The Right Order For Your German Doctor Exams

Do the language exam first. Then a hospital observership.

Then the knowledge exam. That is the order that works, and most foreign doctors do it backward.

What order actually works?

Three steps, in this order: the medical language exam (Fachsprachprüfung, FSP), a hospital observership (Hospitation), then the knowledge exam (Kenntnisprüfung).

Each one needs the one before it. Skip ahead, and you waste weeks redoing a step you were not ready for.

Why the language exam goes first

The FSP is one 60-minute exam with 3 parts (as of 2026). It has a patient interview, a written report, and a talk with a doctor examiner. It tests your language, not your medicine.

It costs about €595 in Lower Saxony and about €400 in Cologne, North Rhine-Westphalia (as of 2026). You need general German at B2 first, then this exam at around C1.

Without it, a hospital observership is mostly you nodding at rounds. With it, you can actually follow the senior doctor and write the note.

What is the Hospitation for?

It is unpaid time on a German ward, often a few weeks, where you shadow the team. You watch handovers, you practice ward German, you learn how discharge letters are written here.

This matters because the knowledge exam is practical: a real patient, 3 examiners, one day (as of 2026). A Hospitation is where you rehearse that, with no exam on the line.

Why the knowledge exam comes last

The Kenntnisprüfung is the normal route for a non-EU medical degree, from 1 November 2026 (as of 2026). You get 3 attempts, and the state must offer you a date within 6 months.

Waiting for a date varies a lot by state. In Bavaria the wait for this exam grew from 6 to 21 months (as of 2026). Use that waiting time for your Hospitation, not after it.

When should you start applying for jobs?

You can apply after you pass the Kenntnisprüfung, or while holding a temporary work permit (Berufserlaubnis). It allows work for at most 2 years total (as of 2026). A booked exam date is not enough for most hospitals.

Sending CVs before your FSP is done usually gets silence. Departments want a licence, or a clear date they can plan a contract around.

What to do now

• Ask your state medical chamber in writing: can I sit the FSP before I move to Germany?
• Book your Hospitation only after you can hold a short ward conversation in German.
• Check the current knowledge exam wait time for your state before you plan your budget.
• Build your German CV while you wait for your exam date, not after you pass.

Stand: 2026-11-03. This is a guide, not legal advice. Every German state has its own rules, and rules change. Check with your state's medical chamber (Landesärztekammer) before you act.