After passing the knowledge exam or having the training recognized as equivalent, all professional requirements for the granting of the Approbation have been met. In most federal states, the application for the Approbation was already submitted at the start of the recognition process, meaning no new application is necessary. In some federal states, however, a separate final step may be required. This should be clarified with the competent authority.

Receiving the Approbation certificate

Once all requirements have been met, the authority issues the Approbation certificate and sends it by post. The duration of this final step is not set by law. In practice, processing after submission of the last passed exam result can take several weeks to several months, depending on the workload of the competent authority. It is therefore advisable to ask the authority about the expected timeline after submitting the final proof. Those who still hold a valid temporary professional license in the meantime may continue working under its conditions.

What the Approbation means

With the Approbation certificate, the recognition process is officially complete. The Approbation permits fully independent professional practice without restrictions and without supervision by third parties. It is also the fundamental prerequisite for specialty training as well as for setting up an independent practice. Unlike the temporary professional license, it is valid nationwide and permanently. Moving to another federal state does not require a new application.

Validity of the Approbation

The Approbation is valid for life. Revocation is possible in certain circumstances, however. The grounds for this fall into three categories:

• Health-related reasons – such as an addiction that puts safe professional practice at risk
• Serious medical errors or medically unjustified procedures
• Criminal offenses – committed both in professional and private context

A single breach of professional duties does not automatically lead to revocation. Each case is assessed individually.

Mandatory membership in the professional chamber

Those holding the Approbation in medicine, dentistry, or pharmacy are required to register with the competent state chamber upon taking up practice. In medicine this is the state medical association, in dentistry the state dental association, and in pharmacy the state pharmaceutical association. Registration is determined by the place of practice. The chambers are responsible, among other things, for professional oversight, compliance with professional regulations, further training, and the recognition of additional professional qualifications.

Next steps

With the Approbation, all professional legal requirements for entering the workforce have been met. To work as a healthcare professional in Germany, however, one further step under employment law is necessary: those already living in Germany generally need to have their residence permit reviewed and adjusted. The visa used during the process does not usually automatically authorize full employment. Those still abroad must instead apply for the appropriate work visa. Only with this step is the path to unrestricted professional practice in Germany fully complete.
The next professional step is taking up work in the relevant field, within which further qualifications and specializations can be pursued.