Working as a Doctor in Germany — Approbation, Recognition & Exams FAQ
Authoritative FAQ for foreign-trained physicians on Approbation, Berufserlaubnis, Kenntnisprüfung, Fachsprachprüfung (C1), visas, and starting medical work in Germany.
What this page covers
This FAQ reflects federal law (Bundesärzteordnung, Aufenthaltsgesetz) and typical administrative practice as of 2026. Individual decisions depend on the competent authority and personal circumstances.
Frequently Asked Questions
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1Which organisation is competent for the recognition of foreign medical diplomas and specialist diplomas?
Foreign-trained physicians apply to the Approbationsbehörde of the federal state where they intend to work for recognition of basic training (Approbation/Berufserlaubnis). Specialist recognition is separate and handled by the Landesärztekammer; membership is mandatory.
2Is it necessary to have a job offer or reside in Germany before submitting an application?
No. You can apply from abroad without a job offer, but authorities often request proof of intent to work in their jurisdiction.
3I am still living outside Germany. Where can I get advice?
Contact ZSBA (Federal Employment Agency). They advise on recognition, visas, residence permits, and may issue confirmations accepted by many authorities.
4Can I request an equivalence assessment without German language certificates?
Yes. The assessment can proceed, but Approbation/Berufserlaubnis is granted only after language and other requirements are fulfilled.
5Can I apply to several Approbationsbehörden simultaneously?
No. Only one recognition procedure can run at a time; you must choose one federal state.
6What documents must be submitted for recognition?
Depends on the authority, typically diplomas, transcripts, experience proofs, Good Standing, CV, passport, certified translations. Specialist docs follow chamber rules.
7Does citizenship matter for Approbation?
No. Recognition is independent of nationality.
8EU/EEA/Swiss diploma: will it be recognised?
Yes if listed in Directive 2005/36/EC (Annex V) and minimum requirements are met. Decisions typically within 3 months after complete documentation (with possible justified extension).
9EU training started before reference date: recognised?
Possible with certificate of conformity, or proof of ≥3 years full-time lawful practice in the last 5 years.
10Diploma from territory that later changed state: recognised?
Requires confirmation from the current EU member state that the diploma has the same legal validity as current national diplomas, plus proof of recent lawful practice.
11Where can I find the European Directive?
Directive 2005/36/EC, the EEA Agreement, and bilateral agreements are publicly accessible via EU/EFTA portals.
12Third-country diploma: recognised?
It undergoes individual equivalence assessment. If substantial differences remain and can’t be compensated, the authority may require the Kenntnisprüfung; rare refusals are possible.
13Third-country diploma recognised in another EU country: automatic in Germany?
No. Germany conducts its own assessment; an aptitude test may be required instead of Kenntnisprüfung.
14I did not complete an obligatory practical phase. What now?
Incomplete training generally prevents recognition. Completing the obligatory practical phase abroad is strongly recommended before applying.
15Can I get financial support for recognition costs?
Possibly, if residing in Germany; eligibility and amounts depend on current programs and your situation.
16What is the Kenntnisprüfung?
A clinical-practical oral exam assessing equivalence to German training, focused on Internal Medicine and Surgery, typically 60–90 minutes, usually up to three attempts.
17Do I need a Berufserlaubnis to take the Kenntnisprüfung?
No, although a Berufserlaubnis is often granted for preparation.
18How can I prepare for the Kenntnisprüfung?
Options include supervised clinical work, structured prep courses (e.g., MEDDEOnline/Amboss), and self-study with German resources. Availability varies by region and funding.
19How expensive is the Kenntnisprüfung?
Usually about €500–€1,500 depending on the federal state (as of 2026).
20How am I paid under a Berufserlaubnis?
Generally comparable to employed physicians under collective agreements; exact terms depend on employer and contract.
21Maximum duration of a Berufserlaubnis?
Typically up to two years, with extensions only in exceptional cases (§10 BÄO).
22Language skills required for Approbation?
Common practice (2026): B2 general German + C1 medical German (Fachsprachprüfung).
23Language skills required for Berufserlaubnis?
