You can study medicine in Germany with a school certificate from outside the EU, but you compete in a separate, small pool. Applicants who are not treated as equal to Germans are ranked only against each other in a foreigners' quota set by each federal state (5% of places per university in Lower Saxony, for example), and they apply to the university directly or through uni-assist, not through hochschulstart. The degree is taught in German (at least DSH-2 or TestDaF 4 in every part, roughly C1), lasts six years and three months, and is tuition-free in most states; Baden-Württemberg charges non-EU students $1,712 (€1,500) per semester. School leavers from countries whose certificates do not give direct access, including Russia and Kazakhstan, first need a Studienkolleg M course or a completed year at a university at home.
This guide explains how the degree is built, who decides on admission, which tests actually move your ranking, what it costs and what changes if you are already a medical student or a doctor.
Is this route realistic for you?
Medicine in Germany is a seven-to-eight-year project once you count preparation. Match your profile honestly before you invest.
| Your profile | How realistic | What to do |
|---|---|---|
| School leaver with top grades, German at A2–B1 | Possible, via a preparatory year | Studienkolleg M course, German to C1 in parallel, TestAS |
| School leaver with good but not top grades | Hard | Aim for a very strong FSP result, collect extra points, keep a related degree as plan B |
| First- or second-year medical student at home | Possible | Check direct access in anabin, pass a German exam, apply in the foreigners' quota |
| Qualified doctor from outside the EU | No need to study again | Recognition procedure and Approbation, general German B2 plus medical C1 |
| No realistic way to reach German C1 | Public medical degree closed | Consider English-taught medicine elsewhere, for example in Turkey, or related English-taught programmes in Germany |
If research appeals to you more than patient care, look at biochemistry, molecular medicine, biomedicine or health sciences. Competition is milder and some master's programmes are taught in English.
How the medical degree is structured
The federal Medical Licensure Regulation (Approbationsordnung für Ärzte, ÄApprO) sets one continuous programme leading to a state examination. There is no bachelor's or master's in medicine.
- Volume: 5,500 hours over six years; the standard period including the final exam is six years and three months.
- Pre-clinical stage, two years. Natural sciences, anatomy, physiology, biochemistry. Ends with the first part of the state examination (Erster Abschnitt der Ärztlichen Prüfung).
- Clinical stage, three years. Clinical subjects and hospital teaching, then the second part of the exam.
- Practical year (Praktisches Jahr). 48 weeks of full-time hospital training, followed by the third, oral part.
- Placements outside lectures: a first-aid course, three months of nursing service (Krankenpflegedienst) and four months of clinical clerkship (Famulatur).
Passing all three parts entitles you to apply for the Approbation, the state licence to practise. Specialist training (Weiterbildung) follows as a salaried junior doctor.
Why non-EU applicants compete separately
For Germans and EU citizens, places in medicine, dentistry, veterinary medicine and pharmacy are allocated centrally by the Stiftung für Hochschulzulassung through hochschulstart. For winter semester 2025/26 the central procedure for these four subjects had 37,836 applicants and 17,298 offers.
Most non-EU applicants are outside those numbers. hochschulstart treats EU and EEA citizens as equal to Germans, as well as foreign nationals holding a German school-leaving certificate (Bildungsinländer). Everyone else counts as "not equal" and competes in advance quotas (Vorabquoten).
How it works in practice:
- Before the main allocation, up to 20% of places are set aside for special groups: foreign applicants, second-degree applicants, hardship cases and future rural doctors.
- State law sets the foreigners' share. Lower Saxony reserves 5% of places at each university (§ 8 NHZVO). A faculty with 200 first-year places therefore admits about ten non-EU applicants a year.
- Within the quota, the university ranks candidates under its own selection statute (Auswahlsatzung). There is no nationwide formula.
- You apply either directly to the university or via uni-assist, depending on the institution. The University of Lübeck, for example, asks non-equal international applicants for the first semester to apply in the special quota through uni-assist.
