The Ultimate Guide to the Medical Language Exam (Fachsprachprüfung) in Germany: With Insider Tips for Foreign Doctors

The Fachsprachprüfung, often abbreviated as FSP, is an oral specialized language exam and official medical language exam that foreign doctors must pass in order to prove their proficiency in the German medical language. Successfully completing the exam requires a C1 level of German and the ability to apply your language skills and medical knowledge in real-life clinical situations.

The Fachsprachprüfung is, alongside the knowledge exam, a key component of the official licensing process (Approbation) for medical professionals. It is coordinated by the relevant state licensing authority. The exam is designed to closely reflect everyday hospital life and assesses how well you can communicate in a clinical setting—especially when dealing with patients and fellow healthcare professionals or a medical colleague during handovers and case discussions.

The Fachsprachprüfung is divided into three parts:

1. a doctor-patient discussion,
2. a written medical report, and
3. a doctor doctor conversation.

The examination board typically consists of licensed and experienced physicians as well as language experts who evaluate your ability to communicate effectively in a clinical context. Their goal is to determine whether you can safely and professionally interact with patients and colleagues in a German-speaking medical environment, based on your language proficiency.

To pass the Fachsprachprüfung, you need to demonstrate strong speaking, writing, and reading skills in each of these segments, as well as apply your medical knowledge in practical communication scenarios.

🔎 What Is the Fachsprachprüfung (FSP)?

The Fachsprachprüfung is a state-recognized medical language exam for foreign physicians. It assesses whether you have the German language and medical terminology proficiency at a C1 level required for the Approbation, i.e., your official license to practice medicine in Germany.

After passing the Fachsprachprüfung, you may be granted a temporary work permit (Berufserlaubnis), which allows you to practice medicine in Germany for up to two years under supervision. However, this permit is only valid in the federal state where it was issued.

For doctors from EU member states, the Berufserlaubnis is usually not required, as they can often apply directly for the permanent medical license (Approbation) needed to practice independently in Germany.

You’ll find detailed information about how to apply for the temporary permit, which documents are required, and what specific medical knowledge you need to demonstrate.. It’s important to note that the permit is typically tied to a specific job offer at a specific institution, such as a hospital or private practice.

If you want to practice medicine in Germany, strong German language skills are essential – for all medical professionals working in direct patient care. But it’s not just about speaking fluently – it’s about mastering the specific medical terminology and demonstrating your medical expertise in clinical settings, from symptoms and diagnoses to detailed treatment plans.

That means being able to clearly and accurately describe symptoms, diagnoses, the patient’s medical history, treatment plans, and medical procedures – often relying on a medical dictionary to build and reinforce your vocabulary during preparation.

This is precisely what the Fachsprachprüfung is designed to assess: your ability to work safely and confidently in German hospitals, where clear and professional communication is essential. As part of the recognition process based on Germany’s Federal Medical Regulations (Bundesärzteordnung), the Fachsprachprüfung evaluates whether you can express yourself professionally – both with patients and colleagues alike – and demonstrate strong communication skills in a profession-specific context within the medical field.

Once you pass, you’ll receive an official certificate confirming your language proficiency in the medical context, which is a key requirement for obtaining your Approbation.

Internal medicine is one of the core fields assessed in the Fachsprachprüfung, as it plays a central role in daily practice at German hospitals. Whether you're dealing with chronic diseases, acute infections, or diagnostic procedures, you must demonstrate that you can clearly articulate complex cases in German—both with patients and colleagues.

The Fachsprachprüfung typically takes about 60 minutes and is structured as an individual examination, usually conducted in a separate room, and divided into three distinct parts:

1. Doctor–Patient Interview (approx. 20 minutes)
2. Medical Report Writing (approx. 20 minutes)
3. Doctor–Doctor Discussion (approx. 20 minutes)

Each section is designed to reflect real-life situations in a clinical environment and requires you to demonstrate practical language skills across speaking, writing, and listening comprehension in medical scenarios. The examination board evaluates your performance based on clear criteria such as accuracy, fluency, and medical appropriateness of your communication.

