Kenntnispruefung Made Simple: What Foreign Doctors Should Know

A major milestone – and you’re not alone. This guide is for foreign-trained physicians seeking to practice in Germany. Here’s how to master the Knowledge Examination (also referred to as the knowledge exam oder knowledge test) step by step.

The moment you register for the Knowledge Examination (Kenntnisprüfung) often feels like the first real step toward your Approbation. Maybe your studies are a while behind you, or perhaps you’ve just started to settle in Germany. What all candidates share is the hope to pass the next milestone – and the uncertainty of what exactly awaits. Proper preparation is essential to increase your chances of success in the exam.

The Kenntnisprüfung (KP) is a hands-on medical examination and oral exam (also referred to as the oral practical examination) that shows whether you, as an international doctor, have the necessary medical expertise and practical skills to work in Germany. The practical exam typically includes patient presentation and clinical case discussions to assess your readiness and decision-making skills under real conditions.The exam structure typically includes several components, such as patient presentation and clinical case discussions, to assess your readiness. It is mandatory if your medical degree is not considered equivalent to a German medical degree.

The exam typically lasts 60 to 90 minutes and is often conducted as a group examination with several candidates present. While the test format may vary slightly by federal state, most exams include:

• A patient case presentation
• A detailed clinical discussion with the examiners
• An assessment of your ability to communicate clearly and professionally in German

🩺 Exam content:
The Kenntnisprüfung primarily assesses whether foreign-trained doctors possess the necessary medical knowledge to practise safely and effectively in Germany’s medical landscape. The focus lies on general medicine and surgical disciplines, but it often includes cross-disciplinary topics such as emergency care, clinical pharmacology, and infectious diseases. A key component is the clinical examination, where your ability to assess, diagnose, and treat clinical cases is tested under real-life conditions. In some cases, additional subjects may be covered—especially if your degree assessment identifies major differences in specific medical fields.

🗣️ Language requirements:
The exam is held entirely in German. Strong medical German and general German language skills are essential, not just for passing the medical language exam (FSP) beforehand, but also for demonstrating your ability to treat patients safely and effectively in the healthcare system in Germany.

Whether or not you need to take the Kenntnisprüfung primarily depends on where you completed your medical degree and whether it is recognized as equivalent to a German medical degree. This exam is part of the procedure for medical recognition and determines whether you can work as a doctor in Germany. This is part of the formal recognition procedure for foreign professional qualifications, which assesses whether your professional qualifications meet German standards.

If you’re from a non-EU country, the answer is usually clear: Yes, you will need to take the Kenntnisprüfung. Often, the foreign degree is not fully recognized in the equivalency process, and in such cases, the German authorities may require a compensation measure, such as the Kenntnisprüfung, to ensure the foreign professional qualification meets the standards of a German qualification. In this case, the Kenntnisprüfung is the official route to Approbation – allowing unrestricted professional practice as a doctor in Germany.

The situation is a bit different if you completed your studies in the European Union, the EEA (European Economic Area, which includes countries like Norway and Iceland, and is relevant because the recognition process for medical licensing in Germany distinguishes between qualifications from the EU/EEA and those from other countries), or Switzerland. In these cases, your degree can be automatically recognized under certain conditions, and a Kenntnisprüfung is usually not required. However, exceptions exist – for instance, if you’ve specialized in a field that doesn’t exist in Germany, your medical qualifications will undergo a case-by-case review. If a qualification is only partially recognised, additional steps may be required.

And what if you’re already a specialist doctor? Even then: Without passing the Kenntnisprüfung or having your studies recognized as equivalent, you won’t receive Approbation in Germany. Your specialist training can only be recognized if your basic studies have been officially confirmed through a successful equivalency check or the Kenntnisprüfung. The recognition procedure is designed to ensure that a doctor trained outside Germany meets the same standards as a doctor trained in Germany.

