The What, Why and How of EFFECTIVELY Getting Your Approbation as an Arzt in Germany in 2022

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Written by Mila Alperson

Dr. Alperson is a medical resident doctor in Germany, and Co-Founder of Doctoringermany.com (DiG). Her goal is to assist foreign colleagues to reach their full potential in the medical field in Germany. She has vast knowledge and experience in the medical licensing process in Germany.

January 3, 2022

A detailed guide on how to become a licensed doctor in Deutschland

Introduction

Guten Tag, aspiring German doctors! Your search for an in-depth guide to getting your Approbation as an Arzt and becoming a certified, licensed doctor in Germany, ends here.

In this article, you will learn:

  • What does Approbation Arzt even mean?
  • Why do you need an Approbation to work as an Arzt (doctor)?
  • What are the types of medical licenses in Germany?
  • Approbation and how it works.
  • Step by step process of getting your Approbation.
  • Berufserlaubnis and how it works.
  • Step by step process of getting your Berufserlaubnis.
  • Necessary exams for the licenses.

So without any further ado, let us carry on and discuss all there is to know about Approbation as an MD in Germany.

What does Approbation Arzt even mean?

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If your German is a little weak, you might be confused as to what an Approbation Arzt even means, (sidenote; you better start studying the language if you dream of working here as a doctor!).

Allow me to clear things up for you. Approbation is the German word for approval or license, and Arzt is the German word for doctor. So together, Approbation Arzt is basically the German term for approval or license required to be a doctor in the country.

The ‘Approbation’ is the medical license that the German state issues to doctors, which permits them to practice medicine in the country. There are various requirements an aspirant must meet if he wants to receive an Approbation. We’ll get to those as the article progresses.

Why do I Need an Approbation?

You must be thinking, “I’m a certified doctor in my home country, why do I have to go through this lengthy process to practice medicine, even after completing so many years of education?”

Now, while your concern is valid and it makes sense from your perspective, you have to look at it from an administrative point of view as well. The German state doesn’t know how valid your education is or if it meets its standards. Don’t get me wrong, this is not to insult or underestimate your skills or qualifications. It is merely a measure for their citizens’ safety and well-being to ensure that only the finest and most qualified doctors work in the country.

Physicians (Ärzte) are required to obtain a medical license (Approbation or Berufserlaubnis) if they intend to work in Germany. This requires them to have up-to-date and accurate knowledge of their field and fluency in the language of the country. Your Approbation will be your documentation of authority to practice medicine throughout Germany.

What are the Types of Medical Licenses in Germany?

As a basic rule of thumb, you’ll need a medical license to practice medicine in any country. We’ve already mentioned the Approbation, which is the German MD license. Along with this, Germany also gives you another option if you want to work in the country as a doctor. This is the so-called Berufserlaubnis. In short, it is a temporary license. Confused between which one is right for you? We will head into both and try to solve your dilemma.

Approbation (German MD License)

Let’s start with the Approbation. By now, you probably have a good understanding of what an Approbation is. It is the medical license required in Germany to work as a doctor. Each and every doctor in the country, from a cardiologist to a general physician, requires an Approbation to conduct their practice. Even if they are native to Germany. This Approbation lasts for a lifetime and grants the holder unhindered permission to practice medicine throughout the country. So you don’t have to worry about renewing your Approbation or checking if your license is valid if you’re planning to move between states in Germany.

There are a few requirements that the candidates must meet in order to get their Approbation. One of them is that they should have a strong hold over the German language, in terms of both everyday use and proficiency in German technical and professional language according to their profession. Next, their degree/educational qualification must be deemed equivalent to the German diploma by the concerned authorities. Additionally, the candidates are required to have a clean criminal record with no outstanding offenses or charges.

Step-by-Step Guide to Getting Your Approbation

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The journey of getting a medical license can be long and confusing. From gathering the necessary documents, to preparing for exams. It can get intense at times. However, for your peace of mind, we have written this short guide to hold your hand through the procedure and make sure you fulfill your goals.

