Road to Residency in Germany

Tarek Safi
Nov 25, 2020
6 min read

Updated: Mar 17, 2021

The pathway of seeking medical residency in Germany is usually considered by many medical students as a long and complicated road, mostly because of the apparent lack of a clear path and the language requirements. Here, we will be discussing in depth every aspect of this pathway, taking you, the medical student/graduate, by the hand through each step along the way to clarify and help you reach your goal with the least effort and time possible.

In summary, the first step in the road to Germany is learning the language, the earlier the better. The next step is doing one or several elective months in German hospitals; this will open many future opportunities and will give you the possibility to experience the German lifestyle. If you enjoyed living in Germany and became more excited about doing your residency there, you should continue learning German, get your MD degree and then apply to one of the 17 states in Germany to get your license to practice medicine, this process is time consuming and complicated , but is discussed in details below. The following step is applying for the visa, which requires several months, after which your journey in Germany can start. After arriving to Germany, you will be applying for the medical language exam which is required to get the allowance to practice medicine, at the same time, you can be doing internships to strengthen your cv, language and connections. Lastly, you apply for several residency programs, and start working as a resident, congratulations!!

In the following, each step is discussed in details:

1- Learn German:

The first, most important, critical, challenging and essential step to continue your medical career in Germany is to learn the German language. It consists of 4 basic levels and one additional German medical language level. Details about each level, the number of hours required, the exam dates and so on are present on the website of the only certified German institution in Lebanon for learning the German language “Goethe” [1]. As for any language, the earlier you learn the better, however this prosses should be started at least 2 years before your expected residency date.

2- Electives in Germany:

Electives in Germany, also known as “Hospitation”, allow you to get a chance to experience living, working and exploring Germany and have grasp of its medical education system. This is not a required step for the residency, but it is definitely an important step that facilitates your journey and opens new opportunities, for example you might impress the program director and make a good connection with him/her so that you might get a residency post in his/her department later. In order to benefit the most from your electives, you need to have at least a B1 certificate, otherwise you will not be able to understand or speak in the hospital and in your daily life. To apply for electives, all you have to do is to prepare an email in German, attach your cv (written in German) and apply to as much hospitals as possible in Germany. Usually you should apply to a minimum of 50 hospitals to get 1 or 2 positive replies. So do not give up after the first 49 negative replies!! This link contains a list of all the German hospitals along with details and contact emails of each one. [2]

3- Applying For The License to Practice Medicine (‘Approbation’ in German).

To simplify this complicated step, we will divide it into 4 parts:

a. Preparing the Necessary Documents:

Each of the 17 states has its own requirements, you can find them simply by googling "Approbation" and the name of the state, for example: Approbation berlin [3]. If you still do not speak German fluently, there is a web browser extension that instantly translate any webpage from any language to any language, I personally used it and I'm still using it a lot to translate German websites. Check this reference for such applications [4].

The usual requirements that are mostly shared with all states are the following:

i. MD certificate, and official transcript.

ii. B2 German language certificate.

iii. License to practice medicine in your home country.

iv. Residency offer/internship offer.

In this link you will find a quick summary about the application to the "Approbation" [5].

b. Getting the Bescheid:

The "Bescheid" is a document provided by the German authorities stating that you applied for the medical licensing certificate and that your file is being processed. This document is essential for for the visa and to sit for the "Fachsprachprüfung" exam (discussed next), it usually takes two months from the application date for the German authorities to send you this document.

c. Applying for the German Medical Language Exam:

Here you can select one of two exams depending on the state you are applying to. The first one is called "Fachsprachprüfung" and is required in 14 out of the 17 states to get your "Approbation". The exam date will be set by the German authorities after you get the "Bescheid". The second test is called "C1 medicine" and is required by the other 3 states (Hessen, Saarland, Schleswig-Holstein). This test is independent from the German authorities and is offered by the Telc German institution, so you must register for this exam. After taking and passing the "C1 medicine" exam, you have to present the certificate to the German authorities [6]. This exam is generally easier to pass and faster to do since you can pick the date that suits you.

d. The Medical Knowledge Exam or ‘’ Kenntnisprüfung’’:

After passing the German medical language exam, you still have another medical knowledge exam, the ‘’ Kenntnisprüfung’’ (similar to the colloquium exam in Lebanon). This exam is set by the German authorities and it allows you to finally earn the Permanent allowance to practice medicine in Germany or “Approbation”. Before doing this exam you are eligible to apply for a ‘’Berufserlaubnis’’ or a transient allowance to practice medicine in Germany for usually a maximum of 2 years. The requirements to get this transient allowance is to have passed the German medical language exam, and to have a job offer (residency). With this certificate you can practice medicine as a resident for a maximum of 2 years, while earning money as normal resident, however the time spent working will not be counted as part of your residency training duration. This link contains a brief nice summary of what we discussed [7].

Alternatively there is a way to avoid doing the "kenntnisprüfung" but still get the "Approbation". This used to happen by providing the state department of medical practice with the detailed curriculum of your medical studies so that they can assess whether your studies are equivalent to the German medical curriculum. This process is called “Gleich” and it is usually time consuming. If the decision was positive. i.e. stating that your medical education is equivalent to the German medical education, you get the "Approbation". If not then you have to pass the "kenntnisprüfung" to get the approbation. All the “Gleich” applications will be sent to the city Bonn where they will be processed there independently from the state they belong to.

4- Visa application:

You have studied the German language basic levels, did a "Hospitation" in Germany and finally decided to seek a residency program in Germany, then it’s probably the right time to start planning to apply for your long term visa. There are several types of visas you can apply to [8]:

a. Language visa(16b): You have to register at a German language center in order to get the visa.

b. Visa for doctors (17a): To get this visa you have to have the "Bescheid" document that we talked about earlier. This type of visa is recently taking a huge amount of time to be processed in the embassy.

c. Research visa: this is a nice way to get your visa early on. In order to apply for this visa you have to have a doctoral thesis contract. Doctoral thesis or “Doktorarbeit” is an optional German degree that doctors can get by doing a research project and writing a thesis about it. This certificate is known all across Europe, and give you the title “Dr. med.”. You can do this thesis while you are in a residency program, separately or during your medical studies (for German medical students). You can get a "Doktorarbeit" contract by sending your application to the chief of department in a university hospital. It is hard to get this contract if you are outside Germany, so a "Hospitation" in Germany may facilitate this process by helping you building contacts [9]. It is in most cases an unpaid position. This visa is super easy and takes less than a month to be processed.