Please read carefully and follow with surgical precision

Aims & terminology

  • The procedure to “apply for the German medical license” = Approbation application, must be started early after A2 level, because it requires many documents and takes 6-8 weeks until the first milestone is reached to obtain a “Feststellungsbescheid” which is needed for visa application (and later on for the exam registrations).
  • The procedure is highly bureaucratic and involves two German governmen entities. Please read and memorize their name abbreivations and tasks carefully to be fully oriented during the process:
  1. The ZAG (Central Recognition Office for Health Professions NRW) in the City of Münster, state of North Rhine-Westphalia (NRW) is responsible to receive applications from foreign medical doctors, who reside or intent to move in this state, and and to assess the equalness of their qualifications with German medical studies. As a routine decision for all applicants, who completed their medical degree outside the EU, they always refuse to issue the medical license immediately and instead reply with a letter, called “Deficitbescheid or Zweckbescheid” where they state that the foreign qualifications cannot be upfront recognised as equal to German medical studies and therefore the applicant has to take the medical language exam (FSP) and knowledge test (KP).
  2. This “assessment notice” is then required by the consulates to prove the purpose of the visa application for participation in a preparation program for the mandated exams.(Detailed instructions how to obtain the assessment notice below)

The ZSBA (Central Service Center for Professional Recognition) is responsible for verifying, if an applicant, who still lives abroad, truly intends to move to the state of NRW. This determines the responsibility of ZAG to process the case. The ZSBA verification includes an assessment via a written form, and sometimes skype interview with the applicant. It results in a document called “Location Note”. Only after ZAG receives the location note from ZSBA, they process an applicants case. (Detailed instructions how to get the location annotation below)

Cooperation with HCA-Niche team for a smooth & professional guidance

Our team will guide you safely through all administrative procedures. In order to achieve maximum effectiveness and efficiency, please observe the following instructions:

Compliance: Read all our instructions, templates, etc. carefully and follow in surgical detail.

Self-relianceAsk us for clarification if you are unsure about the instructions, but strive to complete the tasks independently.

IT proficiency: Indians are perceived in Germany as “IT world champions” and expected to master digitalized workplaces with ease

  • Please never send documents as email attachments, always upload to your google drive folder.
  • When filling forms, pay attention to proper layout and formatting.
  • Always name documents as instructed.
  • Produce clean scans (not fotopics framed with traces of bedcover sheets around).
  • Keep the folder tidy and delete obsolete documents.
  • Always store all documents related to the entire procedure of Approbation application in the proper subfolder “Approbation application”.
  • Do not create additional subfolders within this folder except one called ZSBA for ZSBA related documents.
  • Copy in cc when sending mails to ZAG and ZSBA
  • Forward mails that you receive from ZAG and ZSBA.
  • Upload all attachments that you receive from ZAG and ZSBA into your google cloud folder, even when you forward their mails to us.
  • Allow three days response time for our staff. Be sure we care for your case, but sometimes we have urgent tasks to complete first.


Step 1: Complete online template "Approbation application template ZAG Münster"

  • In your cloud folder is a subfolder “Approbation” and inside a googledocument “TEMPLATE Approbation Application ZAG Münster” . This pre-filled document includes the templates for cover letters, official application documents (including template for a health certificate) and CV.
  • Please open and complete it online. Do not duplicate this file.
  • Look for all text in green-colored letters and exchange it against your personal data.
  • Make sure the layout and formatting is clean and professional.
  • Do not sign and date the document yet.
    Inform on
  • Machmüller when the document is ready to review.

Step 2: Compose required documents for ZAG


Get color-print paper copies of the following documents:

  1. University MBBS degree title
  2. Record of transcripts, including number of hours each subject was taught and your marks achieved
  3. Internship certificate, including rotation subjects and duration in each department
  4. Registered with the Indian Medical Council
  5. Passport (main page with personal data)
  6. Birth certificate
  7. Latest German language certificate (if available)

Step 2.2 : Get the COPIES ATTESTED by the German consulate

  • All copies must be attested by the German consulate as identical to the original.
  • Request an appointment for document attestation at the German consulate in your region.
  • Take all paper copies and their corresponding originals to show to the consulate staff.
  • Consulate staff will compare originals with copies, then bundle, stamp and sign the copies.


