German Approbation
The Approbation is the unlimited license to practice medicine in Germany. There are three examinations; the first covers the first two years of medical studies, the second is after completion of five years of medical studies and the final is taken after a year of practical training.

There are other restrictions to take into consideration before practicing medicine in Germany. Doctors must prove fluency of German Language by achieving a B2 level of the Common European Framework of Reference as well as a C1 level in Medical German. Foreign doctors are assessed before being allowed to register for the Approbation and may be awarded a restricted license to practice and train in a hospital for a limited period of time before taking the examinations.
Medical graduates must have their credentials and certificates assessed before approval to apply. Medical graduates must have completed no fewer than 6 years at a medical school that must include at least 48 consecutive weeks of practical training. Before qualifying for the first exam, proof of completion of first aid training as well as three months of nursing experience must be provided. Before qualifying for the second exam, a four-month clinical elective must be completed. Before the third exam, a year of clinical training must be completed including 16 weeks in each of: surgery, medicine, general practice/clinical specialty.
Path Most Often Used
Medical students or graduates begin learning German, then apply for medical electives and training in the specialty they are interested in allowing them to gain experience, fulfill the requirements for the examination and make contacts in German hospitals. Upon completion of the B2 level, graduates apply for positions at German hospitals. When they are chosen for a position, the hospital sponsors their Approbation application, allowing them to practice with a restricted license until they are ready for the examinations.