Where to apply for approbation: Advantages & disadvantages of each German state

Where to apply for approbation

โ€ข Introduction about where to apply for approbation

Step number six of the 10 steps for beginning a medical residency in Germany is to apply for a German permanent medical license (die Approbation).

In this article, we try to collect and summarize the advantages and disadvantages of applying for the German permanent medical license (Approbation) in each German state. You can find links to the websites of the 16 medical license authorities in each of the 16 German states here. In this article, we put direct links to the application forms for the Approbation and the required documents.

If you have the slightest doubt about a certain point or do not understand any information, ask at any time in the main group of our community “Facharzt JETZT” on Facebook and on Telegram (groups will appear as a folder). We remind you that this article is a guidance article to help you understand things, and you should not rely solely on it. You should always return to the official websites. ๐Ÿ˜Š

Where should I apply for the Approbation? ๐Ÿ˜ญ๐Ÿ˜ข

Hard question facing many foreign doctors wanting to come to Germany

The question: “Where should I apply for Approbation?” is a common question in all Facebook groups. We tried to make a summary of the differences between the German states. This is not an easy task because each state is different and writing about the topic depends only on what doctors post in the different groups on social networks about their experience.

Can you help us add information to the comparison tables in this article? Please write a short comment, JETZT (now) ๐Ÿ˜Š

โ€ข Abbreviations used in the table “Where to apply for Approbation”

StateName of the German state in English
(๐Ÿ‡ฉ๐Ÿ‡ช name in German)
General evaluation0: Very bad –> 10: Perfect. So, the higher the score, the better is it to apply for the Approbation there.
Proof Is a proof of intention needed to apply for approbation?
(In Bavaria, e. g. this is not needed)
B2Is a B2 certificate needed to apply?
(In some states, like NRW, you can send your documents after the internship year without a language certificate and still can know that you will get Gleichwertigkeit or not)
BEBerufserlaubnis (Temporary medical license)
FSPFachsprachenprรผfung (The Medical Language Exam)
KPKenntnisprรผfung (The Medical Knowledge Exam)
How hard is the exam or to get job with BE๐Ÿ˜: easy
๐Ÿ˜Š: normal
๐Ÿ˜ข: hard
๐Ÿ˜ญ: very hard
Processing time of documents (months)How many months they need before they reply that you can do the FSP exam or that some documents are missing (Defizitbescheid ๐Ÿ‡ฉ๐Ÿ‡ช)
Time to FSP (months)How many months do you need to wait until you can do your FSP exam

โ€ข Where to apply for approbation: Comparison tables

We need your help. Can you help us add more information to the table?

N.B. Because this table is large, you can see it best on a PC. But if you use a mobile phone, turn on the horizontal mode.

StateEvaluationProofB2Processing timeTime to FSPFSPKPJob with BE
1Baden-Wรผrttemberg (BW)
(๐Ÿ‡ฉ๐Ÿ‡ช same)
1โœ…many months๐Ÿ˜๐Ÿ˜๐Ÿ˜ข, somehow, half salary often
2Bavaria (๐Ÿ‡ฉ๐Ÿ‡ช Bayern)9โŒโœ…~11-2๐Ÿ˜Š๐Ÿ˜Š๐Ÿ˜Š
3Berlin (๐Ÿ‡ฉ๐Ÿ‡ช same)2๐Ÿ˜Š๐Ÿ˜Š๐Ÿ˜ญ
4Brandenburg (๐Ÿ‡ฉ๐Ÿ‡ช same)3๐Ÿ˜Š๐Ÿ˜Š๐Ÿ˜Š
5Bremen (๐Ÿ‡ฉ๐Ÿ‡ช same)1๐Ÿ˜Š๐Ÿ˜Š๐Ÿ˜ข
6Hamburg (๐Ÿ‡ฉ๐Ÿ‡ช same)1๐Ÿ˜Š๐Ÿ˜๐Ÿ˜ญ
7Hesse (๐Ÿ‡ฉ๐Ÿ‡ช Hessen)1๐Ÿ˜Š๐Ÿ˜Š๐Ÿ˜Š
(๐Ÿ‡ฉ๐Ÿ‡ช same)
9Lower Saxony
(๐Ÿ‡ฉ๐Ÿ‡ช Niedersachsen)
10 North Rhine-Westphalia
(๐Ÿ‡ฉ๐Ÿ‡ช Nordrhein-Westfalen)
7โœ…โŒ3-4Dรผsseldorf: 4-5

