What German level do nurses need in Germany? B1, B2 and exceptions

The German language level for nurses in Germany is generally B2. You need this level to receive the licence and work under the protected registered-nurse title. The competent state authority decides which certificate it accepts. Some recognition routes, especially a recognition partnership, can allow entry with A2, but that does not yet grant the nursing licence or unrestricted permission to work as a registered nurse. You complete the recognition and reach the required B2 while working only within the duties and conditions your residence and professional status allow.

This guide explains the German language level for nurses in Germany at each stage: the visa, the recognition process and the licence. It also covers which certificates count. And it explains what "working without German" means in practice.

If you only wanted the word: a registered nurse in German language is a Pflegefachfrau, Pflegefachmann or Pflegefachperson. The first is the female form, the second the male form and the third is gender-neutral. In everyday speech you will also hear Krankenschwester (the older word for a female nurse).

The nursing law is the Nursing Professions Act (Pflegeberufegesetz). It lists four conditions for the licence:

• you finished your training,
• you are reliable,
• you are healthy enough for the job,
• you have the German skills to work in the profession.

The law does not name a level. In practice the offices ask for B2. B2 is a level on the Common European Framework of Reference for Languages (CEFR). This scale goes from A1 to C2. The federal portal Make it in Germany says it plainly: for recognition you need at least B2.

At B2 you can follow longer conversations. You can read work texts such as care plans. You can write clear reports. A nurse in Germany does all of this in German:

• handing over patients at shift change,
• writing the care documentation (written records of the care given),
• talking with doctors and families.

Handovers, care records and talks with doctors all happen in German.

• Opportunity card (Chancenkarte, a visa to look for a job): German level: A1 (beginner) German or B2 English; better German gives extra points; Where to read the rule: Residence Act
• Visa for a recognition partnership (Anerkennungspartnerschaft, you work while your recognition is finished): German level: At least basic German (A2); Where to read the rule: Residence Act
• Visa for an adaptation course or knowledge exam in Germany (two ways to close gaps in your training): German level: The level your course or exam needs, as a rule at least A2; Where to read the rule: Residence Act
• Licence as a registered nurse (Erlaubnis, the official permit to work): German level: B2; Where to read the rule: Nursing Professions Act and state practice

The Residence Act (Aufenthaltsgesetz) uses German words for the levels:

• "hinreichende" German means A2,
• "ausreichende" German means B1 (intermediate),
• "gute" German means B2.

The visa: A2 can be enough to enter

Since 1 March 2024 there is the Anerkennungspartnerschaft (recognition partnership). With this visa you work while your recognition is finished. You need:

• a job offer,
• a written agreement with your employer about the recognition process,
• German at A2 or higher.

You start the recognition after you arrive. You work while you complete it. Some jobs need a state licence, such as nursing. For these jobs, Make it in Germany says you can work as an assistant until you get your licence.

A2 is the legal minimum for this visa. Make it in Germany also gives a warning. Some professions need a higher level for the courses or exams in Germany that close gaps in your training. An employer or course provider can set its own, higher entry level. So check what your job offer says before you sign.

Recognition: B2 by the end

You do not need B2 on the day you apply for recognition. The states ask for it later:

• In Bavaria, the Landesamt für Pflege (state office for nursing) asks for the B2 certificate only before it issues the licence document. It sends you a separate letter when it is time.
• In Hesse, the state office is the HLfGP (Hessisches Landesamt für Gesundheit und Pflege, the state office for health and nursing). It wants the proof at the latest after you finish the adaptation course or pass the exam.

Until you have B2 and your licence, you do not work as a registered nurse. In March 2026 the Berlin health department wrote about people who failed the language exam. They can keep working as a Pflegehilfsperson (nursing helper). They can also continue their adaptation course while they repeat the exam.

Check your state's list of accepted certificates before you book an exam.

