Study nursing in Germany: Ausbildung, requirements and visa

Reading time: 11 minutes | Category: Working in DACH

Yes, you can study nursing in Germany even if you have no healthcare background. For most international applicants the route is not university but the Ausbildung zur Pflegefachfrau or zum Pflegefachmann: a three-year vocational training that combines classes at a nursing school with placements in hospitals, care homes and home care services. You are paid every month while you train. To get in you need a school-leaving certificate equivalent to the German one, German at B1 or B2 (depending on the federal state), a training contract and, if you are not an EU citizen, a vocational training visa under Section 16a of the Residence Act (Aufenthaltsgesetz).

This article is for people who are not nurses yet: school leavers, graduates in other fields and anyone who wants to change careers and start from scratch in Germany, whether you are reading this in Manila, Nairobi, Delhi or Bogotá. If you already hold a nursing qualification from your country, your route is different: you apply for recognition of your qualification (Anerkennung). Our article on German for nurses covers that path.

What the nursing Ausbildung is

Since 1 January 2020, nursing training in Germany has been governed by the Nursing Professions Act (Pflegeberufegesetz). The act merged the three separate programmes that existed before (general nursing, paediatric nursing and geriatric care) into a single generalist training. Graduates hold the title Pflegefachfrau, Pflegefachmann or, in gender-neutral form, Pflegefachperson.

The law sets the structure in detail. Training lasts three years full-time or up to five years part-time. It includes at least 2,100 hours of theory and practical lessons at the nursing school (Pflegeschule) and 2,500 hours of placements in healthcare settings, so you spend more time on the ward than in the classroom. At the end you sit a state examination.

The first two years are the same for everyone. Before the third year you choose: continue with the generalist training or specialise in elderly care (Altenpflege) or paediatric nursing (Gesundheits- und Kinderkrankenpflege). The generalist qualification is recognised throughout the European Union, useful if you later want to work elsewhere in the EU.

Germany needs to train more nurses. According to the Federal Statistical Office (Destatis), the country could be short of between 90,000 and 350,000 nursing professionals by 2034. That is why many hospitals and care homes take on trainees from abroad.

From your first placement you will be talking to patients, relatives and colleagues. A shift usually starts with the Übergabe, the handover between shifts: „Herr Weber hatte heute Nacht Schmerzen und hat schlecht geschlafen.“ (Mr Weber was in pain last night and slept badly.) German is not a box you tick for the visa. It is part of the job from day one.

Ausbildung, degree or nursing assistant training

There are three ways to train in nursing in Germany. They differ in length, entry requirements and the qualification you end up with:

For most people coming from outside the EU without prior training, the Ausbildung is the most realistic option. The entry requirements are lower than for university, you are paid from the first month, and once qualified you work as a Pflegefachfrau or Pflegefachmann on the same footing as someone with the bachelor's degree.

Nursing assistant training (Pflegehilfe) is shorter and does not lead to the Pflegefachfrau or Pflegefachmann title. If you go on to the full Ausbildung afterwards, you can ask for the assistant training to be credited and shorten the Ausbildung by a third.

Entry requirements for the nursing Ausbildung

1. A recognised school-leaving certificate

The law asks for a mittlerer Schulabschluss (the German certificate after ten years of schooling) or an equivalent qualification. A lower school-leaving qualification is also accepted if it comes with a completed vocational training, as is the completion of ten years of general schooling.

Whether your certificate is equivalent to a German one is decided by the certificate recognition office (Zeugnisanerkennungsstelle) of the federal state where you will live. If equivalence is confirmed, you receive a Bescheinigung über die Gleichwertigkeit. Only completed qualifications are recognised, not individual school years. You can look up the responsible office in the anabin database.

2. German at B1 or B2

The law requires the German skills needed to practise the profession but does not set a single level. According to Make it in Germany, the German government's official portal for skilled immigration, the requirement is B1 or B2, depending on the federal state. Each nursing school may also have its own rules. Before you apply, ask the school or the hospital which level and which certificate they accept. Certificates from ÖSD, the Goethe-Institut and telc are equivalent.

A tip from the classroom: even if you are admitted with B1, aim for B2 during your training. The state examination is in German, and so are care documentation, lessons in anatomy and pharmacology, and conversations with doctors.

3. Other documents

• A medical certificate confirming you are fit for the profession.
• A criminal record certificate (Führungszeugnis, or the equivalent certificate from your country).
• A training contract with a hospital, care home or home care service that works with a nursing school.

How much you earn during the Ausbildung

The nursing Ausbildung is paid, and the amount depends on the employer and the region. A useful benchmark is the collective agreement for trainees in the public sector (TVAöD-Pflege). From 1 May 2026 it sets the following gross monthly amounts:

Private hospitals, care homes and church-run institutions have their own agreements and may pay different amounts. These are gross figures: tax and social security contributions are deducted.

For the visa, your training pay counts as proof of funds if it reaches at least 1,048 € gross a month (Make it in Germany, 2026). The public-sector rates are above that minimum; with other employers, check your contract.

