How the FSP is graded: criteria, points and pass marks

In short

The Fachsprachprüfung (FSP) grades only your language — comprehension, expression, register, grammar and medical vocabulary — not your medical knowledge. The result is "bestanden" (passed) or "nicht bestanden" (failed); wherever a points rule is published, the line is 60%. Berlin requires 12 of 20 points in each of the three parts, Nordrhein 36 of 60 points in total. The chambers that publish figures report pass rates between roughly half and a good two thirds — in Bavaria, 53% passed at the first attempt in 2024.

What "C1" means in the FSP

Every chamber builds on the 2014 guidelines (Eckpunkte) of the health ministers' conference (GMK): general German at B2 as the entry requirement, medical German "orientiert am Sprachniveau C1" (oriented towards C1). The guidelines describe what this means for each part as an ability, not as a grammar list (quoted from the information sheet of the Lower Saxony licensing authority, NiZzA):

Doctor–patient conversation: you understand the patient "inhaltlich ohne wesentliche Rückfragen" (without significant need to ask back) and communicate "so spontan und so fließend" (so spontaneously and fluently) that you can take the history, inform about findings and the illness and explain "Vor- und Nachteile einer geplanten Maßnahme sowie alternativer Behandlungsmöglichkeiten" (pros and cons of a planned measure and of alternatives) — "ohne öfter deutlich erkennbar nach Worten suchen zu müssen" (without often visibly searching for words).
Documentation: your written German is good enough to "Krankenunterlagen ordnungsgemäß führen und ärztliche Bescheinigungen ausstellen" (keep medical records properly and issue medical certificates).
Doctor–doctor conversation: you express yourself "so klar und detailliert" (so clearly and in such detail) that in case presentations "Missverständnisse sowie hierauf berufende Fehldiagnosen, falsche Therapieentscheidungen und Therapiefehler ausgeschlossen sind" (misunderstandings and the misdiagnoses, wrong treatment decisions and treatment errors they cause are ruled out).

The Bavarian chamber (BLÄK) also attaches the general C1 description to its procedural rules: to express yourself "spontan und fließend …, ohne öfter deutlich erkennbar nach Worten suchen zu müssen" and to speak "klar, strukturiert und ausführlich zu komplexen Sachverhalten" (clearly, in a structured way and in detail about complex matters).

Medical knowledge is not tested — but your statements must still make sense

All chambers stress that medical knowledge is not graded. Berlin: "Das Fachwissen der Prüfungskandidaten wird hierbei nicht überprüft" (the candidates' medical knowledge is not tested). Lower Saxony: "auf die Richtigkeit der Diagnose kommt es bei der Bewertung nicht an" (whether the diagnosis is correct does not matter for grading) and "Medizinische Fragestellungen dienen allein dem Schaffen von Sprechanlässen" (medical questions only serve to create occasions to speak). The Nordrhein chamber shows where the line is:

„Für die Fachsprachprüfung ist es nicht erheblich, ob eine falsche Diagnose gestellt oder eine verfehlte Behandlungsoption genannt wird. […] Die Sätze müssen in sich stimmig sein. Eine Aussage wie zum Beispiel: ‚Bei einer Humerusfraktur ist der Fuß einzugipsen.‘ wird die Nachfrage nach dem Verständnis der Worte ‚Humerus‘ und ‚Fuß‘ nach sich ziehen.“

In English: a wrong diagnosis or a mistaken treatment option does not matter, but sentences must be internally consistent — a statement like "for a humerus fracture, put the foot in a cast" will prompt the examiners to check whether you understand the words "humerus" and "foot". So a wrong but well-argued suspected diagnosis costs you nothing; a confused term is a language error. Baden-Württemberg therefore states that in the doctor–doctor conversation a "korrekte Begriffsdefinition, sowie eindeutige Verwendung der medizinischen Fachtermini" (correct definitions and unambiguous use of medical terms) is "zwingend erforderlich" (mandatory), and Saxony warns that "eine Verwechslung von Fachbegriffen kann zu einer falschen Behandlung führen" (mixing up terms can lead to wrong treatment).

The only published scoring sheet: Berlin

The Berlin chamber is the only one that publishes its model scoring sheets (Musterbewertungsbögen). Each of the three parts has a sheet with eight criteria. Each criterion is scored from 2.5 to 0 points; the sheet ends with "Volle Punktzahl = 20, Bestanden = 12" (full marks 20, pass 12).

