Act on Accelerating the Recognition Process for Foreign Professional Qualifications in the Healthcare Professions

Purpose of the Act

The Act essentially pursues three core objectives:

• Streamlining procedures

• Reducing bureaucracy

• Digitization and improved coordination between authorities

The recognition of foreign professional qualifications is typically a prerequisite for the issuance of a medical license or a license to practice a profession. Delays have frequently resulted in qualified professionals being unable to work for months.

Key planned changes

Until now, the focus has been on document-based equivalence assessments. In the future, knowledge-based assessments will become the norm.

Equivalency assessments based on submitted documents will still be possible but will take a back seat. The goal is to simplify the process for both applicants and the relevant authorities.

Important: The professional requirements for the equivalence of training remain unchanged. A lowering of the qualification level is not provided for by law.

Experts are already pointing out that knowledge tests must be subject to uniform quality standards nationwide to ensure a reliable and legally sound assessment.

The draft law implements Article 4f of Directive 2005/36/EC and establishes a clearer legal basis for so-called partial access to the profession.

If there are differences between foreign and German qualifications, in the future, at least work in those areas where equivalence exists should be permitted. Skilled professionals could thus already be deployed in specific areas without having to wait for the full recognition process to be completed.

The practical implementation of this instrument will largely determine whether it can actually ensure both faster processing and patient safety.

For schools operating under the ATA-OTA Act, the deadline for providing proof of state recognition is extended by four years. The goal is to secure training capacity and avoid shortages in the field of anesthesia and surgical technology.

The procedure is also to be comprehensively modernized:

• Option for digital application

• Elimination of the mandatory written form

• Electronic data exchange between authorities

• Information exchange among the states regarding ongoing recognition procedures

Better coordination is intended to prevent parallel or redundant reviews and unnecessary delays in the process.

Professional groups affected

The law applies in particular to:

• Physicians

• Dentists

• Pharmacists

• Midwives

Unfortunately, nursing professions are not covered.

In the case of midwives in particular, it is clarified that practical placements completed abroad and digital teaching formats may also be taken into account in the evaluation, provided they meet German requirements.

Praise and Criticism

In general, the draft bill is welcomed as an important step toward securing a skilled workforce. In light of demographic change and a growing number of people in need of care and treatment, the integration of qualified professionals from abroad is an essential component of ensuring adequate care.

The following points are the subject of particular criticism:

• the exclusion of nursing professions from the scope of application,

• the practical feasibility of the knowledge test as the standard procedure,

• ensuring uniform national quality standards,

• as well as the specific details of partial access to the profession.

There is a significant shortage of skilled workers, particularly in the nursing sector. According to reports from the field, numerous nursing professionals from abroad wait for many months for their qualifications to be recognized. Against this backdrop, there are calls to include nursing professions in the reform as well.

In addition, there are isolated suggestions to presume the professional competence of foreign skilled workers as a matter of principle and to test only language and professional knowledge in order to enable faster entry into the profession. It remains to be seen whether and in what form such proposals will be incorporated into the legislative process.

The draft bill represents a significant reform initiative. The shift to knowledge-based testing as the standard procedure can simplify processes, provided that the organization of the exams, capacities, and quality standards are appropriately structured.

The decisive factor will be whether the planned measures actually lead to a noticeable acceleration of procedures in practice or whether structural implementation problems persist at the state level. 

Speeding up recognition procedures is a key component in ensuring long-term medical care in Germany. However, whether the proposed legal changes will actually lead to a noticeable shortening of procedures and a reduction in administrative burdens in practice will only become clear once they are implemented.

For applicants, healthcare facilities, and competent authorities, a wide range of legal questions are already arising—particularly with regard to the design of the knowledge assessment, partial access to the profession, and transitional and grandfathering provisions.

Since the draft bill is currently still undergoing the parliamentary process, it remains to be seen whether it will enter into force in its current form or whether substantial changes will be made during the further legislative process.