Key Takeaways
You don't register for the Kenntnisprüfung separately. You will apply for Approbation in the state where you want to work, and the authority sends you to the exam.
Under the new rules, you can request the document-based Gleichwertigkeitsprüfung within four weeks of submitting an application. Your choice is binding for the entire procedure.
Other application documents may still need certified copies and sworn German translations. Requirements vary by federal state and profession.
What is the Kenntnisprüfung?
The Kenntnisprüfung is a state licensing exam for doctors, dentists and pharmacists trained outside the EU, EEA or Switzerland. From 1 November 2026, it’s the default route to Approbation and tests everyone against the same standard.
The exam primarily assesses whether foreign-trained doctors, dentists, and pharmacists have the required skills and medical training to practise medicine safely in Germany.
The exam is typically a combined oral-practical test (mündlich-praktische Prüfung) that includes either a real patient case or a simulated clinical scenario, followed by a structured discussion with the examiners.
However, the exact format and structure can vary by profession, federal state, and examination authority.
Here’s how the exam currently runs in Bavaria, based on the Regierung von Oberbayern's exam guides for doctors, dentists, and pharmacists.
Profession | Format | What it covers | Length | Cost (Bavaria, example) |
Doctors | Oral practical, including a patient presentation. Up to 4 candidates, all on one day | Internal medicine and surgery, plus emergency medicine, clinical pharmacology, imaging, radiation protection and professional law | 60-90 minutes per candidate | Up to €1,200 per attempt |
Dentists | Three parts: written treatment plans, an oral exam, and a practical exam in a simulated practice | Prosthodontics, restorative dentistry, oral surgery and orthodontics, plus emergency medicine, pharmacology, hygiene and professional law | Written 45 min; oral 60-90 min; practical about 5 hours | About €1,300 in total |
Pharmacists | Oral only. Up to 4 candidates | Pharmaceutical practice and the special legal areas for Pharmacists | 30-60 minutes per candidate | About €690 per attempt |
In all three cases, you can retake the exam twice if you fail.
What changes on 1 November 2026
The Kenntnisprüfung will become the standard route for recognising qualifications from foreign physicians. You will no longer have to go through the document-based equivalence assessment first unless you choose that route. According to the German government, the change is intended to make recognition faster, more consistent, and less bureaucratic. The changes are set out in the Gesetz zur Beschleunigung der Anerkennungsverfahren ausländischer Berufsqualifikationen in Heilberufen (BGBl. I 2026, No. 225), including amendments to § 9d of the German Medical Act (Bundesärzteordnung, BÄO). The law establishes the new legal framework, while relevant licensing regulations govern practical requirements.
This is a significant change from the previous process, where the authority first assessed your qualification and identified any substantial training differences before requiring the Kenntnisprüfung.
Midwives trained outside the EU may be able to skip the document-based equivalence assessment and go straight to the Kenntnisprüfung or an adaptation course (Anpassungslehrgang).
This new law does not include nurses. This means the existing process does not change. You apply for recognition, and the authority compares your training with German nursing training. If there is a significant difference, you choose between a Kenntnisprüfung and an Anpassungslehrgang.
If you applied before 31 October 2026
Under the transitional provisions, applications submitted by 31 October 2026 will continue under the previous rules. For applicants with medical qualifications from outside the EU, EEA and equivalent states, the licensing authority generally assesses the qualification through the existing document-based equivalence procedure. If substantial differences are found and equivalence cannot be established, you may be required to take the Kenntnisprüfung.
If you currently work in Germany under a temporary Berufserlaubnis while waiting for full Approbation, contact your competent licensing authority for guidance on the next steps in your individual case. The applicable requirements and process may depend on your circumstances and the authority handling your application.
The four-week decision after you apply
Based on the new rules, you can choose a document-based Gleichwertigkeitsprüfung instead of the Kenntnisprüfung route. However, you must request the Gleichwertigkeitsprüfung within four weeks of submitting your application. Whatever path you choose is binding throughout your application process.
Who each route tends to suit
The equivalence route may suit applicants whose training closely mirrors the German curriculum and who can obtain complete, detailed syllabi from their university without delay. The default route may suit applicants whose universities can’t easily supply detailed course documentation, or who would rather prepare for a defined exam than wait on a document review with an uncertain outcome. This depends on your individual qualification. If you’re unsure, ask your Approbationsbehörde before the four weeks run out, because you can’t switch later.
Note: Requesting the document-based Gleichwertigkeitsprüfung does not guarantee that your qualification will be recognised as equivalent to a German qualification. The competent authority will assess your training documents and determine whether any substantial differences remain. If equivalence is established, you may be able to obtain Approbation without taking the Kenntnisprüfung. If substantial differences remain and cannot be compensated for by relevant professional experience or other recognised knowledge and skills, you may still have to take the Kenntnisprüfung.
What this means for your documents
If you follow the standard Kenntnisprüfung route, you no longer need to submit, translate or certify detailed university curricula and study plans. You may need sworn translation for documents required for the Kenntnisprüfung if they aren’t in German and the authority requests it.
