Work and training in Germany
In order to practise medicine or carry out speciality training in
Germany, all physicians must be in possession of a valid full or
temporary licence to practise. The full licence to practise (Approbation) is valid across the country for an unlimited period of time. The temporary licence to practise (Berufserlaubnis)
is limited to a certain time period and is valid only within the
federal state in which it was issued. In certain cases, a temporary
licence may be limited to one position.
The state health authorities (Oberste Landesgesundheitsbehörden) of the respective federal state (Land)
are responsible for issuing full and temporary licences to practise.
The prerequisites for becoming a member of the medical profession in
Germany are set out in sections 3 and 10 of the Medical Practitioners’
Act (§ 3 and § 10 Bundesärzteordnung [PDF]).
Physicians wishing to practise in Germany must also become a member of one of the 17 State Chambers of Physicians (Landesärztekammer).
Each of the 16 federal states of Germany has a State Chamber of
Physicians (there are two in North Rhine-Westphalia). As corporations
under public law, these bodies are in charge of the administration of
all matters related to speciality training in Germany. The state laws
governing the healthcare profession and the activities of the Chambers (Heilberufekammergesetz)
set out the responsibilities of the State Chambers of Physicians with
respect to physicians professionally active, or residing, within their
area of jurisdiction.
Basic medical training in Germany
The principles governing medical training in Germany are set out in the Licensing Regulations for Physicians (Approbationsordnung [PDF]) of 27/06/2002 (last amended 24/07/2010).
According to Article 1, Paragraph 2, medical training comprises:
- undergraduate medical studies of no less than six years at a
university or equivalent academic institution which, subject to section
3, paragraph 3, sentence 2, must include 48 consecutive weeks of
practical training (practical year)
- first aid training
- three months of nursing experience
- a four-month clinical elective
- a medical examination in two stages, the first to take place two
years after commencement of medical training, the second after four
further years of study
- with respect to section 10, paragraph 2 of the framework laws on further education (Hochschulrahmengesetz),
the regular length of study, including examinations and revision time,
should, according to section 16, paragraph 1, sentence 2, amount to six
years and three months
The earliest point at which the period of practical training may
commence is two years and ten months after a student has passed the
first stage of their medical examination. Placements are fixed to
starting points either in February or August. Practical training
consists of three 16-week work placements in:
- internal medicine
- either general practice or another elective subject
Proof of completion of training in first aid has to be presented in
order to register for the first stage of the medical examination after
The three months of nursing experience must be completed at a
hospital either before university or during one of the semester breaks
in the 2 years prior to the first stage of the medical examination. The
aim of this is to give students or prospective students an insight into
the functioning and organisation of a hospital, and to familiarise them
with the day-to-day activities of the nursing profession. The compulsory
nursing experience can also be completed in three one-month segments.
The four-month clinical elective takes place outside of teaching
periods after the first stage of the medical examination and before the
practical year. Proof of completion of a clinical elective must be
presented in order to register for the second stage of the medical
Further information about this may be found under ”Ausbildung“ on the website of the German Medical Association.
The website of the Institute für medizinische und pharmazeutische Prüfungsfragen (IMPP)
(Institute for Medical and Pharmaceutical Examination Questions) is
also a good source of information for queries related to medical studies
in Germany. It also contains the contact details of the Landesprüfungsämter
(State Examination Authorities), who among others are responsible for
assessing the accreditability of periods of study carried out abroad.
The Hochschulrektorenkonferenz (HRK)
(Conference of University Rectors) is the voluntary association of
state and state recognised higher educational institutions in Germany.
Speciality training in Germany
A prerequisite for beginning speciality training is the acquisition of a full or temporary licence to practise medicine (Approbation or Berufserlaubnis).
Speciality training in Germany takes place exclusively within the
framework of medical practise, and junior physicians receive
remuneration for their work. Physicians who have completed their basic
medical training and are in possession of a valid full or temporary
licence to practise are entitled to apply for a position as a junior
physician at an institution licensed for medical training in the
relevant area of specialisation.