👉 Your Overview of the Approbation Process – Clear, Complete, and Easy to Follow.

Before you can even think about sitting for the Knowledge Examination, every foreign doctor must first pass through the equivalence assessment. This crucial step in the recognition process determines whether your medical qualifications are on par with the German professional qualification required to practice medicine in Germany.

The competent authority in your federal state will carefully review your medical degree, transcripts, and other relevant documents to assess whether your training and experience provide the necessary medical expertise and skills expected in the German healthcare system. This evaluation is designed to ensure that all doctors—regardless of where they trained—can deliver safe, effective care to patients in Germany.

👉 In some cases, further documents may be requested—such as internship records or curriculum details—especially if there are ambiguities in your submitted qualifications.

If the equivalence assessment finds that your medical qualifications fully match the German standards, you may receive full recognition and a recognition notice confirming that you are allowed to practise medicine without further exams. However, if there are substantial differences in your training or experience, the recognition notice will indicate that you are required to demonstrate your medical expertise through the Knowledge Examination. In some cases, partial recognition is possible, but you will still need to prove that you meet the necessary medical skills to obtain the Approbation in Germany.

Understanding the importance of the equivalence assessment—and preparing your documents thoroughly—can help you move smoothly through this first hurdle on your path to practicing medicine in Germany.

For many foreign-trained doctors, the Kenntnisprüfung serves as a formal compensation measure when their medical degree is not fully recognized as equivalent to a German qualification. If substantial differences are found during the equivalence assessment, German authorities may require you to take this exam to prove that your knowledge and skills meet local standards. This process ensures that all doctors, regardless of where they were trained, can deliver high-quality medical care in Germany. Understanding the role of the Kenntnisprüfung as a compensation measure helps clarify why the exam is not just a bureaucratic step—but a key gateway to professional practice.

Before you're allowed to take the Knowledge Examination in most German states, you must first pass the medical language exam – the Fachsprachprüfung. This exam tests your ability to communicate confidently and professionally in a clinical setting. It's one of the biggest hurdles in the recognition process – and just as important as your clinical knowledge.

👉 Read our full article: The Ultimate Guide to the Medical Language Exam (Fachsprachprüfung) in Germany

You’ll find insider tips, detailed exam formats, and preparation strategies that have helped many doctors from abroad succeed.

🎯 Want to practise with real-life simulations and expert guidance?
Check out our tailored online course and get step-by-step support for mastering the FSP. Start preparing today – and pass with confidence.

Before you can practise medicine in Germany as a foreign-trained physician, you'll need to navigate a clearly defined recognition process. One of the most important stages is the Kenntnisprüfung, or medical knowledge exam, which ensures that your professional competencies meet the standards required to work safely and effectively in the German healthcare system.

Below, we’ll walk you through each essential step—from the initial application to the final exam—so you can understand what to expect and plan ahead with confidence.

The first step is to submit an application for recognition of your foreign medical qualifications to the responsible licensing authority—this may be the state or district government or the medical chamber. You’ll need to provide documentation of your medical education, professional experience, and language skills (typically at least B2 level in general German).

Once submitted, you’ll need to wait for the result of the equivalence assessment. The competent authority will evaluate whether your foreign medical education is equivalent to a German medical degree. If significant differences are identified, you will be required to take the Kenntnisprüfung as a compensation measure to prove your medical knowledge.

Once deficits have been identified in your equivalence assessment, you must formally register for the Kenntnisprüfung with the competent authority—usually a state examination office or medical chamber. This step is closely tied to your Approbation application, which forms the legal basis for taking the exam. Without having submitted this application, registration for the Kenntnisprüfung is not possible.

⚠️ Important: Many candidates underestimate the timelines involved. Examination offices are often overwhelmed, and there may be long waiting lists. We recommend starting the process at least six months before your desired exam date to secure a spot and align your preparation accordingly.

