Facharzt in Germany: How to Do Specialist Training (Weiterbildung)?

You've got your Approbation (full licence to practise) — now what? In Germany the real career begins with becoming a Facharzt (specialist physician). Unlike in Turkey, you don't compete for a quota through a centralised exam like the TUS; instead you start work at a clinic as an Assistenzarzt (resident physician), complete a defined curriculum over the years, and finally earn your title through the Facharztprüfung (specialist exam). In this article I walk through this path step by step, from the perspective I lived myself.

1. What is a Facharzt? How it differs from specialisation in Turkey

A Facharzt is a physician specialised in a field — the equivalent of an "uzman doktor" in Turkey. But the way you acquire it is fundamentally different. In Turkey you secure a post with your TUS score and complete your residency. In Germany the process rests on two pillars:

• Time-based (Weiterbildungszeit): every specialty has an official minimum duration (e.g. Allgemeinmedizin ~5 years). You must complete that time at a clinic/under a physician who holds the authorisation.
• Content-based (Logbuch): simply putting in the time isn't enough. According to the Weiterbildungsordnung set by your state medical chamber (Landesärztekammer), you must record and prove a certain number of procedures, examinations, cases and competencies in your Logbuch (digital logbook).

So in Germany, to say your "residency is finished" you must both complete the years and document the curriculum. Once both are done, you sit the exam.

2. Weiterbildung durations by specialty (roughly)

Durations vary slightly by state and medical chamber; the table below is meant to give a general orientation. For the exact duration, check your own state's Weiterbildungsordnung.

Important: these durations are for full-time work. If you work part-time (Teilzeit), the duration extends proportionally. In addition, in fields like Internal Medicine, adding a subspecialty (Schwerpunkt — e.g. Cardiology, Gastroenterology) increases the total time.

3. How do you start? Finding an Assistenzarzt position (Stelle)

The door to the specialist path is finding an Assistenzarzt-Stelle (resident physician post). The critical point to watch: the clinic or chief physician you join must hold Weiterbildungsbefugnis (authorisation to provide specialist training) in that field. This authorisation is granted for a certain duration (e.g. "36 months of authorisation for Innere Medizin"). Without it, the time you spend there does not count towards your Weiterbildung — this is one of the most common mistakes.

• In job ads, look for the phrase "Weiterbildungsermächtigung für … vorhanden".
• Clarify how many months the authorisation covers before signing — if it's short, you make it up with a rotation.
• University hospitals and large city hospitals usually grant the full duration; smaller clinics may be partial.

4. The Logbuch, rotations and the Weiterbildungsgespräch

Once you've started work, the process runs like this:

• Logbuch: you regularly fill in the content from your medical chamber (now mostly digital, the eLogbuch). You record the procedures you've done, the cases you've seen, the trainings you've attended, and have them signed off by your chief physician. This logbook is your proof when you apply for the exam.
• Rotations: the curriculum may require you to rotate through different departments (e.g. an intensive-care or emergency rotation in Internal Medicine training). If your own clinic alone isn't enough, you go to another clinic on rotation.
• Weiterbildungsgespräch: at least once a year you have a structured appraisal meeting with your chief physician. Where you stand, your gaps and your next goals are put on record. These meetings are formally mandatory and the documentation may be requested before the exam.

5. The Facharztprüfung (the Kammer oral exam)

Once you've completed the time and finished the Logbuch, you apply to your state medical chamber. If your documents are approved, you're called to the Facharztprüfung. Similar to the FSP, this is an oral exam — held before a panel of specialists appointed by the chamber.

• It usually lasts around 30 minutes, testing the practical and theoretical knowledge of your specialty.
• It proceeds through case-based questions, diagnosis-treatment algorithms and everyday clinical decisions.
• If you pass, you receive the Facharzt-Urkunde (specialist certificate) and may now use the title "Facharzt für …".
• If you fail, you can retake it after a set period; this exam isn't an obstacle to panic over like the FSP — it's confirmation of the work you've done for years.

6. Salary progression: from Assistenzarzt to Facharzt

In Germany physician salaries are mostly tied to a collective labour agreement (Tarifvertrag) and rise incrementally by seniority. You start as a resident physician and move up a tier each year; once you gain the Facharzt title, you jump to a separate, higher pay group. On top of that come on-call (Bereitschaftsdienst) payments.

For the full table of the tiered system, the gross-net difference and on-call pay, see my separate article: Germany physician salaries and Tarifvertrag guide →

7. The relationship with the FSP / Approbation: licence first, then specialisation

The order is clear and must not be confused:

• FSP (Fachsprachprüfung): the medical German proficiency exam. It's a precondition for Approbation.
• Approbation: the full licence to practise. Without it you can't work as a fully authorised physician, so under normal circumstances you can't have your Weiterbildung counted.
• Berufserlaubnis (temporary permit): here's the critical point — before your Approbation is complete, you can start working under supervision at a clinic with a time-limited Berufserlaubnis. In many states the time you spend with a Berufserlaubnis can be counted towards your Weiterbildung once you later obtain your Approbation. This is the most common way to start specialisation early.

Practical takeaway: don't wait around thinking "let me first perfect my German, then I'll look for a job". If you pass the FSP and enter an Assistenzarzt position with a Berufserlaubnis, you both earn money and start clocking your specialist hours. Time is the most valuable resource in this system.

8. Frequently asked questions and common mistakes

• "Does my specialisation from Turkey count?" — Partly. You can apply to the medical chamber and request Anerkennung (recognition); part of your past training may be counted towards the Weiterbildung duration. It requires document translation and a content comparison, and the outcome varies by state.
• The most common mistake: spending years at a clinic without authorisation (Weiterbildungsbefugnis) or with insufficient duration, and only later learning your hours don't count. Document the authorisation before signing.
• The second most common mistake: leaving the Logbuch to the last minute. If you don't record procedures the same day, gathering them and getting them signed off later becomes very hard.
• Choice of specialty: ease of finding a job varies by field. In areas like Innere Medizin, Allgemeinmedizin, Anästhesie and Psychiatrie there are plenty of open positions; this makes the entry door easier for international physicians.
• Language: passing the exam is one thing; using everyday medical German fluently in the clinic is another. The real measure is communication with patients and the team.