In short: If the authority finds substantial differences between your nursing training and German training, you must prove equivalent knowledge – either through a knowledge test covering the content of the state final examination or through an adaptation course of at most three years ending with an examination. Under § 40 (3) PflBG you have the right to choose.
Note: This page provides general information and is not legal advice. The law and the decisions of the competent authorities are decisive; rules can change. As of October 2026.
The knowledge test (Kenntnisprüfung)
An examination based on the content of the German state final examination in nursing, usually with oral and practical parts. It can be faster for experienced nurses with good German, but requires focused preparation.
The adaptation course (Anpassungslehrgang)
A course with theoretical and practical parts, at most three years long, ending with an examination on the content of the course. Its length depends on the deficits identified in your notice.
How to decide
- read your deficit notice carefully – it states which areas differ
- consider your German level, work experience and how much time you have
- ask the competent authority or an official advice service which providers exist in your federal state
How Berlin Tehran helps
We help healthcare professionals prepare their documents in an orderly way and coordinate with employers, following a transparent 8-step process with up to 90 days of support after arrival. We are specialised in Iran and support healthcare professionals from all countries where private recruitment is permitted (see our ethical recruitment rules). We do not provide legal advice; authorities make all decisions.
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Frequently asked questions
Can I choose between knowledge test and adaptation course?
Yes. Under § 40 (3) PflBG applicants have the right to choose.
How long is an adaptation course?
At most three years; the actual length depends on the identified deficits.
What does the knowledge test cover?
The content of the German state final examination in nursing.