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Key takeaway: Nurses trained outside the EU must show equivalent training or pass a knowledge test or an adaptation course (up to three years); health ministers' guidelines name B2 German. In care businesses (hospitals are excluded), the minimum wage for qualified nursing staff is €21.03 an hour from 1 July 2026. This page does not decide whether a given nurse can move.

Short answer: what the route depends on

This page cannot say whether you can move. German law ties the route to a permit to use the nursing title, which needs equivalent training or a pass in a knowledge test or adaptation course, to German language knowledge needed for the profession, and, for skilled employment, to a concrete job offer and a residence permit. The sections below set out each rule and its source.

Gesetze im Internet: § 1 PflBG (Führen der Berufsbezeichnung) Gesetze im Internet: § 2 PflBG (Voraussetzungen für die Erteilung der Erlaubnis) Gesetze im Internet: § 40 PflBG (Gleichwertigkeit und Anerkennung von Ausbildungen) Gesetze im Internet: § 18 AufenthG (Grundsatz der Fachkräfteeinwanderung)

Recognition of a nursing qualification

Under the Nursing Professions Act, anyone who wants to use the title Pflegefachfrau or Pflegefachmann needs a permit, and certain care tasks may be carried out professionally only by people who hold it. For training completed outside the EU, the EEA and Switzerland, § 40 requires equivalence with German training. If equivalence is not given, or it can be established only with unreasonable effort because the documents cannot be provided for reasons that do not lie with the applicant, the applicant must prove equivalent knowledge. That proof is a knowledge test covering the final state examination or an adaptation course of at most three years, and the applicant may choose between the two. An applicant who definitively waives the equivalence check by the competent body must also prove equivalent knowledge. The applicant must be informed of the legal consequences of that waiver and of the choice between test and course.

Gesetze im Internet: § 1 PflBG (Führen der Berufsbezeichnung) Gesetze im Internet: § 4 PflBG (Vorbehaltene Aufgaben) Gesetze im Internet: § 40 PflBG (Gleichwertigkeit und Anerkennung von Ausbildungen)

German-language requirement

The Act makes the knowledge of German needed for the profession a condition of the permit, but it names no level. The conference of the Länder health ministers (its 92nd meeting, 05.06.2019 to 06.06.2019) adopted guidelines, not a statute, stating that nursing professionals must show German at level B2 of the European framework; the Länder aimed to implement them by the end of 2020. As proof the guidelines accept, among other routes, a successfully passed language test that meets the minimum requirements they set out, including a simulated conversation with a patient, and is not older than three years. Check which proof the competent Land authority accepts.

Gesetze im Internet: § 2 PflBG (Voraussetzungen für die Erteilung der Erlaubnis) Gesundheitsministerkonferenz (GMK): Eckpunkte zur Überprüfung der für die Berufsausübung erforderlichen Deutschkenntnisse in den Gesundheitsfachberufen Gesundheitsministerkonferenz (GMK): Beschlüsse 2019 (92nd GMK, TOP 8.6)

Residence routes for skilled employment and qualification measures

Section 18(2) AufenthG makes a residence title for skilled employment depend, among other conditions, on a concrete job offer, consent of the Federal Employment Agency unless an exemption applies, a professional practice permit where one is required, and established equivalence of the qualification where that is a condition. A skilled worker with vocational training is someone with a German qualified vocational training or an equivalent foreign vocational qualification, and § 18a grants such a skilled worker a residence permit for any qualified employment. Whether a nurse's training counts as equivalent is decided in the recognition procedure described above. For a first permit under § 18a or § 18b after the age of 45, § 18(2) also requires a salary of at least 55 percent of the annual pension contribution ceiling unless adequate retirement provision is shown. The sentence that allows the authority to disregard conditions where there is a public interest in the employment, in particular when the salary threshold is only slightly missed or the age limit only slightly exceeded, sits inside that age-45 salary rule (point 5 of § 18(2)). This page does not suggest that the job-offer, practice-permit or equivalence conditions can be waived.

Gesetze im Internet: § 18 AufenthG (Grundsatz der Fachkräfteeinwanderung) Gesetze im Internet: § 18a AufenthG (Fachkräfte mit Berufsausbildung)

Residence permits for the recognition procedure

Section 16d separately provides a residence permit for qualification measures when the competent body has found that adaptation or compensation measures are needed. It is issued for up to 24 months, extended by up to twelve months to a maximum of three years, and requires German matching the measure, as a rule at least A2, which § 2 labels hinreichende (adequate) knowledge. Section 16d(3) provides a permit to carry out the recognition procedure while working in a qualified job. Among other conditions, it requires a concrete job offer, an agreement with the employer under which you start the recognition procedure promptly after entry, and at least adequate German. Where the work would need a practice permit and the employer is a care facility approved under § 72 of Book XI of the Social Code, the statute says the qualified-employment requirement is to be waived if the grading and pay match work that leads to the target profession.

