FSP, telc Deutsch B2·C1 Medizin or FaMed: which counts where?

Who decides which certificate counts?

Neither the medical chamber nor the exam provider decides whether your German skills are proven — the licensing authority of your state does. The legal basis is § 3(1) sentence 1 no. 5 of the Bundesärzteordnung (Federal Medical Practitioners' Act). In 2014 the state health ministers agreed on guidelines (Eckpunkte) for how this proof should look: general language skills at B2 level, medical language "orientiert am Sprachniveau C1" (oriented towards level C1), proven "grundsätzlich durch eine Fachsprachprüfung" (in principle through a medical language exam). These guidelines are not legally binding — which is why the states differ on which exams they accept besides their own chamber FSP.

Three practical rules follow from this:

• No application, no chamber FSP. You are only admitted once you have applied to the authority for the Approbation (full licence) or a Berufserlaubnis (temporary licence). Usually the authority registers you — in Bavaria "ausschließlich über die Regierung" (exclusively via the regional government), and Schleswig-Holstein states: "Eine eigenständige Anmeldung zur Prüfung durch Sie selbst ist nicht möglich" (you cannot register for the exam yourself). In Berlin and Hessen you register with the chamber yourself, using the acknowledgement of receipt for your application.
• Private certificates belong with the application. Baden-Württemberg only considers private exam certificates if they are already available when you apply; certificates submitted later are not considered "aus Verfahrensgründen" (for procedural reasons).
• Certificates expire. In Baden-Württemberg the FSP is valid "in der Regel 3 Jahre" (usually three years); Rhineland-Palatinate and Hessen (for EU degrees) require an exam that is no more than three years old.

The states also differ on the general B2 certificate: Hessen, for example, names only the Goethe-Institut and telc, while other states also accept TestDaF, ÖSD or other ALTE-certified institutes.

The exams at a glance

In addition, individual authorities name the language exam of the Austrian Medical Chamber (ÖÄK, Baden-Württemberg) and the medical language exam of the brmi Akademie für Heilberufe (Hessen, EU degrees).

Which state accepts what?

The table reflects what the licensing authorities themselves publish. Where an authority publishes nothing on a point, the table gives the information from the Marburger Bund's (physicians' union) state-by-state overview, marked (MB). "Not named" does not automatically mean "rejected" — it means you need to ask beforehand.

Two patterns stand out. Private exams are accepted mainly for degrees from the EU, the EEA or Switzerland (Hessen, and per MB also Hamburg). And where one state accepts a private exam, this does not automatically carry over to other states — Baden-Württemberg, for instance, accepts FaMed, telc and the ÖÄK exam only because they are "in einem anderen Bundesland als Fachsprachenprüfung anerkannt" (recognised as a medical language exam in another federal state), and does not check on its own which further exams count elsewhere.

Does an FSP passed in another federal state count?

Generally, yes. Baden-Württemberg accepts an FSP from another state "grundsätzlich" (in principle) if it comes from a recognised exam body such as a medical chamber; Schleswig-Holstein recognises "Fachsprachenzertifikate C1 anderer Landesärztekammern" (C1 certificates of other state medical chambers), and Hessen explicitly names the chambers "anderer Bundesländer" (of other federal states) for EU degrees. Bavaria makes recognition conditional on the exam being equivalent to its own and advises clarifying this with the authority in advance, case by case. Whether a Berlin FSP counts in other states is, according to the Berlin medical chamber, decided by the licensing authority of the state concerned.

There are three restrictions you should know:

• You cannot freely choose the state you take the exam in. The chamber FSP requires that the authority of that state is responsible for you — in Schleswig-Holstein, for example, through residence or a job offer, in Berlin through an application to LAGeSo. According to the Marburger Bund's overview, recognition of another chamber's FSP therefore concerns physicians who took it as part of an Approbation or Berufserlaubnis procedure in that other state.
• The clock is ticking. Several states require the exam to be no more than three years old. In Baden-Württemberg, working under a Berufserlaubnis extends the validity by the time actually worked.
• From 1 November 2026, responsibility depends on where you live. If you live in Germany, you then submit the recognition application in the state of your habitual residence (§ 12(2a) BÄO), and the authorities may ask other states whether a procedure is already pending there (§ 3(4) BÄO). What else the reform changes is explained under FSP or Kenntnisprüfung?

telc and the chamber FSP compared

If you can choose between telc and the chamber FSP, you should know that the two exams are built differently:

The telc individual exam lasts 65 minutes in total, including preparation. In content it therefore resembles the chamber format; the written group part with listening and reading comprehension is additional material that most chambers do not test. Details on grading in the chambers are under Grading.