The examiner acting as a simulated patient may show signs of confusion, anxiety, or frustration—your task is to remain calm, professional, and empathetic while guiding the conversation effectively.

In this section, one of the examiners will play the role of a patient. Your task is to conduct a complete medical history interview (anamnesis). You’ll need to ask questions about the patient’s symptoms, medical history, family history, medication history, pre-existing conditions, and potential risk factors.

You are allowed to take handwritten notes during the anamnesis.

At the end of the conversation, you should explain your initial diagnosis to the “patient” and discuss any necessary further investigations or treatment steps.

💡 Important:

• Use patient-friendly communication. Explain technical terms in a way the patient can understand.
• Stay calm and professional, even if the patient appears anxious, uncertain, or emotionally distressed, especially when cultural differences or unfamiliar expectations come into play.
• Always treat the conversation as confidential and handle the patient’s personal data responsibly and in accordance with medical standards.

Immediately following the doctor–patient conversation, you’ll move on to writing a formal doctor's report or medical report. This section tests your ability to document the patient interaction clearly, correctly, and using appropriate medical terminology with as few foreign words as possible.

Your task is to summarize all relevant information obtained from the conversation in a structured format. Don’t forget, you may use the written notes you took during the anamnesis to structure your report clearly and accurately.

💡 Important:

• Use professional medical language – no informal or colloquial expressions.
• Pay attention to grammar and spelling – accuracy matters.
• Structure your report clearly, with logical sections such as anamnesis, clinical findings, suspected diagnosis, and recommended treatment.

In the final part of the exam, the examiner takes on the role of a senior physician (e.g. a consultant or attending). Your task is to present the patient case from the anamnesis in a clear and structured manner, using the information obtained during the doctor–patient interview.

You’ll be expected to summarize the patient case, explain your suspected diagnosis, and justify your proposed diagnostic and treatment plans. The examiner will ask questions to test your ability to communicate clinical decisions precisely, using accurate medical terms, professional language, and appropriate medical expertise.

💡 Important:

• Use accurate and confident medical terminology.
• Avoid vague language or misunderstandings—especially those that could lead to misdiagnoses or treatment errors.
• Communicate as if you were handing over the patient in a real clinical setting.

🔎 In Lower Saxony, an additional task is included in this section: you must translate 12 medical terms between technical and everyday language—both directions (e.g., from medical to colloquial German and vice versa).

To pass the medical language exam, you’ll need to demonstrate a mix of language proficiency and medical knowledge relevant to daily clinical work – in other words, the skills you need to practice medicine safely and effectively in Germany.

✅ Use C1-level German fluently without long pauses or frequent searching for words

✅ Show strong listening comprehension to understand patient concerns and clinical instructions precisely

✅ Apply correct and precise medical terminology

✅ Describe common clinical conditions such as pneumonia, acute coronary syndrome, or migraine – many of which fall under the field of internal medicine.

✅ Communicate clearly and empathetically with patients, using layman’s terms when needed

✅ Describe common clinical conditions such as pneumonia, acute coronary syndrome, or migraine, and explain relevant medical procedures in a clear and structured way.

💡 Tip: The exam doesn’t test deep academic knowledge. It focuses on your ability to communicate medical information clearly and correctly in the German medical language, based on typical medical cases from everyday clinical practice. This applies across all federal states, no matter where the exam takes place.

If you want to prepare effectively, a practice-based preparation course can help you become familiar with typical conversation structures and real-life scenarios, while reducing anxiety.

During the exam, it's helpful to rely on clear structure, confident communication, and your written notes from the patient interview to support your case presentation and report writing.

Consistent practice is key to building confidence and fluency before exam day.

👉 You can find a tailored training option here.

Don’t panic – failing the Fachsprachprüfung doesn’t mean the end of your journey. You’re allowed to retake the medical language exam as many times as needed.