Gesetze im Internet: § 16d AufenthG (Maßnahmen zur Anerkennung ausländischer Berufsqualifikationen) Gesetze im Internet: § 2 AufenthG (Begriffsbestimmungen, language levels)

Minimum wage in the care sector

The Seventh Care Sector Working Conditions Ordinance sets a gross minimum wage for qualified nursing staff (Pflegefachkräfte) of €21.03 an hour from 1 July 2026 and €21.58 from 1 July 2027. It covers care businesses that mainly provide outpatient, part-inpatient or inpatient care, and it expressly excludes hospitals. Qualified nursing staff here means employees whose qualification entitles them to carry out the tasks reserved by § 4 of the Nursing Professions Act; the ordinance sets lower minimums for other care workers. It is a legal floor, not an expected salary, and this article gives no annual salary range.

Gesetze im Internet: § 2 7. PflegeArbbV (Mindestentgelt) Gesetze im Internet: § 1 7. PflegeArbbV (Geltungsbereich)

Visa and residence-permit fees

The Federal Foreign Office lists €75 as the fee for a national visa for longer stays. The fee for issuing a residence permit in Germany is a separate charge, set at 100 euros in § 45 of the Residence Ordinance (AufenthV). The Foreign Office adds that the rules provide for visa fee reductions or waivers in certain cases; fees can change, so confirm the amount with the authority handling your application.

Federal Foreign Office: Visa fees - how much will applying for a visa cost? Gesetze im Internet: § 45 AufenthV (Gebühren für die Aufenthaltserlaubnis, die Blaue Karte EU)

Settlement permit timelines

On the skilled-worker route, § 18c(1) AufenthG requires three years holding a permit under §§ 18a, 18b, 18d or 18g, 36 months of pension contributions or proof of comparable provision, and sufficient German (ausreichende Kenntnisse), which § 2 defines as level B1; the periods shorten to two years and 24 months after a completed German vocational training or degree. The Blue Card (§ 18g) is for skilled workers with an academic qualification and has its own salary conditions, so its timeline does not apply to every nurse. Its holders can receive a settlement permit after 27 months with simple German (level A1), or 21 months with B1 German. Other conditions apply.

Gesetze im Internet: § 18c AufenthG (Niederlassungserlaubnis für Fachkräfte) Gesetze im Internet: § 2 AufenthG (Begriffsbestimmungen, language levels) Gesetze im Internet: § 18g AufenthG (Blaue Karte EU)

What this article does not establish

It gives no salary range, processing times, shortage forecasts, rent figures, recognition or test fees, or fast-track programme details, because this review did not verify them against an official source. Recognition is handled by the competent Land authority, so ask it for the current procedure and timing before you plan a move.

Gesetze im Internet: § 40 PflBG (Gleichwertigkeit und Anerkennung von Ausbildungen)

Questions before acting

Is a nursing qualification from outside the EU recognised automatically?

No. Under § 40 of the Nursing Professions Act the training must be equivalent to German training; if equivalence is not shown, the applicant proves equivalent knowledge through a knowledge test or an adaptation course of at most three years and may choose between them. An applicant can also definitively waive the equivalence check and go straight to proving equivalent knowledge.

What level of German do nurses need?

The Act requires the knowledge of German needed for the profession without naming a level; the Länder health ministers' guidelines (92nd conference, 05.06.2019 to 06.06.2019), which are not a statute, name B2 for Pflegefachfrau and Pflegefachmann, and the competent Land authority decides which proof it accepts.

Is there a minimum wage for nurses in Germany?

In care businesses the legal gross minimum for qualified nursing staff, meaning employees whose qualification entitles them to the tasks reserved by § 4 of the Nursing Professions Act, is €21.03 an hour from 1 July 2026 and €21.58 from 1 July 2027. It is a floor, not an expected salary, and hospitals are excluded from the ordinance.

Can the practice permit or recognition be waived if there is a public interest in the job?

This page does not say so. The public-interest waiver in § 18(2) AufenthG sits inside the age-45 salary rule, and its examples are a salary threshold that is only slightly missed or an age limit that is only slightly exceeded.

Corrections in this revision

The previous version included statements without sufficient direct support. This revision removes or corrects:

  • Statements without direct official support: removed, or replaced with the official rule. Removed figures are not repeated on this page.

Review scope: legal and financial statements in this revised article. Recheck on a provider, professional, immigration or tax-rule change; reuse of dated figures requires a new check.

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About the author

António Mira is the founder of whereTOemigrate. For over a decade he has worked at the intersection of Portuguese real estate and overseas business, helping international clients navigate the cross-border decisions that come with relocating. He sits on the board of CCIAP (Portuguese-Arab Chamber of Commerce), the Portuguese-Saudi Business Council, and the Portugal-Hong Kong Business Association — always with one focus: enabling overseas business and human mobility into and out of Portugal.

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