Is the Berufserlaubnis usually tied to a single clinic?

Often yes. Many Berufserlaubnisse are tied to the employer/clinic and sometimes even to the department. This means you are only allowed to work in the named Krankenhaus (and possibly under conditions/supervision). What this means for your planning: • Changing hospitals = often a new application or amendment notice (costs time). • Check the conditions in the BE notice: validity period, scope of activity, supervision, location/clinic. • If you are still unsure: try to get a BE directly from a clinic where you realistically want to stay longer (until Approbation/FSP/KP are completed). Ask the authority/HR specifically: "Is my BE tied to the clinic? What happens if I change?" This will save you unpleasant surprises later.