Gleichwertigkeitsverfahren or Approbationsverfahren

With Berufserlaubnis (temporary medical license, which can only be received after a job offer in almost all states, except Bayern), non-EU Graduates are allowed to work temporarily till their Approbation (permanent medical license) is processed.

What is Approbation?

In order to be able to carry out a medical profession in Germany, one requires an Approbation (Permanent Medical Licence). The term Approbation comes from Latin and means approval.

How to apply for Gleichwertigkeitsverfahren or Approbationsverfahren?

In most of the states in Germany (like Bayern), you require a separate application for Approbation process. But in some states (like NRW), there is only one Application needed. Both, Berufserlaubnis and Approbation, are processed based on it.

The contacts and websites of responsible authorities are given in the following link, where you can find application forms, required documents, rules of the state etc.

At the time of Approbation Application, you’re asked if you want to…

  • opt for a Gutachten process, to compare your medical education with German medical education
  • or do you want to give a Gleichwertigkeitsprüfung/ Kenntnisseprüfung (Approbation-exam) to prove your medical knowledge

In some states, like NRW and Hessen, (according to Information from my friends) the Authorities are more strict for non-European graduates. And you have to directly opt for a Gleichwertigkeitsprüfung/ Kenntnisseprüfung. Gutachten is not allowed. In that case, you don’t require to submit a curriculum. But you have to be ready for a medical exam, called Gleichwertigkeitsprüfung.

What is Gutachten?

A review in which Qualifications/ degrees of non-EU graduate doctors are individually checked for equivalence with German qualifications or degrees. Such a Gutachten (review) will be based on the submitted documents including education curriculum and professional experience. (For more information about Curriculum check out this post)

What happens after Gutachten?

If the equivalence with the German training is given during Gutachten, the Approbation is granted. And no further medical equivalence exam (Kenntnisseprüfung) is required.

If your medical education is not equivalent to German medical education, then…

  • very rarely, you are asked to take an adaptation course or you are asked for specific Internships/work experience; and if you submit completion certificate of it, you’re granted Approbation
  • almost all of the times, you have to clear an medical knowledge examination ( Kenntnisseprüfung) for approval of Approbation

How much time does the Gutachten process take?

It is different in each state and totally variable from person to person.
After submitting the curriculum, I had to wait for almost 7 months (Bayern, 2018) and then I received Approbation without any further exam.

When is Kenntnisseprüfung required?

  • If there are shortcomings in your education and your medical education is not equivalent to German medical education; a medical knowledge examination ( Kenntnisseprüfung) must be cleared by the applicant.
  • If you don’t want to opt for Gutachten, as it takes much more time, then you can directly apply for the Kenntnisseprüfung.

In most of the states, as I heard, maximum 3 attempts of Kenntnisseprüfung is allowed. You should inquire with the responsible Authorities.

Upon clearing the Kenntnisseprüfung, Approbation will be granted to you.

What should be done? Should you opt for Gutachten or directly give an examination? What would be my suggestion?

I would recommend you to try for gutachten process. Some of my friends ad I have received positive answers after Gutachten, and we have received Approbation without Gleichwertigkeitsprüfung / Kenntnisseprüfung. Some of us are medical graduates from India too. If there is a chance, why not take it? Otherwise anyways you have to give exam, if you opt for direct exam without any Gutachten process. And the same will happen if you get negative answer in Gutachten-process, but at least you will not regret at any point for not trying for it.



For All Information about medical post graduation in Germany. Look at the following link.

Please give information, ask your questions or request a topic in comments. Comments are always appreciated. It improves the quality of post and helps others more, as it will clear more doubts.

Tejas Ghetia

Tejas Ghetia is a doctor by trade and a writer by heart. An introvert atheist. Having virtues of silence and observance. Enjoying each day with his full consciousness. Befriended with books and movies.Liberating himself with his adventures of literary and philosophical type! Captivated by Fyodor Dostoyevsky, Osho, Kahlil Gibran, Richard Dawkins, Kafka, JKR etc.

44 Responses

  1. Jameel Hijazeen says:

    Great article! Nice “About” section.

  2. Jetmir says:

    i have graduted from medical school in Kosovo ( outside EU) und now want to work in Germany. I have sent my documents in ZAB (Bonn) for a Zeugnisbewertung and then i want to apply for an Arbeitsplatzsuche Visum ?

    Can i go like this way in deutschland

    • Please share the whole situation? When did you complete medical education? At present working? Language level? From where did you apply? I mean, are you in Germany and you want to apply visa here or in Kosovo?

