Postgraduation in Germany

Postgraduation in Germany

The different steps you have to take along your post-graduation journey can seem daunting and difficult. But with the right guidance and planning, each step can be tackled and dealt with as efficiently as possible making you that much closer to your dream. The process towards medical PG in Germany consists of:

  • German language proficiency (B2/C10)
  • Invite from institute for FSP, KP training/invite for hospitation
  • Document translation and attestation  
  • Send documents for Approbation in the respective city
  • Accommodation
  • Visa Interview (with necessary documents)
  • FSP (Fachsprachenprüfung – Exam for temporary license/ Berufserlaubnis)
  • KP (Kenntnisprüfung – Exam for permanent license/ Approbation)

German Language Proficiency

The first and most crucial step is to ensure that you have a solid command of the German Language. As your field will require you to be fully capable of interacting with your patients, it is necessary to ensure that you are fluent enough in the language to be able to be up for the task. This will enable you to get the maximum out of your PG journey. It is an absolute requirement to have an A1 or A2 level in German basics before you apply for the course of your choice.

A medical graduate is also required to have at least B2 level of general German and C1 level of German language knowledge in medical German. According to the Common European Framework of Reference for Languages or the CEFR, C1 level stands for advanced proficiency.

What is FSP?

The next step is to take the Fachsprachenprüfung which aims to test your knowledge of medical German terminology. It should be taken by every foreign applicant who wishes to practice as a physician in Germany and aims to start their specialization in Germany.

The general criteria to be eligible for the FSP exam is to have completed a B2 level of the German language and to have a valid medical degree. The exam will be conducted by the respective state of Germany where the applicant wishes to practice.

Pattern of Fachsprachenprüfung (Specific Language Test)

The Fachsprachprüfung is an individual exam with three stages. The test will be carried out by at least two examiners, at least one of which will be a physician. The medical expertise of the person will not be check in the technical language examination. The three stages include:

  • Doctor-Patient conversation (20 min)

In this part, the doctor will be required to communicate with the patient to try and diagnose their condition. You will be tested on how well you can understand the patient and draw the correct conclusions.

  • Documentation (20 min)

This part requires the doctor to write a well-detailed history of the patient they interviewed and prepare a document with all the necessary case details.

  • Doctor-Doctor communication (Case presentation) (20 min)

Here, the doctor will have to present his observations and conclusions of the case. You will be required to represent all details and documents to the examiner and you will be required to answer certain questions that will be put forth by the examiner.

How to apply for Fachsprachenprüfung (FSP)?

This exam is a necessary part of getting Approbation, the Permanent License. Once the applicant decides the specific state where they want to practice, they will be required to submit the necessary documents to the corresponding medical council (Landesärztekammer) for Temporary (Berufserlaubnis) or Permanent License (Approbation). After verification of all documents, an appointed exam date for the FSP exam will be provided by the medical council.

General Requirements for Medical PG in Germany

Application for PG in Germany requires the following additional documents:

  1. Police Clearance Certificate
  2. Birth Certificate
  3. Passport

The following documents should be acquired from Germany:

  1. Hospitation/Job Offer (Stellenzusage)
  2. Medical Certificate
  3. Notarized Copies of Originals
  4. Attested Translations of all Documents by a certified translator from Germany

These documents need to be combined and authenticated by the process of Beglaubigung to obtain a certified copy of the primary documents. This process is an official certification of the reliability and validity of your documents. It will certify that the duplicates match the original and are a true copy of the primary document.

What is Defizitbescheid?

Defizitbescheid can be defined as a notification of deficit. When an application for Approbation (Permanent Licence) is submitted, a comparison between the applicant’s medical studies with German medical studies is performed. If there is a significant shortage or deficit (defizit) in their medical knowledge, the applicant will be required to take a compensatory knowledge test known as the Kenntnisprüfung. Defizitbescheid is an official document that explains and states this deficit in medical knowledge. If no such difference is observed, an Approbation will be issued.

Significant differences are deemed to exist, if

  • the applicant’s established training duration is at least one year less than the German training duration,
  • the applicant’s training subjects differ significantly from the German training, or
  • the subjects required as an essential prerequisite for the practice of the medical profession differ in their level of knowledge and if the medical training differs significantly from the German training system in terms of duration or content.