Each state publishes its own list, and the lists differ. Here is the list from Bavaria (dated 10 June 2025):

• Goethe-Zertifikat B2 and Goethe-Zertifikat B2 PRO Pflege (Pflege means nursing)
• TestDaF at level TDN 3 (the lowest TestDaF pass grade)
• telc Deutsch B2, and telc Deutsch B2 Pflege from the exam telc Deutsch B1·B2 Pflege
• ÖSD Zertifikat B2
• German Test for Work (Deutsch-Test für den Beruf, DTB) B2 from the BAMF (Federal Office for Migration and Refugees)
• ECL B2 from AFU GmbH (exam date from December 2020), the B2 certificate from Worldwide Bildungswerk and the nursing language exam from BSB Deutschland GmbH

Hesse's list (dated 24 July 2024) is similar. It also accepts:

• telc Deutsch B2 Beruf and B2+ Beruf (Beruf means work),
• the Goethe-Test PRO Pflege,
• the ECL B2 certificate from AFU.

Hesse usually accepts a Fachsprachenprüfung (state nursing language exam) passed in another state. The condition is that the office of that state accepts it. Lists also change. For example, Bavaria stopped accepting telc certificates from telc institutes in Serbia and Bosnia from 23 June 2022.

In Bavaria you do not need a certificate in three cases:

• German is your first language,
• you finished at least ten years at a German-language school,
• you finished a three-year vocational training in German.

Before you book an exam, find your state office on the Anerkennung in Deutschland portal (the federal website on recognition). Read its current list.

There are three kinds of exams you will hear about.

General B2 exams test everyday and general topics. Examples are the Goethe-Zertifikat B2, telc Deutsch B2 and ÖSD B2. They are offered in many countries. Our post on the German B2 exam explains how they work.

Nursing-specific exams at B2 use work situations. telc describes telc Deutsch B1·B2 Pflege as a specialist language exam (a test of the German used at work). It is meant for people who finished nursing training and want to work as nurses in German-speaking countries. It is one exam that covers two levels. The licence needs the B2 result. The Goethe-Zertifikat B2 PRO Pflege is the Goethe-Institut's nursing exam.

The Fachsprachenprüfung Pflege is a third type. It is a state language exam for nurses with role plays (FSP Pflege for short). Berlin introduced its FSP Pflege B2 in June 2024. Bavaria offers an FSP-Pflege and treats it as equal to the other B2 certificates. Bremen runs its own Fachsprachenprüfung B2 Pflege. So ask Bremen's office whether it still accepts a general B2. In March 2026 the Berlin Senate (the city's government) wrote that there is no decision yet on when general B2 certificates will stop counting. It added that the states are at very different stages. For now, check with your state whether a general B2 is still enough.

Does your office accept both kinds? Then the general exam is easier to find and book. The nursing exam trains the language you will use on the ward.

Not as a registered nurse: the Nursing Professions Act has no English-language route to the licence, and offices ask for German at B2 (the Bavarian exceptions apply only to people who already learned in German). With A2 and a recognition partnership, you can enter and work as an assistant while you finish recognition. With B2 English and no German at all, you may apply for the Chancenkarte (opportunity card) under § 20a AufenthG in one of two ways: either you already count as a skilled worker, meaning your qualification is fully recognised, plus proof you can support yourself; or the points route, which needs a qualifying foreign qualification (recognised in your home country: at least two years of vocational training, or a university degree) or partial recognition, plus 6 points, plus German A1 or English B2, plus proof you can support yourself. Either way, the nursing licence itself still needs German B2 later. We cover this topic in more depth in a future post. If you want to start in a helper role first, read our nursing assistants page.

From zero to B2 takes about 600 teaching units on average.

The Goethe-Institut gives average numbers of teaching units. Each unit is 45 minutes. These are the totals from zero:

• A1: about 150 units,
• A2: about 300 units,
• B1: about 450 units,
• B2: about 600 units.

Your own time depends on how many hours you study. It also depends on whether you already speak other languages and whether you live among German speakers.

As an example, at 20 units per week, 600 units are about 30 weeks of classes. Add time for self-study, waiting for exam dates and a possible retake.

Can you take B1 or B2 in your home country before you apply? That is a common question we get. The answer is yes, as long as the exam and the exam centre are on your state's list. One option is to pass the visa level first (A2 or B1). Then you work towards B2.

To see which steps apply to your own case, you can build a free personalised roadmap at get2germany.com/en/my-roadmap. More for nurses is on our nurses page.