Approbation (German licence to practise)

Germany's recognition portal defines the Approbation as official state authorisation to practise an academic medical profession permanently and without restrictions, for example as a doctor or pharmacist. Dentists receive one too, under their own law. It is valid throughout Germany, whichever of the 16 federal states issued it, and it is different from the temporary Berufserlaubnis.

For doctors the rules are in section 3 of the Bundesärzteordnung (BÄO). You must not have behaved in a way that shows you are unworthy or unreliable to practise, must be medically fit, must have the German needed for the job, and must have training equivalent to a German medical degree of at least six years and 5,500 hours, including 8 to 12 months of practical training. German nationality is no longer a condition.

• EU, EEA or Swiss qualification listed in the law's annex: treated as equivalent to German training through automatic recognition.
• Other EU, EEA or Swiss qualification: the authority checks equivalence and, if it finds substantial differences, sets an aptitude test (Eignungsprüfung) on those differences. It must issue that decision within four months of receiving all documents.
• Third-country qualification: the authority carries out an equivalence assessment. If it finds substantial differences that your experience does not cover, you prove your knowledge by passing the Kenntnisprüfung, which relates to the content of the German state exam. The same test applies if your documents cannot be produced for reasons outside your control.

Section 3(3a) BÄO says equivalence should be checked before the other conditions, and you can ask for a separate notice on equivalence alone.

1. Find the authority for your federal state using the Approbation authorities page or the official Recognition Finder.
2. Apply with the documents in section 3(6) BÄO, including proof of identity, a tabular CV, certified copies of your diploma, proof of your right to practise at home and evidence of good conduct. Foreign documents need qualified translations and, in North Rhine-Westphalia, an apostille or legalisation.
3. Wait for the equivalence decision. If it lists gaps, it is often called a Defizitbescheid.
4. Pass the Fachsprachprüfung (medical German test) set by your state.
5. Pass the Kenntnisprüfung if required, then receive the Approbation.

There is no single national fee. The Bezirksregierung Münster, which handles North Rhine-Westphalia, charges between €150 and €700 for the Approbation decision, depending on the work involved, and asks applicants to be patient because of high demand. Exam fees are separate; our Kenntnisprüfung guide lists published examples. Since 1 January 2026, for applications made from 1 September 2024, the medical chambers in North Rhine-Westphalia assess equivalence for doctors.

• Missing documents. If you cannot obtain the documents for a paper-based assessment for reasons outside your control, the law lets you prove your knowledge through the Kenntnisprüfung instead.
• Translations and legalisation. In North Rhine-Westphalia foreign-language documents need qualified translations, and foreign certificates need an apostille or legalisation.
• Waiting times. Authorities report high demand, so send a complete file first time and avoid status requests that slow processing.