusing on learning German, but also engaging in activities that bolster your CV. Discover valuable insights and guidance in another article on our website:
To quickly start a medical residency in Germany, do not forget to build connections. This is really important because they will save you a lot of time, money, and stress. With Facharzt JETZT it is now possible and for free:
3. Finish the internship year to start a medical residency in Germany (das Praktische Jahr)
You MUST finish an internship year to start a medical residency in Germany; either in the country where you studied medicine or in your home country.
The internship year should contain certain rotations and should have certain characteristics. We explained all of that in the following article:
Did you finish your internship year, or can you finish it in the future?
|Congrats 🙂 You are finished with step number 3. Please go to the next step (number 4)||To do it in a third country or in Germany is a complicated thing and should be avoided, not to mention that doing it in a third country would be most probably not recognized. The full details are in the following article:|
“For medical doctors: Is the internship year (🇩🇪 das Praktische Jahr – PJ) a must to be able to work in Germany? 100% yes! No exceptions!“
4. Get your permanent medical license
You can get it after finishing the internship year, either in your home country or in the country where you studied medicine. This is a very important document. Without it, you cannot start a medical residency in Germany.
5. Prepare your documents for applying for the German permanent medical license (die Approbation)
To ensure getting a medical residency in Germany, you can start during the internship year to slowly collect all the needed documents for applying for the German permanent medical license (🇩🇪 die Approbation). Be careful, do not prepare your documents too early because some documents are allowed to be maximally one to six months old at the time of application for the Approbation (For example, the police clearance certificate – 🇩🇪 die Straffreiheitsbescheinigung). A complete list of the needed documents is in the following link:
– Find which documents you need exactly
The documents differ slightly between the 16 medical license authorities in the 16 German states. You can find the exactly needed documents on the websites of the 16 medical license authorities. On the website of each medical license authority, the required documents and application files are listed depending on where you studied medicine; either in the European Union/European Economic Area (EU/EEA) or outside of it. Here we collected the links for you: Direct links.
The authorities do not put a lot of explanation about the documents and there are many pitfalls. Therefore, please read first exactly our article about the required documents.
– The translation of the documents
Wrongly translated documents could completely destroy your chances of working in Germany, or make it a nightmare. Therefore, we wrote a whole article to explain the translation of documents for you:
– The authentication
We recommend the legalization of your documents in the countries where you got them from (country of origin or the country where you studied medicine). However, in a few countries of the world, the German embassies do not legalize documents. We explained all of this here:
6. Send via mail your application for the German permanent medical license (die Approbation)
After you finish the internship year, you can send your application by mail to one of Germany’s 16 medical license authorities. Unlike the USA, Canada, or England, there is no centralized authority for that.
– To start medical residency in Germany: Proof of intention
To be able to apply for a German Approbation, you need in 14 out of 16 medical license authorities a “proof of intention”. We explained this and how to get it in the following article:
The two German states which do not require proof of intention are Bavaria (🇩🇪 Bayern) and Thuringia (🇩🇪 Thüringen). In Berlin, it is enough to provide email copies of answers from hospitals that refused your application for a Hospitation (medical training) (Articles: What is a Hospitation & How to apply).
– For non-EU/EEA doctors: Decide whether you want to apply for the Gleichwertigkeit
All foreign doctors need to do the Fachsprachenprüfung (FSP) (medical language exam) (step 8).
The Kenntnisprüfung (medical knowledge exam) (step 9), is NOT required from graduates of universities in the European Union (EU)/European Economic Area (EEA). Graduates from universities in the rest of the world should decide at the time of the approbation application if they want to register for the Kenntnisprüfung exam or if they want to undergo the process of the Gleichwertigkeit. We explained this in step number 8.
More questions and answers about step six of the 10 steps to start a medical residency in Germany:
The ECFMG: Applying for a medical license in the USA
In the USA, the ECFMG is responsible for testing all medical doctors who want to apply for a medical license in the USA. The USMLE exams. if you ever heard of them, are conducted by the ECFMG.
What are the 16 German medical license authorities (🇩🇪 die Approbationsbehörden)?
