What German level do doctors need: B2, C1 or Fachsprachprüfung?
The language rules for the Approbation, in the order the authority checks them, as of November 2026.
Ahmed Quteishat, Assistenzarzt, Innere Medizin (Berlin) · Founder of Klaro
Updated:
In short
Doctors need two things: general German at level B2 of the European framework (CEFR), and in most cases a medical language exam, the Fachsprachprüfung, at level C1. A general C1 certificate alone is usually not enough. The exam is mostly run by the state medical chamber (Landesärztekammer) and costs about 400 to 595 euros.
The three levels at a glance
| Step | Level | Who checks it | When |
|---|---|---|---|
| General German | B2 (CEFR) | The Approbation authority of your state | Can be sent after you apply |
| Fachsprachprüfung (FSP) | C1, medical German | Mostly the Landesärztekammer | After the authority registers you |
| Kenntnisprüfung | No language level: a medical exam held in German | The Approbation authority | After the FSP, for most non EU degrees |
B2: general German
B2 is the minimum in every state. The law asks for the German you need to work as a doctor (Bundesärzteordnung § 3), and the authorities read that as B2 general German plus the medical exam. You do not need the certificate when you apply: the finder pages say you can prove your German later.
C1: the Fachsprachprüfung
The Fachsprachprüfung tests medical German at C1 in three parts: a talk with a patient to take the history, a written medical report, and a handover of the case to a doctor colleague. There are exceptions, so wait for the authority to tell you whether you need it.
| State | Exam body | Fee |
|---|---|---|
| Lower Saxony | Ärztekammer Niedersachsen | 595 € |
| North Rhine-Westphalia | Ärztekammer Nordrhein or Westfalen-Lippe | about 400 € |
The authority usually registers you for the exam after you apply, so apply for the Approbation first and book nothing on your own. Other states run it differently; the Bundesärztekammer list under the sources names every chamber.
What to do now
- Get a B2 certificate from a recognised provider if you do not have one yet.
- Apply for the Approbation in one state; the certificate can follow later.
- Wait for the authority to register you for the Fachsprachprüfung, then prepare with real case handovers.
- Write your stage on your CV as shown in Approbation pending on your CV.
On 3 November 2026, 162 of the 13,580 doctor adverts on Klaro (1.2%) said a temporary licence (Berufserlaubnis) is enough. Source: Klaro's monthly report on doctor jobs. Search the open jobs or the resident jobs by state.
Questions
Is a general C1 certificate enough to work as a doctor in Germany?
Usually not. The authorities ask for general German at B2 and, in most cases, the medical Fachsprachprüfung at C1. A general C1 certificate does not replace the medical exam unless your authority says so in writing.
Do I need the language certificate before I apply for the Approbation?
No. The official finder pages say you do not need to send a language certificate with the application; you can prove your German later.
Who runs the Fachsprachprüfung?
Mostly the state medical chamber (Landesärztekammer), for example the Ärztekammer Niedersachsen or, in North Rhine-Westphalia, the Ärztekammer Nordrhein or Westfalen-Lippe. The authority registers you after your application.
How much does the Fachsprachprüfung cost?
The official finder names 595 euros in Lower Saxony and about 400 euros in North Rhine-Westphalia (3 November 2026). Other states set their own fee.
Do I need the Fachsprachprüfung for a Berufserlaubnis?
Ask the authority of your state before you plan around it. Each state sets the conditions for the temporary licence, including which proof of German it wants.
Sources
Klaro writes your German application
A German CV and cover letter from your own details, which you can enter in English. Free.