In most states, the same as Approbation; earlier temporary exceptions largely expired after 2023.
24Cost of the medical German exam?
Typically €350–€700 depending on provider and state.
25Who regulates postgraduate medical training?
Exclusively the State Chambers of Physicians (Landesärztekammern).
26Can Berufserlaubnis time count toward specialty training?
Usually no; it generally starts after Approbation. Rare transitional credits depend on chamber rules.
27EU specialist training: recognised?
Automatic recognition if listed in Directive 2005/36/EC; otherwise individual assessment.
28Third-country specialist diploma: recognised?
Individual assessment; substantial differences may lead to an aptitude test/specialist examination; practices vary by chamber.
29Do I have to register with a State Chamber?
Yes, membership is mandatory for doctors working in Germany.
30Income opportunities for physicians?
Governed mainly by collective agreements; exact income depends on employer, experience, and region.
31Job market and vacancies?
Germany has continued physician shortages, especially outside major cities. Vacancies are listed via journals, hospital sites, and agencies.
32Who advises on labour law?
Physicians’ unions and professional associations offer contract checks and labour-law support (membership recommended).
33Which visa/residence permit do I need?
Non-EU doctors usually need a residence permit (e.g., §16d, §18b/§18g, §81a). Choice depends on recognition status, job offer, and nationality.
34Can I enter Germany before Approbation is granted?
Yes with the right visa/permit, but clinical work starts only after Berufserlaubnis/Approbation is issued.
35Typical step-by-step pathway?
Language → Application → Assessment → Exams → Visa/residence → Start work (timelines vary by state).
36How long does the Approbation process take?
Often 6–18 months in practice, depending on documentation, exams, and authority workload.
37Fastest/easiest federal state?
No official “fastest”. NRW is often chosen, but speed depends on workload and case complexity.
38Can I change federal state mid-process?
No transfer; you must start a new application in the new state.
39Can I work while waiting for Approbation?
Only with a valid Berufserlaubnis and within its restrictions.
40Do I need malpractice insurance?
Yes. Coverage may be via employer or private policy.
41Police clearance / health suitability required?
Yes, both are standard requirements for Approbation.
42How must documents be translated/certified?
Usually by sworn translators with certified copies; specific certification rules vary by authority.
43Age limit?
No legal age limit for recognition or employment.
44Can my family join?
Yes, family reunification is possible; spouses often can work.
45Expected net salary after deductions?
Depends on tax class/region/insurance/family status; roughly 40–50% deductions from gross are common.
46Failing Kenntnisprüfung three times?
Recognition is generally refused after exhausting attempts; legal remedies may exist.
47Can I work without Approbation?
No independent practice without Approbation. Medical work is lawful only with a valid Berufserlaubnis; otherwise serious legal/immigration consequences may follow.
48Jobs while waiting for recognition?
Without Berufserlaubnis: only non-licensed roles (research, observership, documentation/coding, admin, translation/writing). With Berufserlaubnis: limited supervised clinical activity per permit.
49Difference between Approbation and Berufserlaubnis?
Approbation = full permanent nationwide license. Berufserlaubnis = temporary restricted permit tied to employer/state/supervision.
50Do I need Fachsprachprüfung, Kenntnisprüfung, or both?
Depends on equivalence assessment: FSP (C1) is standard for many, KP is required if substantial training differences exist; some must pass both.
51What happens after passing Kenntnisprüfung?
It remedies knowledge deficits; Approbation is issued only after all other requirements (language, reliability, health, documents) are met.
52Change employers with a Berufserlaubnis?
Usually no unless the authority approves and amends the permit before you start the new job.
53Is a Berufserlaubnis employer-specific or nationwide?
Almost always employer-specific and valid only in the issuing federal state; nationwide validity is extremely rare.
54Allowed/prohibited activities under a Berufserlaubnis?
Allowed tasks are defined in the permit; typically supervised care within the named institution. Independent practice and activities outside the permit are typically prohibited.
55Night shifts / on-call / emergency work with a Berufserlaubnis?
