Working as a Nurse in Germany: Recognition, German Language Level, Adaptation Course and Visa Steps for Foreign Nurses

Germany has a large and growing shortage of nurses and actively recruits from abroad, including from the Philippines, India, Kenya, Tunisia and other countries. Unlike the UK or US, the biggest hurdle is language: you’ll need to work in German. Here’s an overview of the process.

Germany’s recognition is handled by the competent authority in each federal state, and rules can change. Always check the official “Make it in Germany” and “Recognition in Germany” portals and your state authority.

Key facts

• The protected professional title is Pflegefachfrau / Pflegefachmann (registered nurse). Older titles include Gesundheits- und Krankenpfleger/in.
• Foreign qualifications must be officially recognised before you can work under the protected title.
• You usually need German at B1 or, more commonly, B2 level for professional recognition, depending on the state.

Step 1: Learn German

Start early. Many nurses spend 6–12 months or more reaching B1/B2. Recognised certificates include Goethe-Institut, telc and ÖSD. Some employers and programmes provide free or subsidised language courses.

Step 2: Apply for recognition (Anerkennung)

• Find the competent authority for the federal state where you plan to work using the official Recognition Finder.
• Submit certified copies and translations of your diploma or degree, transcripts with hours of theory and practice, licence, work experience certificates, CV and passport.
• The authority compares your training with German nursing training.

Step 3: Outcome of recognition

• Full recognition: your training is considered equivalent.
• Significant differences: you’ll be offered either a knowledge examination (Kenntnisprüfung) or an adaptation course (Anpassungslehrgang), usually lasting several months, often combined with work in a hospital or care home.

Step 4: Find an employer

• Many German hospitals and care providers recruit internationally, sometimes through government-supported programmes such as Triple Win (run by the Federal Employment Agency and GIZ with partner countries).
• Employers often support the recognition process, language courses and relocation.
• Check job offers carefully and avoid agencies that charge you large fees.

Step 5: Visa

• Non-EU nurses need a visa. Options include a visa for skilled workers (once recognition is complete) or a visa for recognition measures, which lets you come to Germany to complete an adaptation course or exam while working.
• Apply at the German embassy or consulate in your country. Appointment waits can be long, so plan ahead.

Life and work as a nurse in Germany

• Salaries are often set by collective agreements, such as TVöD in public hospitals, and increase with experience.
• Many nurses work in hospitals or long-term care homes. Care for older people is a big part of the job.
• Nursing tasks may differ from what you’re used to; basic care and documentation are emphasised.
• After a period of work and residence, permanent residence and family reunification are possible under German rules.

Pros and cons

Related guides

• Fake nursing recruitment agencies: 12 red flags
• Money plan for nurses moving abroad
• NMCN verification for abroad

Official sources

• Make it in Germany: Nursing
• Recognition in Germany