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In brief
Nurses from abroad may only work as qualified nurses in Germany after recognition and with an authorisation to use the professional title. Offices of the federal states are responsible, and if differences to the German training remain, an adaptation course or a knowledge test usually follows. The procedure includes proof of German language skills, and the responsible office names the level.
Nursing as a regulated profession
In Germany the professional title in nursing is protected. Only people with a state authorisation may work as qualified nurses. This applies to people with German training as much as to people with a foreign qualification.
For foreign qualifications this means: no recognition, no authorisation. Here recognition matters not only for the visa but for the work itself.
In many countries of origin nursing is a degree course, in others a vocational training. Both can lead to recognition. What is assessed is always the individual qualification, not the country.
Until the authorisation is granted, a person can in some cases work as a nursing assistant. Whether and how depends on the residence permit and on the rules of the federal state. Clarify this before entry.
The responsible offices of the federal states
Recognition in nursing is decided by offices of the federal states. Each state determines itself which authority that is. What usually counts is the state in which the work is to be taken up.
The portal Recognition in Germany leads you to the right office through a search. You enter the occupation and the place of work and receive the address. The list of required papers is there as well.
Fix the place of work before the application. Moving to another federal state during the procedure can mean that a different office becomes responsible.
Equivalence and the decision
The office checks whether the foreign training essentially corresponds to the German one. It compares content, scope and practical parts. Work experience can make up for differences. A fee is charged for the assessment, and the office names the amount.
At the end there is a decision. It either confirms full equivalence or names the substantial differences. In nursing, a decision naming differences is common.
The decision is an important document. It shows which content is missing and how it can be made up. Keep a copy in the company.
- Final certificate and proof of the content and hours of the training
- Proof of work experience in nursing
- Passport or identity card
- Translations and certifications as required by the office
- Further documents the office asks for, for example on fitness for work
Compensation measures
If the decision names differences, they can be compensated. There are two routes for this: an adaptation course or a knowledge test.
The adaptation course takes place in practice, often in a care facility with classes alongside. It ends with a final interview. The knowledge test is an examination with an oral and a practical part.
In many cases the nurse can choose between the two routes. The responsible office will tell you what applies in the individual case. Choose the route together, based on prior knowledge, language and what the company can offer.
Once the compensation measure has been passed, the office grants the authorisation to use the professional title. From then on the person can work as a qualified nurse.
Proof of language skills
Sufficient German is part of the authorisation. Which level is required and which proof counts is stated by the responsible office. In many states an examination of professional language comes on top.
Professional language is about everyday work on the ward. This includes handovers, documentation and conversations with patients and relatives. A general course often does not prepare people well enough for this.
Plan for the language early. In nursing it is often the longest part of the route. A course in the country of origin and another one in Germany are not unusual.
What the company prepares
The application is the nurse's task, but the company can contribute a great deal. Above all it can make the compensation possible in-house.
Talk to the team early as well. Colleagues who accompany the course need time and clear tasks. A good start on the ward helps the nurse more than any brochure.
- Offer or arrange a place for the adaptation course
- Name a practical instructor and plan time for this in the roster
- Support preparation for the knowledge test and the professional language
- Clarify the permitted work until authorisation with the responsible office
- Agree on translations, certifications and fees
Routes through the recognition partnership
In some cases a nurse can enter Germany before recognition is completed. That is the route of the recognition partnership. Company and nurse commit to completing the procedure in Germany.
For nursing this is an obvious route, because the compensation often takes place in the company anyway. The detailed conditions are stated by the mission abroad and the foreigners authority.
Our article on the recognition partnership has more on this.
Frequently asked questions
May a nurse work as a qualified nurse before recognition?
No. Only people with the authorisation may work as qualified nurses. Work as an assistant is possible in some cases if the residence permit allows it.
Who chooses between the adaptation course and the knowledge test?
In many cases the nurse. The responsible office of the federal state will tell you what applies in the individual case.
Which language level does a nurse need?
The responsible office sets it. An examination of professional language often comes on top. Ask there before you plan.
Which office is responsible?
An authority of the federal state in which the work is taken up. The portal Recognition in Germany gives the address.
Who applies for recognition?
The nurse, often while still in the country of origin. The company can help with the papers and take over costs. Put any such arrangement in writing before entry.
- For Employers How Regalis works with employers: capture requirements, present candidates, coordinate entry and the start of work. Direct employment, no staff leasing.