Only if explicitly allowed in the permit. Supervision must remain ensured; you cannot be the sole responsible doctor.
56How long after passing all exams to receive Approbation?
No fixed legal deadline; in practice weeks to months depending on the authority.
57Missing/lost documents?
Request official replacements or proof from issuing/successor institutions. Affidavits rarely replace core documents. The burden of proof is on the applicant.
58What if my university no longer exists?
Obtain documentation from the legal successor institution or the responsible state/archive authority confirming succession and your qualification details. This often requires authentication and sworn translation, and processing can take longer.
59Are affidavits or declarations accepted instead of documents?
Generally no. Personal declarations are not accepted as substitutes for official documents. They may be considered only exceptionally as supplementary explanations together with proof that you tried to obtain official replacements.
60Do documents need an apostille or legalization?
It depends on the issuing country and applicable agreements. Hague-Convention countries often require an apostille; non-Hague countries may require full legalization via a chain including the German mission. Do not obtain apostilles/legalizations pre-emptively unless the authority requests them.
61How old may a Certificate of Good Standing be?
Typically no older than three months at submission. If the procedure takes longer, the authority may request an updated certificate.
62How recent must the police clearance certificate be?
Typically no older than three months at submission. After living in Germany for a certain period (often >6 months), a German criminal record certificate may also be required.
63Can I submit digital copies first?
Often yes for initial review (PDF via email/portal). Before a final decision, the authority usually requires certified hard copies and sometimes inspection of originals.
64Do documents need to be translated before or after submission?
Submit official German translations together with the originals/copies. Translations must typically be done by publicly sworn translators. Partial translations for key documents are usually not accepted.
65Can I update documents during an ongoing procedure?
Yes. Provide updated contact details, new language certificates, renewed Good Standing/police certificates if expired, and additional professional experience relevant to equivalence. Inform the authority in writing.
66What happens if my documents are considered insufficient?
The authority may request additional documents (Nachforderung), order a compensation measure (often the Kenntnisprüfung), pause the decision until missing items arrive, or issue a refusal if essential requirements cannot be met. You usually have a right to be heard.
67What happens if I fail the Fachsprachprüfung?
You can re-take the exam. Approbation cannot be issued until you pass. If you work under a conditional permit or your residence permit depends on progress, repeated failures may create issues—so plan re-takes strategically.
68How often can I repeat the Fachsprachprüfung?
There is no uniform federal limit. Practical limits can exist via provider rules, chamber guidelines, or waiting periods. Always check the rules of the state/provider where you take the exam.
69What happens if I fail the Kenntnisprüfung once or twice?
You can usually re-take it within the allowed attempts (commonly up to three). You normally must re-apply, pay the fee again, and observe a waiting period (often at least 3 months). Some authorities request proof of targeted preparation before re-admission.
70Are withdrawals counted as failed attempts?
Usually not if you withdraw before the exam starts and have a valid documented reason (e.g., acute illness). Late withdrawal or no-show without valid reason is often counted as a failed attempt (state/provider rules apply).
71Can I appeal an exam result?
Yes. Exam results can be challenged through formal review procedures (e.g., remonstration) and potentially through administrative court. Deadlines can be short (often ~1 month). Legal advice is recommended.
72Can I change the federal state after failing an exam?
You may apply in another state, but failed attempts are generally documented and the total attempt limit is typically cumulative. Switching states often means restarting the procedure; previous attempts may still be visible.
73Is the Kenntnisprüfung the same in all federal states?
The legal basis and goal are nationwide, but the practical implementation can vary by state and examination board (format details, emphasis, cases, scoring approach). State-tailored prep can help.
74Can examiners ask questions outside Internal Medicine and Surgery?
Yes, if clinically relevant to general competence (diagnostics, pharmacology, emergencies, cross-disciplinary links). Highly specialized niche questions are not standard.
75How long must I wait between exam attempts?
It is set by the competent authority/provider; often at least three months and sometimes longer (especially after multiple failures). Conditions are usually stated in the written notice.
76Can pregnancy or illness pause or extend exam deadlines?
