Working as a foreign doctor in Germany? This is how it works

Number of foreign doctors in Germany reaches 15 percent

Almost 60,000 of the physicians working in Germany come from abroad. This corresponds to around 15 percent of all medical doctors. And the trend is upward. In 2019 alone, the number grew by around 3,800, according to the German Medical Association “Bundesärztekammer". A large proportion of the medical professionals living in this country come from the EU or other European countries.

Most foreign doctors working in Germany come from:

• Romania (4,785)
• Syria (4,732)
• Greece (3,216)
• Austria (2,736)
• Poland (2,163)
• Bulgaria (1,834)
• Hungary (1,834)
• Italy (1,618)

Germany needs doctors from abroad

The number of medical doctors working in Germany has been rising steadily since the 1960s. Currently, more than 400,000 physicians work in German clinics, hospitals and rehabilitation centers, medical practices and health centers or senior citizens home and nursing facilities. In order to maintain the level of quality of medical care in Germany, the local healthcare system urgently needs the support of physicians from abroad.

Despite the steady growth in the number of physicians, experts warn of an impending shortage of doctors. One reason for this is that more and more of them are working part-time. On the other hand, demographic change is leading to an increased number of elderly in the society and thus to a greater need for medical care. At the same time, more doctors will soon be retiring.

"Approbation" as the most important prerequisite

Anyone who wants to work as a doctor in Germany must be prepared for a number of formalities and a demanding recognition procedure – and they must learn the German language. Interested professionals can find support both from the medical associations, as well as from supportive initiatives such as the "Integration through Qualification (IQ)" program of the Federal Ministry of Labor and Social Affairs, and the European Union.

The German license to practice medicine, the so-called "Approbation", is the most important document for foreign doctors who want to work in Germany. Obtaining it requires having both professional and personal qualifications. The criteria are set by the state and can differ depending on candidate’s country of origin.

Criteria for granting the "Approbation"

All foreign physicians who wish to work in Germany must prove the following:

• Graduation from medical studies from a country of the EU, the EEA or Switzerland OR graduation from medical studies (equivalent to the studies in Germany) from another country OR successfully passed examination of professional knowledge ("Kenntnisprüfung") in Germany
• sufficient German language skills on level B2 and technical language on level C1
• credibility and reliability
• physical capability for the exercise of the profession

Doctors who have completed their medical studies in the EU, in a country of the EEA or in Switzerland must apply for an "Approbation", but usually receive it without further conditions. However, if the document certifying doctor’s qualifications is older than the country of origin's membership in the EU, in some cases a verification test must be taken to prove that the qualifications are equivalent. This includes an oral and practical assessment with a patient participating.

There are two ways to prove the professional qualification for doctors from a third country:

1. 1.
   determining the equivalence of qualifications with an expert’s assessment procedure,
2. 2.
   start the practice with a professional permit (befristete Berufserlaubnis) limited to two years, which allows sufficient time to prepare for the knowledge examination for getting the “Approbation”.

Equal curriculum standards must be maintained

Medical doctors from a third country can obtain their "Approbation" through an expert review process. The authorities of the federal state in which the recognition is applied for evaluate and assess the qualification in cooperation with the "Gutachtenstelle für Gesundheitsberufe" (GfG).

The results of an equivalence test, the so-called "Gleichwertigkeitsprüfung", proof whether there are significant differences in the applicant's level of knowledge compared to corresponding medical training in Germany. If differences occur and cannot be compensated, for example by the candidate’s professional experience, a knowledge test called "Kenntnisprüfung" is necessary.

How the "Kenntnisprüfung" works

The "Kenntnisprüfung" is an oral and practical exam that usually takes from 60 to 90 minutes. Within this exam the physicians from third countries must demonstrate their skills in the subjects of internal medicine and surgery. In addition, they can expect questions about clinical pharmacology, emergency aid, diagnostic procedures as well as radiation protection and legal aspects of medical practice. If the differences in education is identified in a particular field, this can be specifically classified as relevant to the examination.

Doctors who successfully pass the exam have proven that their level of education is equivalent to that of a doctor who graduated in Germany. They receive their license to practice medicine and are permitted to practice their profession in Germany on their own authority and without restrictions. If they do not pass, they can retake the examination up to two more times.

Many institutions in Germany offer help in preparation for the "Kenntnisprüfung"; Interested candidates can easily find more information for each federal state online in the "IQ Landesnetzwerken" by using the search term "Kenntnisprüfung Ärzte".

Temporary professional permit as an alternative to the "Kenntnisprüfung"

Working as a medical doctor in Germany is possible also with a temporary permit called "Befristete Berufserlaubnis". It is a convenient and practice-oriented starting point for foreign doctors who want to work in Germany and obtain the "Approbation". The permit is limited to two years and is usually only valid in the federal state in which it was issued. In most cases, there are additional limitations, such as the restriction to certain activities or places of work.

With a temporary permit, foreign doctors may only work in Germany under the supervision of a licensed colleague. This regulation offers a good opportunity to demonstrate one's practical knowledge and at the same time prepare for the examination that grants the "Approbation".

Professionals following such process should apply for the "Approbation" as soon as they receive the "Befristete Berufserlaubnis" no later than one year before the temporary permit expires.

Checklist for foreign doctors from third countries who want to work in Germany 

If you are form a non-EU country and want to work in Germany as a doctor, you need a license ("Approbation") to practice medicine. The following checklist will help you with your application. It lists all the documents you need:

1.       Proof of identity (passport or identity card)

2.       Marriage certificate in case of name change due to marriage

3.       Curriculum Vitae

4.       Certificates such as diploma or professional certificate

5.       Evidence of content and duration of education such as Diploma Supplement or Transcript of Records (ToR).

6.       Employment references

7.       Proof that you are allowed to work as a doctor in your country of origin.

If you come from an Non-EU an non-EEA state and do not yet live in the EU, in the EEA or in Switzerland, prove your intention to work in Germany. Application documents, invitations to job interviews or an application for an entry visa for future employment will come useful. You may confirm your personal reliability by providing a criminal record clearance from Germany and from your country of origin that is not older than three months.

Medical certificates from Germany and from your country of origin that are not older than three months are considered proof of your physical ability to perform the profession.

Your language skills (general knowledge of German at the B2 level and special knowledge of technical language at the C1 level) can be proven with language certificates. You can often provide them also after submitting your application. Free German language courses can be found in online platforms such as IMED-KOMM, the Goethe-Institut or Deutsche Welle.

Applying for visa

 As a citizen of a non-EU and non-EEA state, you must apply for a visa before entering Germany. You have different options for doing so:

1. 1.
   You can obtain an "EU Blue Card" if you already have an employment contract.
2. 2.
   The "Job seeker" visa is suitable for you if you have not yet found a job.

Detailed information on the residence permit is provided by the Federal Office for Migration and Refugees.