Work as a radiographer in Germany: MT recognition (2026)

• A completed radiography, medical imaging or radiation technology qualification that the state where you trained recognises as a qualification for the profession.
• Training that matches the German MT für Radiologie content in Annex 2 MTAPrV, or differences that your documented imaging and radiotherapy experience covers (§ 48 MTBG), or a passed knowledge test or completed adaptation course.
• German at B2 of the CEFR. In Bavaria you prove it through the Bavarian State Office for Care's specialist language exam unless German is your first language or you trained in German.
• Proof that you were allowed to practise in your home country, such as your registration or licence, with a German translation.
• A certificate of good conduct and a doctor's certificate of fitness to practise, which the authorities ask for at the end of the procedure.
• Course documents that show hours by subject for imaging modalities, radiotherapy, nuclear medicine and radiation protection, and the clinical placements in each.
• If your application still runs under the old MTA law in North Rhine-Westphalia, the ability to finish any adaptation measure by 31 December 2026.

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• ApprobationState licensing authorities (Approbation)

  Doctors, dentists and pharmacists; nurses through professional recognition

  Read the registration guide

1. 1

   Map your training against Annex 2 MTAPrV

   Before you apply, compare your course with the five competence areas in Annex 2 of the MTAPrV and with the 2,600 teaching hours and 2,000 practical hours in § 13 MTBG. Note where you had little or no radiotherapy, brachytherapy, nuclear medicine imaging and therapy, or ultrasound. This shows you early whether a knowledge test is likely and which subjects to prepare.
2. 2

   Apply to the state where you will work

   In Berlin the Landesprüfungsamt für Gesundheitsberufe at LAGeSo handles MT für Radiologie. In North Rhine-Westphalia it is the ZAG-PuG at the Bezirksregierung Münster. In Bavaria the Bayerisches Landesamt für Pflege (LfP) in Amberg has been responsible for health professions since 1 July 2025. Other states have their own office; the Recognition Finder names it when you enter your target city.
3. 3

   Send a file that proves your modalities

   The Recognition Finder lists identity documents, a German CV, your qualification certificate, evidence of the duration and content of your training, proof of professional experience, a B2 certificate and proof that you may practise in your home country, all with German translations. For radiographers the content evidence is decisive: a module list that shows contact and clinical hours per modality lets the authority see what you covered. If documents cannot be obtained for reasons outside your control, § 49(2) MTBG lets the authority move straight to an adaptation measure instead of a full comparison.
4. 4

   Wait for the equivalence notice

   The authority confirms receipt within one month and decides within three months of a complete file. The notice either confirms equivalence or names the substantial differences under § 47 MTBG, usually by competence area. Read it closely: it decides whether your test or adaptation course will centre on therapy with ionising radiation, on nuclear medicine, on radiation protection, or on all of them.
5. 5

   Choose between the knowledge test and the adaptation course

   § 51(2) MTBG gives you the choice. The knowledge test is an oral part on competence areas I, II and III of Annex 2 plus two to four practical tasks; it is the quicker route if your gap is narrow and you can prepare on your own. The adaptation course places you in a radiology or radiotherapy department under the responsibility of an MT holder and ends with a final interview; it suits people with a wide gap or little recent clinical practice. In North Rhine-Westphalia either measure is normally organised with a school or a comparable recognised institution.
6. 6

   Sit the oral and practical parts

   The oral part lasts 45 to 60 minutes. Each practical task lasts up to 120 minutes and is a concrete task from radiology practice at a site the authority chooses. Where a patient is involved, the patient and the responsible doctor must consent, and the Radiation Protection Act and § 145 StrlSchV still apply to what you do. You may repeat the oral part once and each failed practical task once.
7. 7

   Pass the language requirement

   Berlin and North Rhine-Westphalia ask for B2 and let you send the certificate after you apply. Bavaria requires a specialist language exam at the LfP in Amberg: two 20-minute oral parts (with a patient and with a colleague) and a 20-minute written task, with 60 per cent needed in each. Book it early, because the permission is not issued without it.
8. 8