Mรผnster: 2-3
Dรผsseldorf: ๐Ÿ˜Š

Mรผnster: ๐Ÿ˜ญ
๐Ÿ˜ญ ๐Ÿ˜Š
(๐Ÿ‡ฉ๐Ÿ‡ช Rheinland-Pfalz)
5โœ…Some say: ๐Ÿ˜ญ๐Ÿ˜Š๐Ÿ˜ญ
12Saarland (๐Ÿ‡ฉ๐Ÿ‡ช same)3๐Ÿ˜Š๐Ÿ˜Š๐Ÿ˜ญ
13Saxony (๐Ÿ‡ฉ๐Ÿ‡ช Sachsen)3๐Ÿ˜Š๐Ÿ˜Š๐Ÿ˜Š
(๐Ÿ‡ฉ๐Ÿ‡ช Sachsen-Anhalt)
15Schleswig-Holstein (๐Ÿ‡ฉ๐Ÿ‡ช same)5๐Ÿ˜Š๐Ÿ˜Š๐Ÿ˜Š
(๐Ÿ‡ฉ๐Ÿ‡ช Thรผringen)
This table was written with help from: Dr. Nero (Thanks ๐Ÿ˜Š๐Ÿ’)

โ€ข Proof of intention to apply for Approbation

To apply for the Approbation, one needs a proof of intention:

๐Ÿ‡ฉ๐Ÿ‡ช Applying for the Approbation: The proof of intention

We list here which proof of intention accepts each state.

1Baden-Wรผrttemberg (BW)
(๐Ÿ‡ฉ๐Ÿ‡ช same)
โœ…“Strong” family connection
2Bavaria (๐Ÿ‡ฉ๐Ÿ‡ช Bayern)โœ…๐Ÿ’žno needno needno needno need
3Berlin (๐Ÿ‡ฉ๐Ÿ‡ช same)โœ…
(or 5 refusals)
4Brandenburg (๐Ÿ‡ฉ๐Ÿ‡ช same)โœ…
5Bremen (๐Ÿ‡ฉ๐Ÿ‡ช same)โœ…
6Hamburg (๐Ÿ‡ฉ๐Ÿ‡ช same)โœ…
7Hesse (๐Ÿ‡ฉ๐Ÿ‡ช Hessen)โœ…
(๐Ÿ‡ฉ๐Ÿ‡ช same)
9Lower Saxony
(๐Ÿ‡ฉ๐Ÿ‡ช Niedersachsen)
10 North Rhine-Westphalia
(๐Ÿ‡ฉ๐Ÿ‡ช Nordrhein-Westfalen)
(๐Ÿ‡ฉ๐Ÿ‡ช Rheinland-Pfalz)
12Saarland (๐Ÿ‡ฉ๐Ÿ‡ช same)โœ…
13Saxony (๐Ÿ‡ฉ๐Ÿ‡ช Sachsen)โœ…
(๐Ÿ‡ฉ๐Ÿ‡ช Sachsen-Anhalt)
15Schleswig-Holstein (๐Ÿ‡ฉ๐Ÿ‡ช same)โœ…
(๐Ÿ‡ฉ๐Ÿ‡ช Thรผringen)
โœ…๐Ÿ’žno needno needno needno need

โ€ข Where to apply for Approbation: Advantages & disadvantages of each state

1Baden-Wรผrttemberg (BW)
(๐Ÿ‡ฉ๐Ÿ‡ช same)
โ€ข Beautiful nature, warm weather
โ€ข 3rd populated state (>11 million)
โ€ข Some say, a salary with BE lower than a normal salary
โ€ข Living costs are relatively high
2Bavaria (๐Ÿ‡ฉ๐Ÿ‡ช Bayern)โ€ข Good weather, nature very beautiful, hiking paradise
โ€ข 2nd populated state (>13 million). Hence large number of hospitals.
โ€ข High living costs
โ€ข Hard to find accommodation in large cities
3Berlin (๐Ÿ‡ฉ๐Ÿ‡ช same)โ€ข Very hard to get accommodation and job
4Brandenburg (๐Ÿ‡ฉ๐Ÿ‡ช same)โ€ข Good alternative for those who want to live in or near Berlin
5Bremen (๐Ÿ‡ฉ๐Ÿ‡ช same)โ€ข Small state (around 0.5 million)
6Hamburg (๐Ÿ‡ฉ๐Ÿ‡ช same)โ€ข Hard to get accommodation and job
7Hesse (๐Ÿ‡ฉ๐Ÿ‡ช Hessen)โ€ข Center of Germany
(๐Ÿ‡ฉ๐Ÿ‡ช same)
โ€ข Some coastal cities
โ€ข Weather not hot like in the south
9Lower Saxony
(๐Ÿ‡ฉ๐Ÿ‡ช Niedersachsen)
โ€ข Large state & many hospitalsโ€ข Fourth populated state (>8 million) > Many hospitals, normal
10 North Rhine-Westphalia
(๐Ÿ‡ฉ๐Ÿ‡ช Nordrhein-Westfalen)
โ€ข Most populated state (>18 million) > largest number of hospitals
โ€ข Waiting times are short
โ€ข Some wrote, if the doctor did “very bad” in the KP, then he will no longer be allowed to work with BE, but may re-take the KP
โ€ข The KP & FSP in Mรผnster are the hardest in Germany. In Dรผsseldorf there is a second test centrum for the FSP only & the exam there is normal.