Basic Framework and Procedure for Approbation

We’ll start with forming a strong base in communication. To live and work in any country, you must be comfortable with the local language. In an effort to make things easier for you, begin learning the German language when you start nearing your graduation, instead of starting when you start the application process. Learn not only German for everyday use, but we would also recommend joining a course aimed at learning German Medical Terminologies. This will help you when you have to sit for the FSP (Fachsprachprüfung) exam.

Next, arrive in Germany. Once you’re in the country (or before that), look for potential hospitals where you can work. Once you’ve found a hospital or hospitals that suit you, apply for a so-called ‘Hospitation’. A hospitation is an observership. After submitting your documents and sound preparation, you can proceed to take the German Medical Language exam, also called the Fachsprachprüfung (FSP). This would be a great time to apply for a Berufserlaubnis while you wait to get your Approbation (this isn’t the case for everyone, and should be determined on an individual basis).


After completing a short hospitation, you can use your Berufserlaubnis (when applicable) to get a job under a doctor to ensure a steady income.

Now, you must gather the necessary documents (listed below) and submit them to have them certified. If your diploma does not receive approval, you will have to give the equivalence exam (Kenntnisprüfung or Gleichwertigkeitsprüfung). After passing the exam and getting the approval of the concerned authorities, you will eventually receive your Approbation.

(Sidenote: While there are some different requirements for candidates from European Union and Non European Union countries, the following points are mandatory for both of them.)

Let’s list down some basic documents and certifications required to kickstart the process of getting your Approbation!

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i. You must be certified in the German Language at B2/C1 Level using the

Common European Framework (CEF), which is the standard for measuring language skills inside the European Union.

The candidate must pass the B2 General German Language Test via the TELC/Goethe Test.

ii. The next certification you have to possess is German Medical Terminology and Clinical Communication Skills.

To obtain this qualification, you are required to pass the Fachsprachprüfung, or FSP. Fachsprachprüfung (FSP) is the German term for the professional German Medical Language Exam.

iii. An obvious step, but nonetheless, a critical one. To get an Approbation, you have to apply for one. The candidate must send an application for a medical license (Approbation) to the relevant regulatory authorities.

iv. As we mentioned earlier in the article, to practice medicine in Germany, the German state must have faith that you are indeed qualified to practice medicine in the country. For this, you must get your diploma certified from them. While this is usually a smooth process, some Non-EU students’ diplomas may get rejected in the application process. Don’t stress over that; this doesn’t end your dream, it just presents an opportunity to brush up on your skills and get acquainted with the German medical practices and requirements.

To prove your competence to the Germans, some non-EU graduates will need to pass an equivalence exam (Kenntnisprüfung or Gleichwertigkeitsprüfung). This exam will check your skills and expertise and decide whether they are equivalent to those possessed by doctors who graduated in Germany. After passing this equivalence exam, you will have cleared a small blockage on your way to getting your Approbation.

If you’re not able to pass this exam the first time around, it’s not the end of the world! You can repeat this exam and pass it the next time (however, keep in mind, this exam can only be taken a limited number of times!)

iv. Lastly, you need a clear criminal record from your home country, which makes it clear that you do not have any recorded crimes in your past and do not have any harmful tendencies.

Some additional important documents that might be requested throughout the process:

  • You will need a certified/legalized copy of the original and translated version of your marriage certificate (if applicable).
  • A certified/legalized copy of the original and translated version of your birth certificate.
  • A certified/legalized copy of the original and translated version of your name change certificate (if it applies).
  • A certified/legalized copy of the original and translated version of your medical educational certificates.
  • A certified/legalized copy of the original and translated versions of the Certificate of Good Standing (Unbedenklichkeitsbescheinigung) from any state/national medical council where you have studied/worked in. This document is valid for a limited period of time.
  • You will also need a Zusage, or a job offer letter.
  • A city registration confirmation letter (‘Anmeldung’)
  • Copies of job applications to other hospitals and their replies.