  3. Jetmir says:

    i hope so. I just wanted to kno if this ZAB Evaluation is valuable ?

  4. Jetmir says:

    thank you very much sir i wish you the very best

  5. Arpit Srivastava says:

    Dt.Tejas…Thanks plenty for such an informative blog.
    Kindly advise whether we are given Berufserlaubnis during the Gutachten process or we just need to sit & wait.

    • Read the first line please…
      With Berufserlaubnis , non-EU Graduates are allowed to work temporarily till their Approbation (permanent medical license) is processed.
      So you ‘can’ get Berufserlaubnis and start working, if you want. Approbation is processed during that time.

  6. Ashok Chakravarthi says:

    Very well written , simple and understandable . Thank you sir Tejas Ghatia

  7. Noma says:

    Hi. Did they need you to have a post graduate internship to Bev able rob do residency? I did six years of medical school and the final one was a practical one in the hospital. Is that enough?

    • Please elaborate. I am not understanding your question properly. What do you mean by “postgraduate internship “?

      six years of med school with practical internship will be mostly enough for starting a PG process in Germany

  8. Ashok kumar says:

    Is there anyone from Delhi who had done MBBS from Delhi, got Approbation thru Gutachten process.
    Thanks in advance.

  9. Masjensen Argadjendra says:

    Dear Dr Ghetia,

    I completed my medical education in Indonesia but has not completed my 1 year internship year. Medical education in Indonesia consists of 4 theoretical years + 2 practical years in the Hospital. It is my understanding that I will need certificate of internship completion and letter of good standing from my country. I learned that I can apply to Landesprüfungsamt in Düsseldorf where they will check for recognition of my degree. They will later ask me to complete internship or ask me to take the Kenntnisprüfung directly. What is your opinion about that? If they asked me to complete an internship in Germany, is it possible for a foreign medical graduate to complete a 1 year internship in Germany and then have it recognized?

    Thank you sir

    • One person, I know, had completed an internship in Germany, then he required to get it approved and attested from the medical college where he completed his medical graduation. I do not know the whole process in detail. But he had submitted documents in Bayern and received Berufserlaubnis for the internship. After completion, it was not considered valid in Germany, until it was approved by his medical college in another country.

  10. Dr Juhi Godara says:

    hello dr Tejas…very informative…. i wanted also to know how to apply for Guteachten?

  11. DR.YAKSH KANANI says:

    hello dr tejas

    This artical is really informative and very helpful. i am confused about gutachten. ill recive my beruferlaubnis in jan-2020 from bayern and i have done 14 months of hospitation 7 month in surgery and 7 month in medicine. i dont have any work expierence in india. i would really like to knw your advice on this.what are the chances to get gleichwertigkeit? as i have heard that in last year its hard to get gleichwertigkeit. thank you so much in advance

  12. Fjo says:


    There is just one thing I don’t understand. If I apply straight for Kenntnisseprüfung without the Gutachten process, do I still get a Defizitbescheid? If not, then what document should I submit for a 17a visa?

    Thank you!

    • They can still give you confirmation of documents and zwischenbescheid or something like that. I am not sure if that is valid, you have to ask your embassy for that. I think it should be considered valid! But a good question, as it can reduce a long waiting time for Defizitbescheid!

  13. Thank you mister for the really helpful yet simple information.
    But i have a question in mind,why should a person sit idle and await the approbation for several months.Wouldn’t it be a wise move to apply for a berufserlaubnis meanwhile,especially if he already got a job offer and he doesn’t want to miss it while waiting?

    • yes you are right, because I did the same. I had applied approbation and then worked as a doctor with Berufserlaubnis in between.
      I have received Approbation und working with it now.
      But most of the states (I think except Bayern) have only single application for Berufserlaubnis and approbation.
      That means that you automatically get Berufserlaubnis, if you have applied approbation and fulfill the criteria for Berufserlaubnis.

  14. Renee says:

    Dr. Ghetia – thank you so much for this informative blog. This is by far some of the clearest information I have found on matters pertaining to German medical licensing.

    Can berufselaubnis be used to start in private practice while approbation is pending, or is it only for those who have an employed position? (from a US trained psychiatrist)

    Thanks in advance.

    • private practice can be started only after completing Facharztweiterbildung / Specialisation .
      You can start specialisation residency only with the Berufserlaubnis

      • Renee says:

        Thank you for your response. I’ve already completed a US residency in my specialty and now have a few years of post graduate experience. I’m hoping to apply directly for Approbation (though I don’t know if my training and/or experience will be fully recognized!). It seems Bayern does not require a letter of employment – maybe I should try there?