Yes. You can request deadline extensions with documentation (medical certificates, maternity documents). Coordinate also with the immigration office if your residence status depends on timelines.
77Can hospitals help with recognition paperwork?
Some hospitals provide administrative support (HR contacts, visa documents, in-house courses), but they cannot submit the application for you, influence the authority’s decision, or guarantee outcomes.
78Do I need a German employment contract before Approbation?
Not for Approbation itself, but often yes for practical steps like Berufserlaubnis, residence permits, and relocation logistics.
79Can I work part-time with a Berufserlaubnis?
Yes if your contract is part-time, the permit terms allow it, supervision can be ensured, and your residence permit permits part-time work.
80Is clinical work under a Berufserlaubnis paid or unpaid?
Paid. Clinical work under a valid Berufserlaubnis is regular employment and must be remunerated under German labor law/collective agreements.
81Can I do multiple jobs at the same time?
Usually not under a standard Berufserlaubnis because it is tied to one employer. Secondary work may require prior written approval; a second medical job is unlikely to be approved.
82Are locum / temporary positions allowed?
Usually not compatible with a standard Berufserlaubnis because stable supervision and employer binding are required. After Approbation, locum work is generally unrestricted.
83What happens if I lose my job while holding a Berufserlaubnis?
Because the permit is employer-bound, it typically becomes invalid. You must inform the authority. To start a new job, you generally need a new/modified permit; your residence status may also be affected, so inform the immigration office promptly.
84Can my employer terminate me if recognition is delayed?
Yes, depending on labor law and your contract (especially during probation). Delays can affect fixed-term contracts and extensions—try to ensure realistic timelines and support are clearly written.
85Are there minimum salary requirements for residence permits?
Yes for certain permits (e.g., EU Blue Card thresholds). For skilled-worker permits, salary must be comparable to German workers and usually aligns with collective agreements; immigration offices check contracts.
86Can I work in private clinics or practices?
With a Berufserlaubnis, only within the named institution (which could be private), and supervision must be ensured. Most permits are issued for hospitals. With Approbation, you can work in any setting subject to regulations.
87Can foreign clinical experience reduce exam requirements?
Sometimes, case-by-case, if it is relevant and well documented. It is not automatic and rarely replaces German language requirements.
88Is experience from non-EU countries fully recognized?
It is assessed individually; there is no automatic recognition. Authorities evaluate quality, duration, and relevance. For specialist recognition, scrutiny can be stricter and only partially credited.
89Can I start specialist training before Approbation?
As a rule, no. Specialist training is regulated by the State Chamber and requires Approbation. Time under a Berufserlaubnis generally does not count, except rare transitional cases with written approval.
90Can time under Berufserlaubnis ever count toward specialization?
Only in very rare exceptional cases with explicit prior approval from the responsible State Chamber and if all training documentation and supervision requirements are met.
91How is part-time specialist training treated?
Training time is extended proportionally according to Chamber regulations (e.g., 50% employment counts as half time). Minimum weekly hours may apply.
92Can I change specialties after recognition?
Yes. After Approbation you may start another specialty under Chamber rules. Prior training from abroad may be partially credited at the Chamber’s discretion.
93What if my specialty does not exist in Germany?
The Chamber conducts an individual assessment. Outcomes may include equivalence to an existing specialty, partial recognition (e.g., Schwerpunkt), or no protected-title recognition (while Approbation can still be possible).
94Can I work as a specialist without German specialist recognition?
You may work as a physician with Approbation, but you cannot use protected German specialist titles or be billed/advertised as a specialist. Hospital roles and salary may be limited.
95Do I need separate recognition for subspecialties?
Yes if the subspecialty is a regulated protected title (Schwerpunkt). If it is not regulated, it may not exist as a separate formally recognized title.
96How long does specialist recognition usually take?
EU/EEA/Swiss listed specialties: typically within 3 months (extendable by 1). Third-country individual assessments often take 6–18 months depending on complexity and workload.
97Can I enter Germany as a visitor and apply from inside the country?
Usually discouraged and often not possible. Visitor/Schengen status typically does not allow switching to recognition/work permits inside Germany; most applicants must apply for the correct national visa from abroad (exceptions are limited).
