Recognition of a Georgian medical diploma in Germany: Approbation, documents and the 2026 changes

What is Approbation and how does it differ from a Berufserlaubnis?

In Germany, the medical profession is governed by a federal law, the Federal Medical Code (Bundesärzteordnung, BÄO for short), while the licence itself is issued by the competent authority of each federal state. So the first decision you have to make is which federal state you plan to work in: that is where you apply, and that authority sets the exact list of documents. In Lower Saxony, for example, this is handled by NiZzA, the joint office for issuing doctors' licences, and in Bremen by the office of the Senator for Health.

Approbation is a permanent and unrestricted licence. Under section 3 of the BÄO, a person educated outside the EU, the European Economic Area and Switzerland, in a so-called third country, is granted it when their training is equivalent to German training. If substantial differences are found, the required knowledge and skills are proven by an exam based on the content of the German state final examination. This exam is the Kenntnisprüfung. Under the same section, the licence also requires the knowledge of German needed for the profession.

A Berufserlaubnis, a temporary licence to practise as a doctor, is issued under section 10 of the BÄO. It is always revocable, usually covers a maximum of two years of medical practice in total and may be limited to specific activities or a specific workplace. In practice, many foreign doctors start working with exactly this permit while the Approbation procedure is still under way. Which option fits your plan is something you decide together with the clinic that employs you and the authority in your federal state.

What changes from 1 November 2026?

On 28 July 2026, the law on accelerating recognition procedures for foreign professional qualifications in the health professions was adopted (Gesetz zur Beschleunigung der Anerkennungsverfahren ausländischer Berufsqualifikationen in Heilberufen, BGBl. I 2026 Nr. 225). According to the Federal Ministry of Health, the law comes into force on 1 November 2026. The main changes described by the Ministry are as follows:

• The knowledge test becomes the rule. The standard route to recognition of qualifications obtained in third countries by doctors, dentists and pharmacists will be a direct Kenntnisprüfung.
• The document comparison becomes optional. The equivalence check based on documents is no longer a compulsory first step and will only be offered as an option.
• Language may be checked earlier. The federal states are given the option of checking an applicant's language competence before assessing their professional qualification.
• Electronic submission. As an alternative to sending documents in writing, electronic transmission of documents and the electronic form become permissible.

As the Ministry describes it, the changes also affect midwives: they can waive the document check and go straight to the knowledge test or an adaptation course. This material does not describe a similar change in the procedure for general nurses, so for nurses the current rules described below remain the point of reference.

What German does a doctor need: B2 and the Fachsprachprüfung

The language requirement has two stages. First, you need a B2 certificate in general German: according to the Lower Saxony checklist, you cannot even register for the medical language exam without it, and in Bremen level B2 is named as a prerequisite for submitting the application. The second stage is the specialist medical language exam, the Fachsprachprüfung, pitched at level C1; this principle was agreed by the Conference of Health Ministers in 2014.

In Lower Saxony the exam is run by the Medical Association (Ärztekammer Niedersachsen), and according to the information sheet of 1 January 2026 the fee is 595 euros, payable in advance once NiZzA has requested it. The exam is taken individually and consists of three parts of 20 minutes each:

1. Simulated doctor-patient conversation

   Taking the medical history and explaining to the patient the diagnosis, the next steps and the advantages and disadvantages of alternative treatments.

2. Documentation

   A written summary of the information from the conversation in the form of a doctor's report (Arztbericht).

3. Doctor-to-doctor conversation

   Handing the case over to a medical member of the examining board and answering their questions in a way that rules out misunderstandings and errors.

This exam does not test medical knowledge, only language in a professional context; there is a separate Kenntnisprüfung for knowledge. If you fail, the whole exam is repeated, and under the rules in Lower Saxony the number of attempts is not limited. Fees and organisation may differ in other federal states, so check the figures with the authority in yours.

Which documents should you prepare in Georgia?

Each federal state sets its own list of documents, but the basic framework is similar. The table below is based on the NiZzA checklist (January 2024 version) and shows where each document comes from in the case of a Georgian doctor. Baden-Württemberg, for example, asks for a criminal record certificate from every country where you have lived for more than six months in the last three years.

The list is an example, not an exhaustive one: Lower Saxony also asks for proof of your intention to work there, for example a letter from an employer, as well as a declaration of no criminal record and a medical certificate on its own forms.

The right to practise: the key question for new graduates

One row of the table deserves special attention. The Law of Georgia on Medical Practice allows a new graduate to work as a "junior doctor", but such a doctor performs their duties under the instructions and responsibility of an independent doctor. Independent medical practice requires a state certificate, which is issued after residency or an alternative form of postgraduate education and the certification exam. So if you have not yet completed residency, ask the German authority in advance which Georgian document it will accept as proof of your "right to practise in the country of study".

