Fachsprachprüfung for doctors in Germany: three 20-minute parts, a fee from €420 to €600, and a pass rule that depends on your chamber
The Fachsprachprüfung (FSP) is the German language exam a doctor trained abroad needs for the Approbation or a temporary Berufserlaubnis. The format comes from a 2014 decision of the health ministers' conference and is the same three parts everywhere we read: 20 minutes each, 60 in all. The level is orientated to C1, in a medical setting.
The fee, the pass rule, the aids allowed and how fast you get the result are not the same. They depend on the state body running your exam. Below are six of them, each from its own page, read on 5 November 2026.
The three parts
1. Doctor and patient (20 minutes). You take a history from a simulated patient and explain findings, next steps and options. In Thuringia a medical member of the committee plays the patient, and clear language with few technical terms counts here.
2. Documentation (20 minutes). You write up that conversation as a doctor's report.
3. Doctor to doctor (20 minutes). You present the case to a medical examiner and answer questions. Thuringia ends this part with a short list of medical terms for which you write the German word.
Your medical knowledge is not what is tested. Lower Saxony's information sheet says so in one line: "Das ärztliche Fachwissen wird in der Fachsprachprüfung nicht überprüft." Berlin says the same.
What it costs, by state
These are the figures on each body's own page. Nordrhein and Bavaria write "derzeit" (currently); Lower Saxony's sheet is dated 1 January 2026; the others carry no date in the passage we read. We could not open the page of the Westfalen-Lippe chamber, so it is not in this table.
- Baden-Württemberg€420Same fee again for each retake
- Nordrhein€430Paid after the chamber asks for it
- Bavaria€550Paid after the chamber's email
- Berlin€550Same fee again for each retake
- Lower Saxony€595Paid to NiZzA, only once asked
- Thuringia€600Paid again for each retake
The pass rule is not one rule
Nordrhein: three examiners each fill in a sheet worth up to 20 points, 60 in total, and 36 points overall is a pass. On that wording, one weak part can be carried by the others.
Berlin: also 60 points, but the page says the exam is passed when at least 60% is reached in each part.
Lower Saxony states no points: you pass when the assessors find that you meet the language requirements.
Our reading: if your preparation assumes that a strong conversation will rescue a weak report, check your own chamber's rule first. In Berlin it will not.
Other differences that change your preparation
Aids. Thuringia lets you use your notes for the report and has a medical dictionary available. Nordrhein gives you a notepad and a pen and says no other aids are allowed; the notes are not marked.
The result. Thuringia tells you straight after the exam. Berlin says the result is ready ten days later at the earliest, by email.
Examiners. Thuringia and Nordrhein have three. Berlin and Lower Saxony say at least two, with at least one a doctor.
Registering. Thuringia asks for a general German certificate of at least B2 when you register. In Lower Saxony and Nordrhein you do not register in person: the authority handling your application passes you on.
Retakes, cancelling and moving state
Retakes are not capped in Lower Saxony, Baden-Württemberg, Berlin or Thuringia. In Lower Saxony and Berlin you repeat the whole exam, not just the part you failed. Nordrhein suggests leaving a few months between attempts for more language training.
Cancelling can cost you the fee. In Thuringia the fee is not refunded if you cancel after the invitation. In Berlin, cancelling with good reason costs €100; without one, you register and pay again. In Lower Saxony you still pay for the slot if you miss it and nobody can take your place.
A pass in one state is not automatically a pass in another. Berlin says the approbation authority of the other state decides. Bavaria says its central recognition office checks each case. Ask before you move.
Mistakes worth avoiding
Quoting one national fee or one national pass mark.
Reading the page of the body that will run your exam.
On the pages we read, fees run from €420 to €600, and Nordrhein and Berlin word the pass rule differently.
Treating a general B2 certificate as enough.
Preparing for medical communication orientated to C1.
Thuringia asks for B2 only to register. The exam itself is orientated to C1.
Revising medicine for the exam.
Practising the history, the report and the handover in German.
Lower Saxony and Berlin both say medical knowledge is not what is tested.
Questions
How long is the Fachsprachprüfung?
Three parts of 20 minutes each, 60 minutes in all: doctor and patient, documentation, doctor to doctor.
How much does the Fachsprachprüfung cost?
It depends on the state. On the pages we read on 5 November 2026: €420 in Baden-Württemberg, €430 in Nordrhein, €550 in Bavaria and Berlin, €595 in Lower Saxony and €600 in Thuringia.
What level of German does the Fachsprachprüfung need?
It is orientated to C1, in a medical setting. Thuringia also asks for a general certificate of at least B2 when you register.
How many times can I retake the Fachsprachprüfung?
Lower Saxony, Baden-Württemberg, Berlin and Thuringia set no limit. Baden-Württemberg, Berlin and Thuringia charge the fee again each time.
Is a Fachsprachprüfung from one state valid in another?
Not automatically. Berlin says the other state's approbation authority decides, and Bavaria's central recognition office checks each case.
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