• 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 websites of the 16 medical license authorities in each of the 16 German states here. In this article, we put direct links to for the application forms for the Approbation and the required documents.
😭😢 Where should I apply for the Approbation?
Hard question facing many foreign doctors
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 the following article?
• Abbreviations used in the table
| Abbreviation | Meaning |
|---|---|
| State | Name of the German state in English (🇩🇪 name in German) |
| Proof | Is a proof of intention needed to apply for approbation? (In Bavaria, e. g. this is not needed) |
| B2 | Is 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) |
| BE | Berufserlaubnis (Temporary medical license) |
| FSP | Fachsprachenprüfung (The Medical Language Exam) |
| KP | Kenntnisprüfung (The Medical Knowledge Exam) |
| How hard is the exam or to get job with BE | 😍: easy 😊: normal 😢: hard 😭: 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 🇩🇪) |
| Time to FSP (months) | How many months do you need to wait until you can do your FSP exam |
• 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 are using a mobile phone, turn on the horizontal mode.
| State | Proof | B2 | Processing time | Time to FSP | FSP | KP | Job with BE | |
|---|---|---|---|---|---|---|---|---|
| 1 | Baden-Württemberg (BW) (🇩🇪 same) | ✅ | 😍 | 😍 | 😢, somehow | |||
| 2 | Bavaria (🇩🇪 Bayern) | ❌ | ✅ | ~1 | 1-2 | 😊 | 😊 | 😊 |
| 3 | Berlin (🇩🇪 same) | 😊 | 😊 | 😭 | ||||
| 4 | Brandenburg (🇩🇪 same) | 😊 | 😊 | 😊 | ||||
| 5 | Bremen (🇩🇪 same) | 😊 | 😊 | 😢 | ||||
| 6 | Hamburg (🇩🇪 same) | 😊 | 😍 | 😭 | ||||
| 7 | Hesse (🇩🇪 Hessen) | 😊 | 😊 | 😊 | ||||
| 8 | Mecklenburg-Vorpommern (🇩🇪 same) | 😊 | 😊 | 😊 | ||||
| 9 | Lower Saxony (🇩🇪 Niedersachsen) | 😊 | 😊 | 😊 | ||||
| 10 | North Rhine-Westphalia (NRW) (🇩🇪 Nordrhein-Westfalen) | ✅ | ❌ | 3-4 | Düsseldorf: 4-5 Münster: 2-3 | Düsseldorf: 😊 Münster: 😭 | 😭 | 😊 |
| 11 | Rhineland-Palatinate (🇩🇪 Rheinland-Pfalz) | ✅ | Some say: 😭 | 😊 | 😭 | |||
| 12 | Saarland (🇩🇪 same) | 😊 | 😊 | 😭 | ||||
| 13 | Saxony (🇩🇪 Sachsen) | 😊 | 😊 | 😊 | ||||
| 14 | Saxony-Anhalt (🇩🇪 Sachsen-Anhalt) | 😊 | 😊 | 😊 | ||||
| 15 | Schleswig-Holstein (🇩🇪 same) | 😊 | 😊 | 😊 | ||||
| 16 | Thuringia (🇩🇪 Thüringen) | 😊 | 😊 | 😊 |
• Proof of intention to apply for Approbation
To apply for the Approbation, one needs a proof of intention:
We list here which proof of intention accepts each state.
| State | Nothing needed | Hospitation | Anmeldung | Standortvermerk | Zusage | Others | |
|---|---|---|---|---|---|---|---|
| 1 | Baden-Württemberg (BW) (🇩🇪 same) | ✅ | “Strong” family connection | ||||
| 2 | Bavaria (🇩🇪 Bayern) | ✅💞 | no need | no need | no need | no need | |
| 3 | Berlin (🇩🇪 same) | ✅ (or 5 refusals) | ✅ | ✅ | ✅ | ||
| 4 | Brandenburg (🇩🇪 same) | ✅ | |||||
| 5 | Bremen (🇩🇪 same) | ✅ | |||||
| 6 | Hamburg (🇩🇪 same) | ✅ | |||||
| 7 | Hesse (🇩🇪 Hessen) | ✅ | |||||
| 8 | Mecklenburg-Vorpommern (🇩🇪 same) | ❌ | ❌ | ✅ | ❌ | ✅ | |
| 9 | Lower Saxony (🇩🇪 Niedersachsen) | ✅ | |||||
| 10 | North Rhine-Westphalia (NRW) (🇩🇪 Nordrhein-Westfalen) | ❌ | ✅ | ✅ | ✅ | ||
| 11 | Rhineland-Palatinate (🇩🇪 Rheinland-Pfalz) | ✅ | ✅ | ||||
| 12 | Saarland (🇩🇪 same) | ✅ | |||||
| 13 | Saxony (🇩🇪 Sachsen) | ✅ | |||||
| 14 | Saxony-Anhalt (🇩🇪 Sachsen-Anhalt) | ✅ | |||||
| 15 | Schleswig-Holstein (🇩🇪 same) | ✅ | |||||
| 16 | Thuringia (🇩🇪 Thüringen) | ✅💞 | no need | no need | no need | no need |
• Where to apply for Approbation: Advantages & disadvantages of each state
| State | Advantages 😊 | Disadvantages 😢 | |
|---|---|---|---|
| 1 | Baden-Württemberg (BW) (🇩🇪 same) | • Beautiful nature, warm weather • 3rd populated state (>11 million) | • Some say, a salary with BE lower than a normal salary • Living costs are relatively high |
| 2 | Bavaria (🇩🇪 Bayern) | • Good weather, nature very beautiful, hiking paradise • 2nd populated state (>13 million). Hence large number of hospitals. | • High living costs • Hard to find accommodation in large cities |
| 3 | Berlin (🇩🇪 same) | • Very hard to get accommodation and job | |
| 4 | Brandenburg (🇩🇪 same) | • Good alternative for those who want to live in or near Berlin | |
| 5 | Bremen (🇩🇪 same) | • Small state (around 0.5 million) | |
| 6 | Hamburg (🇩🇪 same) | • Hard to get accommodation and job | |
| 7 | Hesse (🇩🇪 Hessen) | • Center of Germany | |
| 8 | Mecklenburg-Vorpommern (🇩🇪 same) | • Some coastal cities • Weather not hot like in the south | |
| 9 | Lower Saxony (🇩🇪 Niedersachsen) | • Large state & many hospitals | • Fourth populated state (>8 million) > Many hospitals, normal |
| 10 | North Rhine-Westphalia (NRW) (🇩🇪 Nordrhein-Westfalen) | • Most populated state (>18 million) > largest number of hospitals • Waiting times are short | • 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 • The KP & FSP in Münster are the hardest in Germany. In Düsseldorf there is a second test centrum for the FSP only & the exam there is normal. |
| 11 | Rhineland-Palatinate (🇩🇪 Rheinland-Pfalz) | • Many say it is hard to get a job there with BE | |
| 12 | Saarland (🇩🇪 same) | • Small state (1 million) and few hospitals | |
| 13 | Saxony (🇩🇪 Sachsen) | • 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 | |
| 14 | Saxony-Anhalt (🇩🇪 Sachsen-Anhalt) | • Small state and few hospitals | |
| 15 | Schleswig-Holstein (🇩🇪 same) | • 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 | |
| 16 | Thuringia (🇩🇪 Thüringen) |
• Further readings about where to apply for approbation
• A beautiful table from Wikipedia containing a comparison between all 16 German states: Link.
Want to learn more? Questions?
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