Points	Meaning
2.5	sehr gut (very good)
2	gut (good)
1.5	befriedigend (satisfactory)
1	nicht befriedigend (not satisfactory)
0.5	mangelhaft (poor)
0	gänzlich verfehlt (completely missed)

Every sheet ends with a free-text field "Ihre Empfehlung zur Nachbesserung der Sprachkenntnisse" (your recommendation for improving the candidate's language skills). The criteria, verbatim with a gloss:

Part 1: Simulationsanamnese (simulated history taking)

The candidate …

… stellt eine professionell-persönliche Kommunikation her. (establishes professional yet personal communication)
… drückt sich klar und detailliert aus. (expresses themselves clearly and in detail)
… hat eine gut verständliche Aussprache. (has easily understandable pronunciation)
… weicht gewinnbringend von vorgegebenen Schemata ab. (departs from set schemes to good effect)
… führt das Gespräch zielgerichtet und situationsbezogen. (conducts the conversation purposefully and appropriately to the situation)
… ist in der Lage, Sachverhalte flüssig zu erklären. (can explain matters fluently)
… versteht ihr/sein Gegenüber problemlos. (understands the other person without difficulty)
… erklärt das weitere Vorgehen verständlich und patientengerecht. (explains the next steps clearly and in a patient-appropriate way)

Notice: no criterion counts your questions. Completeness hides inside "purposeful" and "clear and detailed", and criterion 4 explicitly rewards departing from a memorised scheme. Criterion 8 demands the closing explanation in lay language — more on this under history taking.

Part 2: Schriftliche Dokumentation (written documentation)

The document …

… ist der/dem Simulationspatient:in sicher zuzuordnen. (can be assigned to the simulated patient with certainty)
… ist strukturiert und vollständig abgefasst. (is structured and complete)
… ist grammatisch korrekt. (is grammatically correct)
… ist orthografisch korrekt. (is correctly spelled)
… zeigt die nötige Detailtiefe. (shows the necessary level of detail)
… enthält korrekt angewandte fremdsprachliche Fachwörter in angemessenem Umfang. (uses Latin/Greek medical terms correctly and in appropriate measure)
… gibt die wesentlichen Anamnesebefunde semantisch korrekt wieder. (renders the essential history findings with the correct meaning)
… trifft klare Aussagen über die wesentlichen Behandlungsschritte. (makes clear statements on the essential treatment steps)

Criterion 1 can only score 2.5, 1.5 or 0: if the name or date of birth is missing, those points go quickly. Criterion 7 checks that you report what the patient said — the reason patient statements are written in Konjunktiv I (reported speech). About half the criteria concern content (2, 5, 7, 8), the other half form (1, 3, 4, 6). How the form is laid out is shown under documentation.

Part 3: Ärztliches Gespräch (doctor–doctor conversation)

The candidate …

… stellt den Fall der Simulationsanamnese flüssig und situationsangemessen vor. (presents the case fluently and appropriately)
… drückt sich grammatisch korrekt und gut verständlich aus. (speaks grammatically correctly and clearly)
… verwendet fremdsprachliche Fachwörter korrekt und in angemessenem Umfang. (uses medical terms correctly and in appropriate measure)
… trifft klare Aussagen über die wesentlichen Befunde und Behandlungsschritte. (makes clear statements on the essential findings and treatment steps)
… kann Rückfragen ohne sprachliche Probleme beantworten. (answers follow-up questions without language problems)
… ist in der Lage, an einer Diskussion über den Fall teilzunehmen. (can take part in a discussion of the case)
… übersetzt 5 medizinische Fachbegriffe ins Deutsche. (translates 5 medical terms into German)
… vervollständigt 2 medizinische Abkürzungen und liest 3 Laborwerte mit den entsprechenden Zahlen und Maßeinheiten korrekt vor. (completes 2 medical abbreviations and reads out 3 lab values with the correct numbers and units)

A quarter of the points (criteria 5 and 6) depends on your answers to follow-up questions, another quarter (7 and 8) on small tasks you can drill — see medical terminology.

What other chambers publish about their criteria

Lower Saxony grades, among other things, "Sprachfluss, Ausdruck und Verständlichkeit, allgemein- und fachspezifischer Wortschatz, sprachinhaltliches Verstehen, sprachinhaltliche Vermittlung, Gesprächsführung, Grammatik, Orthographie" (fluency, expression and intelligibility, general and specialist vocabulary, comprehension of content, conveying content, conversation management, grammar, spelling).
Saxony lists what matters in each part, for example "Vermeiden Sie Floskeln" (avoid stock phrases), "Achten Sie auf richtiges Zahlenverständnis" (make sure you understand numbers correctly), "Geben Sie exakt das Gesagte wieder, interpretieren Sie nichts" (reproduce exactly what was said, do not interpret) and "Reagieren Sie sprachlich korrekt und fließend auf Rückfragen" (respond to follow-up questions correctly and fluently).
Hamburg decides with a four-part sheet (general professional communication, doctor–patient communication, written expression, doctor–doctor communication) and minus points; shaded fields covering particularly important exam content count 4 : 1. In the documentation, "Lesbarkeit und Vollständigkeit" (legibility and completeness) count.
Bavaria examines with two physicians and one language expert and introduced an updated scoring module on 1 March 2025. Points are not published but do exist: according to the retake leaflet, the preparation time before a retake is set "in Abhängigkeit von der erreichten Punktzahl" (depending on the score achieved).
Rhineland-Palatinate names concrete deductions: unintelligible or illegible answers, wrong capitalisation in the vocabulary list, more than one translation per term, overlong answers in the reading section — and patient questions that you push to the end ("Punktabzug bis hin zum Nicht-Bestehen", deductions up to failing).
Westfalen-Lippe, Baden-Württemberg, Thuringia grade against an "einheitliches, strukturiertes Schema" (uniform, structured scheme) that is not published.