It is also mandatory to submit a Defizitbescheid along with your application for a 17a German National Visa. Usually, a Defizitbescheid is not usually asked as a requirement for a 16b Visa. This explains why many courses are designed starting with completing basic levels in German (A1 or A2) therefore enabling the applicant to complete the entire process during their stay in Germany as they work towards changing their visa status to 17a. However, due to some recent changes in the rules, some embassies may require you to submit a Defizitbescheid regardless of the type of visa you apply for.

How long will it take to get Defizitbescheid?

The process may take up to 3-6 months after submitting the complete set of documents. In some states, this period may extend to more than a year, all depending on the Approbation Authority in charge of processing your application.

What is Kenntnisprüfung?

If a significant difference is noted between the German level of medical studies and the applicant’s medical studies, he or she will be required to compensate for their deficit and prove their knowledge by taking the Kenntnisprüfung or Knowledge Test. The applicant also has the option to skip the process of Defizitbescheid and directly ask to take the Kenntnisprüfung examination.

Kenntnisprüfung is an oral-practical examination that includes a patient presentation. This exam is based on the requirements of the Third Section of the Medical Examination in accordance with ÄApprO (Approbationsordnung für Ärzte).

What is Approbation?

Approbation is the permanent medical license extended by the German state that allows doctors to pursue their profession. It is valid all across Germany and has a permanent status that lasts their whole career.

Pre-requisites for Approbation

Conditions required for the granting of approbation include that the applicant:

  • has completed the required training and has passed the Kenntnisprüfung exam or has received a positive decision after comparison of studies.
  • has been able to attain a good standing certificate and is not found to be guilty of any behavior that makes them unworthy or unreliable of practicing the profession.
  • has the health and well-being to practice the profession proved by a medical certificate.
  • has sufficient German language skills attested by the results of their Fachsprachenprüfung test.

If the required conditions are met, the applicant has the legal right to be granted the license to practice medicine in Germany in accordance with Approbationsordnung für Ärzte (ÄApprO).

What is Hospitation?

Hospitations, also known as work shadowing, are short-term visits to hospitals or private practices. It serves as an opportunity to get an up-close and personal experience of the working processes and requirements of the medical systems and practices in different states across Germany. Hospitations are individually offered by different institutions. Information regarding requirements, vacancies, and the application process can be found on the individual websites of each institution or organization.

In general, a well-rounded application should include:

  • A personalized motivation letter
  • A clear and compelling CV
  • Proof of education and studies
  • Employee references
  • Work samples
  • Letters of recommendation

Advantages of Hospitations in Germany:

  • Hospitations enable the intern doctors to familiarize themselves with the natural environment and working of things at German hospitals.
  • It enables the individual to get a more practical and firsthand experience of the German medical system.
  • You will get to further learn and practice your German language skills, particularly your knowledge in medical German language, as all the staff and hospital members usually converse in German.
  • You are presented with an opportunity to interact with consultant physicians and obtain references from them. This will in turn increase your chance of getting accepted into a residency program in the same hospital as well as other hospitals.
  • Hospitation can be a huge asset in preparing you for your residency process. It will enable you to gain the self-confidence and interview skills that will help during your application process.
  • Generally, after you successfully complete your Hospitation from a particular hospital, you are issued a certificate that will further enhance your resume.
  • After completion of your Hospitation, you may also obtain recommendation letters from your senior physicians which will increase your profile and better your chances for residency.

How to Apply for Hospitation in Germany?

The process of getting a Hospitation position in German hospitals is extremely competitive. So in order to ensure a position, applicants need to make sure to fulfill all requirements and work smart. The initial requirements that the applicant needs to take into consideration include:

  • German language Skill (Minimum requirement B1 Level of German language)
    It is recommended to start your Hospitation application after completion of B2 level.
  • Curriculum Vitae (lebenslauf)
    Your resume should be well-rounded and include all information about your academic background, your work experience, and your training. It should be written in the German language.

The CV should be accompanied by a motivation letter written in German. The motivation letter should state the applicant’s preferred department and work duration. Special focus should be placed on information about the applicant’s personal motivation, expectations, added values, competences, and the reasons why they chose Germany.

When applying for a Hospitation position, you are encouraged to select a position that corresponds to your particular field of interest and the field which you wish to pursue. This will limit the number of positions that you have applied for, enabling you to focus more on the application process itself.  This will also make your selection easier when you will apply for residency. Hospitation applications can be done online via the particular hospital website or through emails to the specific head of the department. The email and the applications should all be submitted in the German language.

Once your application is approved, you will receive an invitation letter from the designated institution. This letter can be used to apply to the German Embassy for a visa.

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