Speciality medical training usually takes between 5 and 6 years to
complete, depending upon the specific training regulations for the
speciality. Training is supervised by a clinical tutor authorised by the
State Chamber of Physicians and takes place in a university hospital,
clinic or other approved medical institution. This may include at an
outpatient unit under the supervision of a practise-based physician.
Lists of authorised institutions may be found on the websites of the
relevant State Chambers of Physicians under “Weiterbildung“.
Whereas the regulations regarding basic medical training and the
granting of licences to practise are standardised at a national level
through the Medical Practitioners’ Act (Bundesärzteordnung [PDF]) and the Licensing Regulations for Physicians (Approbationsordnung [PDF]),
regulations on the content and configuration of speciality training are
laid out in state by-laws and the autonomous statutes of the State
Chambers of Physicians. These are largely based upon the Guideline Regulations on Speciality Training
of the German Medical Association. These define the areas, focus and
competencies covered during speciality training, as well as additional
designations. The up-to-date speciality training regulations of each
State Chamber of Physicians, which set out the content and duration of
the speciality training for each area of specialisation, are available
on their websites.
During their period of training, junior physicians must fulfil the
points stipulated in the speciality training regulations and guidelines
on the content of speciality training. Only when the checklist is
complete may they apply to the State Chamber of Physicians to be
assessed. This takes the form of an oral examination with a committee of
three physicians, two of which will be qualified specialists in the
area to be examined, who decide whether the speciality training has been
completed successfully. Upon successful completion of the examination,
the physician will be awarded a specialist diploma (Facharztdiplom) by the State Chamber of Physicians.
Further information about speciality training may be found under „Weiterbildung“ on the website of the German Medical Association.
Recognition of speciality training carried out abroad
The State Chambers of Physicians (Landesärztekammer)
and the regional chambers of physicians, for example in
Baden-Wurttemberg and Rhineland-Palatinate, are the main authorities
responsible for the recognition of speciality training carried out or
completed abroad. A physician must be a member of a State Chamber of
Physicians before his or her specialist qualifications may be assessed
for equivalence. For information concerning membership of the State
Chambers of Physicians (compulsory or voluntary) please contact them
According to the speciality training regulations (Weiterbildungsordnung)
of the relevant State Chamber of Physicians, periods of speciality
training, or other professional activity abroad, can only be accredited
if they have taken place for a minimum duration of 6 months at an
institution licensed for speciality medical training. Upon completion of
training abroad, physicians should obtain a detailed certificate
containing information about the size of the hospital at which training
took place, the activities of the department in which he or she was
employed, as well as any activities carried out independently. The
certificate should reflect the content of the speciality training
regulations of the relevant State Chamber of Physicians.
If a physician holds a licence to practise that has been issued by a
foreign medical association, the state health authorities must first
verify whether the evidence of formal qualifications in basic medical
training can be recognised as equivalent to the German standards.
The Medical Practitioner’s Act (Bundesärzteordnung [PDF]) and the Licensing Regulations for Physicians (Approbationsordnung [PDF])
form the legal basis for the practise of medicine in Germany. The
recognition of speciality training carried out within the European Union
is regulated by the EU directive 2005/36/EC.
For further information for citizens of the European Union, the
European Economic Area and Switzerland, as well as for citizens of other
countries not members of the above, please see the links below.
Information concerning vacancies for physicians in Germany may be found on the website of the Federal Employment Agency.
- The German Medical Journal (Deutsche Ärzteblatt),
published weekly by the German Medical Association and the National
Association of Statutory Health Insurance Physicians, is sent
automatically to every physician in Germany registered with the State
Chamber of Physicians. It contains a large jobs section.
Tel. +49 (0) 22 34 70 11 - 1 20
Fax: +49 (0) 22 34 70 11 - 1 42
The following link contains information about other medical organisations within Germany:
- Medical Organisations and Associations