In which one of the 16 medical license authorities should you apply for the Approbation?
The decision should take into consideration many factors like how hard the exams in the sate are, how easy is it to get a job with Berufserlaubnis (BE), but the most important factor is if you can get the Gleichwertigkeit in that state. So, please ask firstly medical graduates from your university where you should apply for the Approbation (you can also ask in our main group on Facebook and Telegram). The following article can help you a lot in your decision:
Can the application be online?
No! Never! You need to send authenticated copies of your documents by post (Article: “What is authentication?”)
Can I apply simultaneously to many authorities?
Never! Do not do that!, It is not allowed, and sooner or later they will discover it.
Can I apply for Approbation in one German state and work in another?
Once you get your Approbation, you can from day one work overall in Germany. On the other hand, with a temporary medical license (Berufserlaubnis), you can work only in one German state. More details are in the comparison article between the Approbation and the Berufserlaubnis (link).
Can you change your mind and move your application for the Approbation from one German state to another?
Yes, but this takes at least 2 to 3 months. We explained here how you can move your application for the approbation from one German state to another:
Do the months/years of residency I spend working with Berufserlaubnis (temporary medical license) count for the residency period?
In the great majority of states, no. 😥 More details are in the comparison article between the Approbation and the Berufserlaubni: Link.
7. Apply for a visa (if you need one) & travel to start medical residency in Germany
In order to travel to Germany, citizens of many countries in the world need to apply for a German visa. You should give the German embassy a reason for coming to Germany. We explained the reasons and other issues related to this topic in a separate article:
To get a German visa, one of the things you need is a “proof of financial resources”. We explained the two methods for that in this article:
8. Do the medical language exam (die Fachsprachenprüfung – FSP)
This exam is required from all doctors who did not finish high school in Germany; even if they have a German passport. You can do it ONLY after you send your application to apply for the German permanent medical license (🇩🇪 die Approbation) (step number 6) and get a reply that you can do this exam. Again, as explained in step number 5, applying for a permanent medical license is only possible after finishing medical school.
• Detailed articles:
After passing the medical language exam, the steps required from you depend on the country in which you studied medicine. We explain this in the following algorithm and table:
Did you study medicine in a country of the European Union (EU) or of the European Economic Area (EEA)?
🇪🇺 🇮🇸 🇱🇮 🇳🇴 🇨🇭
(Rest of the world)
After passing the medical language exam, you are going to get the approbation. 🥳🥳
You do not need to read further in step 8 or 9. Go straight to the last step (number 10).
|Most graduates from outside the EU/EEA need to take the medical knowledge exam (🇩🇪 die Kenntnisprüfung). Who should now take it is explained in the next questions in yellow.|
– All about the Gleichwertigkeit/gleich & should you apply for it
What is the 🇩🇪 Gleichwertigkeit/gleich?
The German word “gleich” is an adjective that means “equal or smiliar”. Gleichwertigkeit is the noun form of it.
In the context of non-EU/EEA doctors applying for the Approbation, it means that they apply for an evaluation (🇩🇪 Gleichwertigkeitsprüfung) of the subjects they studied in medical school (syllabus), of their work experience after the internship year, and the courses they attended. This evaluation process costs around 1000-1800 euros and takes between four months and 18 months (depending on state). After this waiting period, they get an answer if what was submitted is “gleich” or not. If they are gleich, then they do not need to take the medical knowledge exam and are treated like EU/EEA graduates. 🥳 If they are judged to be not “gleich”, then they need to do the medical knowledge exam (Kenntnisprüfung). 😥
How do I know if the graduates of my “batch” from our university get the Gleichweritgikeit?
Only if you can find ones who applied in Germany, and they told you about the answer they got. You can ask in our main group on Facebook and Telegram. More details in this article:
Should I apply for the Gleichwertigkeit?
