To practice medicine in Germany, you are required by law to be approved by the state in which you wish to practice. This certificate of registration (in German, ‘die Approbation’) will grant you permission to work as a medical professional in the state that accepts the request and only in this state.
The regulations that determine if you will be approved are determined by the Federal Department of Health (‘Gesundheitsministerium’), which determines the requirements for the study of medicine in Germany.
As of April 2012, any foreign national can apply for ‘Approbation’ in Germany in accordance with the Recognition Act, or ‘Anerkennungsgesetz.’ However, for this application to be considered and accepted, many requirements must be met and documentation must be provided. These requirements vary depending on the country in which basic medical training was completed.
First and foremost, before beginning any application processes, it is important to recognise that knowledge of the German language is required for an Approbation request to be approved. Whilst the level required differs between states, the general consensus is that an applicant must have completed at least level B2 in the Common European Framework of Languages (CEFR) for conventional German. Furthermore, a more specific C1 CEFR level understanding in the medical language of the applicant’s speciality is usually required. If your language skills are not currently at this level, it will be necessary to improve them before applying.
If the language requirements are met, then the next step will be recognition of your basic medical training and specialisations. How this process works depends on the country in which you received this qualification.
Note: It is possible to have your basic medical training recognized before the language requirements are met. However, this does not grant you permission to work in German medical facilities.
Irrespective of the origin of your qualification, you should decide on where you are applying before proceeding with an application. Since it is not possible to apply to multiple states simultaneously, you must have a location preference. Each state has its own restrictions and requirements; it is therefore important to research which area would be best for you. A list of all registration authorities is available here. There is no requirement that you receive a job offer before beginning your application; the process can begin as soon as you have made up your mind about where to apply.
If you received your qualifications in one of the EU member states, including Norway, Iceland, Liechtenstein, or Switzerland, your qualifications should be automatically accepted according to the ‘EU directive on the recognition of professional qualification s- 2005/36/EC.’
However, you must have started your training after a specified date, your specific degree/specialisation must be among those listed, and minimum periods for your training/education must be met. All of these requirements are listed in annex V of the directive here.
If you have received your qualifications in a non-EU country, with the exception of Norway, Iceland, Liechtenstein, or Switzerland, your degree will be compared with its German counterpart after submission. If it is deemed sufficiently similar and as long as other requirements (such as health requirements, no criminal record, etc.) are met, your Approbation request should be approved. However, if it is decided that the discrepencies between the degrees are too great and these can not be compensated for by work experience or another recognized form of experience, then you may be required to sit for an examination.
In a very small number of cases, the difference between a foreign degree and a German may be deemed too great to be compensated for with an examination. In this case, the physician will not be allowed to work in a medical capacity in Germany.
It’s important to note that all of the processes mentioned above come with costs attached, which normally range from 130 to 1000 Euros, depending on the region in which you apply. In some cases, it is possible that these costs will exceed 1000 Euros, especially if the examination must be taken.
Subsidies are available from the German government to help offset this expenditure. These, however, are subject to conditions, such as having resided in Germany for at least 3 months and having limited financial capacity. Subsidies must also be requested before the Approbation application is sent off for approval. Further information can be found here.