Coming to Berlin as a doctor

Approbation or temporary permit from LAGeSo, C1 medical German test, knowledge test, Blue Card. Also: dentists and pharmacists.

Doctor is a regulated profession in Germany. You may only treat patients once you hold a full licence (Approbation) or a temporary permit to practise (Berufserlaubnis). In Berlin both are issued by the State Office for Health and Social Affairs (LAGeSo). You also need good German: B2 general German and C1 in medical language.

In short: the job and the usual route

• Approbation (§ 3 Federal Medical Code, BÄO): permanent, valid throughout Germany, allows independent practice.
• Berufserlaubnis (§ 10 BÄO): temporary, revocable, can be limited to certain activities, as a rule at most 2 years in total until 31 Oct 2026; from 1 Nov 2026 it can be unlimited in exceptional cases. According to LAGeSo it is valid only in Berlin.
• Until 31 October 2026 (studies outside the EU/EEA/Switzerland): LAGeSo first checks whether your training is equivalent. If there are substantial differences, the knowledge test follows (Kenntnisprüfung, § 3 (3) BÄO).
• From 1 November 2026: the direct knowledge test is the rule; the equivalence review is only done on request (Act to speed up recognition in the health professions, BGBl. 2026 I Nr. 225 of 28 July 2026). More below.
• After the Approbation, specialist training is organised by the Berlin Medical Association (Ärztekammer Berlin). It also recognises foreign specialist titles.

Suitable residence permits

Aged 45 or over: the first permit under § 18a/§ 18b needs a salary of 55 percent of the contribution ceiling (2026 about €55,770) or adequate pension provision (§ 18 (2) no. 5 AufenthG). Check the exact amount before relying on it. More: EU Blue Card (German), Residence permits overview (German).

Approbation in Berlin: LAGeSo

• Competent office: LAGeSo, State Examination Office for Health Professions, Turmstraße 21, 10559 Berlin, [email protected] (LAGeSo).
• Fee for the Approbation: €430. Time: about 3–4 months once documents are complete (Service Berlin).
• You must show a link to Berlin, e.g. a job offer, residence or job applications.
• Typical documents: diploma and transcripts with translation, CV, passport, certificate of good standing, police certificates (not older than 3 months), medical certificate, language certificates.

New from 1 November 2026: direct knowledge test

• The Act to speed up recognition procedures for foreign qualifications in the health professions was promulgated on 28 July 2026 (BGBl. 2026 I Nr. 225). Some parts apply since 29 July 2026, most of it from 1 November 2026. For doctors, dentists and pharmacists from third countries the direct knowledge test becomes the rule. The document-based equivalence review is then only done on request (Federal Ministry of Health, Recognition in Germany).
• The federal states may also check German skills earlier, and the temporary permit can be unlimited in exceptional cases.
• How LAGeSo applies the new rules in practice had not been published; check before relying on it.

More: Recognition of foreign qualifications (German), Chambers and regulated professions (German).

German and the medical language test

• General German B2: certificate from telc, TestDaF or Goethe-Institut, not older than 3 years.
• Medical German C1: Fachsprachprüfung at the Berlin Medical Association. Three parts of 20 minutes each: taking a history from a simulated patient, written documentation, conversation between doctors.
• You can only register with the receipt confirmation (Eingangsbestätigung) from LAGeSo. The fee is €550 (Berlin Medical Association). You can retake it as often as you like, but only the whole exam with all three parts.
• Learning German: Language and the workplace (German).

Steps

1. Get free advice: from abroad at the Central Service Office for Professional Recognition (ZSBA, [email protected]); in Berlin at the Berlin recognition counselling (IQ Network).
2. Learn German to B2 and apply to LAGeSo.
3. With the receipt confirmation, register for the medical language test; prepare for the knowledge test.
4. Look for a job. Depending on your stage: a § 16d visa (exam, preparation, temporary permit) or the Blue Card (Approbation or permit promised) at the German mission abroad.
5. Your employer can start the fast-track procedure for skilled workers (§ 81a, fee €411) at the Berlin Immigration Office (LEA).
6. After arrival: register your address, get the residence permit at the LEA, knowledge test, Approbation. See Entry and first steps (German).

Staying and family

With the Blue Card, a settlement permit under § 18c (2) is possible after 27 months (German A1), or after 21 months with German B1. With § 18b the requirements are 3 years with the permit, 36 months of pension contributions and German B1 (§ 18c (1)). Family: Family reunification (German).

Dentists and pharmacists (short)

• Dentist: Approbation from LAGeSo, fee €430, B2 plus the C1 language test at the Berlin Dental Association (Zahnärztekammer), about 3–4 months (Service Berlin).
• Pharmacist: Approbation from LAGeSo, fee €430, B2 plus the C1 language test at the Berlin Chamber of Pharmacists (Apothekerkammer), about 3–4 months (Service Berlin).
• Both professions are on the Blue Card shortage list (ISCO 226). From 1 November 2026 the direct knowledge test is the rule for them too.

Watch out

• Agencies promising a "guaranteed Approbation" or a quick job for high fees: only LAGeSo decides on the Approbation.
• WHO list: from the countries in the annex to § 38 BeschV only the BA may recruit and place health and care workers, which includes doctors. Private agencies may not recruit there.
• Courses for the knowledge test and repayment clauses in job contracts: read carefully and have them checked first.
• Labour law applies with a temporary permit too. The general minimum wage in 2026 is €13.90 an hour (BMAS).
• Free help with employer problems: Faire Integration and, in Berlin, BEMA (Berlin Advice Centre for Migration and Good Work).

Sources

• § 3 BÄO, § 10 BÄO, § 18g AufenthG, § 16d AufenthG, § 18c AufenthG
• Service Berlin: Approbation doctor (third country), LAGeSo: academic health professions, Berlin Medical Association: language test
• Federal Ministry of Health: faster recognition, zm-online: direct knowledge test, BGBl. 2026 I Nr. 225 (recognition act for health professions)