Approbation in Germany: Guide for Indian Doctors and Dentists
Everything you need to know about getting your permanent German medical or dental license

What Is Approbation?
Approbation (German: Approbation) is the permanent, unrestricted medical license that allows you to practice medicine independently in Germany. Unlike the temporary Berufserlaubnis (temporary work permit), Approbation grants you full rights to work as a doctor anywhere in Germany — and across the entire EU.
For Indian MBBS doctors, Approbation enables medical work and Facharzt training. For Indian BDS dentists, dental Approbation enables work as a licensed dentist in Germany. The two routes share language, document, and recognition steps, but dentistry has its own dental authority review, dental FSP/KP expectations, and career path.
Who Needs Approbation?
Every non-EU medical graduate who wants to practice medicine in Germany permanently needs Approbation. This includes:
- Indian MBBS graduates — whether freshly graduated or experienced practitioners
- BDS graduates — dentists from India seeking to practice in Germany (see dentist-specific guide)
- Doctors from other non-EU countries — the process is similar regardless of home country
If you have completed a recognized medical or dental degree and hold the required registration documents, you can plan an Approbation pathway. Dentists should also read the dedicated BDS to Germany guide because the dental route is not the same as the MBBS residency route.
Approbation vs. Berufserlaubnis: What's the Difference?
| Feature | Approbation | Berufserlaubnis |
|---|---|---|
| Duration | Permanent | Temporary (max 2 years) |
| Scope | All of Germany + EU | Specific state only |
| Independent practice | Yes | Under supervision only |
| Residency training | Counts toward Facharzt | Counts toward Facharzt |
| Salary | €5,000+/month | €5,000+/month |
Step-by-Step Approbation Process
Step 1: Learn German to B2 Level
You need a minimum of B2 German certificate (Goethe or telc) before applying. Many states also require B2-C1 Medizin (medical German). Starting early with German language learning is crucial — most doctors take 8-12 months to reach B2.
Step 2: Document Preparation
Gather and prepare the following documents:
- MBBS or BDS degree certificate with transcripts
- Medical Council or Dental Council registration, depending on your profession
- Internship completion certificate
- Birth certificate
- Passport (valid for at least 6 months)
- B2 German certificate
- CV in German (tabellarischer Lebenslauf)
- Certificate of good standing from Medical Council
All documents must be attested and translated by a certified German court-authorized translator. MedGermany handles this entire process for you.
Step 3: Choose a German State (Bundesland)
Each of Germany's 16 states has its own medical authority (Ärztekammer) that processes Approbation applications. Processing times vary significantly — from 3 months in some states to 12+ months in others. Choosing the right state is critical.
Key factors to consider:
- Processing time (Bayern and NRW tend to be faster)
- Whether the state grants direct Approbation or requires Defizitbescheid
- Hospital availability for Hospitation
- FSP exam format (varies by state)
Step 4: Submit Your Application
Submit your complete document package to the chosen state's Regierungspräsidium or Landesprüfungsamt. The authority will evaluate your medical education against the German standard. Two outcomes are possible:
- Direct Approbation — Your degree is recognized as equivalent. You receive Approbation after passing the FSP exam.
- Defizitbescheid — Deficiencies are identified. You must pass both the FSP exam and the Kenntnisprüfung (KP).
Step 5: Pass the FSP Exam (Fachsprachprüfung)
The FSP exam tests your medical German language skills in a clinical setting. It consists of three parts:
- Doctor-Patient Conversation (Anamnesegespräch) — 20 minutes
- Documentation (Arztbrief) — 20 minutes
- Doctor-Doctor Conversation (Arzt-Arzt-Gespräch) — 20 minutes
The FSP is mandatory for ALL applicants. With proper preparation, most Indian doctors pass on their first attempt.
Step 6: Pass the KP Exam (If Required)
If you received a Defizitbescheid, you must also pass the Kenntnisprüfung (KP) — a medical knowledge exam covering internal medicine, surgery, and your chosen specialty. This is an oral-practical exam, not a written test.
Step 7: Receive Your Approbation
After passing all required exams, your state authority issues the Approbation certificate. With this document, you can work as a fully licensed doctor anywhere in Germany and begin your medical residency.
Timeline: How Long Does Approbation Take?
The typical timeline from start to Approbation:
- German language (A1 to B2): 8-12 months
- Document preparation: 1-2 months
- Application processing: 3-12 months (varies by state)
- FSP preparation + exam: 1-3 months after arrival
- KP preparation + exam (if needed): 2-4 months
Total: 12-24 months from starting German lessons to receiving Approbation. With MedGermany's guidance, many of our clients achieve it in 14-18 months.
Cost Breakdown
- German language courses (A1-B2): ₹60,000 - ₹1,50,000
- Document attestation & translation: ₹30,000 - ₹50,000
- Approbation application fee: €150-€500 (varies by state)
- FSP exam fee: €350-€500
- KP exam fee (if needed): €350-€600
- Visa application: €75
The total investment is significantly lower than USMLE (USA) or PLAB (UK) pathways. And once you start working in Germany, you earn €5,000+/month from day one.
How MedGermany Helps
MedGermany provides end-to-end guidance through the entire Approbation process. Our team of Indian doctors currently practicing in Germany understands every step intimately. We help with:
- State selection strategy (choosing the fastest, most suitable state for you)
- Complete document preparation, attestation, and translation
- Application submission and follow-up with authorities
- FSP and KP exam preparation guidance
- Hospitation placement at German hospitals
- Visa assistance and arrival support
- Job search after licensing
Book a free consultation to discuss your specific situation and get a personalized timeline.
Ready to Start Your Journey?
Get expert guidance from doctors who have already walked this path.
Book Free Consultation