   Get the permission to use the title

   Once equivalence or a passed measure, German, good conduct and fitness are confirmed, you receive the Erlaubnis zum Führen der Berufsbezeichnung. In North Rhine-Westphalia this is a second application: after the ZAG-PuG declares your qualification equivalent, you apply for the permission to the lower health authority of the district or city, or to the Bezirksregierung. From then on the StrlSchV treats you as having the Fachkunde in radiation protection for the technical work.
9. 9

   Keep your radiation protection knowledge current

   Radiation protection Fachkunde in Germany does not last forever on its own. § 48 StrlSchV requires it to be updated at least every five years through a course recognised by the competent body. Ask your employer which update course its radiation protection officer expects and when your first one is due.

• Kenntnisprüfung: oral part on Annex 2 areas I to III

  Under § 77(2) MTAPrV the oral part covers competence area I (diagnostic imaging with and without ionising radiation, including nuclear medicine diagnostics), area II (therapy with ionising radiation and radioactive substances) and area III (radiation protection and personal safety, with quality, risk, process and data management). It should last 45 to 60 minutes. If you fail it, you may repeat it once on application (§ 81).

• Kenntnisprüfung: practical tasks in a radiology setting

  Two to four tasks from the profession, with the number and the Annex 2 areas set by the authority (§ 82). Each should take no more than 120 minutes and is examined by one school examiner and one practical examiner, who may ask about your approach as you work (§ 84). The authority picks sites that meet § 19 MTBG (§ 83). Each failed task may be repeated once (§ 86).

• Anpassungslehrgang with final interview

  A course of up to three years (§ 51 MTBG) whose length and content the authority sets so that you gain the competences you lack (§ 89 MTAPrV). It ends with a final interview (Abschlussgespräch) on what the course taught (§ 91). If you do not pass, the examiners may extend the course once, followed by another interview, and after a further fail you may repeat the course once (§ 94).

• German, not English, is the language requirement. Berlin, North Rhine-Westphalia and Bavaria all set B2 of the CEFR for MT für Radiologie in their Recognition Finder profiles.
• In Berlin you do not have to enclose the language certificate with the application, but the authority may ask for it later.
• North Rhine-Westphalia lists a B2 certificate among the documents and waives it if German is your first language or you trained in German.
• Bavaria requires job-related B2 shown through the LfP specialist language exam for health professions, which tests talk with patients, talk with colleagues and a written task over 60 minutes in Amberg.
• Radiology German is specialised: positioning instructions, contrast agent questions, consent and radiation protection explanations to patients are all likely in the language exam and in daily work, so practise them as well as general B2.

Estimate your total cost

• Receipt is confirmed within one month in Berlin, NRW and Bavaria, and the notice follows within three months of a complete file, according to the Recognition Finder profiles for MT für Radiologie.
• Preparing a knowledge test on Annex 2 areas I to III usually takes months if radiotherapy or nuclear medicine is new to you; the oral part alone runs 45 to 60 minutes and the practical tasks up to 120 minutes each.
• An adaptation course lasts as long as your notice says, up to three years under § 51 MTBG, and may be extended once if the final interview is not passed.
• In North Rhine-Westphalia, applications under the old MTRA law must have their adaptation measure fully completed by 31 December 2026, according to the ZAG-PuG.
• In Bavaria add the time to book and pay for the specialist language exam in Amberg; elsewhere add the time to reach B2 and obtain a certificate.
• After recognition, your radiation protection Fachkunde must be updated at least every five years (§ 48 StrlSchV).

