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Guide for doctors trained abroad

Approbation in Germany:
B2 first, then C1 medical German

To work as a doctor in Germany you need the full licence to practise, called the Approbation. The language part comes in two steps: a B2 certificate in general German, then the Fachsprachprüfung, an exam in medical German at level C1. The same route applies to dentists and pharmacists. This guide explains both steps and what changes for non-EU doctors from 1 November 2026.

B2General German certificate
C1Medical German exam (Fachsprachprüfung)
60/100Pass mark per Goethe B2 module
1 Nov 2026Kenntnisprüfung for non-EU doctors

Which certificate does this goal need?

Accepted certificates

The Approbation for doctors, dentists and pharmacists takes two steps: a B2 general German certificate (Goethe, telc, ÖSD) first, then the C1 Fachsprachprüfung in medical German. From 01.11.2026 non-EU doctors must also pass the Kenntnisprüfung.

LevelB2 + C1 FSP

Source: bundesgesundheitsministerium.de ·

Two language steps, not one

Medicine is a regulated profession in Germany. Your medical degree is checked by the authority of the federal state (Land) where you apply, and your German is checked separately. Many doctors expect one language exam and are surprised to find two. The first shows that you can live and work in German in everyday situations. The second shows that you can talk with patients and colleagues about medicine. You cannot skip the first step by going straight to the second.

Step 1: B2 general German

A standard exam certificate at level B2, for example Goethe-Zertifikat B2, telc Deutsch B2 or ÖSD B2. It tests reading, listening, writing and speaking on everyday and work topics, not medical vocabulary. Every state asks for it as part of your application, and a course attendance letter is not a certificate.

Step 2: C1 Fachsprachprüfung

The Fachsprachprüfung (medical language exam) is set at level C1. For doctors it is mainly held by the state medical chamber (Landesärztekammer). It checks whether you can use German in your daily medical work, with patients and with colleagues. Some states also accept other medical German exams, so ask your authority which ones count.

The road to Approbation at a glance

The table puts the three checks side by side. The first two are about language; the third is about your medical knowledge, but it is held in German, so it depends on the first two as well.

CheckLevel or ruleWho it applies to
General German certificate (Goethe, telc, ÖSD)B2Doctors, dentists and pharmacists trained abroad
Fachsprachprüfung (medical language exam)C1Doctors, dentists and pharmacists trained abroad
Kenntnisprüfung (knowledge test)Must be passed from 1 November 2026Doctors from outside the EU
Goethe B2 pass mark60 out of 100 points in each moduleEveryone who takes the Goethe B2 exam

The exact list of accepted certificates and the order of the steps are set by each state. Before you book any exam, ask the authority that will handle your application which certificates it accepts.

Choosing your B2 exam: Goethe or telc

Goethe B2 and telc B2 are both general German exams at the same level and both are named for the Approbation. The difference is in how they are built. Goethe B2 is modular: reading, listening, writing and speaking are separate modules, and you pass each one with 60 out of 100 points. If one module goes badly, you can book and repeat that module alone. telc Deutsch B2 is one exam with 300 points, split into a written part (225 points) and an oral part (75 points); you need 60 percent in the written part and in the oral part separately.

Goethe B2 reading (Lesen)

5 parts, 30 items, 65 minutes.

Goethe B2 listening (Hören)

4 parts, 30 items, about 40 minutes.

Goethe B2 writing (Schreiben)

2 parts, 75 minutes: a forum post worth 60 points and a message worth 40 points.

Goethe B2 speaking (Sprechen)

2 parts, about 15 minutes after 15 minutes of preparation: a short talk, then a discussion with your partner.

Exam fees are set locally by each Goethe-Institut, partner centre or telc centre, so check the price list in your country. For Goethe B2, a single module costs less than the full exam.

What changes from 1 November 2026

The Kenntnisprüfung becomes the rule for non-EU doctors

From 1 November 2026, doctors who trained outside the European Union must pass the Kenntnisprüfung, a knowledge test of their medical skills, to receive the Approbation. Until now the authority could often decide on the basis of your documents alone. Under the new law passed by the German parliament (Bundestag), the Kenntnisprüfung becomes the standard route instead.

This makes your German even more important. The Kenntnisprüfung is held in German, so a doctor who still struggles with the language will struggle with the medical questions as well. The federal dentists' chamber argued that German should be checked first, before the knowledge test. In practice that means one thing for your plan: get your B2 certificate early, then build your medical German towards C1 while you prepare for the knowledge test.

Your plan, step by step

  1. 1. Pass a B2 exam in general German

    Goethe B2, telc B2 or ÖSD B2. This is the certificate you can prepare for from home, in your own country.

  2. 2. Choose a state and apply

    Send your medical degree and the documents the authority lists to the state where you want to work. Ask which language certificates it accepts before you book an exam.

  3. 3. Pass the Fachsprachprüfung at C1

    Usually with the state medical chamber. A general C1 certificate does not replace it, because this exam is about medical German.

  4. 4. Pass the Kenntnisprüfung if you trained outside the EU

    From 1 November 2026 this knowledge test is required for non-EU doctors. Once every check is complete, the authority issues the Approbation.

Looking further ahead: German citizenship (Einbürgerung) needs 5 years of legal residence, B1 German, the citizenship test (Einbürgerungstest) and the ability to support yourself. That period is the same whatever level you hold; neither B2 nor C1 makes it any shorter. The B2 certificate you already hold for your licence covers the B1 language rule.

Start with the B2 certificate

Practise with full Goethe B2 mock exams in reading, listening and writing, built with the same parts, item counts and timing as the real exam, and see which module still costs you points.
Try a Goethe B2 mock exam

Frequently asked questions

Which German level do I need for the Approbation?

Two levels, in two separate exams. First a general German certificate at B2, for example Goethe B2, telc B2 or ÖSD B2. Then the Fachsprachprüfung, an exam in medical German at level C1.

Is a general C1 certificate enough instead of the Fachsprachprüfung?

No. The Fachsprachprüfung tests medical German, which a general exam does not cover. A general certificate proves the B2 step; the C1 step is the medical language exam, usually held by the state medical chamber (Landesärztekammer).

Do dentists and pharmacists follow the same route?

Yes. Dentists and pharmacists also need a B2 certificate in general German first and then the C1 Fachsprachprüfung for their profession. Ask the authority in your state which exams it accepts for your profession.

What is the Kenntnisprüfung and who has to take it?

It is a knowledge test of your medical skills. From 1 November 2026, doctors who trained outside the EU must pass it to receive the Approbation. It is held in German, so strong German helps you here as well.

Should I take Goethe B2 or telc B2?

Both are general B2 exams named for the Approbation. Goethe B2 is modular: you need 60 out of 100 points in each module and can repeat a single module. telc B2 is one exam of 300 points, and you need 60 percent in the written part and in the oral part separately.

How much does the B2 exam cost?

Fees are set locally by each Goethe-Institut, partner centre or telc centre and differ from country to country, so check the price list where you plan to sit the exam. For Goethe B2, a single module costs less than the full exam.

Does C1 German make German citizenship faster for doctors?

No. German citizenship needs 5 years of legal residence, B1 German, the citizenship test and the ability to support yourself, and no language level shortens that period. The B2 certificate from your Approbation already covers the B1 rule.

Keep preparing