Berufserlaubnis and How it Works

First off, the word Berufserlaubnis is a mouthful. But then again, most German words are. One of the many quirks of the German language. You better get used to it, you’re gonna be speaking the language every day soon!

Coming back to our main subject matter, let’s talk about the Berufserlaubnis shall we? Basically, the Berufserlaubnis is a temporary work permit. It is designed for people who wish to work in Germany on a temporary basis or for professionals who are waiting to get their Approbation and have to work till then. These people can apply for a Berufserlaubnis.

The duration of validity of a temporary license (Berufserlaubnis) is up to two years. That should be more than enough time for you to complete the procedure to get your Approbation and start practicing in Germany as a full-fledged doctor. One of the few caveats of the Berufserlaubnis is that you cannot open a private practice while holding one.

A Berufserlaubnis holder can only work under a doctor who has a valid Approbation. Another caveat is that the Berufserlaubnis you receive is only valid within the state you got it in. This means that you cannot move to another state and work there with the temporary permit you got in another state. As a precautionary measure, make sure the state where you apply for a Berufserlaubnis is somewhere you’re comfortable to live and work in till you get your Approbation.

Step-by-Step Guide to Getting Your Berufserlaubnis

First things first, please note that each state in Germany has its own separate demands for applying for and receiving a Berufserlaubnis (temporary medical license). You can download your respective state’s form and look at their requirements from the website of that particular state’s authority in charge.

  • First, you will have to enter some regular details about yourself and your educational qualifications.You also have to download a declaration from the same website.
  • Next, you have to prepare a CV or a resume that is aligned with the German norms. This is quite easy and you can find guidelines for it online.
  • Now, the documents you submit to the authorities must be certified and be both, in their original language and a professionally translated version in German.
  • Certified copies of your passport and visa must be submitted.
  • You also have to submit a medical health certificate. This can easily be taken from a ‘Hausarzt’ or a family doctor( in German) and will cost you somewhere in the ballpark of 30-50 Euros.
  • The health certificate is legitimate for a particular period of time. You have the option of submitting either the original or a legalized copy (‘beglaubigte Kopie’) of the certificate.
  • Next, you are required to submit a PCC (Police Clearance Certificate) from your current country of residence and native country. You have the option of obtaining it from either the Embassy, Passport Authority, or Consulate of your home country. The validity of the Police Clearance Certificate is for a duration of three months.

You will require a legalized copy of the original and translated version of this document. Along with that, you also have to apply for a local certificate of conduct (‘Führungszeugnis’) at the Bürgeramt (City Office). This certificate is valid for a limited period of time and costs around 13 Euros. You will get this delivered to the address you have mentioned.

Language requirements differ according to each state and you are mandated to submit the legalized copies of original German Language certificates as required by the state.

Some additional important documents that might be requested throughout the process:

  • You will need a certified/legalized copy of the original and translated version of your marriage certificate (if applicable).
  • A certified/legalized copy of the original and translated version of your birth certificate.
  • A certified/legalized copy of the original and translated version of your name change certificate (if it applies).
  • A certified/legalized copy of the original and translated version of your medical educational certificates.
  • A certified/legalized copy of the original and translated versions of the Certificate of Good Standing (Unbedenklichkeitsbescheinigung) from any state/national medical council where you have studied/worked in. This document is valid for a limited period of time.
  • You will also need a Zusage, or a job offer letter.
  • A city registration confirmation letter (‘Anmeldung’)
  • Copies of job applications to other hospitals and their replies.

Necessary Exams in Your Journey

Fachsprachprüfung (FSP)

The Fachsprachprüfung tests your knowledge of the German language from a medical or professional point of view. You have to take this exam at the Medical Council before getting a Berufserlaubnis or Approbation.

