Working as a doctor in Germany

Anerkennung is the formal recognition in Germany of a diploma or vocational training obtained abroad. It comes up in two separate places, and confusing them is one of the costliest mistakes: in regulated professions it is what lets you practise, while on the vocational route (§18a) it is required for the residence permit itself — under §18(2) no. 4 the training must be recognised even when the occupation is not regulated. On the EU Blue Card route it is enough to show that the degree is "comparable". These three are often mixed up:

Comparability (anabin)

The normal route for the Blue Card. Two separate checks are needed in the KMK anabin database: the university must be listed with H+ status (H+/− brings additional conditions, H− is not accepted), and the degree itself must be listed under that university. Most Turkish state universities are listed; foundation and newer universities vary — check rather than assume.

Zeugnisbewertung (ZAB)

The fallback route if the degree is not in anabin. It costs €208 (€104 for a second copy) and takes up to three months once the documents are complete. The most common cause of delay is starting this step too late.

Anerkennung (actual recognition)

Only for regulated professions: doctors, dentists, pharmacists, nurses, vets and teachers. Neither anabin nor ZAB replaces it.

The first is a general German B2 certificate, the second a C1 medical language exam (Fachsprachenprüfung). It rests on the June 2014 decision of the Conference of Health Ministers and applies in all sixteen states. The exam is run by the Landesärztekammer of the relevant state on behalf of the licensing authority.

The exam lasts 60 minutes in three twenty-minute parts: a patient consultation (history taking), a written patient report (Arztbrief) and a handover conversation with a colleague. It tests language, not medical knowledge. The B2 certificate must be in hand before sitting it.

Holders of a degree from a German-language university or a German school leaving certificate may be exempt. An exam passed in one state is valid in all the others.

telc B2·C1 Medizin is not accepted everywhere. Baden-Württemberg, Hamburg, Hesse, Saarland and Schleswig-Holstein accept it; Berlin does not — there only the medical chamber’s own exam counts.

Berlin, for example: the authority is the Landesamt für Gesundheit und Soziales, the fee is €430, and with complete documents the process takes roughly three to four months.

A Kenntnisprüfung is required only where equivalence cannot be established and experience does not close the gap. While waiting for the Approbation you can work for up to two years on a Berufserlaubnis.

The Blue Card is a work and residence permit for people with a university degree and a job offer above a set salary threshold. For 2026 the standard threshold is €50,700 and the threshold for shortage occupations and career starters is €45,934.20 gross a year.

Federal Employment Agency approval required. At the lower threshold the employment contract must run for at least six months. The Federal Employment Agency also carries out a comparability check: pay and working conditions may not be worse than those of a local employee.

Someone who graduated within the last three years qualifies for the lower threshold even if their profession is not on the shortage list.

Residence law sets no specific German requirement for the Blue Card itself. German enters indirectly in two places: permanent residence (after twenty-seven months with A1, twenty-one months with B1) and, in regulated professions, the language requirement set by the licensing authority.

§18g(1) sentence 2 no. 1 AufenthG defines shortage occupations by reference to ISCO-08 groups: 132, 133, 134, 21, 221, 222, 225, 226, 23 and 25. Among these, 21 covers natural scientists, mathematicians, engineers and architects; 221 doctors; 222 academic nursing and midwifery; 23 teachers; and 25 IT professionals — software developers, systems analysts, web developers, database administrators, systems administrators and network specialists.