Germany FSP and Kenntnisprüfung: compare 3 states before applying

Schleswig-Holstein replaced my chamber language exam with telc Deutsch C1 Medizin, but I would still choose a Bundesland by the first job I could get. Your Approbation, Germany’s full medical licence, is only useful when a hospital gives you a junior doctor contract. A fast file in Kiel is valuable. A contract in Berlin, Munich or a smaller town is the next thing that pays your rent.

I filed my Approbation papers in Schleswig-Holstein in January 2025. I held my Approbation on 13 February 2025, around 4 weeks later. My first medical certificate was rejected because the doctor who signed it was still in residency. I sent a new certificate signed by a fully licensed doctor, and the file moved forward.

Schleswig-Holstein: use telc C1 Medizin if it fits your file

Schleswig-Holstein accepts telc Deutsch C1 Medizin for the medical German requirement in its Approbation process. That matters because you can sit the telc exam in many German cities instead of waiting for a chamber-run Fachsprachprüfung, the medical language exam. For me, this removed months of waiting for an exam date.

The authority is the Landesamt für soziale Dienste in Schleswig-Holstein. Send the certificate exactly as the authority requests, with your diploma, transcript, passport, good-standing certificate and medical certificate. My rejected certificate shows why the signature matters. A doctor still in training is not the person who should certify your health document.

The trade-off is the job market. Schleswig-Holstein has hospitals in Kiel, Lübeck, Flensburg, Neumünster and many smaller towns. A junior doctor who accepts internal medicine, general surgery, geriatrics or psychiatry outside Hamburg has more realistic first applications than someone applying only to plastic surgery in Kiel.

Berlin: more hospitals, but the language exam is local

Berlin gives you a larger concentration of hospitals, including Charité, Vivantes and many smaller clinics. That creates more departments to contact after you have a licence. It also attracts doctors from across Germany and abroad, so a new Approbation holder competes with applicants who already worked on a German ward.

For Berlin, the Ärztekammer Berlin runs the Fachsprachprüfung for doctors seeking Approbation. A telc certificate shows strong German, but it does not replace Berlin’s chamber medical language exam. The chamber test checks a doctor-patient conversation, a written medical report and a handover to a colleague.

Berlin is a sensible choice when you have a real reason to work there: a spouse lives there, you already have interviews, or you will apply widely to hospital departments. It is a poor choice if your only reason is a story about another doctor’s fast licence. Your file enters Berlin’s own office and exam system.

Bavaria: choose the city and specialty before the licence office

Bavaria has large university hospitals in Munich, Erlangen, Regensburg, Würzburg and Augsburg, plus many regional hospitals. A doctor who wants anaesthesia, internal medicine or general surgery can find a broad list of departments. Munich is not the whole state. Hospitals in Lower Bavaria, Franconia and Swabia also hire junior doctors.

The Bayerische Landesärztekammer runs Bavaria’s Fachsprachprüfung. Like Berlin, Bavaria uses its own chamber exam rather than treating telc C1 Medizin as the medical language exam for Approbation. Your case then moves through the responsible Bavarian government authority, which depends on the district where you apply.

Bavaria works best when your job search is already tied to a place. A signed offer from a hospital in Passau or Würzburg gives the licensing office a clear connection to the state. Do not pick Bavaria only because you want Munich. Munich departments receive applications from doctors who already have German ward experience and referrals.

What changes between the 3 states?

The language-exam route changes first. Schleswig-Holstein accepts telc Deutsch C1 Medizin under its published Approbation requirements. Berlin and Bavaria use their own chamber-run Fachsprachprüfung. That difference affects where you sit the exam, who gives you the result and how soon you can submit the language paper.

The authority changes next. Schleswig-Holstein uses its state social services office. Berlin uses the Landesamt für Gesundheit und Soziales for Approbation and the Ärztekammer Berlin for the language exam. Bavaria divides Approbation work among district governments, while the Bavarian chamber handles the language exam.

The Kenntnisprüfung, the medical knowledge exam for doctors whose training is not judged equivalent, also follows the state where you apply. The licensing authority compares your diploma, transcript, internship papers and employment certificates with German training. If it finds important differences and does not accept compensation through your papers or experience, it sends you to the Kenntnisprüfung route.

Do not choose a state from a claimed waiting time. Files slow down when a passport copy is unclear, a good-standing certificate has expired, translations differ from the original, or a medical certificate has the wrong signer. My own file moved quickly after I fixed one signer problem. That is my case, not a promise for your file.

Pick the state that gives you both papers and a job

Choose Schleswig-Holstein when telc C1 Medizin is ready or easy for you to book, and you will apply to hospitals across the north. Choose Berlin when you have a Berlin-based reason and will send applications beyond Charité. Choose Bavaria when you will apply to regional hospitals as well as Munich.

A licence application is not a race between Instagram stories. It is a file of certificates in one office, followed by interviews with chief doctors and senior doctors. The best Bundesland is the one where your language paper is accepted and where you will actually say yes to a first junior doctor job.

What to do this week

• Open Schleswig-Holstein’s Approbation page and compare the listed telc Deutsch C1 Medizin requirement with your current certificate.
• Email the Approbation office in your chosen state with one question: “Does my telc Deutsch C1 Medizin certificate replace the medical language exam for my Approbation application?”
• Ask the doctor signing your medical certificate whether they hold a full licence, then include their professional stamp and registration details.
• Make a list of 20 hospitals in your chosen state, including regional hospitals, and apply for junior doctor posts in internal medicine, general surgery, anaesthesia, psychiatry or geriatrics.

Stand: 2026-09-21. This article is orientation, not legal advice. Rules differ by Bundesland and change — always confirm with your [Landesärztekammer](https://www.bundesaerztekammer.de/aerztekammern) before acting.