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Recognition reform from 1 November 2026: what changes for doctors with a foreign degree?
On 1 November 2026 the German Act to Accelerate Recognition Procedures for Foreign Professional Qualifications in the Health Professions (Gesetz zur Beschleunigung der Anerkennungsverfahren ausländischer Berufsqualifikationen in Heilberufen) comes into force. For doctors with a degree from a third country – outside the EU, the EEA and Switzerland – the route to the Approbation (German medical licence) changes. What counts is when you submit your application.
What changes on 1 November 2026?
- Kenntnisprüfung as the standard route: For applications from 1 November 2026 with a degree from a third country, the Kenntnisprüfung (medical knowledge exam) is the standard route to the Approbation (§ 9d BÄO, new version) – a licensing exam with the same standards for everyone. BGBl. 2026 I Nr. 225 BMG
- Equivalence assessment only by choice: The document-based assessment (Gleichwertigkeitsprüfung) only takes place if you choose it within four weeks of submitting your application. The choice is binding for the entire licensing procedure; the authority must inform you about this option and its consequences. If substantial differences are found, you take the Kenntnisprüfung after all. BGBl. 2026 I Nr. 225
- Cut-off date: Applications submitted by 31 October 2026 continue under the old law (§ 15 BÄO, new version). BGBl. 2026 I Nr. 225
- Language skills can be checked earlier: According to the Federal Ministry of Health (BMG), the federal states may in future check the language skills of applicants with a third-country degree even before the professional qualification. For degrees from the EU, the EEA and Switzerland, the qualification is still checked first. BMG-FAQ
- Fewer translations: According to the Federal Ministry of Health, if you do not opt for the equivalence assessment, you no longer need to have documents translated and certified that would only be needed for that assessment – such as your university's curricula. BMG BMG-FAQ
Legislative process: Bundestag 26 March 2026, Bundesrat 8 May 2026, promulgated in the Federal Law Gazette on 28 July 2026 (BGBl. 2026 I Nr. 225), in force from 1 November 2026. Bundestag BGBl. 2026 I Nr. 225
Who is affected, and how?
What matters is not your passport but where you obtained your degree – and the date of your application for the Approbation.
| Your situation | What applies |
|---|---|
| Degree from a third country, application by 31 October 2026 | Old law (§ 3(2) and (3) BÄO, previous version): the authority assesses equivalence based on your documents. The Kenntnisprüfung is required if equivalence is not established or cannot be fully assessed. § 3 BÄO BGBl. 2026 I Nr. 225 |
| Degree from a third country, application from 1 November 2026 | Kenntnisprüfung as the standard route (§ 9d BÄO, new version). Document-based equivalence assessment only if you choose it within four weeks of applying – binding; if substantial differences are found, the Kenntnisprüfung follows anyway. BGBl. 2026 I Nr. 225 |
| Degree from the EU, the EEA or Switzerland | No Kenntnisprüfung. Medical degrees are usually recognised automatically; substantial differences are compensated by an aptitude test (Eignungsprüfung, § 36 ÄApprO). For the EU reference dates, Annex V No. 5.1.1 of Directive 2005/36/EC now applies – the previous annex to the BÄO is deleted. § 36 ÄApprO BGBl. 2026 I Nr. 225 |
| German language skills | So far, as a rule, general German at B2 plus a Fachsprachprüfung (medical language exam) oriented to C1 (key points of the 2014 Health Ministers' Conference), usually at the state medical association. According to the BMG, for third-country degrees the federal states may in future check them before the professional qualification. GMK 2014 BMG-FAQ |
Responsible authorities by federal state
You submit your application for the Approbation to the licensing authority of the federal state where you want to work. The table lists the responsible bodies with links to their official pages; clicking a state opens its page with fees and special features (in German).
Frequently asked questions about the recognition reform
When does the reform apply?▾
The act comes into force on 1 November 2026 (Art. 6(1)). It was promulgated in the Federal Law Gazette on 28 July 2026 (BGBl. 2026 I Nr. 225). What matters for you is the date of your application for the Approbation.
I am applying before 1 November 2026 – what applies?▾
Applications submitted by 31 October 2026 are processed under the old law (§ 15 BÄO, new version): the authority first assesses equivalence based on your documents; the Kenntnisprüfung is required if equivalence is not established.
Can I still get the equivalence assessment after the cut-off date?▾
Yes, but only if you choose it within four weeks of submitting your application. The choice is binding for the entire licensing procedure. If substantial differences are found, you take the Kenntnisprüfung after all.
Do I now need a Kenntnisprüfung with an EU degree?▾
No. The Kenntnisprüfung as the standard route only applies to degrees from third countries. Medical degrees from the EU, the EEA and Switzerland are usually recognised automatically; substantial differences are compensated by an aptitude test (Eignungsprüfung) – not by the Kenntnisprüfung.
When will my German be checked?▾
According to the Federal Ministry of Health, the federal states may in future check the language skills of applicants with a third-country degree even before the professional qualification; for degrees from the EU, the EEA and Switzerland the qualification is checked first. The responsible authority will tell you how your state implements this.
Will I have to have fewer documents translated?▾
According to the Federal Ministry of Health: if you do not opt for the equivalence assessment, documents that would only be needed for it – such as your university's curricula – no longer have to be translated and certified.
Will the responsible authorities and fees change?▾
Our research contains no confirmed information on this. The authorities and fees on our state pages were researched on 29 September 2026, i.e. before the cut-off date. Ask the responsible authority before you apply.
Where do I submit my application?▾
To the licensing authority of the federal state where you want to work. The table above and the German government's Recognition Finder (anerkennung-in-deutschland.de) show which one that is.
Sources
All information on this page comes from these official sources (checked up to 2 October 2026; mostly in German):
- Federal Law Gazette 2026 I No. 225: Act to Accelerate Recognition Procedures for Foreign Professional Qualifications in the Health Professions (§§ 9c, 9d, 15 BÄO, new version)
- Federal Ministry of Health: professional recognition in the health professions
- Federal Ministry of Health: FAQ on professional recognition in the health professions
- German Bundestag: text archive on the vote of 26 March 2026
- § 3 Federal Medical Code (Bundesärzteordnung) – version for applications up to 31 October 2026
- § 36 Medical Licensing Regulations (ÄApprO) – aptitude test (EU, EEA, Switzerland)
- § 37 Medical Licensing Regulations (ÄApprO) – Kenntnisprüfung
- Key points of the 87th Health Ministers' Conference 2014 on German language skills (cited by the Saxon State Medical Association)
- Recognition Finder of the German government (anerkennung-in-deutschland.de)
Not legal advice. All information without guarantee, summarised from official sources (as of 2 October 2026). Only the information provided by the responsible authorities is binding.