Fachsprachprüfung in Rhineland-Palatinate: the Mainz format, fees

In short

In Rhineland-Palatinate, the Bezirksärztekammer Rheinhessen (Rheinhessen district medical chamber) in Mainz runs the Fachsprachprüfung (FSP, medical German exam) for the whole state, on behalf of the state medical chamber and the Landesamt für Soziales, Jugend und Versorgung (LSJV, state office for social affairs). It is considerably more extensive than elsewhere: six parts, from a vocabulary test to a reading and listening part with phone calls, taking 3 to 3.5 hours including waiting time. Every part has a minimum score, and overall you need more than 60 %. Since 1 January 2026 the fee has been €470.

At a glance

Item	Rhineland-Palatinate
Examining body	Bezirksärztekammer Rheinhessen, Mainz, on behalf of the state medical chamber and the LSJV; the LSJV also names FaMed in Mainz
Registration via	„Qualifizierte Eingangsbestätigung“ (qualified acknowledgement of receipt) from the LSJV Koblenz, then registration by e-mail with the district chamber
Fee per attempt	€470 (since 1 January 2026)
Duration and parts	six parts, 3–3.5 hours including waiting; parts 1–5 in varying order
Written part	four-page Anamnesebogen (history form, 20 min) and Untersuchungsanforderung (investigation request, 5 min), on paper
Terminology task	20 medical terms → patient German, 20 German terms → Latin/Greek, three tasks on a body diagram
Permitted aids	not published; mobile phone, tablet and smartwatch are handed in
Result	straight afterwards; certificate (original) only if you pass
Pass rule	minimum score in every part and more than 60 % overall; the exam is stopped as soon as a part is failed
Retakes	possible, after the preparation time recommended by the panel; full fee

How the exam works in Rhineland-Palatinate

The Mainz exam has little in common with the widespread FSP format of three 20-minute parts. The chamber examines in these parts:

Part	Task	Time
1	Verständnistest (comprehension test): translating terms, body diagram	20 + 5 min
2	Free, partly medical conversation	10–15 min
3	History taking and informing the patient in everyday language	20 min
4	Investigation request and history form	5 + 20 min
5	Reading (one-page text, three questions) and listening (two phone calls)	20 min
6	Specialist conversation with an „Oberärztin“ or „Oberarzt“ (senior physician)	15–20 min

Parts 1 to 5 can be examined in varying order; the specialist conversation comes at the end. The chamber gives detailed guidance on each part:

Comprehension test. A translation is required, not an explanation — „Antebrachium = Unterarm / nicht: Teil des Arms oberhalb der Hand“ (forearm, not: part of the arm above the hand). More than one translation per term costs points, as do mistakes in capitalisation. On the body diagram, marks should be exact and no larger than necessary. For preparation the chamber names dictionaries such as the Pschyrembel; more in Medical terminology in the FSP.

History taking. „Es ist nicht erforderlich, eine komplette Anamnese zu erfragen.“ (It is not necessary to take a complete history.) What is assessed is how well you speak, understand and respond. Record numbers and names correctly, ask for unfamiliar words to be spelt, and do not work through a memorised list of questions. Note the investigations named at the end separately — you need them in part 4.

History form and investigation request. In 5 minutes you fill in every field of the investigation request: the „Fragestellung“ (clinical question) in medical language addressed to a colleague, the clinical details as the patient reported them. The four-page history form follows in 20 minutes. Page 1 holds the personal data (name, date of birth, age, weight, height, place of residence, GP, occupation, marital status, children) and the current history in full sentences; page 2 previous illnesses and operations, family and gynaecological history; page 3 the vegetative history, mental state, medication, substance use and allergies; page 4 suspected diagnosis, differential diagnoses and the investigations discussed with the patient. On pages 2 and 3 you explicitly do not write full sentences (otherwise points are deducted). And you do not translate the patient's statements into medical language — „Eine Anamnese ist kein Arztbrief“ (a history is not a medical letter); medical terms belong on page 4 only. Many other chambers expect the opposite in the written part.

Reading and listening. You receive one page of medical text, such as a findings report or medical letter, with three questions. Answer briefly and precisely: unnecessarily long answers containing information that was not asked for cost points. In addition there are two phone calls whose content you note down — ideally first on a separate sheet, then legibly on the exam form. You may ask for patients' names to be spelt.