The practical conclusion: judge your chances by each faculty's rules, not by hochschulstart cut-offs.
How a faculty ranks international applicants: the Freiburg example
The University of Freiburg publishes a points table for non-EU applicants for 2026/27. The statute is what legally binds, but the table shows the logic clearly.
| Criterion | Points |
|---|---|
| School-leaving grade (converted to the German scale) | 0–40 |
| German at the minimum level (TestDaF 4×4, DSH-2) | 5 |
| German above the minimum: DSH-3, TestDaF at least 3×TDN 5 + 1×TDN 4, Goethe C2 "sehr gut"/"gut", telc C2, telc C1 Hochschule "sehr gut"/"gut", FSP graded 1.7 or better | 15 |
| TestAS: core test and one subject module (5–7 points each) | up to 14 |
| Successful semesters of medicine or natural sciences | 1 per semester, up to 5 |
| Placement in a hospital or medical practice: 3 / 6 months | 1 / 2 |
| Motivation letter and CV | 0–6 |
| Studienkolleg M course | 5 |
| Completed vocational training of at least three years (listed professions) | up to 6 |
What the table tells you: the grade is worth at most 40 points, yet the other criteria together can add more. Moving from "minimum C1" to DSH-3 is worth 10 points, and TestAS up to 14. A German grade of 1.0 earns 40 points, 2.0 earns 30, 2.5 earns 20, 3.0 earns 10, and from 3.5 you get zero.
How your grade becomes a German grade. Most universities and uni-assist use the "modified Bavarian formula": X = 1 + 3 × (Nmax − Nd) / (Nmax − Nmin), where Nmax is the best possible mark, Nmin the lowest pass mark and Nd your average. Two worked examples:
| System | Your average | German grade | Freiburg points |
|---|---|---|---|
| 5-point scale, pass = 3 (e.g. Russia, Kazakhstan) | 5.0 | 1.0 | 40 |
| 5-point scale, pass = 3 | 4.6 | 1.6 | 34 |
| 5-point scale, pass = 3 | 4.0 | 2.5 | 20 |
| Percentage, pass = 50% (illustrative) | 90% | 1.6 | 34 |
| Percentage, pass = 50% (illustrative) | 80% | 2.2 | 26 |
Treat this as an estimate: a faculty may use your FSP grade instead of the school certificate, and rounding is defined in its statute. The order of magnitude still helps you decide where to invest effort.
Freiburg groups international applicants by region and publishes last year's thresholds. For winter semester 2025/26, admitted applicants in the "Europe" group scored 71–76 points and those in the "Asia" group 73–80. The statute defines which group your country belongs to.
TMS, TMSnat, HAM-Nat and TestAS: which test matters for you
This is where most applicants get confused.
TMS (Test für medizinische Studiengänge) is a roughly five-hour aptitude test costing $114 (€100). In the central hochschulstart procedure, universities must take a subject-specific aptitude test into account for medicine, dentistry and veterinary medicine; applicants are not obliged to sit it but lose points without it. So it matters above all for Germans, EU citizens and others treated as equal. Ulm, for example, awards up to 44 of 100 ranking points for the TMS in its own university quota and up to 90 in the additional aptitude quota.
What changes in 2027. TMS and HAM-Nat are being merged into a new test, TMSnat. The last TMS in its old format takes place in November 2026 (registration closed in summer 2026). The first TMSnat is planned for 8–9 May 2027, with registration expected in February 2027. It may be retaken without limit and the fee stays at $114 (€100). Each university decides how long it accepts old TMS results; Freiburg plans to consider only TMSnat from the 2028/29 winter selection.
Do you need TMS in the foreigners' quota? That depends on each faculty's statute. Freiburg's non-EU table does not include it but does include TestAS. Before you spend months preparing, open the Auswahlsatzung of each target university and check whether TMS or TMSnat appears for international applicants.
TestAS is the aptitude test for international students. For medicine you take the core test plus a subject module (Freiburg counts "Mathematics, Computer Science and Natural Sciences" or "Medicine and Life Sciences").
