Coming to Berlin as a nurse

Registered nurse: recognition by LAGeSo, knowledge test or adaptation course, § 16d, German B2, fair recruitment.

Nursing is a regulated profession in Germany. You may only work as a registered nurse (Pflegefachfrau / Pflegefachmann) once an authority has recognised your training. In Berlin this is the State Office for Health and Social Affairs (LAGeSo). The usual route: start recognition, learn German to B2 and enter with a job contract. Often this works through a § 16d permit while recognition is still under way.

In short: the job and the usual route

The German target profession is Pflegefachfrau / Pflegefachmann under the Nursing Professions Act (PflBG). Once recognised, you receive the permit to use the professional title (§ 2 PflBG).
Conditions: equivalent training, reliability, health fitness and the German skills the job requires.
Many nurses first receive partial recognition and close the gap in Germany (knowledge test or adaptation course).
No nursing training yet? You can train in Berlin: see Coming to Berlin as a trainee.

Suitable residence permits

Permit	For	Main requirements	BA approval
§ 18a AufenthG	Skilled worker with vocational training, recognition completed	Job offer; permit to use the title granted or promised (§ 18 (2) no. 3)	yes, as a rule
§ 16d (1)	Adaptation course or preparing for the knowledge test	Partial recognition; as a rule at least "adequate" German (A2); up to 24 months, extendable to 3 years in total; side job up to 20 hours a week	yes, if employment is part of it
§ 16d (3) (recognition partnership)	Working while recognition only starts in Germany	Training of at least 2 years recognised by the state of origin, job offer, written agreement with the employer, at least adequate German (A2); first at most 1 year, up to 3 years in total. With a care facility licensed under § 72 SGB XI the work until recognition need not be "qualified", but grading and pay must match the target job.	yes
§ 16d (4) (placement agreement)	Placement by the Federal Employment Agency (BA), e.g. the Triple Win programme	Health and nursing professions; German as set in the agreement, as a rule at least A2; 1 year, extendable by 1 year each up to 3 years; side job up to 20 hours a week	yes
§ 18g (EU Blue Card)	only with a university degree (e.g. nursing degree)	ISCO group 222 is on the shortage list: €45,934.20 gross a year (2026) with BA approval, otherwise €50,700; licence required	yes for the lower threshold
§ 19c + § 22a BeschV	Nursing assistant	State-recognised training as a nursing assistant, or established equivalence of the foreign qualification	yes

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). Through § 1 (2) BeschV this age-45 rule also applies to nursing assistants under § 22a BeschV. Check the exact amount before relying on it. More: Recognition partnership (German), Residence permits overview (German).

Recognition in Berlin: LAGeSo

Competent office: LAGeSo, State Examination Office for Health Professions, Turmstraße 21, 10559 Berlin, [email protected]. Only LAGeSo issues the permit in Berlin.
Fee: €164. 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: CV, passport, birth certificate, training records with translation, police certificates (not older than 3 months), certificate of good standing, medical certificate.

Knowledge test or adaptation course

If there are substantial differences from German training, work experience can offset them. Otherwise you must prove equivalent knowledge.
There are two ways, and you may choose (§ 40 (3) PflBG): a knowledge test (oral and practical, § 45 PflAPrV) or an adaptation course (at most 3 years, with a final exam).
Under § 40 (3a) PflBG you can finally waive the equivalence review and go straight to the test or course. This can be faster, but your documents are then not assessed. Get advice first.

Nursing assistants

In Berlin the assistant profession is currently called Gesundheits- und Krankenpflegehelfer/-in. Recognition is also at LAGeSo, fee €164, German B2 (Service Berlin).
From 1 January 2027 there is a nationwide training called Pflegefachassistenz (Nursing Assistance Act). For foreign qualifications, a knowledge test or adaptation course is meant to replace a full equivalence review. How Berlin implements this had not been published; check before relying on it.

More: Recognition of foreign qualifications (German), Regulated professions (German).

German

For recognition LAGeSo requires B2, proven with a certificate from Goethe-Institut, telc, TestDaF or an ECL-certified language school, not older than 3 years. You can submit it later.
For a § 16d visa A2 ("adequate") is often enough. Full recognition still needs B2 in the end.
Tip: learn nursing vocabulary on purpose. Info: Language and the workplace (German).

Steps

Get free advice: from abroad at the Central Service Office for Professional Recognition (ZSBA, [email protected]); in Berlin at the Berlin recognition counselling or the advice centre for nurses with foreign qualifications (linked on the LAGeSo page).
Apply to LAGeSo and learn German.
Find an employer. With the decision or a § 16d agreement, apply for the visa at the German mission abroad.
Your employer can start the fast-track procedure for skilled workers (§ 81a, fee €411) at the Berlin Immigration Office (LEA).
After arrival: register your address, get the residence permit at the LEA, complete recognition and switch to § 18a. See Entry and first steps (German).

Staying and family

A settlement permit (permanent) is possible under § 18c: the requirements are 3 years with a § 18a/§ 18b permit, 36 months of pension contributions and German B1 (2 years / 24 months after training in Germany). Time in a recognition partnership does not count. Family: Family reunification (German).

Watch out

Do not pay placement fees. The state quality seal "Faire Anwerbung Pflege Deutschland" requires recruitment to be free for nurses (the employer pays) and all rights and duties to be explained in writing in your language (Federal Ministry of Health).
WHO list: in 55 countries with severe health-worker shortages only the BA may recruit and place health and care workers (§ 38 BeschV with annex, e.g. Afghanistan, Nigeria, Pakistan; based on the WHO list 2023). A private agency recruiting there acts unlawfully.
Read repayment clauses for courses or flights carefully and have them checked before signing.
Care minimum wage from 1 July 2026: €16.52 (nursing assistant), €17.80 (with at least one year of training), €21.03 (registered nurse) per hour; from 1 July 2027: €16.95 / €18.26 / €21.58 (Federal Government). It applies only in care businesses within the meaning of the Care Work Conditions Ordinance (Pflegearbeitsbedingungenverordnung, mainly elderly and long-term care), not in private households. General minimum wage: €13.90 (BMAS).
Free help with employer problems: Faire Integration and, in Berlin, BEMA (Berlin Advice Centre for Migration and Good Work). If an employer in Germany signed the contract with you while you still lived abroad, it must inform you in text form, at the latest on your first working day, about the advice service under § 45b AufenthG (Faire Integration), with the contact details of the nearest advice centre (§ 45c AufenthG).

Sources

A question this page does not answer? Contact us. Free orientation only, no legal advice for individual cases.