Specialist conversation. Doctor to doctor, in medical language, about the patient, what you read and heard, or other topics. Medical errors are not marked.

Registration and exam date

You need an application for a Berufserlaubnis (temporary licence) or Approbation (full licence) in Rhineland-Palatinate and the „Qualifizierte Eingangsbestätigung“ (or an interim decision) from the LSJV in Koblenz. If you apply from abroad, according to the LSJV you must first get advice from the Zentrale Servicestelle Berufsanerkennung (ZSBA, central recognition service). You register by e-mail with the current registration form, the acknowledgement, your B2 certificate, CV and a copy of your ID as PDFs. Applicants with a job offer, a Hospitation (clinical observership) or residence in Rhineland-Palatinate are invited first.

The chamber plans dates by quarter, without an exact preferred date; invitations come at least two weeks ahead, for a visa at least eight weeks ahead. You transfer the €470 only when asked; a date is assigned only once payment has arrived. If you cancel less than 14 days beforehand or do not attend, the fee is forfeited; for an earlier cancellation or postponement the chamber keeps half. Information is given in writing only. The exam takes place at Bauhofstraße 5a in Mainz. How the fee compares with other states is shown in FSP fees.

The LSJV accepts an FSP that is no older than three years and, besides the district chamber, also names the provider FaMed in Mainz as a contact — what that means is explained in Recognition of telc and FaMed.

Marking and result

You are examined by two people experienced in medicine with German as their first language, at least one of them with an Approbation. Every part has a minimum score; if it is missed, the panel stops the exam. The minimum scores alone are not enough, though: overall you need more than 60 %, so narrow results in one part have to be offset by above-average ones elsewhere. Anything unintelligible or illegible costs points.

The chair announces the result straight after the exam; a certificate (original) is issued only if you pass. The chamber publishes no current pass rates; in 2014 it reported a failure rate of 40 % among the 360 candidates examined up to then.

Retakes

The exam can be retaken, at the earliest after the preparation time recommended by the panel. You may deviate from this only for compelling reasons documented in writing, such as your visa expiring or a new job offer in Rhineland-Palatinate. Every retake requires a new registration form and the full fee. More on planning: Failed the FSP.

Tips for the exam in Rhineland-Palatinate

Answer patient questions immediately. The procedure notes explicitly threaten „Punktabzug bis hin zum Nicht-Bestehen“ (point deductions up to failing the exam) if you push the patient's questions to the end. Answer briefly and honestly, then lead back:

Example — fictional case (Frau Demir, 34, recurring headaches):

Patientin: Meistens rechts, hinter dem Auge. Kann das ein Tumor im Kopf sein?

Ärztin: Ich verstehe, dass Ihnen das Angst macht, und ich nehme die Frage ernst. Nach wenigen Minuten kann ich das noch nicht beurteilen. Genau dafür stelle ich Ihnen jetzt noch einige Fragen, und am Ende sage ich Ihnen, was ich vermute und welche Untersuchungen sinnvoll sind. Ist das in Ordnung?

Patientin: Ja, gut.

Ärztin: Dann noch einmal zu den Schmerzen: Wie fühlen sie sich an — pochend, stechend oder drückend?

The patient asks whether it could be a brain tumour; the doctor acknowledges the fear, says she cannot judge this yet, explains that her next questions serve exactly that purpose and promises an answer and a plan at the end — then returns to the pain (throbbing, stabbing or pressing?).

A „Dazu komme ich am Ende“ (I'll come to that at the end) would be the most expensive sentence of the exam here. More on anxious and demanding patients: Difficult patients.

Two registers on one form. Patient wording on pages 1 to 3, medical terms only on page 4 and in the „Fragestellung“ — practise exactly this switch.
Every part counts. Because the exam stops after a failed part, there is no part you can „sacrifice“ — and you only learn the order on the day.
Practise speaking freely. The free conversation in part 2 has no script. Practise answering unexpected questions aloud in full sentences — for example in the voice conversations with AI patients on fsppruefung.de, which, however, reproduce the standard format rather than the Mainz procedure.

Sources

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