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Nursing Recognition in Germany: Knowledge Test or Adaptation Course?
A nurse trained in Turkey cannot start working in Germany straight away as a registered nurse (Pflegefachfrau or Pflegefachmann); professional recognition (Anerkennung) comes first. The key decision is how you close any gaps. In this article I compare the two routes and explain what changes in 2027.
Hamza Çakın · IR - Law / Consultant
Nursing is a regulated profession in Germany. To use the professional title, you need a licence (Berufserlaubnis) from the state authority. That requires your foreign degree to be found equivalent to German nursing training.
How does recognition work?
- Application: to the authority of the state where you want to work. You can apply from Turkey.
- Equivalence review (Gleichwertigkeitsprüfung): the authority compares your training with German nursing training.
- Deficit notice (Defizitbescheid): if there are significant differences, you are told in writing where the gaps are.
- Compensation measure: you close the gaps with a knowledge test (Kenntnisprüfung) or an adaptation course (Anpassungslehrgang).
- Licence: granted once the compensation measure and language requirement are complete.
A new option: skipping the detailed review
Section 40(3a) of the Nursing Professions Act lets applicants from outside the EU waive the detailed equivalence review and go straight to the knowledge test or the adaptation course. That can save time if you want to skip the lengthy document review. Be careful, though: the waiver cannot be withdrawn.
The two routes compared
| Knowledge test (Kenntnisprüfung) | Adaptation course (Anpassungslehrgang) | |
|---|---|---|
| Format | Practical and oral exam | Theory and practical training, ending with an assessment interview |
| Duration (Bavaria example) | Practical part 240 minutes, oral part 45 to 60 minutes | 640 teaching units of theory (45 minutes each), 1,650 hours of practice |
| Best for | Nurses with strong experience and exam practice | Those who want structured preparation and a step-by-step introduction to the German system |
| Risk | Failing extends the process | Longer overall |
Source: information sheet of the Bavarian State Office for Nursing (LfP). Durations may vary by state.
German language requirement
The licence requires German good enough to practise. In practice, most states ask for a B2 certificate. Because patient safety is at stake, this is not relaxed. Preparing your German in parallel with recognition is the step that saves the most time.
The visa side
You can get a residence permit under section 16d of the Residence Act to take part in compensation measures. Since 2024 there is also the recognition partnership (Anerkennungspartnerschaft): you agree terms with an employer, move to Germany and start working while recognition is still under way. Nursing is a shortage occupation for the Blue Card, so the lower Blue Card salary threshold is also an option once you are recognised.
What changes in 2027?
According to the Federal Ministry of Health, a new nationwide training programme starts on 1 January 2027: Pflegefachassistenz (nursing assistant). Full-time training usually takes 18 months. The law also makes it easier to recognise assistant-level qualifications gained abroad: recognition through a knowledge test or adaptation course instead of a detailed equivalence review.
Our assessment
For candidates without a nursing degree but with healthcare experience, 2027 opens a new door. For nurses with a degree, the core task stays the same: choose the right compensation route and get your German to B2 in time.
Frequently asked questions
Is my Turkish nursing degree automatically recognised?
No. Every application is assessed individually. Even with strong training in Turkey, gaps in practical hours and some subject areas are common.
Which route should I choose?
With strong experience and time to prepare, the knowledge test is usually faster. If you want a gradual introduction to the German system, the adaptation course is more predictable.
Can I apply from Turkey?
Yes. You can apply from abroad; the state you apply to depends on where you want to work.
You can see the full path from recognition to your first job on our nursing and healthcare page, or find the right route for your case with us in a free consultation.
Last updated: October 2026 · Sources: Pflegeberufegesetz § 40 · Landesamt für Pflege Bayern · Bundesgesundheitsministerium · Anerkennung in Deutschland
This article is for general information and is not legal advice; durations may vary by federal state.