Last checked against the official source: 29 August 2026
Medicine is a regulated profession in Germany: it cannot be practised without the licence to practise (Approbation). Section 3 of the Federal Medical Practitioners’ Regulation (BÄO) sets the conditions, and graduates from outside the EU follow a route built on an equivalence assessment — with the knowledge examination (Kenntnisprüfung) required only where substantial differences are found. It is not an automatic step.
The general conditions (paragraph 1)
- Legal basis
- Section 3 of the Federal Medical Practitioners’ Regulation (Bundesärzteordnung, BÄO).
- Personal suitability
- No conduct indicating unworthiness or unreliability for practising the profession.
- Health fitness
- The health fitness required to practise the profession.
- Academic qualification
- Medical studies of at least six years and 5,500 hours, including 8 to 12 months of practical hospital training.
- Examination
- Passing the medical state examination.
- Language
- The German language knowledge required for practising the professional activity.
The route for graduates from outside the EU
- Assessment of the equivalence of the training levelThe competent body examines whether your qualification shows substantial differences compared with German medical training. This is the primary route — the knowledge examination is not an automatic step.
- If no substantial differences are foundEquivalence is recognised, and no knowledge examination is required.
- If substantial differences are foundThe required knowledge and skills are demonstrated through an examination relating to the content of the final state examination — this is what is known as the Kenntnisprüfung.
- Where documents are missingThe provision also allows the competent body to require the knowledge examination where the application cannot be assessed without unreasonable effort because documents are missing. This case affects many people who cannot obtain their papers from their home country — missing documents do not close the door, but they move you onto the examination route.
The statute names neither B2 nor C1. Almost every article asserts that “B2 general and C1 medical” are required. The text we checked names no level of the Common European Framework; it requires the German knowledge needed to practise the professional activity. The levels in circulation come from the decisions of the state medical chambers, which run the specialist language examination (Fachsprachenprüfung) — and they differ from one federal state to another. Check with the medical chamber of the state you will apply in, not with a general article.
Competence sits with the federal states. The licence is granted by a body of the state, not by a single federal authority. Procedures, waiting times, documents and the conditions for a temporary practice permit (Berufserlaubnis) differ substantially between states. Choosing the state you apply in is a strategic decision, not an administrative detail.
Official source and related reading
Section 3 BÄO — full text · The substantial-difference test · The recognition procedure and the three-month rule
Please note: this page is general guidance, not legal advice. The medical licensing route is long, expensive and governed at state level — check with the competent body in your state and with the medical chamber before any decision about relocating or applying.
Frequently asked questions
Is B2 or C1 required for the Approbation?
The text we checked names no level of the Common European Framework; it requires the German knowledge needed to practise the professional activity. The levels in circulation come from state medical chamber decisions, which govern the specialist language examination and differ between states.
Is the knowledge examination compulsory for non-EU graduates?
No, and it is not automatic. The primary route is an assessment of the equivalence of the training level: if no substantial differences are found, equivalence is recognised and no examination is required; if they are found, an examination relating to the content of the final state examination is required.
What if I cannot obtain my documents from my home country?
The provision allows the competent body to require the knowledge examination where the application cannot be assessed without unreasonable effort because documents are missing. Missing documents do not close the door — they move you onto the examination route.
What academic qualification is required?
Medical studies of at least six years and 5,500 hours, including 8 to 12 months of practical hospital training, plus passing the medical state examination — alongside the personal suitability and health fitness conditions.
Is the licence the same across Germany?
No. It is granted by a body of the federal state, not a single federal authority, and procedures, waiting times, documents and temporary practice permit conditions differ substantially. Choosing the state is a strategic decision.
What is a Berufserlaubnis?
A temporary permit to practise, whose conditions are set at state level and differ between states. Ask the competent body in the state you are targeting what it requires and how long it lasts.