However, keep in mind:

• Each attempt comes with additional fees
• Some state medical councils (Landesärztekammern) require you to wait several weeks or months before you can reapply

The most important step after a failed attempt is to reflect:

❗ Was it a lack of preparation in medical German?

❗ Was it stress or exam nerves?

A focused preparation can make all the difference next time. You might benefit from a specialized Fachsprachprüfung course or our mobile app ApproLearn, which trains you in realistic scenarios and helps you build confidence in your Medical German.

👉 When choosing a course, make sure it includes authentic exam questions and realistic simulations. That’s how you’ll get the most out of your learning time—and step into your next attempt feeling more prepared and self-assured.

The cost of the Fachsprachprüfung (FSP) can vary significantly depending on the federal state in which you take it. On average, the exam fees range from €350 to €650 (as of September 2024).

But don’t forget: in addition to the official exam fee, you should also budget for:

• Preparation courses
• Study materials
• Language training

These additional costs are highly individual and depend on your current level of medical German, the course provider, and the intensity or duration of your preparation.

Example: In Lower Saxony, the current fee for the Fachsprachprüfung is €490. Beyond this, you should also factor in the cost of materials or courses you may need to feel confident and prepared.

Even though these costs can add up, investing in proper preparation can save you money and stress in the long run—especially if it helps you pass on the first try.

Comprehensive statistics across all German states are hard to come by, as they’re collected differently by each State Medical Council (Landesärztekammer). However, regional data from Berlin show that approximately one-third of candidates fail the Fachsprachprüfung, which means over 60% pass.

This means you stand a solid chance of success—especially if you prepare deliberately.

✅ Looking for guidance? Our free e‑Guide walks you steadily through the licensing process, so you know exactly what to register, when, and where—helping you get started as a doctor in Germany as quickly as possible.

👉🏾 Register now – it's free

Each federal state in Germany has its own State Medical Chamber (Landesärztekammer) or medical association that is responsible for organizing and conducting the Fachsprachprüfung. These authorities set the exam dates, define the procedures, and serve as your first point of contact for questions regarding registration.

You can find an overview of all State Medical Chambers in Germany here, including the most important email addresses and links for additional information about the Fachsprachprüfung in each region.

👉 Important: In most states, registration for the Fachsprachprüfung is only possible after you’ve applied for your Approbation or temporary work permit (Berufserlaubnis). In many cases, the responsible authority or medical chamber will contact you directly with further instructions.

💡 Some medical chambers also offer phone consultation hours. If you don’t receive a response to your email, a quick call might get you the information you need faster.

• Registration is handled by the regional government.
• The Bavarian State Medical Chamber (BLÄK) will contact you after reviewing your application.
• Direct email registration is not possible.
• You’ll find more details about the Fachsprachprüfung in Bavaria on the BLÄK website.

• Once you receive confirmation from the State Office for Health and Social Affairs (LAGeSo),
  you can submit your documents to the Berlin Medical Chamber via email.
• The exact email address is provided in the online registration form.
• Alternatively, you’ll find contact details directly on the Medical Chamber’s website.

• Submit your application via email or post to the State Office for Social Services of Schleswig-Holstein (LASD).
• You can download the application form here (PDF).
• Email address: [email protected]

• After registering via the online portal of the Hessian State Medical Chamber, you can sign up for the Fachsprachprüfung.
• For questions, use this dedicated email: [email protected]

In most states, you cannot register for the Fachsprachprüfung by email alone. Instead, you’ll usually need to go through an online platform or wait for an official request from the relevant authority. Email is typically used for follow-up questions or document submission once you’re in the system.

💡 Tip: Always check the website of the State Medical Chamber or Health Authority you are attempting to practice in, as procedures and contact details may change.

In most cases, you must first apply for Approbation or Berufserlaubnis. After that, you’ll automatically receive an invitation to the Fachsprachprüfung.

Please note: the certificate is only issued once you’ve passed all parts of the exam.

