Information about the recognition procedure

On this page you will find an overview of all the content concerning the recognition procedure and everything related to it.

Quick overview:

Language (acquisition) (B1/B2)

Recognition Process

(Defizitbescheid / Anpassungslehrgang / Kenntnisprüfung / needed documents)

How do I get my visa?

Administrative procedures


In order to obtain a visa, you’ll need at least a B1 language certificate according to the Common European Framework of Reference for Languages ​​(CEFR) and a B2 level for your recognition. The B2 language certificate can also be obtained in Germany.

If you already have a B1 level, you will find an app here that you can use to playfully improve your German in the nursing profession.

Further helpful links regarding the language acquisition and the German language requirements in general: 

In the future, the language certificate will be based on a B2 technical language test (Fachsprachtest), i.e. a test for the technical language in the medical care profession. Some federal states are already preparing for the transition. Initially, this B2 specialist language test is to be introduced in Schleswig-Holstein, Hamburg, Bremen, Lower Saxony and Mecklenburg-Western Pomerania. General language courses will be offered as well as those that specifically prepare for the practice of nursing.

The “Regulation on job-related German language support” („Verordnung über die berufsbezogene Deutschsprachförderung“) – DeuFöV for short – is the legal basis on which professional language courses for the German language are carried out. The Federal Office for Migration and Refugees (BAMF) is responsible for conducting the DeuFöV courses. The BAMF allows public and private providers for this. Authorizations can be granted by the BAMF for persons in the recognition phase of their foreign professional qualification.


Recognition Process

In order to be able to work in Germany, you must have your degree recognized in Germany. To do this, you must submit an application for professional recognition. As soon as this has been done, you will receive a so-called Defizit- or Feststellungsbescheid (assessment/recognition notice). If you then do not have enough work experience or the appropriate professional qualification to receive a direct recognition, there are two ways to make up for your deficits:

Kenntnisprüfung (knowledge exam) or Anpassungslehrgang (adaptation course)

How does the recognition process work?

Shown as an example for the federal state of Hesse (should be similar in most federal states)

Application for recognition

Formal review

Have all documents been submitted?


Content review – Gleichwertigkeitsprüfung (equivalence assessment)

a) no significant differences ⇒ direct recognition

b) significant differences ⇒ can be compensated by professional experience ⇒ direct recognition

c) significant differences, no compensation through work experience is possible ⇒ no direct recognition ⇒ Defizitbescheid (recognition notice)


Feststellungsbescheid (Defizitbescheid)

Choice between:

a) Anpassungslehrgang (adaptation period)

b) Kenntnisprüfung (knowledge test)

What is a Kenntnisprüfung?

A Kenntnisprüfung (knowledge exam) is, as the name suggests, a test, that consists of an oral/theoretical and a practical exam. Before the exam, you will be prepared for everything in a preparatory course. The duration of this preparation differs depending on the federal state and organizer. Depending on the federal state, you can sometimes start the preparatory course with a B1 language certificate, but a B2 language certificate is usually required.

In your Defizitbescheid you will find more detailed information on what you will be specifically tested for in the practical and oral part of the examination. Candidates with regular training/education (4 years of middle school) are usually tested in the practical part for 2 care situations and retrainees* (2 years of middle school) for 4 care situations.

We are currently working mainly with Lingoda, who also offer a B2 language course before the preparatory course, if you only have a B1 language certificate. You can find the details on the preparation with Lingoda here (only in German):

What is an Anpassungslehrgang?

The Anpassungslehrgang (adaptation course) consists of a practical part and a final interview.

To put it simply, you can think of an adaptation course as a longer internship in different departments of a hospital (or other institutions). The adaptation course ends with a final interview. For the practical part of the training, a person qualified in this profession supervises the employee. The duration of the adaptation course and the required departments are also determined in the Defizitbescheid.

Depending on the federal state and the Defizitbescheid, the duration of the adaptation course is often indicated in hours or months. In our experience, the upper tolerable limit for the duration of an adaptation course is usually 9 months.

It is important to discuss both options with the employer beforehand and to see whether the necessary facilities or departments are available at all.

Simplified brief overview of required documents

*For non-recognized applicants (all documents must be sent in the native language and in German)

Applicants with a university degree (bachelor or master) generally submit the following documents:

CV with a photo (only in German)
Diploma of completed university education
Transcript of records
Language certificate B1 or B2 (only Goethe, ÖSD, telc and ECL are acknowledged)

Documents for candidates with a secondary education

  • CV with a photo (only in German)
  • Secondary school diploma
  • Report cards for grades 1 to 4
  • State Exam
  • Training certificate
  • Subjects list
  • Language certificate B1 or B2 (only Goethe, ÖSD, telc and ECL are acknowledged)
  • Professional license (only in some countries)

Documents for candidates with a recognition in Germany

  • Tabular CV (and a CV with a picture for us) 
  • Berufsurkunde – Certificate of entitlement (the document confirms that you are permitted to practice your occupation)
  • Language certificate – B2 level (only Goethe, ÖSD, telc and ECL are acknowledged)

* All documents are only required in German

Since each federal state requires the documents in a different form, it is safest if you first have the copies of all your original documents certified at the embassy and then have them translated by a publicly appointed and sworn translator.

IMPORTANT! However, it would be best if you contact us before preparing your documents so that we can advise you specifically according to your situation and the federal state you are interested in.

You can find a complete explanation for the application of the “Defizitbescheid” and all required documents for Hesse here:

All application forms for the Defizitbescheid by federal state

Here you will find links to all application forms and information sheets for the Defizitbescheid (deficit notice) for each federal state in Germany. Under the link to the respective page is a brief overview of how your documents must be certified and translated, whether the federal state also accepts retrainees, and particularities about the respective federal states, for example special regulations regarding language certificates.

How do I get my visa? – The immigration process

Fachkräfteeinwanderungsgesetz / beschleunigtes Fachkräfteverfahren (FEG)

Skilled Worker’s Immigration Act / fast-track admission procedure

If you come from a third country and not from the Balkans, we can help you to obtain your visa via the Skilled Immigration Act and the fast-track procedure for skilled workers (Section 81a of the Residence Act).  This procedure theoretically enables you to receive the visa within 4 months, which unfortunately is not always the case in practice.

For more information, you can watch this short and descriptive video:

You’ll find detailed information here:

If you want to read about our practical experience with the fast-track procedure for the federal state Rhineland-Palatinate, you can click our blog here (only German version):

The above mentioned process is currently the only process we accompany for candidates who are not from the Balkans.

You can find further information on this topic in the information brochure and here: 

Administrative procedures after your arrival in Germany

Here is just a brief overview of the things that need to be done as soon as you come to Germany:

Registration with the responsible registration authority

(Einwohnermeldeamt/Landratsamt – residents’ registration office/district office etc.)

-> Here you should receive your tax number (Steuernummer)

Registration at the immigration office/immigration office (Ausländerbehörde)

Opening of a bank account

Registration with the health insurance company

(We can help you with this last step. You are welcome to contact us a few days before your arrival in Germany.)