Once your documents have been reviewed, you’ll receive an official invitation—sometimes only a few days or weeks before the exam—with the date and location. It’s common not to know who your examiners will be until the day of the exam. This is standard practice and nothing to worry about.

Please note: As part of the registration process, additional documents may be requested depending on the region. Always double-check requirements with the relevant authority.

Preparation focuses on mastering the relevant exam content—particularly in internal medicine and surgery, as well as cross-disciplinary areas such as emergency care, pharmacology, imaging techniques, radiation protection, and legal aspects of medical practice. A strong command of medical terminology in German is also essential, as the exam requires precise and professional communication in clinical settings.

Make sure your study plan covers high-yield medical topics that are commonly tested during the exam and reflect the German curriculum. To prepare effectively, it's crucial to structure your learning around the core competencies evaluated in both the clinical and oral-practical parts of the exam.

Many candidates prepare using specialized courses, online learning platforms, and medical textbooks aligned with the German curriculum.

In some federal states, examiners may also refer to specific legal frameworks such as the Radiation Protection Ordinance, particularly when evaluating your knowledge of diagnostic imaging and radiological safety standards.

👉 Looking for expert support? Our tailored preparation courses and 1:1 exam coaching are designed to help you master every topic that counts in the Kenntnisprüfung—so you can walk in confident and walk out licensed.

The Kenntnisprüfung usually takes place at a university hospital or an approved teaching German hospital.
It consists of two parts, typically conducted on the same day:

It consists of two parts, typically conducted on the same day:

• Clinical Exam / Patient Presentation:
  You’ll examine a real or simulated patient, take a full medical history, perform a physical examination, make a diagnosis, and write a medical report. The report generally includes the history, diagnosis, differential diagnosis, prognosis, treatment plan, and a discharge summary (Epikrise). You will usually have 30–45 minutes for the clinical exam and up to 30 minutes to complete the written report.
• Oral-Practical Exam / Case-Based Interview:
  This is followed by an oral-practical examination (oral exam)—often conducted in small groups—in which examiners ask in-depth questions. These focus primarily on general medicine and surgical disciplines, but may also include emergency medicine and other cross-disciplinary areas.
  This part usually lasts about 60–90 minutes per candidate.

The entire examination is conducted exclusively in German.

Immediately after the exam, the examination board decides whether you’ve passed. The result is officially confirmed in writing—though no grade is issued.

If you pass, you may proceed to receive your Approbation (full medical license). If you do not pass, you may repeat the exam twice, for a total of three attempts.

Important Notes:

• The exact process—including the order of language and knowledge exams, deadlines, and registration procedures—may vary slightly between German federal states.
• Strong communication skills and the ability to clearly and empathetically explain medical issues to patients are key evaluation criteria during the exam.

In Summary:

1. Application & Equivalence Assessment
2. Registration for the Kenntnisprüfung
3. Exam Preparation
4. Exam Day (Patient Case & Oral Interview)
5. Results & Possible Retakes

No one likes to talk about it – but the reality is: not everyone passes the Kenntnisprüfung on their first attempt. And that’s completely okay.

You have a total of three attempts to pass the Kenntnisprüfung – meaning two retakes. However, it’s important to understand that these attempts are tracked nationwide: even if you take the exam in a different federal state, it still counts toward your total. The competent authorities across Germany share candidate records through a central system, ensuring that all attempts are registered and recognized nationwide.

⚠️ If you fail all three attempts, you are generally no longer eligible to receive Approbation in Germany. Only in very rare and exceptional cases—for example, following a successful legal appeal—may a fourth attempt be granted. But this is the exception, not the rule.

If you don’t pass, you will usually receive a recommendation from the examination commission regarding when to try again. Many candidates use this time to intensify their preparation and work on their weaknesses. A focused, strategic study plan can make a big difference.