Kenntnisprüfung document and translation requirements
The exact documents depend on your Bundesland. As a rule, assume your translations need to be sworn: in the over 16,000 orders we’ve handled for customers in Germany, the large majority are ordered as sworn translations by a translator court-appointed in Germany (beeidigt/ermächtigt), rather than standard certification. Here’s a general list and the translation requirements:
Document | German Term | Needed For | Translation Type |
Degree certificate (medicine, dentistry, pharmacy) | Abschlussurkunde / Diplom | Both routes | Sworn translation |
Academic transcripts | Notenübersicht / Studiennachweise | Both routes | Sworn translation |
Certificate of good standing | Unbedenklichkeitsbescheinigung | Both routes | Sworn translation |
Proof of professional experience | Arbeitszeugnisse / Tätigkeitsnachweise | Both routes | Sworn translation |
Passport or national ID | Reisepass / Identitätsnachweis | Both routes | Certified copy |
CV in tabular form | Tabellarischer Lebenslauf | Both routes | Usually written in German |
Proof of name change (Marriage certificate, court order) | Nachweis der Namensänderung | If applicable | Sworn translation |
Birth certificate | Geburtsurkunde | Both routes | Sworn translation |
Police clearance certificate (criminal record certificate) from each country you've lived in | Strafregisterauszug / Führungszeugnis | Both routes | Sworn translation |
Medical fitness certificate | Ärztliches Attest | Both routes | Sworn translation if not issued in German |
German language certificate (B2) | Sprachnachweis Deutsch | Both routes | Issued in German |
Fachsprachprüfung certificate (often submitted later) | Fachsprachprüfungsnachweis | Both routes | Issued in German |
Current professional licence | Berufszulassung / Berufserlaubnis im Herkunftsland | Both routes | Sworn translation |
University curricula/syllabus | Studienpläne / Curricula | Equivalence route only | Sworn translation, if you follow the document-based assessment route. |
All documents not in German must be translated into German by a sworn translator before submission to the Bundesland. Additionally, many states require certified copies, not plain photocopies.
Note the following about the documents you require:
You need a police clearance certificate from every country outside Germany where you have lived for more than six months in the last five years.
You need a Certificate of Good Standing from every country where you practised in the last five years.
The medical certificate must come from a doctor in Germany or another EEA country, and not be older than three months.
So if you studied in Egypt, then worked for two years in Saudi Arabia, you’d need a police certificate and a Certificate of Good Standing from both countries.
Need sworn German translations for your Approbation documents? From €48.90 per page, with urgent turnaround. Get a quote.
Step-by-step: how to apply for Approbation from 1 November 2026
Before we walk through the process, know that you do not register for the Kenntnisprüfung on its own. You apply for Approbation to the authority in the state where you plan to work, and that authority sends you to the exam.
Here’s how it works in practice:
1. Identify the federal state and licensing authority: Choose the Bundesland (federal state) where you intend to practise and identify its Approbationsbehörde (Licensing Authority). Each state has its own application process, forms and document requirements.
2. Gather your documents and arrange sworn translations: Start with time-sensitive documents such as police clearance and good standing, since many authorities accept them only if they’re under three months old.
3. Submit your Approbation application: Send the form with the required documents and the application fee. The fees vary by state. In Berlin, it is €430; in Bavaria, it’s €400. In Berlin, processing takes about three to four months.
4. Complete the required language assessments: You may need general German proficiency at B2 level and the Fachsprachprüfung, usually associated with C1-level professional language skills.
The precise requirements depend on your profession and state. Under the reform, states may assess language proficiency for applicants with third-country qualifications before assessing their professional qualifications.
5. Get an exam date: The authority checks your file and assigns you to an exam at a university or chamber. In Bavaria, once the authority approves your file, you’re asked to complete a separate exam registration. Dates are usually set 1–6 months later.
6. Sit the exam: The format in which you’ll take the exam depends on your profession, as we’ve explained above. If you fail, you can retake it twice. However, you must register again and pay the exam fee for each attempt.
7. Receive your Approbation: Once you pass, the authority grants your Approbation, valid anywhere in Germany.
While you wait, you may be able to work under a Berufserlaubnis (temporary medical work permit). It's usually time-limited, tied to a specific job, and may come with conditions. Under the new law, doctors and dentists may, in exceptional cases, get one without a time limit.
Do you need an apostille or legalisation?
This depends on the country where your documents are issued. Many authorities want proof that your foreign documents are genuine.
If your authority requires authentication and your country is a Convention member with Germany, you’ll usually need an apostille. Germany objects to some members, such as India, where other procedures apply. Check with your Approbationsbehörde if you need additional authentication like an apostille or consular legalisation.
What if my document expires?
Some documents, such as your police clearance, Certificate of Good Standing, or medical fitness certificate, are valid for about three months. If one of them expires before your application is complete, you’ll have to request it again, get it apostilled, and translate it again. Get the apostille on the original first, then have the document and the apostille translated together.
Common reasons applications are delayed
Translations not done by a court-sworn translator. Use a translator who is sworn in Germany.
Name discrepancies between passport, degree and transcripts. If there’s a change, include proof in your application.
A good standing certificate or police clearance older than three months is usually rejected.
Using plain photocopies where officially certified copies are required will often delay your application.
Applying to the wrong federal state can delay your application because each state has its own steps and requirements.
Get your documents translated on time
Some documents in your application are usually only accepted if they're less than three months old; don’t let translation eat into that time. Translayte provides sworn German translations for Approbation applications from €48.90 per page, with urgent turnaround available. We also offer notarization and apostille services where required. Upload your documents and order a sworn translation from Translayte today.