After school: Studienkolleg M course or a year at university at home
Many school certificates from outside the EU, including the 11-year certificates of Russia and Kazakhstan, do not give direct access to a German university. The university or uni-assist decides, based on the KMK recommendations in the anabin database. There are two routes.
Studienkolleg, M course. A one-year preparatory programme in Germany, taught in German: biology, chemistry, physics, mathematics and German, ending with the Feststellungsprüfung (FSP). Medicine requires the M course specifically; a T or W course will not do. Public colleges with an M course include those in Marburg (Studienkolleg Mittelhessen), Munich, Hamburg, Frankfurt, Heidelberg and at Freie Universität Berlin. Entry to the college itself usually requires B1–B2 German. See our Studienkolleg guide for entrance tests and deadlines.
The year is an investment. The FSP grade feeds into your average, and at Freiburg the M course itself earns 5 points while an FSP graded 1.7 or better counts as high-level German worth another 15.
A year at university at home. A successfully completed first year in your country, in medicine or a natural science, typically opens direct access to a related subject. The upside is no preparatory year in Germany; the downside is that you must bring your German to exam level on your own while studying.
How much German you need and how it affects ranking
The minimum for medicine is DSH-2 or TestDaF with TDN 4 in all four parts. That satisfies the formal requirement, but in the foreigners' quota language often works as an extra ranking criterion: at Freiburg, DSH-3 or TestDaF with three TDN 5s is worth 10 points more than the minimum.
Aim for the top band, not the pass mark. It pays off in substance too: from the first semester you read anatomy and physiology in German. Which certificates are accepted and where to sit them is covered in our guide to German language tests: TestDaF, DSH and Goethe.
Deadlines and an 18–24-month plan
Most faculties admit first-year students only for the winter semester (starting in October). Freiburg's window for international applicants for 2026/27 runs from 1 June to 15 July 2026, and the deadline is final. If a university works through uni-assist, submit six to eight weeks before the deadline, because document checks take time.
| When | What to do |
|---|---|
| 24–18 months before | Shortlist 6–10 faculties, read their statutes, check your certificate in anabin |
| 18–12 months before | German to B2, apply to a Studienkolleg (M course) or plan your first university year at home |
| 12–6 months before | TestAS, hospital placement (3+ months if it scores points), DSH-3/TestDaF certificate |
| 6–2 months before | Translations, certifications, motivation letter, submission via uni-assist or directly |
| June to 15 July | Final applications for the winter semester |
| August–September | Decisions, visa, blocked account, housing |
uni-assist charges $86 (€75) for the first programme and $34 (€30) for each additional one in the same semester. Our uni-assist application guide explains how to avoid delays.
What it costs
| Item | Amount | Notes |
|---|---|---|
| Tuition in most states | 0 | Public state-examination programmes are free |
| Baden-Württemberg (Heidelberg, Freiburg, Tübingen, Ulm) | $1,712 (€1,500) per semester | Non-EU students who entered from winter 2017/18; exemptions under the LHGebG |
| TUM, Munich | 0 | TUM does not charge fees for state-examination programmes, although it does for non-EU bachelor's and master's students |
| Semester contribution | usually a few hundred euros | Transport ticket, student services, administration; Hamburg, winter 2026/27: $459 (€402) |
| Proof of funds for the visa | $13,584 (€11,904) per year | $1,132 (€992) per month; usually a blocked account |
If you enter Germany before admission, for example for preparation or entrance exams, the missions expect at least $1,245 (€1,091) per month (prospective-student status under § 17 of the Residence Act).
Private medical schools exist in Germany, but they charge fees and are few. Check two things: that the programme ends with the German state examination and that the institution is state-recognised (visible in the Hochschulkompass).
A student residence permit allows up to 140 full working days a year. In medicine this is mostly theoretical: clinical semesters and the practical year leave little time.