What’s especially encouraging: most candidates pass on their second try. In Berlin, for instance, the estimated failure rate is around 18%, with an 82% pass rate. However, please note that these figures are based on anecdotal reports and may vary by federal state and year. There are no official nationwide statistics, and individual success depends on your preparation and personal circumstances.

With consistent effort—especially in clinical knowledge and medical German—your chances of passing improve significantly.

While the Kenntnisprüfung is primarily designed to test your medical expertise and clinical skills, examiners are also paying close attention to your overall personal aptitude. This includes your ability to stay calm under pressure, communicate clearly and respectfully with colleagues and patients, and approach complex situations with sound clinical judgment. In many cases, candidates with strong technical knowledge struggle simply because they lack confidence or fail to structure their thoughts under exam conditions. That’s why it’s essential to train not just your knowledge—but also your mindset. Practise speaking out loud, simulate exam situations with peers, and reflect on your communication style. Remember: The way you present yourself can make just as much of a difference as the facts you know.

In addition to content preparation, many people also wonder: How much does the Kenntnisprüfung actually cost?

The exam fees vary by federal state and typically range from €400 to €1,100. However, that’s only part of the total cost. There are several additional expenses to keep in mind:

• Course fees for targeted preparation courses for the Kenntnisprüfung
• Learning materials for the exam
• Possible travel expenses if the exam is not in your hometown
• Potential overnight accommodations
• Document-related costs, such as official translations, notarized copies, and administrative fees for the recognition process itself

These hidden costs can add up quickly, so it’s important to plan your budget accordingly.

💡 Tip: Look into funding programs and financial support for foreign professionals. Many federal states offer financial assistance through foundations, regional initiatives, or educational projects. On our website, we provide a comprehensive overview of these support options.

The Kenntnisprüfung is undoubtedly a significant challenge – but it’s manageable. You are not alone on this path. Thousands of international doctors have successfully completed this step – many with the same questions, uncertainties, and hopes as you.

To succeed, focus on developing your practical clinical skills, clinical skills, and practical skills through hands-on training and direct patient interaction. Mastering theoretical knowledge, clinical reasoning, and the ability to create effective treatment plans for patient cases is essential. Make sure to study high-yield medical content, including key areas such as emergency medicine and clinical pharmacology. Practice using medical terminology in German and work on improving your language skills, especially medical German, to ensure strong German language proficiency and effective communication in the German language during the exam.

What really matters is structured preparation for the Kenntnisprüfung, confidence in your professional skills, and the willingness to embrace the German healthcare system and its language.

• What language level is required for the Knowledge Test?
  In most cases, you’ll need at least B2 in general German and C1 in medical language to be eligible for the exam. The Fachsprachprüfung (medical language exam) often needs to be completed first – in many federal states, it’s a mandatory prerequisite.
  
• What practical clinical skills are tested in the oral-practical part of the Knowledge Test?
  The exam typically includes a simulated real-life clinical situation in which you are required to take a medical history, make a diagnosis, propose a therapeutic strategy, and discuss the case with the examiners – often involving both internal medicine and surgery components. Communication skills and logical reasoning are just as important as medical knowledge.
  
• Do I need to pass the FSP before the Kenntnisprüfung?
  In most states: Yes. But in some, both exams can be scheduled in parallel. Always confirm locally.
  
• How many attempts do I have?
  Three in total – regardless of the federal state. Each attempt counts nationwide, even if taken in a different federal state. The competent authorities exchange information across Germany to ensure that attempts are tracked consistently throughout the country. ⚠️ Important: If you fail the Kenntnisprüfung three times, you are generally no longer eligible to obtain Approbation in Germany. Exceptions to this rule are extremely rare and only granted under exceptional circumstances. Plan and prepare carefully to make the most of your opportunities.
  

Our courses and materials are designed to prepare you in the best possible way for the knowledge exam (Kenntnisprüfung). However, we cannot guarantee that you will pass the exam, as this also depends on your individual preparation, language proficiency, and the specific exam situation.

All information provided without guarantee.