Approbation for Doctors — Complete Guide

From a Serbian medical diploma to full practice license in Germany. Step by step through the entire process — Berufserlaubnis, Fachsprachprüfung, Kenntnisprüfung and Approbation.

High demand for doctors

Germany has a major doctor shortage, especially in rural areas and smaller hospitals. Serbian doctors are in demand — many hospitals actively recruit and assist with the recognition process.

Two paths to Approbation

There are two main paths to getting Approbation (full practice license) in Germany. Which path is right for you depends on how your diploma compares to the German one.

Recommended path

Path 1: Kenntnisprüfung (Knowledge exam)

For doctors whose diploma is not automatically considered equivalent.

●Pass the Fachsprachprüfung (language exam)
●Obtain Berufserlaubnis (temporary permit)
●Pass the Kenntnisprüfung (knowledge exam)
●Receive Approbation (full license)

Alternative path

Path 2: Gleichwertigkeitsprüfung

If your diploma is evaluated as equivalent (rare for Serbian diplomas).

●Submit application with complete documentation
●Wait for equivalency decision
●If positive — direct Approbation
●If not — switch to Path 1

Practical advice

Most Serbian doctors take Path 1 (Kenntnisprüfung). Start the language course as soon as possible — it's usually the longest part of the process.

Fachsprachprüfung — Medical Language Exam

The Fachsprachprüfung is a medical German language exam administered by the Landesärztekammer (State Medical Chamber). It simulates real doctor-patient communication and requires C1 level in medical German.

Exam structure

Anamnesegespräch (Patient interview)

20 minutes — simulation of the first patient conversation. Taking medical history, asking about symptoms.

Dokumentation (Documentation)

20 minutes — writing an Arztbrief (doctor's report) based on the conversation.

Arzt-Arzt-Gespräch (Doctor-to-doctor conversation)

20 minutes — presenting the case to a colleague. Discussing diagnosis and treatment plan.

Preparation is key

The first-attempt pass rate is about 60-70%. We recommend a specialized medical German course (minimum 3 months). Many hospitals offer internal courses for foreign doctors.

Berufserlaubnis — Temporary Work Permit

The Berufserlaubnis allows you to work as a doctor while waiting for Approbation. It is limited to one federal state and valid for up to 2 years.

You can work in a hospital

Under supervision of an experienced doctor with Approbation.

You receive full salary

Average for hospital doctors: EUR 4,500–6,000 gross monthly.

You cannot open a private practice

Private practice requires Approbation.

Limited to one federal state

Moving to another state requires a new Berufserlaubnis.

Strategic advice

Make the most of the Berufserlaubnis period — work at the hospital, learn terminology on the job and prepare for the Kenntnisprüfung. Experience in a German hospital is invaluable for the exam.

Costs and timelines

Cost estimate

Approbation application

Varies by federal state

EUR 150–500

Fachsprachprüfung

Retake possible for additional fee

EUR 350–500

Kenntnisprüfung

One-time exam fee

EUR 300–600

Translations and certifications

Diploma, certificates, attestations

EUR 200–500

Medical German course

3–6 months intensive course

EUR 500–2,000

Berufserlaubnis application

Administrative fee

EUR 100–300

Total (estimate)EUR 1,600–4,400

Timeline

Month 1–6

Language course and preparation

Intensive medical German course from B2 to C1. In parallel — document preparation.

Month 6–9

Fachsprachprüfung + Berufserlaubnis

Take the language exam. After passing — apply for Berufserlaubnis and start working.

Month 9–18

Work with Berufserlaubnis + exam preparation

Work at the hospital while preparing for the Kenntnisprüfung. Practical experience is the best preparation.

Month 18–24

Kenntnisprüfung → Approbation

Take the knowledge exam. After passing — apply for Approbation. Processing time: 4–8 weeks.

Important deadline

The Berufserlaubnis is valid for a maximum of 2 years. Plan your timeline so you pass the Kenntnisprüfung before it expires. Extension is possible but not guaranteed.

Differences by federal state

The Approbation process varies between federal states. Some are known for faster procedures and better treatment of foreign doctors.

Bayern

Strictest Fachsprachprüfung. High standards but also the most positions.

Demanding

Nordrhein-Westfalen

Largest number of hospitals. Good integration programs for foreign doctors.

Favorable

Sachsen

Major doctor shortage. Fast procedure, many hospitals actively recruiting.

Favorable

Baden-Württemberg

Medium requirement level. Good network of IQ counseling centers.

Medium

Berlin

Long processing times. Many applicants, limited capacity.

Demanding

Brandenburg / Mecklenburg-Vorpommern

Major doctor shortage. Special programs for foreign doctors, fast procedure.

Favorable

How to choose a federal state

Think strategically — an easier process in a smaller federal state can mean faster Approbation. After receiving Approbation, you can work anywhere in Germany.

Back to Diploma Recognition Check your diploma →

Sources: Berufsqualifikationsfeststellungsgesetz (BQFG) — gesetze-im-internet.de/bqfg; AufenthG §16d — gesetze-im-internet.de.

Last updated: March 2026. Costs and timelines are approximate and may vary by federal state.