Landesprüfungsamt (state examination and licensing office)

Health professions in Germany are regulated by federal law, but each of the 16 states (Länder) applies it. The office that does so for medicine is often called the Landesprüfungsamt, literally the state examination office, because it also runs the state exams for German medical students. Berlin's office, for example, holds all three sections of the medical state exam (M1, M2 and M3) and grants the Approbation.

The name varies. In Baden-Württemberg it is the Landesprüfungsamt für Medizin und Pharmazie at the Regierungspräsidium Stuttgart, which the state health ministry says is responsible statewide for Approbation and Berufserlaubnis. In Berlin it is a department of LAGeSo. Other states give the job to a different body, so use the official Anerkennungs-Finder to find yours.

• Checks equivalence. For third-country diplomas it compares your training with German training using your documents, and considers whether experience makes up any gap.
• Sets the Kenntnisprüfung. If substantial differences remain, you prove your knowledge in a Kenntnisprüfung. Baden-Württemberg's guidance says it is an oral-practical exam with a patient, held on one day, lasting 60 to 90 minutes per candidate, covering internal medicine and surgery.
• Issues a Berufserlaubnis. A temporary permit, which may be limited to certain tasks and posts, for a total of up to two years in Germany; it can be valid for one state only.
• Checks language. Under health ministers' rules, doctors need general German at B2 and medical German at C1, tested in a Fachsprachprüfung; in Baden-Württemberg the district medical chambers run it.

Baden-Württemberg's guidance says doctors with diplomas from the EU, EEA or Switzerland are recognised automatically under Directive 2005/36/EC, without an individual assessment, but must still apply for the Approbation and prove sufficient German. Doctors providing temporary and occasional services under section 10b of the Federal Medical Code do not need a German licence, but must notify the authority in writing before they start. Doctors whose diploma comes from a state that joined the EU after they qualified may need a certificate of conformity from that state.

1. Choose the state where you will work and find its authority.
2. Download its application form and checklist, and send certified, translated documents.
3. Answer requests promptly; the decision clock only runs on a complete file.
4. Book your language and knowledge tests as instructed.
5. Receive your Approbation or Berufserlaubnis.

• Applying to the wrong state. Each office deals with people who plan to work in its state.
• Relying on a recruiter's word. Baden-Württemberg's guidance reminds employers to check personally that a doctor holds a valid licence, because practising without one is an offence.
• Expecting specialist recognition. Specialist titles are recognised separately by the state medical chamber.

See the Approbation authorities page and our Kenntnisprüfung guide.