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Knowledge about recognition and recruitment.

The most important terms, routes and contact points, explained briefly. The German terms are the ones you will meet at the authorities. This page does not replace advice on your individual case.

Key terms

Pflegefachfrau and Pflegefachmann (registered nurse) are protected professions in Germany. To work as one, you need a state permit. With a foreign qualification, the way there is recognition.

Reglementierter Beruf
Regulated profession – a job you may only do with a state permit. Nursing is one of them.
Anerkennung
Recognition – the authority checks whether a foreign qualification corresponds to the German training. The legal basis is §§ 40 ff. of the Nursing Professions Act (PflBG).
Erlaubnis zum Führen der Berufsbezeichnung
Permit to use the professional title – the result at the end. The person may work as „Pflegefachfrau“ or „Pflegefachmann“.
Gleichwertigkeitsprüfung
Equivalence assessment – the authority compares training content and hours with the German training. This needs many documents.
Defizitbescheid
Deficit notice – a decision listing substantial differences from the German training. It names the compensation measure required.
Ausgleichsmaßnahme
Compensation measure – the way to make up for the differences. You choose between a knowledge test and an adaptation course.
Kenntnisprüfung
Knowledge test – an exam with an oral and a practical part, usually with a preparation course.
Anpassungslehrgang
Adaptation course – a course with practical work, at most 3 years long, in practice often 6 to 12 months.
Verzicht auf die Gleichwertigkeitsprüfung
Waiver of the equivalence assessment – possible since the reform (§ 40 (3a) PflBG). You go straight to the compensation measure, need fewer documents and are often faster. Final; it cannot be withdrawn.
Drittstaat
Third country – any country outside the European Union, the European Economic Area (EEA) and Switzerland.
B2
The German language level required for the permit. Accepted are certificates from Goethe-Institut, telc, TestDaF and ECL.
Pflegehilfskraft
Care assistant – works in care without the permit as a registered nurse. The typical job during the recognition procedure.
Chancenkarte
Opportunity Card – a residence permit to look for work for people from third countries (§ 20a AufenthG). More below.
Anerkennungspartnerschaft
Recognition partnership – entry and work before recognition (§ 16d (3) AufenthG). More below.

Recognition across Germany

The requirements are the same in all 16 federal states, because the Nursing Professions Act and the training regulation (PflAPrV) are federal law. The states only differ in the procedure – for example, which authority is responsible and in which form documents are submitted.

Everywhere, four requirements apply:

  1. completed nursing training that is state-recognised in the country of origin – equivalent, or compensated by a knowledge test or an adaptation course,
  2. health suitability (medical certificate),
  3. reliability (police clearance certificates),
  4. German at level B2.

Qualifications from the EU, the EEA and Switzerland are usually recognised automatically (EU directive on the recognition of professional qualifications). In Berlin this takes about 4 to 6 weeks in our experience.

The Opportunity Card (Chancenkarte)

The Opportunity Card (§ 20a Residence Act) has existed since June 2024. It is a residence permit to look for work for people from third countries.

  • Requirement: a recognised qualification or at least 6 points – among others for training of at least 2 years, German A1 or English B2, and secure means of living.
  • Allowed: up to 20 hours of work per week, trial employment and taking part in recognition measures.
  • Duration: up to one year. With an employment contract, it can be extended by up to 2 years. If you find a job, switch in time to a residence permit under § 16d or § 18a.

The recognition partnership (Anerkennungspartnerschaft)

With the recognition partnership (§ 16d (3) Residence Act), nurses enter Germany and start working before their qualification is recognised. The recognition procedure then takes place in Germany.

Requirements include training of at least 2 years, German at level A2, a job offer and a written agreement with the employer. Until recognition, the person works as a care assistant.

What is changing right now

  • Act to speed up recognition procedures in the health professions: passed by the Bundestag on 26 March 2026. It is planned to enter into force on 1 November 2026 at the earliest; the Bundesrat must agree. It is still open whether the new rules – such as a language check before the qualification check – also apply to nursing.
  • Nursing Assistance Act (Pflegefachassistenzgesetz): from 1 January 2027 there will be separate recognition rules for care assistants.

We will update this page as soon as it is clear what changes for nursing.

Contact points and abbreviations

LAGeSo
State Office for Health and Social Affairs Berlin. Decides on the recognition of nursing qualifications.
LEA
State Office for Immigration Berlin (immigration office). Home of the Business Immigration Service for employers and applications under § 81a.
ZAB
Central Office for Foreign Education. Evaluates foreign qualifications and gives information even before entry.
BBeFaP
Berlin advice centre for nurses with a foreign qualification. Since 2024, on behalf of the Berlin Senate, free of charge.
IQ Netzwerk Berlin
Free advice on recognition and qualification, part of the federal programme „Integration through Qualification“.
ZSBA
Central Service Point for Professional Recognition at the Federal Employment Agency. Advises people who still live abroad.
GAPA
Quality association for the recruitment and placement of nurses from abroad. Awards the quality mark „Faire Anwerbung Pflege Deutschland“ (fair recruitment).
DKF beim KDA
German Competence Centre for International Professionals in Health and Care. Developed the quality mark.
Triple Win
State recruitment programme of the Federal Employment Agency (ZAV) and the GIZ.
WHO-Liste
WHO list – 55 countries that lack health workers themselves. Private recruitment there is prohibited.

Sources (in German)

As of: October 2026