Who translates the documents and how are they certified?

German authorities check translations and copies strictly, and this is exactly where most applications are sent back. The NiZzA checklist sets three rules, which you will find in similar form in other federal states too.

Copies. Documents are submitted as originals or as officially certified or notarised copies. In Lower Saxony, copies can be certified by towns, municipalities and districts, by any authority within its own competence, and by notaries. Certification by other institutions or by translators is generally not accepted.

Translation. Every foreign-language document is translated into German, every page of it according to Baden-Württemberg's guidance. A translation is accepted only if it was made by a publicly appointed and sworn translator (öffentlich bestellte und beeidigte Übersetzer) in Germany or abroad; a translation made abroad must come from an institution entitled to make sworn translations in that country. A German translation submitted as an original stays on file and is not returned, so keep a set for yourself as well.

Apostille. Foreign documents proving medical education need a Hague apostille or legalisation by the German embassy. Georgia is a party to the Apostille Convention. You submit the education document at the Public Service Hall, where state services are under one roof, and the decision on the apostille is made by the National Center for Educational Quality Enhancement (NCEQE); the usual time limit is 10 working days. The apostille service page describes the procedure in detail.

We prepare an accurate translation of your diploma, supplement and curriculum, and arrange notarisation through our notarisation service as well as the apostille. If your authority only accepts a translator sworn in Germany, our translation will serve as a working version for the sworn translator to check.

Nurses: how to become a Pflegefachfrau or Pflegefachmann

In Germany, nursing is governed by a separate law, and after recognition the person receives the professional title Pflegefachfrau or Pflegefachmann. According to the version of the Bremen service portal of 2 September 2026, a nurse educated in a third country must meet four conditions: a comparable qualification, personal reliability, health fitness for the profession and German at level B2.

If the comparison reveals substantial differences, the applicant chooses between two routes. The first is an adaptation course (Anpassungslehrgang) lasting up to three years. The second is a knowledge test with oral and practical parts. In Bremen you can waive the equivalence check from the outset and choose the course or the test straight away; this often saves time when you already know that the structure of your programme differs significantly from the German one.

For nurses, too, the competent authority tells you the exact list of documents and in what form to submit them: a simple copy, a certified copy or the original. As a rule you will need ID, education documents, proof of experience and, if you have changed your surname, a marriage certificate; later on, a criminal record certificate, a medical certificate and a B2 certificate. The translation of a marriage certificate and other civil status certificates is covered by our civil document translation service.

Action plan: in what order should you proceed?

The process takes several months or longer, and getting the steps in the wrong order is what most often costs time. Some certificates, such as the criminal record and medical certificates, must not be older than a certain period, so they are obtained last.

1. Choose a federal state and download its checklist

   The authority is determined by the federal state where you plan to work. Its forms and checklist are your key document.

2. Request your university documents

   Diploma, supplement and a personalised curriculum with hours and subject content. The university needs time to prepare this.

3. Apostille

   Submit your education documents at the Public Service Hall; the apostille is affixed by the National Center, usually within 10 working days.

4. Translation in the form your authority accepts

   First check whose translations will be accepted, then place your order. Names, dates and hour totals must match the original exactly.

5. B2 certificate and application

   The application is submitted with B2, after which the authority refers you to the Fachsprachprüfung and decides whether you will start with a Berufserlaubnis or continue straight on the route to Approbation.

6. Time-limited certificates last

   In Lower Saxony and Baden-Württemberg, criminal record and health certificates must be no older than three months, so they are obtained shortly before submission.

If you are also interested in treatment in Germany, this is covered separately in our guide to treatment in Germany. The requirements of other countries are reviewed in our guide to diploma recognition abroad, and when you need an apostille and when a notary is explained in a separate guide on the subject.

Why applications are sent back and how we can help

Recognition authorities check that the documents are complete before they examine the case on its merits, and an incomplete package means a request for more documents and lost time. Typical problems that get a package sent back:

• A curriculum without hours. A list of credits is not enough if the authority asks for teaching hours and content by subject.
• Inconsistent Latin transliteration. The surname is spelt one way in the passport and another way in the diploma translation; it must be the same in every document.
• An apostille on the wrong document. The apostille must be on the original of the medical education document or on a properly certified copy, and it is also translated.
• Expired certificates. The criminal record or medical certificate was obtained too early and was out of date by the time of submission.
• An unrecognised translator. The translation was made by someone the authority does not recognise as a sworn translator.

Solidaroba.ge is not a recognition authority and has no influence on the decision; our job is a correctly prepared package. Through our education document translation service we translate your diploma, supplement and curriculum with hours, check that names and figures match, and arrange the apostille. To get an idea of the price and turnaround in advance, you can use the translation price calculator.

Frequently asked questions about diploma recognition in Germany