German hospitals, particularly outside the large cities, depend increasingly on doctors trained abroad. Indian doctors with MBBS degrees are one source. The path to practising in Germany is well defined but demanding, and hospitals that understand it can plan recruitment realistically.
The Licence: Approbation
To practise medicine without restriction in Germany, a doctor needs the Approbation, the full licence issued by the competent authority of the federal state. For doctors trained outside the EU, the authority examines whether the training is equivalent to German medical training. For many third-country degrees it is not found fully equivalent, and the doctor must pass a knowledge test (Kenntnisprüfung) covering the content of the German state exam, usually with emphasis on internal medicine and surgery.
Applicants can often waive the detailed equivalence review and proceed directly to the knowledge test. For Indian doctors, this is frequently the faster route because the review would likely end in the test anyway.
Language: Two Requirements
General German: a certificate at B2 level is generally required.
Medical German: doctors must pass a medical language examination (Fachsprachprüfung), usually held by the state medical chamber at C1 level. It tests communication with patients, documentation and communication with colleagues. Many candidates find it harder than the knowledge test.
Reaching this level from scratch typically takes well over a year of intensive learning. Hospitals that recruit doctors still in India usually fund language training and medical-communication preparation.
The Temporary Licence
While working towards Approbation, a doctor may receive a temporary licence to practise (Berufserlaubnis), generally limited in time and scope, for example to supervised work at a specific hospital. It allows the doctor to work as an assistant doctor while preparing for the knowledge test. Not every state grants it under the same conditions.
Visa and Residence Routes
Typical routes include:
- Residence for recognition measures — for doctors who need to prepare for and take the knowledge test while in Germany, often combined with work under a temporary licence
- Skilled-worker permit or EU Blue Card — once the licence is in place; medicine is a shortage occupation for Blue Card purposes, so the reduced salary threshold can apply
Our Blue Card guide covers thresholds; the recognition partnership guide explains how recognition after arrival works in general.
Documents From India
Hospitals and candidates should prepare:
- MBBS degree and mark sheets, with the curriculum and hours by subject
- Proof of completed internship
- Registration with the Indian medical council and a recent certificate of good standing
- Passport, CV and birth certificate
- Experience certificates from hospitals
- Sworn translations and apostilles where required
Specialist Training
An Indian MD or MS is not automatically recognised as German specialist status. Doctors usually enter as assistant doctors in specialist training (Weiterbildung). The state medical chamber decides whether prior specialist training abroad can be credited. Hospitals should discuss realistic training plans at interview.
Pay
Doctors in public and many private hospitals are paid under collective agreements for physicians. Assistant doctors under these agreements earn significantly more than most other occupations covered on this site, and pay rises with experience and specialist status. Under a temporary licence, pay terms should be set out clearly.
A Realistic Timeline
- Year 0–1: selection, German to B2, document preparation
- Year 1–1.5: application for Approbation, medical language exam, arrival
- Year 1.5–2: work under a temporary licence, knowledge test preparation, test
- Year 2 onward: Approbation and specialist training
Every stage can take longer, particularly appointment waits for exams.
What Hospitals Should Prepare
- A named mentor in the department
- Time for knowledge test preparation within the working week
- Clear communication on the duties permitted under a temporary licence
- Support for accommodation and family relocation
Ethical Recruitment
Medical recruitment falls under the WHO Code of Practice. India is not on the WHO safeguards list in the editions published so far, but hospitals should check the current list and apply fair-recruitment principles; see our fair recruitment guide.
Next Step
We prepare documentation for medical candidates and coordinate language preparation with hospital partners. To discuss a programme, see our Germany hiring page.