Get fresh originals of the following documents:

8. Police Clearance Certificates (PCC)

9. Certificate of Good Standing from your Medical Council

10. Health Certificate (template within the document “Approbation application form ZAG Münster). It must be signed and stamped by another registered doctor.

These fresh originals do not need to get attested, because you have to submit them as originals.

By the date of arrival at ZAG, they must not be older than 3 months. Count that you have to send them to our office, then we forward it to the translator, translator may need 2-3 weeks for translation. Then we forward the paper package to ZAG.

Note: Before you come to Germany, you need again a fresh PCC from India (plus, if applicable, additional fresh PCC of all countries where you officially lived within the last 5 years.)

Step 3: Print, sign, scan and upload ALL DOCUMENTS to your cloud folder

  • Print the document “Approbation application template ZAG Münster”. Be sure that is was checked by Dr. Petereit.
  • Sign and date all pages or wherever indicated.
  • Produce one  scanned pdf-document (not individual photos, not individual pdf files) with a maximum file size of 10 MB , as an electronic twin of everything you will send to Germany, including:
  1. all signed and dated page of the “Approbation application”, including the “Ärztliche Certificate/Health certificate” exactly where it was placed in the form before
  2. all pages of the bundle of attestations, including the front page with the bundle strip and back page with official consulate stamp
  3. all new certificates (police clearance, good standing)
  • Name this pdf “Approbation application complete- yourLASTNAME” and store it in the googlecloud folder. It will serve as security backup in case the postal package gets lost, translator or German authorities misplace them, etc.
  • Keep the “appro application” cloud folder slim and tidy: At this point it should only contain TWO documents: 

1. “Approbation application-yourLASTNAME” (stays as google doc)
3. “Approbation application complete-yourLASTNAME” (one pdf of all scans)

Step 4: Triple Check

  • Check the entire file thoroughly and in detail. Then inform us for a final check.

Step 5: Send "application for approval complete" by email to translator

  • Send the pdf-file “Approbation application complete-yourLASTNAME” to: Mrs Lamia Ahmad at . Mrs Ahmad is sworn for English and Arabic translations. State that you are a HCA participant and request translation of your English documents into German.
  • Ms. Ahmad will send the bill based on the number of words/pages. (Standard translation fees.)
  • Transfer translation fees directly to her German bank account.
  • Note: We cooperate with Mrs. Ahmad and recommend her services since many years but do not receive any commission, etc. All business between you and her is independent of us.

Step 6: Send paper documents to HCA

Send the following documents by DHL to our HCA office:

  1. all paper pages of “Approbation application complete…” with your original signatures, including the medical certificate
  2. the bundle of certified copies
  3. the new originals (police clearance and good standing)

Do not send any other documents such as employer references, university good standing letters, etc. They are not needed neither appreciated by ZAG and would only cost unnecessary translation fees.

  • Use international DHL air-express transport.
    Mr. Linoy Joseph – HCA-Germany An der Lune 13 45966 Gladbeck, Germany
  • Upon arrival, we double-check if all documents are complete and will forward the package to the translator.
  • Translator will translate and staple the translations with you copies according to German standards.
  • We receive the package back from the translator and send it by postal mail to ZAG.

Step 7: G et a "location note" from ZSBA

ZAG will reply to you with a letter/email stating that an additional document called “Standortvermerk” is needed from the German labor agency’s department ZSBA.

“Location note” is an unbinding “letter of intent”, in which a foreign doctor declares to ZSBA his/her desire to work in a certain state in Germany. This determines, in which state his/her approval application will be processed. Upon declaring to ZSBA that you intend to work in NRW, which is the state where our HCA institute is located and where you will live throughout the HCA DocPrep Program, ZSBA will issue this “Standortvermerk” to the German authority ZAG.

