Kenntnisprüfung (knowledge test)

Under the German Federal Medical Code (Bundesärzteordnung, section 3), a doctor with a qualification from a third country receives the Approbation if their training is equivalent. If it is not, or if checking the documents would take unreasonable effort, the doctor proves the necessary knowledge by passing an exam based on the content of the German final state examination. That exam is the Kenntnisprüfung.

Before requiring the exam, the authority compares your training with German training. The law says substantial differences can be offset, fully or partly, by knowledge and skills gained in medical practice or through formally recognised lifelong learning, in any country. If substantial differences remain, the Kenntnisprüfung is based on the content of the German final state examination as a whole, unlike an EU-style aptitude test, which is limited to the differences found.

For doctors, the Medical Licensing Regulations (ÄApprO, section 37) set the format:

• An oral-practical exam with a patient: taking a history, examining the patient and writing a report with diagnosis, prognosis and treatment plan.
• The focus is internal medicine and surgery, with questions on emergency medicine, clinical pharmacology, imaging, radiation protection and the legal framework of practice.
• It lasts at least 60 and at most 90 minutes per candidate, with up to four candidates per session.

The Kenntnisprüfung exists for several regulated health professions, each under its own regulations. For nurses, the nursing regulations (PflAPrV, section 45) set an oral part of 45 to 60 minutes and a practical part covering two to four nursing situations. For many professions the official recognition portal says you can generally choose between an adaptation period and a knowledge or aptitude test. For doctors with third-country qualifications, the Federal Medical Code specifies the exam itself as the way to prove equivalent knowledge.

1. Apply for Approbation to the competent authority in the federal state where you want to work, as part of the recognition procedure.
2. Prove your German, usually by passing the medical Fachsprachprüfung.
3. The authority decides whether you need the Kenntnisprüfung, often in a deficit notice, and registers you with the examining body. In Westfalen-Lippe, for example, the Bezirksregierung Münster registers candidates with the medical chamber.
4. Sit the exam. Under ÄApprO it must be scheduled within six months of the eligibility decision, with at least five calendar days' notice.
5. After passing, the authority grants the Approbation.

Fees are set by each state or chamber. The Ärztekammer Westfalen-Lippe, for example, charges €1,050. Under ÄApprO the exam should be offered at least twice a year, and you can repeat it twice, so three attempts in total.

• Waiting times vary between states.
• A Berufserlaubnis can allow temporary practice while you prepare.

See our Kenntnisprüfung guide for the full route.

For nurses, the nursing regulations allow each failed oral part and each failed nursing situation in the practical part to be retaken once. In Westfalen-Lippe, the Ärztekammer has run the Kenntnisprüfung for doctors since 5 February 2021, after the health ministry transferred responsibility to it.