  15. Darshan says:

    I am in a very unique situation. I have completed my FSP in January 2020, and came back to India in Jan end. I was supposed to travel back in March and because of Corona pandemic flights were not available and my visa got expired. I had to apply for a new visa, and now in Bangalore embassy they are asking for a job contract for them to approve my visa. I want to come back to Germany and apply for approbation. What should I do now? Kindly advice.

    • I am thinking, what could I have done in the situation.
      – would have applied Approbation from nativ country as soon as possible.
      – get defizit Bescheid / letter to submit with visa
      – never applied visa for any job offer, as I do not have work permit
      – job seeker visa, only as a last option if I can not find any other way to apply visa.
      – qould have tried 16b, or any other variant of privious ly known 17a visa
      – also explained in the visa cover letter that why I require visa, what will be my process, why I can not get Berufserlaubnis or approbation because of beurocratic situation, attached a authority letter to allow to talk to my ansprechpartner for approbation
      – Explained to embassy in detailed cover letter that job offers require personal interviews (to prove my point I would have done applications, and attached job interview dates of 3 or 4 Months later along with application)
      – asked on ‘doctors going to germany fb group’, also read all posts of ‘doctors going to germany’ fb group from last 3 to 6 months, just to get idea about situations of thers and get mire ideas

  16. Rusheendra says:


    Thanks for sharing all your experiences and valuable info. Could yo also share about how much did it cost you for the Gutachten process?

    Thank you in advance!

  17. Sehar says:

    Thanks for valuable info,
    I have done postgraduation (fcps) in gynae n obs from pak n now live in dresden. According to my search i have to do my residency in Germany. But Are there chances to get approbation without kp after passing fp? Thanks

  18. Karandeep Singh says:


    Thank you for the valuable information in the blog.

    I have done my MBBS from India and then my post graduation (M.S) in Orthopaedics from India and worked as an Orthopaedic surgeon for 5 years in India, I am currently in Niedersachsen, doing a hospitation. According to the information I have till now, I have to do my residency again here in Germany to work as a Facharzt. I had a question! Do I have to complete 6 years of residency training again here or can my residency training years be waived to some extent because of my previous residency from India. And which states here are more friendly in Gutachten of post graduate degrees from India? If you know anyone with same situation as me who has gone through the same process, it would be really helpful for me.
    Thanks and Regards

    • They do Gutachten in Bayern, and approve your indian postgraduation. of Course, you always have to give exam.

      Before they used to give ‘Defizitbescheid’ and you had to complete few months of postgraduation/ Weiterbildung according to what they say. Then you could give exam.

      Now they do not allow ‘Defizitbescheid’, I heard, I am not sure about information.
      Now they. either approve your Postgraduation or do not approve.
      So upon approval, you can directly give Facharztprüfung.
      Or when it is not approved, you have to repeat whole postgraduation.

      I know 4 people, who applied and all of them received approval, but of course, they had to give the exam.

    • Sorry. for such a late reply!

  19. Karandeep Singh says:

    Hi Dr Tejas,

    I am Karandeep from India, I have done my MBBS and M.S Orthopaedics from India and have worked as an Orthopaedic surgeon for approximately 5 years. I am currently in Germany and in process of filing my application for Berufserlaubnis. I am currently doing Hospitation and i have got a Job offer here in Niedersachsen with a contract of 48 months as Assistantarzt.

    I wanted to ask that do you have any experience or do you know someone who has done PG from India and they have applied for Gleichfertigkeit here in Deutschland and have got some knowledge about the whole process. I have some queries like, will i need to repeat my Orthopaedics residency here for 6 years or can the total number of Facharztweiterbildung can be reduced here on the basis of my Orthopaedic residency from India and my work experience. I have searched so much on Internet before i found your website and found really helpfull information here, Thanks for the superb information provided in your blogs.

    Please reply me back, I will wait for your reply. Thanks

    • They do Gutachten in Bayern, and approve your indian postgraduation. of Course, you always have to give exam.

      Before they used to give ‘Defizitbescheid’ and you had to complete few months of postgraduation/ Weiterbildung according to what they say. Then you could give exam.

      Now they do not allow ‘Defizitbescheid’, I heard, I am not sure about information.
      Now they. either approve your Postgraduation or do not approve.
      So upon approval, you can directly give Facharztprüfung.
      Or when it is not approved, you have to repeat whole postgraduation.

      I know 4 people, who applied and all of them received approval, but of course, they had to give the exam.

  1. January 20, 2019

    […] Information about Gleichwertigkeitsverfahren or Approbationsverfahren […]

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