Kenntnisprüfung — Medical Licensing
Licence Types
| Type | What it is |
|---|---|
| Approbation | The full, unrestricted licence, issued by the competent authority of the relevant federal state and valid throughout Germany |
| Berufserlaubnis | A temporary professional licence, usually limited to a specific employment setting or period. Under the 2026 reform it can be granted for an unlimited duration in exceptional cases |
| Partielle Berufserlaubnis | New with the reform — for EU/EEA-trained applicants only. Not available to third-country applicants |
The Kenntnisprüfung
| Feature | Details |
|---|---|
| Legal basis | Section 37, Approbationsordnung für Ärzte (ÄApprO) |
| Format | Oral-practical examination with patient presentation, aligned with the German state exam M3 format |
| Duration | Minimum 60, maximum 90 minutes per candidate |
| Candidates per session | Up to 4 |
| Core subjects | Internal Medicine and Surgery |
| Additional areas | Emergency medicine · clinical pharmacology and pharmacotherapy · imaging · radiation protection · medical law |
| Extra subject | May be added based on the applicant's identified differences |
| Language | German |
| Patient presentation | Real or simulated patient |
| Written component | Patient report: history, diagnosis, prognosis, treatment plan, epikrisis |
| Pass standard | Holistic pass/fail by the examination commission. No fixed percentage is published |
| Attempts | Up to 3 — the exam may be repeated twice |
| Content blueprint | Not published |
On attempts. Final failure is governed by §3(1) sentence 7 of the Bundesärzteordnung, federal law. Do not expect a fresh set of attempts by moving to another state.
In November 2024 the Ärztekammer Niedersachsen resolved to call for one nationally unified Kenntnisprüfung, modelled on the German state exam. It has not been adopted.
The Fachsprachprüfung
A separate medical language examination. It tests German medical communication, not medical knowledge.
General German: B2. Medical German: oriented toward C1.
Structure — three sections of about 20 minutes each: doctor–patient conversation · written medical documentation · doctor–doctor handover communication.
Pass standards differ by state. The Ärztekammer Berlin requires 60% in each section. The Ärztekammer Westfalen-Lippe publishes no numeric pass mark at all. Check your own chamber's rule.
Accepted certificate providers for the general B2/C1 requirement are commonly telc, the Goethe-Institut, ÖSD and TestDaF — but acceptance varies by chamber. Verify with your state's chamber before paying for a course or a test.
The Pathway
1. Submit a recognition application to the responsible state authority 2. The authority assesses equivalence — the Gleichwertigkeitsprüfung 3. If substantial differences are found, you take the Kenntnisprüfung 4. Meet the German medical language requirement 5. Receive Approbation or a temporary Berufserlaubnis
A job offer is not universally required to submit a recognition application, though employment and immigration requirements are separate.
The 2026 Reform
The law is the Gesetz zur Beschleunigung der Anerkennungsverfahren ausländischer Berufsqualifikationen in Heilberufen.
| Milestone | Date |
|---|---|
| Bundestag passed | 26 March 2026 |
| Bundesrat approved | 8 May 2026 |
| Signed | 22 July 2026 |
| Promulgated | 28 July 2026 |
| In force | 1 November 2026 |
What changes:
- The Kenntnisprüfung becomes the default route for non-EU/EEA qualifications - The document-based Gleichwertigkeitsprüfung remains available on application — but it must be requested within 4 weeks of the start of the procedure. Miss that window and you are on the exam route - A partielle Berufserlaubnis is introduced, for EU/EEA applicants only - A medical Berufserlaubnis may be granted for unlimited duration in exceptional cases
The reform has been reported to move the qualification examination before verification of remaining requirements including language, which would change the Fachsprachprüfung-before-Kenntnisprüfung sequence. Both the Bundesärztekammer and the Marburger Bund raised concerns. This comes from secondary reporting and is not confirmed in the enacted text.
Whether applications submitted by 31 October 2026 keep the existing rules is a reasonable reading of the 1 November in-force date, but no specific cutoff date is stated in the law.
Fees
Fees are not nationally standardised. They are set by each federal state and examination body.
| State / item | Fee | Status |
|---|---|---|
| Lower Saxony — Fachsprachprüfung | €595 | Effective 1 January 2026 |
| Lower Saxony — Kenntnisprüfung | €980 | Effective 1 January 2026 |
| Baden-Württemberg — Fachsprachprüfung | €420 | Confirmed |
| Bavaria — Approbation, third-country | €200 | Confirmed |
| Baden-Württemberg — Approbation decision | Not published | — |
| Bavaria — Kenntnisprüfung | Not published | See below |
On the Bavarian Kenntnisprüfung fee. The Bayerische Landesärztekammer's own fact sheet states €170 per examined applicant, plus possible examiner travel costs. Commercial prep sites quote €800 to €1,200. These may be different things — the €170 being the examination committee's fee and the higher figure the candidate's all-in cost including the state authority's charges — but that is not confirmed. Contact the authority directly: info.zaaby@reg-ob.bayern.de, +49 89 2176-2634.
Lower Saxony's figures changed on 1 January 2026. Fee schedules move.
What we offer
Germany medical licensing preparation built around clinical case practice in the oral-practical format the Kenntnisprüfung actually uses — Internal Medicine and Surgery cases, emergency scenarios, clinical pharmacology, imaging, radiation protection, medical law, and patient case presentation and report writing in German.
German medical language preparation for the Fachsprachprüfung — the C1 medical German examination set by the state medical chamber. Doctor–patient consultation, written medical documentation and doctor–doctor handover, in the three-part format the chambers actually use.