Recognition as a registered nurse in Germany: step by step

If you trained or studied nursing abroad, you may only work as a registered nurse (Pflegefachfrau / Pflegefachmann) in Germany once your qualification has been recognised by the state. It sounds complicated, but it follows a clear process.

1. The responsible authority

Recognition is decided by an authority of the federal state where you want to work. In North Rhine-Westphalia this is the Bezirksregierung Münster. It checks whether your training is equivalent to German nursing training. Your work experience is also taken into account if you can prove it.

2. Documents you usually need

• Diploma or final certificate
• Transcript of subjects and hours (which subjects, how many hours of theory and practice)
• Proof of your licence or registration in your home country
• CV and employment references
• Passport and birth certificate
• Language certificate
• Police clearance certificate and medical certificate

Foreign documents usually have to be certified and translated into German by sworn translators.

3. The decision

If your training is equivalent, you receive recognition. Often, however, the authority finds differences and lists them in a so-called deficit notice (Defizitbescheid). This is normal and no reason to worry – you can make up for the differences.

4. Aptitude test or adaptation course

• Aptitude test (Kenntnisprüfung): for qualifications from outside the EU it has an oral and a practical part.
• Adaptation course (Anpassungslehrgang): several months of practical training in a hospital, care facility or home care service, often with classes.

Which route suits you better depends on your decision letter and your situation. We discuss it with you.

5. German language skills

For recognition you need German at level B1 or B2, depending on the federal state, proven with a recognised language certificate. We support you in learning German.

6. Working while recognition is in progress

Until you are fully recognised, you can often already work in care, for example as a nursing assistant. There is also the recognition partnership (Anerkennungspartnerschaft): with an employment contract you can come to Germany and complete recognition here. Among other things, you need German at level A2 for this.

Official information

• Recognition in Germany: www.anerkennung-in-deutschland.de/html/en/
• Make it in Germany: www.make-it-in-germany.com/en/

Good to know

As of October 2026. Rules differ between federal states and change from time to time. This article is not legal advice – we are happy to look at your case personally.