Scholarships: what to expect
There are practically no scholarships for first-year non-EU medical students, so do not plan your studies around one. Realistic options appear after enrolment:
- Deutschlandstipendium: $342 (€300) per month, open to students of all nationalities at state or state-recognised universities and independent of family income. The university selects and pays, usually based on performance and engagement.
- Gifted-student foundations (Begabtenförderungswerke) and DAAD programmes mostly fund advanced students, master's students and researchers; see scholarships in Germany and DAAD. Russian citizens should note that since February 2026 DAAD, like several German political foundations, has been on Russia's list of undesirable organisations; check a foundation against that list before applying.
A scholarship counts towards proof of funds only if it covers at least $1,132 (€992) a month; you must show the difference in a bank account. See our blocked account guide.
After graduation: work and specialisation
Graduates of a German medical faculty do not need a recognition procedure: after the third part of the state exam they apply for the Approbation at the state authority like their German classmates. Citizenship plays no role for the licence. Specialist training then begins: you work as a junior doctor (Assistenzarzt) in a hospital, earn a salary, and the length depends on the specialty.
Under § 20 of the Residence Act, graduates of a German degree can receive a residence permit of up to 18 months to look for a job, provided they can support themselves. The local foreigners' authority, not the university, decides.
If you are already a medical student abroad
Transferring into a higher semester is harder than starting in the first. Crediting your subjects and placements is decided by the state examination office (Landesprüfungsamt), not the faculty, and foreign curricula rarely match the German structure. Lübeck, for instance, asks applicants for higher semesters to contact the International Office first.
For most first- and second-year students the realistic path is a new application to the first semester in the foreigners' quota. Your completed semesters still help: they give direct access without a Studienkolleg and at some universities earn points (up to 5 at Freiburg).
If you are already a doctor: Approbation in brief
Doctors with a non-EU degree do not need to study again, but they must obtain a licence through recognition. State health authorities run the procedure under § 3 of the Federal Medical Code (Bundesärzteordnung):
- Equivalence check. The authority compares your training with the German programme.
- Knowledge test (Kenntnisprüfung). If equivalence is not confirmed, or documents are insufficient, you sit an exam covering the content of the final state examination.
- Language. Following the 2014 decision of the health ministers' conference, you need general German at B2 and medical German at C1, tested in the Fachsprachprüfung at the state medical chamber. In Baden-Württemberg it has three parts of about 20 minutes each (patient interview, documentation, discussion with a colleague) and costs $479 (€420) per attempt, with no limit on attempts.
Language requirements and accepted certificates differ between states; the doctors' union Marburger Bund keeps an overview by state.
Dentistry, pharmacy, veterinary medicine and related options
Dentistry, pharmacy and veterinary medicine follow the same admission logic: hochschulstart allocates places for Germans and EU citizens, each programme has its own foreigners' quota, and the university selects. The German requirement and the Studienkolleg M course are the same. Competition in dentistry and veterinary medicine is also high, so they rarely work as a fallback.
If you want to work in health but not necessarily as a treating physician, consider programmes outside central allocation:
| Programme | How it differs from medicine | Leads to a medical licence? |
|---|---|---|
| Molecular medicine, biomedicine | Laboratory and research work; some master's in English | No |
| Health sciences, public health | Prevention, management, epidemiology | No |
| Medical informatics, medical engineering | Data, devices, hospital IT; often at universities of applied sciences | No |
| Pharmacy | State examination and pharmacist licence | No, pharmacist licence |
These programmes have their own selection rules; Ulm, for example, also considers the TMS for molecular medicine. Our guide to universities of applied sciences in Germany explains where medical informatics and engineering are usually taught.
Common mistakes
- Relying on hochschulstart cut-offs. They are irrelevant for non-EU applicants; what counts is the foreigners' quota and each faculty's rules.
- Preparing for the TMS "just in case". Many foreigners' quotas do not use it, and the format changes in 2027. Read the statutes first.
- Choosing the wrong Studienkolleg course. A T or W course does not lead to medicine.