Pass rules by chamber

Chamber	Scoring system	Passed if …	Compensation between parts
Berlin	3 sheets × 8 criteria, 0–2.5 points each (max. 60)	at least 60% in each part (12 of 20)	no
Nordrhein	3 examiners, max. 20 points per sheet (max. 60)	at least 36 of 60 points (60%)	yes — no per-part minimum published
Hamburg	minus points; shaded fields count 4 : 1	fewer than 12 minus points	not published
Rhineland-Palatinate	points per section, weighted differently	minimum score in every section and total above 60%	no — the exam stops as soon as a section is failed
Brandenburg	not published	all three parts passed	no
Bavaria	internal points, not published	the panel finds that all requirements are met in all three areas	not published
Other chambers	"einheitliches, strukturiertes Schema" or nothing published	judgement of the examination board	not published

Rhineland-Palatinate goes further: a candidate who only just reaches the minimum in one section must make up for it with above-average scores in other parts, according to the chamber. Bremen records the result formally as "Die erforderlichen Fachsprachenkenntnisse sind gegeben" or "nicht gegeben" (the required language skills are / are not present).

A worked example shows what the difference means in practice (illustrative, not the sheet of a specific chamber): 11 points in the patient conversation, 16 in the documentation and 17 in the doctor–doctor conversation make 44 of 60. Under Berlin's rule that is a fail, because part 1 is below 12. Under Nordrhein's total rule it would be above 36. So prepare in such a way that each part stands on its own.

Pass rates: what the chambers publish

There is no nationwide statistic by exam part. Individual chambers publish totals:

Chamber	Period	Result	Source
Bavaria	2024 (3,030 exams)	first attempt 53% passed, second attempt 49%	Bayerisches Ärzteblatt 3/2025
Nordrhein	2023 (2,040 exams)	35.8% failed (2022: 33%)	Rheinisches Ärzteblatt 10/2024
Westfalen-Lippe	2014–2023 (4,868 candidates)	"Rund der Hälfte" (around half) pass at the first attempt; 86.6% had passed by the end of 2023	Westfälisches Ärzteblatt 2/2024
Baden-Württemberg	2019 / 2020 / 2021	62% / 65% / 65% passed	German Medical Association 2022
Saxony-Anhalt	2019–2022 (1,110 exams)	"gut zwei Drittel" (a good two thirds) passed	Deutsches Ärzteblatt 2023
Thuringia	2018 (348 exams)	209 passed, 139 failed	Deutsches Ärzteblatt 2019

No chamber publishes which part candidates fail most often. The only hint comes from a Nordrhein examiner who finds that the colleague conversation and the documentation "in der Regel besser als das Gespräch mit den Schauspielpatienten" go (usually go better than the conversation with the actor patients). The typical causes are covered in common mistakes.

How and when you learn the result

Chamber	Announcement	In writing
Bavaria	orally after the panel's deliberation	proof of the result on the day, no certificate; reported to the government on the next working day
Westfalen-Lippe	immediately after the exam, with an information sheet	in writing the following week
Lower Saxony	orally, discussed with you, with a recommendation if needed	reported to NiZzA after about a week
Baden-Württemberg, Saxony, Thuringia, Hessen	immediately after the exam or after deliberation	reported to the licensing authority
Brandenburg	orally at the end of the exam	written confirmation from the state office (LAVG)
Mecklenburg-Vorpommern	immediately after the exam	if passed, certificate by email and post within two weeks
Rhineland-Palatinate	by the chair right afterwards	certificate only if passed
Nordrhein	"zeitnah" (promptly)	reported to the district government
Hamburg	"zeitnah per E-Mail" (promptly by email)	reported to the social authority
Berlin	at the earliest ten days after the exam	certificate as a PDF by email; no information by phone
Bremen	orally by the chair	"rechtsmittelfähiger Bescheid" (a formal decision open to legal challenge)

What applies after a failed attempt — waiting time, fee, access to the evaluation — is covered under failed the FSP.

What this means for your preparation

Bring every part to 60% on its own. Where parts are not compensated, a strong doctor–doctor conversation does not rescue a weak patient conversation.
Practise part 1 as a communication test: ask back, steer the conversation, answer the patient's questions immediately in lay language, and end by explaining the suspected diagnosis and next steps.
Write part 2 for safety: name and date of birth, full sentences, Konjunktiv I, correct medical terms.
Do not underestimate part 3: on the Berlin sheet, follow-up questions and the terminology tasks make up half of this part's points.
Know your chamber's rules: check the task sheet, the form and the permitted aids on your federal state's page.

Sources

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