Which German state handles your Approbation application?
Where to send your Approbation application with a medical degree from abroad, from the Bundesärzteordnung as it reads in November 2026.
Ahmed Quteishat, Assistenzarzt, Innere Medizin (Berlin) · Founder of Klaro
Updated:
In short
If you already live in Germany, the authority of the state where you have your usual residence decides on your foreign medical degree. If you live abroad, you apply in the state where you plan to work. A Berufserlaubnis (temporary licence) always comes from the state where you will work. With a degree from outside the EU, the Kenntnisprüfung (knowledge exam) is the default; you can choose a document check instead only within four weeks of applying, and that choice is binding.
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The rule in one table
| Your situation | Which state decides |
|---|---|
| Approbation with a foreign degree, you live in Germany | The state of your usual residence (gewöhnlicher Aufenthalt) |
| Approbation with a foreign degree, you live abroad | The state where you plan to work as a doctor |
| Berufserlaubnis (temporary licence), wherever you live | The state where you will work |
| European Professional Card (EU doctors) | The state where you work or plan to work |
The law lets the states agree that another state or a shared office does this work for them. So the office that reads your papers can sit in another state. The authority of your state tells you where to send what.
Living abroad: you choose the state by your plan
- Pick the state where you really want to work first, because that state's authority runs your whole file.
- Ask that authority what it accepts as proof that you plan to work there, for example a job offer or applications.
- Do not file in two states at once: the authorities can ask each other whether you already have an open application elsewhere (§ 3 Abs. 4).
- Once you move to Germany, the rule for residents applies to new applications: the state where you live.
Degree from outside the EU: the four week choice
- By default you prove your knowledge in the Kenntnisprüfung, an exam on the content of the German final medical exam (§ 9d Abs. 2).
- Instead, you can ask for a check of your documents against the German degree (Gleichwertigkeitsprüfung, often called Gutachten). You must choose this within four weeks of filing your application.
- The choice is binding for the whole Approbation procedure, and the authority has to explain it to you.
- If the document check finds essential differences, you take the Kenntnisprüfung anyway. The same happens when papers cannot be sent in full for reasons outside your control (§ 9d Abs. 3).
- A degree from outside the EU that an EU state already recognised is checked like an EU degree (§ 9b Abs. 1).
If you filed before November 2026, ask your authority which rules apply to your file. How to show a pending application on your CV: see Approbation pending on your CV.
Open doctor jobs per state
| State | Open jobs |
|---|---|
| Nordrhein-Westfalen | 2,617 |
| Bayern | 1,680 |
| Baden-Württemberg | 1,505 |
| Niedersachsen | 1,108 |
| Hessen | 1,104 |
| Sachsen | 818 |
| Brandenburg | 744 |
| Rheinland-Pfalz | 646 |
| Thüringen | 605 |
| Berlin | 566 |
| Sachsen-Anhalt | 512 |
| Mecklenburg-Vorpommern | 512 |
| Schleswig-Holstein | 469 |
| Hamburg | 278 |
| Saarland | 208 |
| Bremen | 132 |
Browse them by state and specialty on doctor jobs in Germany, or see hospitals that hire with a Berufserlaubnis.
Questions
Which state handles my Approbation if I live in Germany?
The authority of the state where you have your usual residence decides on your foreign medical degree, even if you later want to work in another state.
Which state handles my Approbation if I live abroad?
You send the application to the authority of the state where you plan to work as a doctor. Ask it what proof of that plan it accepts.
Can I apply for the Approbation in two states at the same time?
It is not a good idea. The authorities may ask each other whether you already have an open application in another state, so a second file shows up.
Who gives the Berufserlaubnis?
The authority of the state where you will work. It is a temporary licence that lets you work as a doctor while your Approbation is open.
Do I have to take the Kenntnisprüfung with a degree from outside the EU?
It is the default. You can choose a check of your documents instead, but only within four weeks of applying, and that choice is binding. If the check finds essential differences, you still take the exam.
Sources
Klaro writes your German application
A German CV and cover letter from your own details, which you can enter in English. The first 2 days are free, then €19 a month.