temporary medical practice permit

What is the purpose of the practice permit?

It bridges the period during which someone could already work professionally but has not yet met all the requirements for full licensure. The legal basis is § 10(1) of the Federal Medical Act. The permit is granted on a revocable basis only and only for a total period of medical practice of no more than two years in Germany. It may be restricted to specific activities and places of employment, applies in practice only in the issuing federal state, and is usually subject to medical supervision. Anyone working under it is a physician in a training position, not independently licensed. An extension beyond two years is only possible in exceptional cases and for reasons of healthcare provision.

How does this work in practice?

In practice, it usually runs as follows: the application is submitted to the same licensing authority that will later decide on licensure, often in parallel with the licensure application. The documents required include evidence of training, a certificate of good conduct, a medical certificate of physical fitness, and proof of language competence. Many states already require the completed specialist language examination for the permit; others initially accept a B2 certificate. These differences between states are the most common cause of delays and the reason why an agreed employment contract cannot start on the planned date. Fees also differ; depending on the state, they are in the mid-three-figure range.

What applies to graduates from EU countries abroad?

Anyone who has completed a medical degree in Bulgaria, Romania, Hungary, Croatia, Malta, or the Baltic states and holds a qualification listed in Annex V No. 5.1.1 of Directive 2005/36/EC generally does not need the practice permit, because full licensure is granted directly. § 10(1a) even generally excludes holders of EU, EEA, and Swiss qualifications, unless there is a specific interest in the grant. In practice, the permit is therefore mainly relevant for graduates from Serbia or Bosnia and Herzegovina, and for EU graduates with incomplete documentation.

What changes on 1 November 2026?

Under the Act on the Acceleration of Recognition Procedures for Health Professions promulgated in July 2026, an indefinite permit will in exceptional cases also be possible for physicians and dentists. At the same time, the knowledge test moves to the centre of the procedure. The specific implementation is left to the individual states.