(๐Ÿ‡ฉ๐Ÿ‡ช Rheinland-Pfalz)
โ€ข Many say it is hard to get a job there with BE
12Saarland (๐Ÿ‡ฉ๐Ÿ‡ช same)โ€ข Small state (1 million) and few hospitals
13Saxony (๐Ÿ‡ฉ๐Ÿ‡ช Sachsen)โ€ข Some areas are isolated in the most northern parts of Germany, but this could be an advantage if you want to live near Scandinavian countries
(๐Ÿ‡ฉ๐Ÿ‡ช Sachsen-Anhalt)
โ€ข Small state and few hospitals
15Schleswig-Holstein (๐Ÿ‡ฉ๐Ÿ‡ช same)โ€ข Some areas are isolated in the most northern parts of Germany, but this could be an advantage if you want to live near Scandinavian countries
(๐Ÿ‡ฉ๐Ÿ‡ช Thรผringen)
This table was written with help from: Dr. Nero (Thanks ๐Ÿ˜Š๐Ÿ’)

โ€ข Further readings about where to apply for approbation

โ€ข A beautiful table from Wikipedia containing a comparison between all 16 German states: Link.

Want to learn more? Questions?
Join JETZT (๐Ÿ‡บ๐Ÿ‡ธ 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)


  1. Respected sir/ma’am,
    I am MBBS doctor from India. I am currently doing B2 and I wanted to know about C1 FSP and KP courses and learning institutes in Hamburg, Germany. If you could suggest some , then would be a great help .

    Thank you

  2. Which state would be the best for me? I have my MBBS degree from Kyrgyzstan but permanent license and residency from home country Pakistan.

    1. Bayern is good. But please read a lot. Ask so maany people as you can. You can ask in our main groups:
      ๐Ÿ‡ฉ๐Ÿ‡ช ร„rzte in Deutschland – ุงู„ุฃุทุจุงุก ุงู„ุนุฑุจ ููŠ ุฃู„ู…ุงู†ูŠุง – Doctors in Germany
      โ€ข Facebook: http://www.facebook.com/groups/arabische
      โ€ข Telegram:
      – Join all all of our Telegram groups (they appear as single folder): https://t.me/addlist/EDf_7TH3qlE0MmNi

      ๐Ÿ‡ฉ๐Ÿ‡ช Foreign Doctors in Germany (Posts auf Deutsch/Englisch, nicht nur Arabisch bitte im Text): http://www.facebook.com/groups/auslaendische

      ๐Ÿ‡ฉ๐Ÿ‡ช Medical PG in Germany – Doctors wokring in Germany: http://www.facebook.com/groups/1436238759972943

      ๐Ÿ‡บ๐Ÿ‡ฆ Ukrainische ร„rzte in Deutschland (Posts auf Deutsch/Englisch, nicht nur Arabisch bitte im Text):
      – Facebook: http://www.facebook.com/groups/41589709991320
      – Telegram: https://t.me/+-Yc7VzITWbMzMWNi

      ๐Ÿ‡ฉ๐Ÿ‡ช ุงู„ุฃุทุจุงุก ุงู„ุณูˆุฑูŠูˆู† ููŠ ุฃู„ู…ุงู†ูŠุง Syrische ร„rzte in Deutschland – ูุงุฎ ุขุฑุชุณุช ูŠุชุณุช

  3. Hello, I have done my MBBS and MD ( anaesthesia) in India with 1+ year work experience after PG. I am considering between Lower Saxony and NRW states. Which would you suggest? also is it possible to register my post graduation after KP rather than joining for a residency course all over again?

  4. Hi there,
    Nicely written article. I liked the comparison tables.
    I am MBBS and MD General Medicine from India. I want to pursue Cardiology Training in Germany (likely Bavaria), could you tell me about the duration of cardiology training and if my internal medicine residency would be accepted as such without needing to repeat some or whole of it . Thank you very much.

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