Medical Post-Graduation in Germany: Steps

The steps for Medical specialization in Germany are;

1. German Language A1-B2 (General)

2. C1 Medizin & Fachsprachenprüfung Course 

3. Apply for a Defizitbescheid from Germany (For §17a Visa)

4. Apply for a National Visa for Germany (§16b or §17a)

5. Hospitation/Observership

6. Special Language Exam (Fachsprachenprüfung)

7. Temporary Licence (Berufserlaubnis)

8. Knowledge Test (Kenntnisprüfung)

9. Permanent Licence (Approbation)

The post-graduation starts with Approbation. With temporary licence, one will be able to start working with full salary and benefits, however this period won't be counted for Post-graduation. Individual steps are elaborated below.

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What is Defizitbescheid?

When a doctor apply for Approbation (Permanent Licence) a comparison is done between his or her medical studies with German medical studies. If significant shortage or deficit (Defizit in German) is there in the studies, the doctor will be asked to take a knowledge test. (Kenntnisprüfung) If no difference is there, an Approbation will be issued. Defizitbescheid is the document explaining this deficit. It is usually is the result of a comparison process. (Gutachterliches Verfahren).

It is mandatory to submit a Defizitbescheid along with your application for a §17a National Visa for Germany.

How can I avoid Defizitbescheid for Visa?

This question is based on suggestions by some consultancies to it clients. They say, if you apply for Masters Course in Health Care Management, you can avoid these hurdles. It is not true. First of all if your aim is to practice as a Doctor in Germany, you don´t have to join a masters course which costs a lot. Secondly you will be committing Visa fraud and it may affect your future stay in Germany. Because of these factors, now a days so many Visas for Health Care Management courses are getting rejected too.

§16b Visa and Defizitbescheid: Usually Defizitbescheid will not be asked for §16b Visas. This is why some courses are designed from basic levels in Germany (A1 or A2) so that you can complete these steps in Germany and change your Visa to §17a during your stay in Germany. However because of the new change in rules, you may be asked to submit a Defizitbescheid by some embassies.

Join an institute which supports with Defizitbescheid: Probably it´ll be the most secure way. You don´t need to be in Germany to apply for Approbation or Defizitbescheid. However translations need to be done through an official translator from Germany and there are some documents you should obtain from Germany. Rather than doing it yourself, it will be better to go with an institute which offer these services. Alternatively you can hire a consultancy from Germany.



Is Eingangsbestätigung is same as Defizitbescheid?

No. Eingangsbestätigung is the acknowledgement that the concerning authority has received your application. 

How long will it take to get Defizitbescheid?

Depending on the Approbation Authority this may take 3-6 Months, if you provided complete set of documents. In some states this period may extent more than a year.




What is Berufserlaubnis?

Berufserlaubnis is the temporary licence to practice medicine in Germany. This is valid for 2 years. Even though the doctor will receive salary and benefits, this period will not be counted for post-graduation.Within this period of 2 years, a doctor need to complete the procedure of Approbation.Most of the states require a job offer(Stellenzusage) from a German hospital to apply for Berufserlaubnis



What is Kenntnisprüfung?

If there is a substantial difference between applicants studies and German medical studies, he or she has to prove the knowledge by participating in a Kenntnisprüfung or Knowledge Test. Applicant can also opt-out the comparison process and ask for Kenntnisprüfung. 

Pattern of Kenntnisprüfung

The knowledge test Kenntnisprüfung is an oral-practical examination with a patient presentation, which is essentially based on the requirements of the Third Section of the Medical Examination in accordance with ÄApprO. (Dritten Abschnitts der Ärztlichen Prüfung nach der ÄApprO )




What is Approbation?

Approbation is the permanent licence to practice medicine in Germany.  

Pre-requisites for Approbation


Prerequisites for the granting of the approbation are that the applicant

1.Completed the prescribed training and passed the exam (Kenntnisprüfung or a positive decision after comparison of studies)
2.Has not been guilty of any behavior that results in the unworthiness or unreliability of practicing the profession (Good standing certificate)
3. has the health to practice the profession (Medical certificate)
4. has sufficient German language skills (Fachsprachenprüfung)

If the conditions are met, the applicant a legal right to be granted the license to practice medicine in Germany in accordance with Approbationsordnung für Ärzte (ÄApprO).

This website is an initiative by Foreign Physicians in Germany. The website is for information purposes only. The views, information, or opinions expressed here are solely those of the individuals involved and do not necessarily represent those of any official Authorities, Agencies or Institutes. None of the authors, contributors, administrators or anyone else connected with this website, in any way whatsoever, can be responsible for your use of the information contained in or linked from these web pages.The authors assumes no responsibility or liability for any errors or omissions in the content of this site. The information contained in this site is provided on an “as is” basis with no guarantees of completeness, accuracy, usefulness or timeliness. 

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