It depends on the likelihood of your getting it.
|Highly likely||Little or no hope|
|What should you decide?||We recommend trying to apply for the Gleichwertigkeit.||Request from the beginning in your approbation application (step 6) that you want to do the medical knowledge exam.|
|Disadvantages of the decision||• Costs for applying for the Gleichwertigkeit (around 1000-1800 euros)|
• The reply needs months. If you got at the end “not gleich”, then you should wait for an appointment for the knowledge exam like someone who sent his application for the approbation on the same day, but asked to directly do the knowledge exam.
|That you might be missing getting a “gleich” if you applied for it.|
|Advantages of the decision||No knowledge exam if “gleich”||If you apply from the beginning to do the knowledge exam and did not apply for a gleich, then:|
1) You can quickly register for an appointment to do the knowledge exam (appointment needs months)
2) You can start early preparing for the knowledge exam, which is a clinical exam mainly and you are not wasting time learning for it (seep step 9).
If I applied for the Gleichwertigkeit, can I work until I receive an answer?
Yes. You can work with a 🇩🇪 Berufseralubnis (BE) (temporary medical license). Read this article for the details:
Can you apply for the Approbation in one German state, do the Fachsprachenprüfung (FSP) there, and then do the medical knowledge exam (Kenntnisprüfung) (KP) in another German state?
Yes! This is how to move your application: Article.
Doing the FSP in one state then the KP in another state is common in the German state of Northrhine-Westphalia (NRW). This is because the medical knowledge exam there (which takes place in Münster) is the hardest in Germany. In NRW, the medical language exam (FSP) takes place in two cities; either in Düsseldorf or in Münster. In Münster, the FSP is also the hardest in Germany. In Düsseldorf, it is normal. Therefore, after succeeding in the FSP, the doctors move their applications to do the KP in another German state.
9. When requested from you, do the medical knowledge exam (die Kenntnisprüfung – KP)
As we explained in detail in step number 8, not all foreign doctors are required to do this exam. This is an oral medical exam. There is not a single MCQ question in it. 🥳 This means that the exam is a friendly discussion and the doctors need at least a general outline of diseases, medications, and therapies. We wrote a detailed article about it here: “What is the medical knowledge exam (die Kenntnisprüfung – KP)?“
Doctors who need to do a medical knowledge exam are allowed by many medical license authorities to work for 6 to 24 months with a temporary medical license ( eine Berufserlaubnis). We explained the differences between a permanent and a temporary medical license in this article:
We hope that you could avoid doing a medical knowledge exam (🇩🇪 die Kenntnisprüfung) and that you now have a permanent German medical license (🇩🇪 die Approbation).
Do not forget to post your photo with the Approbation document in the main group of Facharzt JETZT on Facebook and Telegram.😊🥳 This will motivate others, especially if you write small tips from your experience. That would be very nice of you. 😊💐
10. Apply for a job (die Bewerbung um eine Stelle)
To save time, already after passing the required exams from you, and while waiting for the Approbation/Berufserlaubnis document, start applying for a job. Simply write in your job application that you passed the exam(s) and include a copy of the confirmation of that (you get this on the day of the exam). You can begin working immediately after getting the approbation certificate by mail.
• We explained in the following articles how you can apply for a job (including free samples for your application email and your motivational letter):
• In the following articles, we explained the job interviews and how you can fully succeed in them:
After being accepted in the job, there are small few easy steps to take. Some of them are voluntary and some are mandatory. Please do not forget them because they could cause you to earn more or less money.
• YouTube video: Same steps summarized
At the end of this article, we want to assure you that if you followed carefully these 10 steps to start medical residency in Germany, we will guarantee you that you will get your German Approbation. 🥳
Herzlichen Glückwusnch (Congratulations) 😊
You will get the job! 🥳💐😊
Want to learn more? Questions?
Join JETZT (🇺🇸 now) all of our groups & ask what you like
(On mobile phone: The links are at the end of this page/ On PC: On the right side)
• “Approbation in Germany”, Helena Mamić – Soprano website (Foreign doctor in Germany from Croatia), link.
• “Getting Started with Medical Residency in Germany”, German medical residency website, link.
• “Application Process for Medical Residency in Germany”, German medical residency website, link.
• “Preparation of documents for Berufserlaubnis / Approbation”, your second heart blog, link.