98Can I switch from student or asylum status to a doctor’s residence permit?
Sometimes, under specific conditions. Students may switch if skilled-worker requirements are met. Refugees may work but still must complete Approbation recognition to practice clinically.
99What happens if my visa expires during recognition?
Maintain lawful stay: apply for extension early, submit proof of ongoing recognition, and request a Fiktionsbescheinigung if you applied before expiry. Do not overstay.
100Can I change residence permits after Approbation?
Yes. Many move from §16d (recognition) to §18b/§18g or an EU Blue Card after Approbation and an employment contract. Apply at your local immigration office with the required documents.
101Is permanent residence possible as a doctor?
Yes. Typical routes include EU Blue Card pathways (e.g., 33 months with B1 or 21 months with C1) or skilled-worker permits with longer timelines, plus livelihood and contribution requirements.
102Can recognition time count toward permanent residence?
Time under §16d can count toward residence duration if your stay remains lawful. Pension contributions are key; paid employment under Berufserlaubnis with contributions counts.
103Can my spouse work immediately?
Often yes when joining holders of skilled-worker permits or Blue Cards; spouse permits commonly allow unrestricted employment (“Erwerbstätigkeit gestattet”).
104What happens if recognition is finally refused?
You cannot practice medicine in Germany; any Berufserlaubnis becomes invalid, employment ends, and permits tied to recognition/work may not be renewed. New applications may be possible only with substantially new evidence.
105Can I change employers with a §18b / §18g permit?
Often yes. These permits are typically less employer-bound than a Berufserlaubnis, but notification/approval rules vary by office and time period. The new job must still meet permit conditions.
106Do I need a separate permit for night or on-call duties?
Not separately, as long as those duties are part of the contract and you hold valid Berufserlaubnis/Approbation plus residence rights for that employment.
107What health insurance do I need before starting work?
You need valid German health coverage. Before employment starts, travel/temporary private insurance may be required for entry/visa. Once employed (below the threshold), statutory insurance (GKV) typically applies and your employer registers you.
108When can I switch to statutory health insurance?
Usually from day one of eligible employment. Your employer registers you with a statutory fund once your contract starts.
109Do I need private malpractice insurance if my employer insures me?
Employer coverage may be sufficient for in-hospital duties, but additional personal coverage is strongly recommended for legal defense and gaps. For private practice, personal coverage is mandatory.
110How much are Ärztekammer fees?
Fees are mandatory and vary by state, usually income-dependent. For employed physicians, they are often roughly in the range of a few dozen euros per month, depending on the chamber’s scale.
111Do I need to file German tax returns?
Often yes depending on your situation (tax class combinations, deductible expenses, additional income). Even if not strictly required, filing can lead to refunds.
112What tax class applies to married doctors?
Couples often choose IV/IV or III/V depending on income distribution. It affects monthly withholding but final liability is settled via the annual tax return.
113Are relocation costs tax-deductible?
Often yes as income-related expenses (Werbungskosten) when moving for work, subject to rules. Keep receipts and check current guidance.
114Do I need to open a German bank account?
Yes. Salary is typically paid via SEPA transfer, and many contracts (rent, utilities, insurance) rely on EU bank accounts and direct debit.
115Can I claim child benefits?
Often yes if you are legally residing and working in Germany. Apply via the Familienkasse with the required documents.
116What happens during parental leave?
Germany provides parental leave rights and protections, with possible parental allowance (Elterngeld) replacing part of net income. Notify your employer in writing within required deadlines.
117Are language exam exemptions possible?
Extremely rare and only in exceptional legally defined cases. For clinical work, C1 medical German requirements typically apply.
118Is medical German required before or after arrival?
C1 Fachsprachprüfung must be passed before Approbation is granted. Many candidates take the exam in Germany, but reaching a high level before arrival reduces delays.
119Can I work while still preparing for C1?
Clinical work generally requires Berufserlaubnis and strong German. While preparing, you can work in non-clinical roles that do not require a medical license.
120Are online language certificates accepted?
