Legal Amendment to the Medical Licensing Process Starting this Autumn: The New Acceleration Act from November 2026

The German Federal Government has taken decisive action: To counteract the acute shortage of doctors, the "Act to Accelerate the Recognition Procedures for Foreign Professional Qualifications in Healthcare Professions" will enter into force on November 1, 2026. For physicians from third countries (non-EU/EEA), this ostensibly marks the beginning of an entirely new era.

Away from paralyzing bureaucracy, towards a clear, exam-oriented system. This article outlines precisely what is changing and how you can benefit the most from this reform.

Fundamental Changes for Foreign Physicians
1. The Direct Medical Knowledge Exam (Kenntnisprüfung) Becomes the New Standard
Previously, every procedure legally defaulted to a highly complex, months-long document review process (equivalence assessment), which was statutorily mandated. A medical knowledge exam was only administered if professional deficits were identified based on the submitted documents that could not be compensated for through courses or internships.

As of November 2026, the direct knowledge exam will be elevated to the legal standard for graduates from third countries. As a rule, authorities will forgo the time-consuming, detailed review of foreign curricula. Accordingly, the knowledge exam is now officially anchored in the statutory text as a fully-fledged professional licensing examination.

2. Binding Right of Option and Irrevocable Waiver
Although you retain the right to request a document-based equivalence assessment, you must make this decision within four weeks of submitting your application. If you formally declare your waiver of the equivalence assessment to the authority in order to take the knowledge exam, this decision is final and irrevocable. Switching back to the document review process at a later date is legally prohibited.

3. Absolute Obligation to Prove "Completion"
The law also makes it unequivocally clear: No procedure can be initiated without formal proof of the full completion of the medical qualification in the country of origin.

Important Exception: Should you be unable to fully submit the necessary detailed documentation due to objective reasons beyond your control (such as war or displacement), the path to the knowledge exam remains open to you.

4. Measures Against "Procedure Tourism"
To prevent applicants from simply restarting the process in another federal state after a rejection—which was previously possible due to a lack of data synchronization—this inter-authority data alignment is now being massively tightened. In the future, state authorities will be permitted and enabled to digitally query in real-time whether a procedure is already underway or has been legally and bindingly rejected in another federal state.

Financial and Time Relief
The National Regulatory Control Council (an independent advisory body for federal legislative review) has calculated the impact of the new law in detail. The savings for you as an applicant are drastic: we are talking about approximately €3,000 per applicant, as the copying, translation, and notarization of extensive curricula will generally be completely eliminated.

The planned reduction of bureaucracy is definitely a positive development. In the future, curricula from foreign universities will neither have to be procured nor sent to the authorities after costly and complex legalization. Furthermore, a significant acceleration of processing times at state authorities is expected due to the elimination of lengthy equivalence assessments.

Our Assessment
The law merely codifies what many authorities have already been practicing for some time. Since the central review office (GfG) in Bonn did not accept any applications for a long period (from 2024 to April 2026) and only a few federal states employ their own assessors, several states have—illegally but pragmatically—been sending out the offer to take the medical knowledge exam (Kenntnisprüfung) along with the acknowledgment of receipt for a while now.

Regarding the aforementioned cost savings, we believe that focusing solely on the €3,000 saved on translation and notarization costs is short-sighted. The expert assessment process could be initiated and awaited from abroad, meaning applicants could still live in their social environment and earn a living. However, prior to taking the knowledge exam, most physicians will likely want to attend a preparatory course, which can cost anywhere from around €1,200 (for a pure video self-study course) to €5,000 (for an on-site intensive course). In the case of an in-person course, living expenses in Germany must also be factored in.

Furthermore, it remains to be seen how quickly the additional capacity required for an expanded offering of knowledge exams can be established. Even though an estimated 70% of medical professionals previously chose the document review path, waiting times for the knowledge exam in the federal states already ranged from 4 to 15 months. If the number of required exams now doubles or even triples, the availability of knowledge exams must be massively expanded here. We will stay on top of this and hope for a rapid, positive development.