Coming to the details of the exam, the FSP is conducted by three officials (at least one of whom will be a doctor). This will be a one-on-one discussion between you and the officials.

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The Fachsprachprüfung is a simulation between you and another person who acts as a patient.

Four Primary Segments of the Exam:

Simuliertes Arzt-Patienten-Gespräch (Simulated Doctor-Patient-Discussion)

In this segment, one of the three examiners will role-play as a patient and you will be required to play the doctor. You’ll perform a standard medical history-taking and give them a probable diagnosis and details regarding any other tests. The main part here is that the whole conversation will be conducted in German, and you will need to have detailed knowledge about the concerned medical terminologies. You should also be able to resolve any queries the patient might have while conversing in German. This part of the exam will take around 20 minutes.

Documentation

After the simulation, you will get 20 minutes to write down and fill in all the information regarding the patient in German, on a sheet of paper. Including, but not limited to the patient’s history, diagnosis and your treatment recommendations.

The point here is to check your proficiency in written German and whether or not you can properly write in the language.

Arzt-Arzt-Gespräch (Doctor-Doctor-Discussion)

The third part of the FSP is a doctor-doctor discussion. Here, you’ll go through the case you’ve taken in the earlier segments and you will present it to a doctor in the committee. You will then be thoroughly asked questions on this.

Translations

After these three, you’ll have to complete some translations where you’ll have to –

First, translate complicated medical german terms to simple german.

Then, you’ll have to do the opposite and translate simple german terms to complicated/official ones. This can get tricky, as the official German terms are usually in Latin and you have to be very particular about each translation.

Quick Tip: Try to use simplified terms when talking to patients and proper, official terms while speaking to doctors. Also, keep your pronunciations and accent in check and make it sound as German as possible.

Kenntnisprüfung

The Kenntnisprufung is the German equivalence exam or knowledge test. Using this exam, the German medical council determines whether or not the skills you possess as a doctor are equivalent to German doctors. When compared to the FSP, this exam will focus more on your knowledge of medical science rather than your knowledge of the German language.

The exam consists of two main parts. One is the Practical part and one is the Oral part.

The Practical exam will have you clinically examine a patient and take their history. You might be asked questions during your examination of the patient.

Then, you will have the oral exam, where you will present a case and theory to three examiners who will ask you questions regarding the same case.

In the case study, you will be questioned on the reports you took from the patient in the practical exams. They will ask you every detail of the examination, and you will have to provide them with the necessary answers, from why you gave the diagnosis you did to possible treatment options.

While in the theory part, you will have to answer questions from various disciplines, such as Internal Medicine, Emergency Medicine, Radiation Protection, Clinical Pharmacology, etc.

Conclusion

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In conclusion, while the procedure of becoming a licensed MD in Germany can seem long, complicated and tedious, it becomes easier once you break it down into smaller, bite-sized parts.

Speedy Recap:

  • An Approbation as an Arzt is the license required to work as a doctor..
  • An Approbation will give you the approval to practice medicine in Germany.
  • A Berufserlaubnis is a temporary, two-year license, which is only valid in the state in which it has been issued.
  • Fachsprachprüfung (German Medical Language Exam) and Kenntnisprüfung (German Equivalence Exam) are two important exams you will encounter on your journey to getting your Approbation.

We hope that we were able to answer some of your burning questions regarding the process of receiving the Approbation as an Arzt and were able to help you get one step closer to becoming an MD in Germany.

WE CAN HELP YOU START YOUR MEDICAL CAREER IN GERMANY

Need help with becoming a medical doctor in Germany? First of all – subscribe to our YouTube channel Doctor In Germany, we will be uploading valuable content on a regular basis to help future and current doctors in Germany maximize their potential. Secondly, if you’d like us to go over your particular situation with you and find your best route for becoming a medical doctor in Germany, and of course answer any of your questions, you can book a one-on-one private counseling session. We would love to assist you!

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