🔎 Still unsure which federal state is right for your licensing process? Check out our blog article on choosing the right state for helpful insights.

Passing the Fachsprachprüfung requires more than general language skills or fluency. It demands a specialized vocabulary and communication style used in clinical settings. That’s why many foreign physicians choose to prepare with a language school that offers tailored Medical German courses.

A good language school can provide structured lessons, simulated patient interactions, and targeted feedback to help you feel confident on exam day. The most effective programs include focused training in medical terminology, helping you internalize the medical language and professional expressions you’ll need to communicate clearly and safely in a clinical environment.

Practicing realistic patient interactions not only improves your medical vocabulary but also helps you build the confidence needed to communicate effectively in stressful clinical situations.

Make sure to choose a provider with experience in FSP preparation, a strong track record of successful graduates, and a clear focus on preparing you for the medical language exam. Some courses even offer specific practice in translating everyday language into accurate medical terms, a key skill tested in many federal states. These exercises are most effective when paired with consistent practice in realistic clinical scenarios.

Many international doctors choose to prepare with specialized online courses that simulate real exam conditions and focus on communication in clinical settings.

👉 At Get2Germany, you’ll find focused exam coaching and online courses designed specifically for the Fachsprachprüfung, including intensive practice with medical communication and medical terminology.

The Fachsprachprüfung (FSP) is one of the most important milestones in your recognition process.

It’s your gateway to becoming a licensed physician in Germany – and to being allowed to practice medicine within the German healthcare system.

With the right preparation and a smart, structured study plan, you can pass this exam with confidence –whether you're aiming to work in internal medicine, surgery, general practice, or any other clinical field.

🎯 Ready for the next step? Choose the FSP course that fits your goals and start practicing now—with real exam questions and expert feedback.

• How many times can I retake the FSP?
  You can retake it unlimited times, but each attempt requires paying the exam fee again.
• How many times can I retake the FSP?
  You can retake the FSP as many times as necessary. There is no official limit.
  However, you’ll have to pay the exam fee each time, and some states may impose waiting periods between attempts.
• Is the Fachsprachprüfung the same as a medical language exam?
  Yes. The Fachsprachprüfung is Germany’s official medical language exam for foreign-trained doctors and a required step in the Approbation process.
• Do I need the Fachsprachprüfung to get my medical license in Germany?
  Yes. For all foreign-trained doctors (except certain EU nationals), passing the FSP is a mandatory step in the Approbation process.
  It proves you have the language skills required to properly treat patients in German.
• How long does the exam take?
  The exam lasts 60 minutes in total, split into three parts of about 20 minutes each:
  Doctor–patient conversation, Written medical report, Doctor–doctor conversation
• Is there a written exam?
  Not in the traditional sense. The Fachsprachprüfung is primarily oral, but the medical report you write during the exam is assessed as a written component.
• Where can I take the Fachsprachprüfung?
  The exam is organized by the State Medical Chamber of the federal state where you submitted your Approbation application.
  Registration and scheduling usually happen via email or official portal after your application has been processed.
• Who can support me with the application process?
  Inside our digital eGuide, you can ask real doctors your questions and receive customized support for your recognition journey.
  Our team is happy to help you through each step.
  You can also connect with other international doctors in our free community to exchange tips on the exam, share study resources, find language partners, or discuss preparation strategies. Unlike many public online forums, the Get2Germany platform offers a safe and professional space moderated by experts who understand the recognition process in detail.
  Log in here
• Which course best prepares me for the Fachsprachprüfung?
  Looking for a flexible, online solution with real exam simulations and expert guidance?
  Check out our FSP and knowledge exam courses here and find the perfect fit for your schedule and learning style.
• How much medical knowledge do I need for the Fachsprachprüfung?
  While the focus is on language, many examiners in recent years have also started testing basic medical knowledge. You don’t need deep academic expertise, but you should understand common clinical topics and be able to describe symptoms, diagnoses, and treatments clearly—both in technical and patient-friendly terms.