Germany is one of the countries our graduates ask about most often. To work there as a doctor you need the Approbation, the full licence to practise. New rules for degrees from outside the EU have applied since 1 November 2026, so we describe the current route with a degree from Ukraine or Georgia and the route with a degree from Poland.
Who decides
The Approbation is issued by the authority of the federal state (Land) where you live. If you live outside Germany, the authority of the federal state where you intend to work is responsible. In North Rhine-Westphalia this is, for example, the Bezirksregierung Münster, in Saxony the Landesdirektion Sachsen and in Baden-Württemberg the Regierungspräsidium Stuttgart.
For the Approbation you need a completed medical degree, health fitness for the job, good character and the German you need to practise.
A degree from Ukraine or Georgia step by step
Since 1 November 2026 the standard route for a degree from outside the EU is the Kenntnisprüfung, a knowledge test covering the content of the German state examination. Instead, you can choose an assessment of your documents, but only within 4 weeks of applying, and the choice is binding. If the assessment finds substantial differences, or if not all documents can be provided, you take the Kenntnisprüfung anyway. Applications filed by 31 October 2026 are processed under the previous rules.
- Application You apply for the Approbation to the authority of the competent federal state.
- German You prove your German. North Rhine-Westphalia requires general German at B2 level and medical German at C1 level, usually shown by passing the Fachsprachprüfung.
- Kenntnisprüfung You take an oral and practical state exam in German in internal medicine and surgery, preceded on the same day by preparation with a patient. The exam lasts 60 to 90 minutes per candidate, is taken in groups of at most 4 candidates and is held at least twice a year. You can repeat it twice.
- Approbation Once you meet all the conditions, you receive the Approbation and can work as a doctor in Germany.
Berufserlaubnis
Until the Approbation, the authority can issue a temporary permit to practise (Berufserlaubnis). It can be revoked and limited to certain activities and workplaces, and it allows at most 2 years of medical work in total. In Saxony it allows only non-independent work under supervision and does not entitle you to specialist training.
If another EU country has already recognised your degree from Ukraine or Georgia, the authority follows the procedure for EU qualifications: it checks your qualifications first, and any differences are tested by an aptitude test (Eignungsprüfung) limited to those differences, not by the Kenntnisprüfung.
A degree from Poland
A medical degree from an EU country listed in Annex V of Directive 2005/36/EC automatically meets the education requirement in Germany. The authority checks your qualifications first and only then your German, your character and your health. With an EU degree you cannot get a Berufserlaubnis, so you apply for the Approbation straight away.
For Poland, the Annex V qualification consists of the medical degree, the certificate of a passed Final Medical Examination (LEK) and the certificate of a completed postgraduate internship. LEK can be taken in English. Questions for the Polish Final Medical Examination are available on Medmigrant, our learning platform.
Even with an EU degree you must prove your German. In Saxony and Baden-Württemberg the medical language exam is held by the state chamber of physicians (Landesärztekammer). In Saxony it is an individual exam in three parts: a conversation with a patient, a written report and a handover of the patient to another doctor, and each attempt costs EUR 425. In Baden-Württemberg the fee is EUR 420.
Specialist training (Weiterbildung)
The state chamber of physicians decides on crediting foreign specialist training under its own specialist training regulations (Weiterbildungsordnung). For example, the chamber of physicians of Saarland requires membership of the chamber and an Approbation or a Berufserlaubnis. It can credit training completed outside the EU fully or in part if the training meets the principles of the regulations and at least 12 months of training in the specialty take place in Germany.
Frequently asked questions
Does Germany recognise a medical degree from Ukraine?
Yes, the route to the Approbation is open. Since 1 November 2026 it usually leads through the Kenntnisprüfung, and you can choose the assessment of your documents within 4 weeks of applying.
What level of German do I need?
The law requires the German needed to practise the profession, and the federal states set the details. North Rhine-Westphalia, for example, requires general German at B2 level and medical German at C1 level.
How can Edumetric help?
We help you choose a university and plan your studies with work in Germany in mind, and, if you wish, a transfer to studies in Poland. Book a free consultation.
Read also: Studying medicine in Ukraine: is it a good idea?, Studying medicine in Georgia: admission, costs and recognition in the UK and Studying medicine in Poland in English: admission, tuition and what comes next. We write about work in the other German-speaking countries in Working as a doctor in Austria with a degree from Ukraine, Georgia or Poland and Working as a doctor in Switzerland with a degree from Ukraine, Georgia or Poland. You will find all universities in the university directory.
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