FaMed is structured differently from both: according to the provider, there are two oral stations of 11 minutes each (23 minutes including reading time) — a history-taking conversation and an Aufklärungsgespräch (informed-consent conversation) with the patient, and two patient presentations to a head physician — and finally a written station of 22 minutes in which you write the history section of a medical letter based on a short video. The FIA's PKT starts with a 20-minute written part on communication between colleagues (a case description); after 30 minutes' preparation it continues with a patient presentation and a conversation on patient information or counselling of 20 minutes each.

What this means for your preparation

• Start from your state, not from the exam date. With a third-country degree, only the chamber FSP counts in most states; a private exam your authority does not accept costs money and time without moving your procedure forward.
• Get written confirmation. For exams not on its list, Baden-Württemberg explicitly requires proof that exactly this exam is accepted as an FSP in another state.
• Plan for a move. If you might move to another state later, a chamber FSP gives you the most flexibility — provided it is not too old when you apply.
• Prepare for the right format. For telc you also need listening and reading comprehension and the short medical letter; for the chamber FSP what counts is the history-taking conversation, the form and the patient presentation. Training on fsppruefung.de follows the common chamber format (3 × 20 minutes with a documentation form); it does not cover telc's written group part.

The chambers' fees are listed under Costs. This overview is not legal advice; only your licensing authority decides which certificates count for your application — confirm your individual case with them before registering for an exam.

Sources

• Regierungspräsidien Baden-Württemberg: FAQ Sprachkenntnisse
• Regierung von Oberbayern: Arzt/Ärztin; Beantragung einer Approbation bei Ausbildung in einem Drittstaat
• BLÄK: Fachsprachenprüfung
• Ärztekammer Berlin: Fachsprachprüfung
• LAGeSo Berlin: Hinweise zum Fachsprachentest für Ärztinnen und Ärzte
• LAVG Brandenburg: Hinweise zum Fachsprachtest im Rahmen der ärztlichen Approbationsverfahren
• Landesprüfungsamt für Heilberufe Hamburg: Anmeldung zur Fachsprachenprüfung
• HLfGP: Merkblatt für Ärztinnen und Ärzte mit Abschlüssen in den EU-/EWR-Staaten oder der Schweiz
• HLfGP: Kurzinformation zum Antrag auf Approbation und Berufserlaubnis mit Abschluss aus einem Drittstaat
• LÄK Hessen: Merkblatt Fachsprachprüfungen
• NiZzA: Informationsblatt zur Fachsprachprüfung für Ärzte mit ausländischem Berufsabschluss
• Bezirksregierung Münster: FAQ Approbation
• Ärztekammer Nordrhein: Fachsprachprüfung
• LSJV Rheinland-Pfalz: Approbationen für akademische Heilberufe
• Bezirksärztekammer Rheinhessen: Informationen zur Fachsprachprüfung 2026
• Landesamt für Soziales Saarland: Merkblatt zur Beantragung der ärztlichen Approbation oder Berufserlaubnis
• Landesdirektion Sachsen: Approbation-FAQ, Deutschkenntnisse
• SHIBB Schleswig-Holstein: Häufig gestellte Fragen Ärztin/Arzt
• Marburger Bund: Deutschkenntnisse — Anforderungen in den Bundesländern für die Approbationserteilung
• Gesetz zur Beschleunigung der Anerkennungsverfahren ausländischer Berufsqualifikationen in Heilberufen (BGBl. 2026 I Nr. 225)
• telc: telc Deutsch B2·C1 Medizin Fachsprachprüfung
• telc: Übungstest 1, Deutsch B2·C1 Medizin Fachsprachprüfung
• FaMed: Prüfungsablauf (provider information)
• FIA: Prüfungsordnung Patientenkommunikationstest (PKT) v4.0