- Stopping at "minimum C1". In the foreigners' quota, top-band German can be worth as much as a quarter of the grade points.
- Applying to one or two universities. With only a handful of places per faculty, apply to 6–10 universities with different rules.
- Confusing health-related degrees with medicine. Health sciences or medical engineering do not lead to the Approbation.
FAQ
Not in a programme that leads to the German state examination and Approbation at a public university: every faculty whose rules we checked requires at least DSH-2 or TestDaF 4×4. Related fields such as biomedicine, molecular medicine and public health are available in English, but they are not medical degrees.
The state decides. Lower Saxony reserves 5% of places at each faculty; overall, advance quotas for all special groups can reach 20%. A faculty with 200 places admits roughly ten non-EU students a year.
In the central procedure for Germans and EU citizens, universities must weigh an aptitude test. In the foreigners' quota each university decides; Freiburg, for example, uses TestAS instead. From 2027 the TMS is replaced by TMSnat, first sitting 8–9 May 2027.
Only if anabin grants your certificate direct access. Otherwise you need a Studienkolleg M course and the FSP, or a completed first year at university at home, before applying in the foreigners' quota.
Most states charge no tuition, only the semester contribution ($459 or €402 in Hamburg for winter 2026/27). Baden-Württemberg charges non-EU students $1,712 (€1,500) per semester. For the visa you must show $13,584 (€11,904) per year for living costs.
The state examination office decides after reviewing your curriculum. Even without credits, completed semesters give direct access without a Studienkolleg and sometimes extra points.
Recognition by the state authority (equivalence check or Kenntnisprüfung), general German at B2 and a medical-language exam at C1 at the medical chamber. The Approbation follows.
Next step
Shortlist six to eight medical faculties, open their selection statutes and write down what earns points in the foreigners' quota. Compare that with your grades, your German level and whether you can fit in TestAS. For the wider picture, see studying in Germany.
StudyU does not decide on admission or allocate places: the university allocates places within its quota and the consulate issues the visa. Choosing faculties that fit your profile, planning preparation and putting together applications are provided under an agreement with StudyU.
Sources
- Medical Licensure Regulation (ÄApprO), § 1 — checked 23.09.2026
- hochschulstart: international applicants, procedure and quotas, statistics WiSe 2025/26 — checked 23.09.2026
- Lower Saxony admission regulation (NHZVO), § 8 — checked 23.09.2026
- University of Freiburg: applying for medicine and selection criteria for non-EU applicants, 2026/27 — checked 23.09.2026
- Grade conversion table, modified Bavarian formula, Leibniz University Hannover — checked 23.09.2026
- Ulm University: medicine selection — checked 23.09.2026
- University of Lübeck: applying for medicine — checked 23.09.2026
- TMS: news on the switch to TMSnat — checked 23.09.2026
- Baden-Württemberg Ministry of Science: fees for international students — checked 23.09.2026
- TUM: tuition fees for non-EU students — checked 23.09.2026
- University of Hamburg: semester contribution 2026/27 — checked 23.09.2026
- uni-assist: fees — checked 23.09.2026
- German missions: proof of funds, Residence Act, § 16b, § 20 — checked 23.09.2026
- Deutschlandstipendium: student FAQ — checked 23.09.2026
- Federal Medical Code (BÄO), § 3 — checked 23.09.2026
- Baden-Württemberg Medical Chamber: Fachsprachprüfung, Marburger Bund: German requirements by state — checked 23.09.2026
- Exchange rate: ECB, 23.09.2026, €1 = $1.1411
Next steps
- Blocked Account in Germany 2026: Amount, Opening Steps and Alternatives
- German Language Tests for German Universities: TestDaF, DSH, Goethe and telc Compared (2026–2027)
- Applying to German Universities: uni-assist, VPD and hochschulstart Step by Step
- Universities of Applied Sciences in Germany: How a Fachhochschule Differs from a University and Who It Suits
- Studying in Germany for international applicants
- Medicine in Turkey
