Kenntnisprüfung 2026 third countries: What will change for foreign doctors from November
On March 26, 2026, the Bundestag passed the Act to Accelerate the Recognition Procedure for Foreign Professional Qualifications in Healthcare Professions. Pending approval by the Bundesrat, it will enter into force on November 1, 2026 – changing the rules for every doctor with a degree from a third country.
The most important consequence in one sentence: The Kenntnisprüfung will become the standard. The document-based Equivalency Examination – the years-long administrative process many of us know – will lose its priority.
TL;DR
- From November 1, 2026, the Kenntnisprüfung is the standard path to Approbation for all third-country doctors.
- The Equivalency Examination remains possible only as an optional application – it is no longer the first step.
- The Federal States are permitted to test language skills before the professional qualification exam.
- For EU/EEA/Switzerland, there is additionally the new partial Berufserlaubnis.
- If you are currently in the application process: clarify transition rules, do not wait.
What has changed specifically?
Previously, the path for most third-country colleagues was: Application for Approbation → Equivalency Examination of documents → if “significant differences” were found → Kenntnisprüfung or adaptation period. The administrative process took 12 to 24 months in many Federal States, and in some cases longer.
The new law reverses this logic. Quote from the Federal Ministry of Health announcement: “The direct Kenntnisprüfung is to become the standard.” Thus, the exam is no longer a consequence of a “deficit,” but a professional licensing exam with a uniform benchmark – the same standard as for German graduates, just as an exam at the end.
The crucial point: It is no longer about whether a degree from Damascus, Baghdad, Cairo, or Karachi is “equivalent” to Heidelberg. It is about whether you pass the exam. Period.
Who is affected?
Directly affected:
- Doctors with a degree from a third country (anywhere outside EU/EEA/Switzerland)
- Dentists and pharmacists with the same requirements
Not affected by the KP requirement:
- EU/EEA/Switzerland graduates – automatic recognition under Directive 2005/36/EC still applies to them. New here is the possibility of a partial Berufserlaubnis.
Special case for midwives: Here, too, the procedure is being streamlined, but the KP requirement for third countries applies explicitly to doctors, dentists, and pharmacists.
If you are a Syrian, Iraqi, Jordanian, Egyptian, Lebanese, Palestinian, Moroccan, Tunisian, or Algerian doctor – in short: from any Arabic country – you fall under the new rule. The same applies to colleagues from Ukraine, Russia, Turkey, India, Pakistan, Iran, Afghanistan, and all other third countries.
Timeline
| Date | Event |
|---|---|
| October 1, 2025 | Cabinet decision on the draft law |
| March 26, 2026 | Bundestag passes the law |
| Q2/Q3 2026 | Bundesrat consideration (approval required) |
| November 1, 2026 | Planned entry into force |
The Bundesrat approved the law in its 1065th session on May 8, 2026 (Item 7). Entry into force: November 1, 2026. (Sources: bundesrat.de, bundesgesundheitsministerium.de)
Practical implications – what does this mean for your planning?
1. Less waiting time at the beginning – more pressure at the end
The licensing authority will no longer make you wait 18 months for an equivalency notice. Good. At the same time, the “buffer” in which many colleagues prepared on the side is gone. Anyone applying in November 2026 will receive a KP appointment faster – and must be truly prepared by then.
2. The KP becomes the only bottleneck
Previously, bottlenecks were distributed: document review, translations, waiting lists for the KP. In the future, everything will concentrate on the exam itself. Expect longer waiting periods for KP appointments in the large Federal States (NRW, Bavaria, Baden-Württemberg, Hesse).
3. Language exam can be brought forward
“The states are given the opportunity to test the language skills of applicants from third countries before the professional qualification exam.” In plain English: Some states will require the FSP or a recognized C1 certificate as a prerequisite for admission to the KP. This is not new everywhere, but it will become the nationwide standard.
4. The Equivalency Examination remains – as an option
Those with a very strong CV including European Approbation, US Boards, or comparable qualifications can still apply for equivalency. For 95% of third-country colleagues, however, this is not the practical path.
Preparation Roadmap: What do you do now?
If you have not yet submitted an application (recommendation: wait until November 2026):
- Complete B2, start C1. Telc Deutsch B2-C1 Medizin or Goethe C1 are the accepted formats.
- Start FSP preparation. Patient consultation, medical report, doctor-to-doctor communication – the format does not change due to the new law.
- Build up KP material in parallel. Internal Medicine, Surgery, Emergency + cross-sectional subjects (Pharmacology, Forensic Medicine, Hygiene).
- Decide on a Federal State. Fees and waiting times differ significantly – see our FSP & KP Comparison NRW vs. Hesse.
- Inquire in writing with the licensing authority to find out under which regulation your procedure will continue. Transitional provisions are provided for in the law.
- If you have already been offered a KP appointment: accept it, do not postpone.
- If you are waiting for an equivalency notice: clarify whether you can switch directly to the KP.
- FSP-Simulator — 87 klinische Fälle kostenlos üben
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If your application is already in progress:
If you are already admitted to the KP:
Nothing changes for you. Focus on the exam.
FAQ
1. Do I have to take the KP if I come from Syria/Iraq/Egypt?
As of November 1, 2026, yes, in the standard procedure. You can optionally apply for the Equivalency Examination, but it is no longer the standard path.
2. Will the KP become harder because of the new law?
No. The scope of the exam (using the second section of the Medical Examination as a benchmark) remains. What changes is the path to get there – not the exam itself.
3. Does the law also apply to pending applications?
The law provides for transitional arrangements. Anyone who submitted a complete application before November 1, 2026, should actively inquire with the authority.
4. Do I still need the FSP?
Yes. FSP (or a recognized C1 Medical certificate) remains a requirement for Approbation. The only new aspect is that individual states can bring forward the language exam as a prerequisite for admission to the KP.
5. Will my total time until Approbation be shortened?
Realistically: yes, if you are well prepared. Instead of 24 months of administrative processing + 6 months of KP preparation, you will largely save the administrative part. However, the KP itself must still be passed.
What we do at Kennti
We are currently preparing our KP materials for the new legal situation: updated case collections, Live Course 2026 with a focus on the direct KP, and state-specific strategy guides. If you are already planning, this is the right moment to join.
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Last update: May 28, 2026. Status of legislation: Bundestag resolution of March 26, 2026, Bundesrat approval pending. We will update this article as soon as changes occur.
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