Usually not unless from a recognized provider with secure proctored conditions. Always confirm acceptance with your authority.
121Which language exams are recognized?
Commonly: Fachsprachprüfung by State Chambers; some states accept Goethe/Telc/TestDaF/DSH with specific scores. Always confirm the accepted list with your chosen Approbationsbehörde.
122How long are language certificates valid?
Often no formal expiration once submitted, but skills must be current. For visas/initial steps, certificates are often treated as current if not older than about two years (practice varies).
123Can I repeat only parts of the Fachsprachprüfung?
No. If you fail, you repeat the entire exam (no modular partial pass).
124Is medical terminology the same across Germany?
Core terminology is standardized. Minor regional lay variations exist but are not exam-relevant; professional communication uses Hochdeutsch.
125Can dialects affect the exam?
Exams are conducted in standard German (Hochdeutsch). Strong dialect can hinder comprehension; you’re expected to communicate clearly in standard German.
126Are interpreters allowed during exams or work?
No. Interpreters are prohibited in exams and generally not permitted in clinical practice where direct German communication is required for safety and legal compliance.
127Which specialties are most in demand in Germany?
Demand exists across many fields, especially outside major cities. Often in high demand: General Practice, Internal Medicine, Psychiatry, Anesthesiology, Pediatrics, Gynecology/Obstetrics, General Surgery.
128Which regions offer the best chances of employment?
Smaller towns and rural/structurally weaker regions often have higher demand and more active recruitment than major hubs.
129Are rural jobs easier for recognition?
No. Standards are the same nationwide. However, rural hospitals may be more experienced supporting foreign doctors and coordinating locally, which can make the process smoother in practice.
130Can I later move to a big city?
Yes. Approbation is nationwide. After Approbation you can work anywhere; competition in large cities and university hospitals may be higher.
131How competitive are university hospitals?
Often more competitive and may prefer strong academic/research profiles. Non-university hospitals are frequently more accessible for initial entry and provide solid training opportunities.
132Are there age disadvantages in hiring?
Age discrimination is prohibited. Employers focus on qualifications, language, experience, and fit.
133Is research experience valued?
Yes, especially for university hospitals and academic roles. For many clinical roles, strong clinical experience can be more decisive.
134Can I do a PhD before Approbation?
Yes, in non-clinical research if admitted to a program. Patient-intervention clinical research typically requires appropriate licensure and approvals.
135Are there mentoring programs for foreign doctors?
Yes. They can be offered by Chambers, hospitals, non-profits, and professional associations depending on region.
136Do hospitals offer integration programs?
Many do (housing help, admin support, tandems, intercultural training), but the scope varies widely—ask during interviews.
137What happens if I work without proper authorization?
Unauthorized medical practice can be a criminal offense and may lead to fines/imprisonment, job termination, refusal of recognition, and severe immigration consequences including deportation and re-entry bans.
138What are the consequences of false documents?
Forgery is a serious criminal offense and typically leads to immediate refusal, possible prosecution, and revocation of residence status.
139Can recognition be revoked later?
Yes, for example if obtained through fraud/false information, if mandatory conditions were not met, or if later conduct shows unreliability. Revocation has major legal consequences.
140Are criminal convictions always disqualifying?
Not automatically. Authorities assess severity, recency, and proportionality. Minor offenses may be irrelevant; serious offenses can lead to refusal. Full disclosure is required.
141What medical conditions can prevent Approbation?
Only conditions that substantially and permanently impair safe practice. Many manageable chronic conditions are not barriers; assessment is functional and proportionate.
142Can I practice telemedicine from abroad for patients in Germany?
Generally no. Treating patients located in Germany usually requires German Approbation and compliance with professional rules; cross-border telemedicine is complex and not a shortcut for recognition.
143Can I volunteer in hospitals?
Yes in non-medical roles. You cannot perform medical tasks without appropriate licensure.
144Can I observe surgeries without a permit?
Often yes as a passive observership (Hospitation) with permission—no hands-on care and no independent clinical decisions.
145Who is liable for mistakes under a Berufserlaubnis?