Note: After you pass the FSP and KP exams and obtain the Approbation certificate (medical license), you are free to work in any state in Germany. Nevertheless, most of our alumni indeed find their first jobs in NRW after they lived here during the 10 months HCA DocPrep Program.

7.1 Complete the ZSBA forms

Download the templates
Add your personal data in the form “editable ZSBA_Registration sheet partly filled” .
In the language section, replace the word “mother tongue” with your mother language and add one other language in the line below and tick the suitable proficiency box.
In the section regarding German language, either state your highest level certificate and in which course level you currently are. If you don’t have any certificate yet mention ” currently in XY course.
Create a new subfolder “ZSBA” within your “Approbation” folder.
Save the document as “ZSBA-Registration Sheet-yourLASTNAME” as pdf there.
Copy the information from the document “Authorization to third parties pre-filled” into the form “Editable Authorization to third parties”.
Save as “ZSBA-Proxy-yourLASTNAME. pdf in your HCA googledrivefolder “ZSBA”.
Either print, sign, scan again, or insert an electronic signature in both documents.

7.2. Mail ZSBA forms and personal documents to ZSBA

  • Write an email with the following text to , copy to


Email header: ZAG requests location note

Ladies and Gentlemen 

I am a doctor in India and have already applied for a license to practice medicine at the ZAG Münster in order to receive the notification of approval for the visa application in the first step 

The ZAG has now asked for a location note from the ZSBA. That’s why I’m hereby registering with you. 

In the attachment you will receive 

  1. ZSBA Registration Form & Power of Attorney
  2. ZAG confirmation of receipt with request for location note
  3. Complete license application with all documents

I am already registered for a ten-month preparatory course for the medical language and knowledge test at the training company HCA based in Dortmund/Gladbeck. That’s why I’m well informed about the recognition requirements for foreign doctors and would be very grateful for a quick response so that the ZAG can continue to process my application for a license to practice medicine and issue the notice of assessment. 

Best regards 

First name Last Name 

7.3 Complete the ZSBA forms

Within approx. 1-2 weeks, ZSBA will reply by mail and offer a personal skype meeting to discuss your plans for Germany. 

Confirm the skype meeting by email.

The purpose of the skype meeting for ZSBA is to inquire whether your really want to move to our state of NRW in Germany. Otherwise the ZAG wouldn’t process your application. They will ask where you intend to work as a medical doctor after you obtain your license and you are supposed to confirm that you intend to work in NRW. In reality, it is impossible to now at this moment in time where in Germany you will find a job. With a full license you are free to work in any state anyway. However, as a bureaucratic procedure ZSBA is obliged to obtain the information that you intend to work in the state of NRW (Bonn and Münster are also in NRW) . Only with this unbinding confirmation of yours they will issue a document called “Geortatermerk” = confirmation of local intent. After the skype meeting they will send you this location note document and ask that you sign and return it to ZSBA by mail. Please do so and use the following email text:


Dear Ms/Mr LASTNAME (of the person who sent you the mail),

Many thanks for the note on the location, which I am hereby signing and returning to you. Thank you for your advice and I will be happy to contact you if you have any further questions. 

Best regards

your first name LASTNAME 

Attachement: signed location note


Store your version of the location note in your ZSBA folder.


8 Receive "assessment notice" document from ZAG

Within approx. 4 weeks ZAG will then send you the “assessment notice”.
The “Feststellungsbescheid” is a letter stating that your foreign qualification can be safely assessed as equivalent to a German medical study degree and that you will have to take the medical language exam (Fachsprachprüfung=FSP) and medical knowledge exam (Kenntnisprüfung=KP) before getting the approval.

This “Feststellungsbescheid” statement is a prerequisite for the visa application with which you have to proof the necessaty to move to German with the purpose to prepare for these exams at our HCA DocPrep Program in Germany.

Next tasks

During the waiting time for the “assessment notice” please already start to prepare for visa application. (Instructions will be released after payment of the final installment of HCA & Niche International program fees.)