Fachsprachprüfung in Lower Saxony: format, report form, fees

At a glance

How the exam works in Lower Saxony

The exam is an individual, non-public exam held on the second floor of the Ärztekammer Niedersachsen. At least 50% of the examination committee are licensed physicians. After checking in on the day, you wait in the waiting area until the chair collects you. The general structure of the FSP is described in How the FSP works.

Part 1: Arzt-Patienten-Gespräch — doctor–patient conversation

In a role play you take the history of a simulated patient: personal details, current complaints, previous illnesses and medication, social and family history. You then share your suspected diagnoses and respond to the patient's questions and remarks — "auf die Richtigkeit der Diagnose kommt es bei der Bewertung nicht an" (whether the diagnosis is correct does not matter for the assessment). The focus is on understanding reliably and on language the patient can clearly follow. Paper for notes is provided; the notes are not assessed but must be handed in at the end.

Part 2: Schriftlicher Bericht — written report

In a separate supervised room you summarise the conversation "in Form eines Aufnahmebogens (handschriftlich und leserlich)" (as an admission form, handwritten and legible) and describe the next steps. You may use your notes and the medical dictionary provided. The published sample Berichtsbogen has two pages:

• Page 1: fields for Patient/in, Datum, Alter (Jahre), Größe (cm), Gewicht (kg), Allergien/Unverträglichkeiten, Genussmittel/Drogen, Sozialanamnese and Familienanamnese (patient, date, age, height, weight, allergies/intolerances, stimulants/drugs, social history, family history).
• Page 2: a summary "in Form eines Berichts mit Anamnese/Verdachtsdiagnose/Vorschlägen zur weiteren Diagnostik und Therapievorschlägen" (as a report with history, suspected diagnosis, proposals for further diagnostics and treatment), with the instruction "Bitte formulieren Sie in ganzen Sätzen!" (please write in full sentences). Anything already on page 1 need not be repeated here.

How to fill in such a form step by step is shown in Documentation in the FSP.

Part 3: Arzt-Arzt-Kommunikation — doctor–doctor communication

You present the patient to a physician examiner playing a senior doctor and then answer their questions — concisely and using standard medical terminology. You may use your notes from part 1 here as well. The exam ends with the vocabulary test: a short list of 12 common medical terms that you translate into their German equivalents, and vice versa.

Registration and dates

1. You apply to NiZzA (department 1) for the Approbation or Berufserlaubnis. Without an ongoing application you cannot take the FSP in Lower Saxony.
2. Once your documents are complete, NiZzA asks you to transfer the €595 in advance — only after this request, not before. At that point you can name a period in which you would like to take the exam.
3. After payment, NiZzA registers you with the ÄKN. The ÄKN emails you a planned date; exams usually take place on Tuesdays, Thursdays and Fridays. If the date does not suit you, agree an alternative by email as soon as possible.
4. About four to six weeks beforehand you receive the binding invitation with the time and instructions. You must confirm that you will attend.

Before 1 January 2026 the exam cost €490; the ÄKN's older information sheet still gives that amount. What counts is the amount NiZzA asks you to pay. Fees in all states are compared in FSP fees by federal state.

Cancelling is expensive: If you cancel after receiving the invitation and the slot cannot be reassigned, the fee becomes due again — including if you stay away because of illness. You must also expect to wait up to five months for a new date.

NiZzA generally accepts an FSP that you passed at another state medical chamber; you then submit a certified copy of the confirmation.

Scoring and result

The committee assesses according to a uniform, structured scheme oriented towards level C1. The ÄKN lists criteria including Sprachfluss (fluency), Ausdruck und Verständlichkeit (expression and intelligibility), general and specialist vocabulary, sprachinhaltliches Verstehen and sprachinhaltliche Vermittlung (understanding and conveying content), Gesprächsführung (conducting the conversation), grammar and orthography. Only language is assessed: "Medizinische Fragestellungen dienen allein dem Schaffen von Sprechanlässen" (medical questions serve only to create occasions for speaking). The chamber does not publish points or a pass mark. According to NiZzA, you pass if the assessment panel finds that you meet the language requirements. How other chambers grade: How the FSP is graded.

You are told the result orally immediately after the exam. The examiners discuss it with you and may recommend how to improve your language skills. About a week later the ÄKN reports the result to NiZzA, which continues your licensing procedure if you passed.

Retaking

After a failed attempt you decide whether to retake the exam or withdraw your application. The whole exam is always retaken, and the number of attempts is unlimited. For a retake, too, only NiZzA can register you. The recommended preparation time is not mandatory, but the ÄKN advises using it for suitable language courses or language-active observation placements (Hospitationen) in hospitals or practices. More: Failed the FSP?

Tips for the exam in Lower Saxony

• Practise with the sample Berichtsbogen. Fill page 1 in note form and page 2 in full sentences. Do not repeat on page 2 what is already above — it only costs time.
• Do not forget the social history. Lower Saxony names it explicitly in the task, and the form has its own field for it. So in part 1, ask specifically about occupation, living situation and marital status.
• Write legibly by hand. The report is handwritten, and "leserlich" (legible) is in the task. Practise under time pressure with pen and paper, not only on a computer.
• Learn vocabulary in both directions. The 12 terms go from medical term into German and vice versa — so not only „Hepatomegalie → Lebervergrößerung“ (hepatomegaly → enlarged liver) but also „Lebervergrößerung → Hepatomegalie“. See Medical terms in the FSP.
• Organise your notes by the form. You may use your notes in parts 2 and 3. If you already take notes in part 1 along the fields of the Berichtsbogen, you save minutes later. On fsppruefung.de you have a notes pad during the patient conversation for exactly this, and you write part 2 on a chamber-style documentation form.
• Avoid cancelling. Up to five months' wait and a fee that may fall due again make a late cancellation costly. Give NiZzA a period in which you will definitely be prepared.
• On the day: phones, luggage and aids may not be taken into the exam rooms, and your phone must be on silent. Bring something to drink yourself.

Sources

• Ärztekammer Niedersachsen: Fachsprachprüfung
• Ärztekammer Niedersachsen: Drei Schritte zur Fachsprachprüfung — Informationsblatt (PDF)
• Ärztekammer Niedersachsen: Berichtsbogen – Fachsprachprüfung (Muster, PDF)
• NiZzA: Informationsblatt zur Fachsprachprüfung für Ärzte mit ausländischem Berufsabschluss (PDF)
• NiZzA: Kosten Fachsprachprüfung und Kenntnisprüfung Ärzte / Ärztinnen NEU
• NiZzA: Fragen und Antworten (FAQ) Abteilung 1 (PDF)