Liability can be shared. Supervisors have oversight responsibility; the permit holder may be personally liable for negligent acts—especially beyond authorized scope—and the employer can also be liable.
146Where can I file a complaint against authorities?
Use formal remedies (objection/appeal) stated in decisions, administrative court action, or supervisory complaints (Dienstaufsichtsbeschwerde). Legal advice is often crucial.
147Can I choose the Kenntnisprüfung instead of adaptation training?
Often yes: applicants ordered to compensate substantial differences are usually informed about both options (adaptation period vs Kenntnisprüfung). In practice, many choose KP because it can be faster; availability varies by state.
148Is the Kenntnisprüfung harder than final German medical exams?
It is not designed to be harder; it differs in format and practical emphasis. Many find it challenging due to language demands and stress—targeted preparation helps.
149Do examiners fail candidates on purpose?
No. Examiners must assess objectively by defined criteria. Failures typically reflect deficits in knowledge/communication/safe reasoning, not quotas. Decisions can be reviewed.
150What is the pass rate of the Kenntnisprüfung?
There are no uniform nationwide statistics. Outcomes vary by state/board and individual factors. Success depends largely on language proficiency, clinical experience, and familiarity with German standards.
151Can my employer pressure me to do tasks not covered by a Berufserlaubnis?
No. You are personally responsible for staying within permit limits. Performing unauthorized activities can cause serious legal, professional, and immigration consequences—even if instructed by an employer.
152Who supervises me legally under a Berufserlaubnis?
Usually a named supervising physician or the head of department, depending on the permit wording. Supervision must be realistic and compliant with the authority’s requirements.
153Can I be personally liable before Approbation?
Yes. Civil and criminal liability can apply regardless of full licensure. Employer insurance does not remove personal responsibility in serious cases.
154What happens if I lose my job during probation (Probezeit)?
A Berufserlaubnis and residence permits linked to that employment may need reassessment. You typically must notify authorities promptly; continued residence/employment depends on securing a new qualifying option within permitted timelines.
155Can I change from §16d to a Blue Card directly?
Sometimes after Approbation, if Blue Card requirements (especially salary) are met. It depends on your case and the immigration office; it is not automatic.
156Does unemployment affect my recognition procedure?
Unemployment does not automatically stop recognition, but you must maintain lawful residence. Longer unemployment can indirectly affect residence permits and renewals.
157Can I drive in Germany with my home country license?
Often only for a limited period (commonly up to 6 months after establishing residence), depending on the issuing country. After that, conversion may be required.
158Is German medical handwriting an issue in exams?
Legibility matters. Perfect handwriting isn’t required, but documentation must be clearly understandable; illegibility can be assessed as a practical deficiency.
159Can patients refuse treatment by foreign doctors?
Patients generally have physician choice rights. Institutions must balance patient autonomy with duty of care and staff protection; discriminatory refusals raise ethical and legal concerns.
160Is the Kenntnisprüfung written or oral?
It is typically an oral-practical case-based examination. There is usually no multiple-choice written component.
161How many times can I fail the Kenntnisprüfung?
Commonly a maximum of three attempts. After exhausting attempts, recognition is generally refused, subject to legal remedies.
162Is a Berufserlaubnis the same as provisional Approbation?
No. Berufserlaubnis is a temporary restricted permit. Only Approbation is the full permanent nationwide license.
163Can I work as a nurse/assistant doctor/physician assistant while waiting?
Generally no. Those professions require separate recognition. Without Approbation or Berufserlaubnis, you can only work in non-licensed roles without independent medical responsibility.
164Do I need Approbation to start specialist training (Facharztausbildung)?
Yes. Formal specialist training in Germany begins after Approbation. Time under a Berufserlaubnis generally does not count toward specialist training.
Legal notice: This page provides general information and does not constitute legal advice. Requirements and procedures vary by federal state and individual case. Always confirm with your competent Approbationsbehörde, Landesärztekammer, and immigration office.
Last updated: 2026-01-01 (structure + SEO/FAQ schema). If you need a state-specific checklist (NRW/Bayern/BW etc.), we can generate it.
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