The Bundesrat approves: the Kenntnisprüfung stays compact – what the new recognition regulation means for you

At a glance: On 16 October 2026, the Bundesrat (Germany’s Federal Council, representing the 16 federal states) voted on the Regulation to Accelerate the Recognition of Foreign Professional Qualifications in the Healthcare Professions (Drs. 504/26). The states approved it, but with amendments (known as Maßgaben). The most important news for doctors from non-EU countries: the much longer exam planned by the federal government will not happen. The Knowledge Test (Kenntnisprüfung) will still take place on a single day and keep its current length. This could mean more exam dates and shorter waiting times.

What happens next?
In July, we presented the Federal Ministry of Health’s (BMG) draft of the regulation. Since then, the draft has gone through the legislative process, and the Bundesrat has now made its decision. It approved the regulation but changed several points. This is not final yet: the amendments only take effect once the BMG agrees to the Bundesrat’s conditions. After that, the regulation will be published in the Federal Law Gazette (Bundesgesetzblatt) and come into force.

 

What changes in the exam?

The exam stays on one day. A longer exam spread over two days had been discussed. The states reversed this. The oral-practical exam will still last 60–90 minutes per candidate. The draft had proposed 90–120 minutes.

The patient-based exam preparation will be shorter. As planned, a new preparation phase with a patient will still occur before the oral exam. However, the time allowed for it has been cut significantly:

• Taking the patient’s history and examining the patient: a maximum of 20 minutes (draft: 30 minutes)

• Written report: a maximum of 30 minutes (draft: 60 minutes)

In future, the supervising person may also countersign the report.

Simulated patients and more. Simulated patients may be used both for the preparation phase and for the exam itself. Simulators, models and other suitable tools are also explicitly permitted.

The examination board will still have three members. The draft had provided for two examiners. Now it remains a chair plus two further members. It will also be easier to staff the boards: it is enough for one examiner to represent either internal medicine or surgery. Both specialties no longer need to be represented.

The exam subjects remain as in the draft. The main focus is on internal medicine and surgery. In addition, the exam covers:

• emergency medicine,
• clinical pharmacology and pharmacotherapy,
• imaging procedures,
• radiation protection,
• the legal framework of medical practice, and
• doctor–patient communication.

Communication covers building a relationship of trust with patients and communicating professionally with relatives and other healthcare professionals.

 

Why is this good news?

The states did the maths: with the longer format, around one third fewer Kenntnisprüfungen could have been held. With waiting times often lasting many months, that would have been a major step backwards. If the shorter format stays, this should mean more exam dates and shorter waiting times for you.

Other changes at a glance

• Documents: German or English documents are fully sufficient. Otherwise, a machine translation may be used if needed. Originals or equivalent documents only have to be submitted if there are justified doubts about their authenticity. If necessary, the authority can contact the responsible body in the country of training directly to request originals. The documents required for a temporary licence to practise (Berufserlaubnis) for completing one’s training are now conclusively defined.
• A new route for unfinished degrees: If you were unable to complete a medical or pharmacy degree abroad for serious reasons, such as war or displacement, you can continue your studies in Germany, starting from the second section of the medical state examination (M2). Berlin wanted to remove this route but did not succeed. Applicants must prove that they have the required German language skills.
• Exam dates: Religious holidays recognised by state treaty should be taken into account when scheduling exams.

 

The Match Doctors check

The Bundesrat has clearly opted for an exam format that works in practice. A longer exam may sound more thorough at first. But above all, it would have meant fewer exam dates and even longer waiting times. The fact that the states prevented this is good news for everyone waiting for their medical licence (Approbation).

The high standards of the exam content remain unchanged. The exam covers a broad range of subjects, and the patient-based preparation adds a new element. There is now even less time for taking the history, examining the patient and writing the report. That makes it all the more important to practise this format under time pressure.

Please note: Our summary is based on the committee recommendations from the Bundesrat and the plenary minutes. The official resolution (Drs. 504/26(B)) has not yet been published, and the BMG still has to accept the amendments. Details may therefore still change. We will let you know as soon as the regulation has been published.

Our preparation courses for the theory test have already been adapted to the new examination procedures, providing you with targeted practice tests, regular progress checks and feedback from experts to help you pass the theory test. Register with Match Doctors and let’s plan your path to your medical licence together.

 

Sources: Regulation (Drs. 504/26) · Committee recommendations (504/1/26) · Berlin motion, medicine (504/2/26) · Berlin motion, pharmacy (504/3/26) · BMG draft regulation