Most imaging and radiotherapy posts in municipal hospitals are paid on the TVöD for municipal employers (VKA). The figures below are monthly gross table rates from Anlage A, valid from 1 May 2026, as printed in the VKA hospitals edition. That edition's Entgeltordnung still uses the old MTA wording: state-examined medical technical assistants sit in EG 7, and in EG 8 if at least a quarter of their work is difficult, so confirm with your employer how it places the new MT für Radiologie title. Your starting step depends on relevant experience: one year usually means step 2 and three years step 3. Outpatient radiology practices, private hospital groups, church-run and university hospitals pay under their own agreements or contracts.

Monthly amounts

• EG 7, step 1

  €3,294.98

  State-examined medical technical staff.

• EG 7, step 3

  €3,682.69

• EG 7, step 6 (top)

  €4,045.24

• EG 8, step 1

  €3,486.40

  At least a quarter of tasks are difficult.

• EG 8, step 3

  €3,843.36

• EG 8, step 6 (top)

  €4,230.97

• Hospital radiology departments, radiotherapy centres and nuclear medicine units, which together cover all three clinical areas of Annex 2.
• Outpatient radiology practices and imaging centres, often with CT and MRI as the main workload; they set pay themselves.
• Radiotherapy and nuclear medicine departments are a good place for an adaptation course if your notice names therapy gaps, because the course runs under the responsibility of an MT holder.
• Before the permission is issued you cannot use the title or do the reserved work as an MT, so check the job title, duties and pay in any contract signed before recognition.
• Ask each employer which radiation protection update course it uses and whether it pays for it.

• MT für Radiologie is a vocational qualification in Germany, so once recognition is complete the skilled worker permit for vocational training under § 18a AufenthG is the usual fit for radiographers.
• If your notice names gaps, the residence permit for recognition measures under § 16d AufenthG fits the knowledge test well, because test preparation and sitting it can be done within the permit's limits. A long adaptation course is harder: § 51 MTBG allows up to three years, which is also the maximum the § 16d(1) permit can run, so ask the authority for the realistic length of your course before you apply.
• The recognition partnership under § 16d(3) suits radiographers who already have an offer from a hospital radiology or radiotherapy department willing to host the adaptation course, because the employer has to commit to enabling it.
• For every visa option, its conditions and the visa fee, see the Germany country guide on this site.

1. 1

   Gulf radiography licences from DHA, DOH, MOHAP, SCFHS, QCHP, NHRA or OMSB do not convert into the German title. The authority looks at the course you completed; a licence and a good-standing letter from the regulator serve as proof that you were allowed to practise.

2. 2

   Gulf imaging work counts against gaps under § 48 MTBG, because experience in the profession is accepted whatever the country. Ask each department for a letter that lists the modalities you operated (CT, MRI, fluoroscopy, interventional, mammography, nuclear medicine, radiotherapy), the years and the weekly hours. If you worked in radiotherapy or nuclear medicine, document it in detail, because those are the areas where gaps are most often found.

3. 3

   CPD points earned for a Gulf licence count as lifelong learning only if a competent body in that country has formally recognised them (§ 48(1) MTBG). Keep the official CME or CPD certificates, not just the course attendance lists.

4. 4

   The usual document gap for Gulf-based radiographers is the training content: if you trained in a third country before moving to the Gulf, you need the module and clinical hour breakdown from the original university, not from the Gulf employer. Request it early, with translations into German.

5. 5

   Gulf imaging departments work in English, while German patients expect positioning, breathing and consent instructions in German. If you are heading to Bavaria, plan for the LfP specialist language exam rather than a general B2 certificate.

• Application plan with every step, fee and deadline

• Document checklist tailored to you, and a review of each document before upload

• Timeline built around the regulator's closure windows and document validity periods

• Help completing the application forms accurately and consistently

• Support with profession-specific evidence, such as the HCPC standards of proficiency mapping

• Guidance on certificates of good standing, references and certified translations

• Preparation for identity checks and declarations on health and character

• Tracking your application and help responding to regulator requests

• Next steps after the decision: exams, adaptation, PIN or licence and your first job

Regulators make all registration decisions and set all fees. Our fee is separate from the regulator's fees, exam fees and translation costs.

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