The vocational training visa (Section 16a AufenthG)

If you are not an EU citizen, you need a residence permit for vocational training. It is regulated by Section 16a of the Residence Act. The key points:

• A confirmed place: you need a training place in Germany before you apply.
• Approval from the Federal Employment Agency: for in-company training, the Bundesagentur für Arbeit checks that you are employed on the same terms as German trainees.
• German: B1 is generally required. The law does not require a certificate if the school has already checked your level or if you will attend a preparatory German course in Germany.
• Proof of funds: your training pay (at least 1,048 € gross) or, if it is lower, a blocked account or a formal declaration of commitment from a sponsor.
• Side job: you may work up to 20 hours a week in a job unrelated to your training.

Once you finish the Ausbildung, you have up to 18 months to find a job in your profession. After two years of work you can apply for permanent residence (Niederlassungserlaubnis), provided you meet the other requirements. For the wider picture of work visas, see our article on Germany's skilled immigration law.

What if you do not have a training place yet?

There is a visa for looking for a training place (Section 17 AufenthG). It lets you stay in Germany for up to nine months to apply. The requirements: you must be under 35, have German at B1, hold a school-leaving certificate that gives access to university studies (or a certificate from a German school abroad), and have at least 1,091 € a month in a blocked account (2026 figure).

Studying nursing at university (Pflegestudium)

Since the 2020 reform you can also qualify as a nurse through a bachelor's degree at a university or Hochschule. The degree takes at least three years, includes placements and gives you the same licence as the Ausbildung. Since 1 January 2024, under the Nursing Studies Strengthening Act (Pflegestudiumstärkungsgesetz), nursing students are paid throughout their studies under a contract with a healthcare provider.

The hurdle is university admission. Whether your school-leaving certificate gives you direct access depends on your country and the type of certificate; in some cases you first need to complete a Studienkolleg or some university study at home. You can check this with the uni-assist tool, which is based on the anabin database. Universities that teach in German also tend to ask for a higher level than nursing schools, often C1 proven by DSH or TestDaF. Check each university's requirements before you decide.

How much German you need and how long it takes

From zero to B1 you go through levels A1, A2 and B1. In our courses that means seven sub-levels, each with 30 hours of live classes and 30 hours of guided work on the learning platform. On an intensive course (two or more classes a week) you reach B1 in about 12 months, including breaks; on an extensive course (one 2.5-hour class a week) it takes about 21 months. If your federal state asks for B2, add four more sub-levels. Classes are live online, so you can start from your home country.

Once you have a solid base in general German, it pays to add the vocabulary of the sector. Our German for nurses course (A2/B1) works on the language of real care situations. A few sentences you will use from your first day:

• „Haben Sie Schmerzen? Wo genau?“ (Are you in pain? Where exactly?)
• „Ich messe jetzt Ihren Blutdruck.“ (I'm going to take your blood pressure now.)
• „Möchten Sie etwas trinken?“ (Would you like something to drink?)
• „Ich habe diese Woche Frühdienst.“ (I'm on the early shift this week.)

Notice the Sie: patients are addressed with the formal form. English has only one "you", so many learners mix up du and Sie, and on a hospital ward people notice straight away.

For your certificate you can choose between ÖSD, the Goethe-Institut and telc; all three are accepted. Our exam centre in Buenos Aires (ARG 001) runs ÖSD exams from A1 to B2, on paper and in person. If you are working towards B1, here is an ÖSD B1 model test with practice tasks.

Austria and Switzerland

Austria. The registered nursing qualification (diplomierte Gesundheits- und Krankenpflege) is a three-year bachelor's degree at a Fachhochschule. There are also two shorter trainings: Pflegeassistenz (about one year) and Pflegefachassistenz (two years). Another route is the Pflegelehre, an apprenticeship of three years (Pflegeassistenz) or four years (Pflegefachassistenz); it does not lead to the diploma, but you can go on to study for it at a Fachhochschule afterwards.

Switzerland. The most common route is the Pflegefachfrau or Pflegefachmann HF at a Höhere Fachschule. It takes between one and a half and three years, depending on your previous education. A bachelor's degree in nursing at a Fachhochschule is also available. Residence rules in both countries differ from Germany's, so check them before you apply.

If you are already a nurse

If you already have a nursing qualification, you usually do not need to start again with an Ausbildung. The normal route is to apply for recognition (Anerkennung) of your qualification, which generally requires German at B2. The steps and authorities are explained in our article on German for nurses.

Frequently asked questions

Can I study nursing in Germany without speaking German?

No. Classes, placements and the state examination are all in German. Nursing schools usually ask for B1 or B2, depending on the federal state, and the vocational training visa normally requires B1.

Can I study nursing in Germany in English?

The nursing Ausbildung and the state examination are taught and assessed in German, and German is a legal requirement for the licence to practise. Plan to learn German before you start.

Do nursing trainees in Germany get paid?

Yes. In the public sector, the TVAöD-Pflege collective agreement sets gross monthly pay from May 2026 at 1,490.69 € in the first year, rising to 1,653.38 € in the third. Other employers may pay different amounts.

Is there an age limit?

No age limit is mentioned for the vocational training visa itself. The visa for looking for a training place is only available if you are under 35.

I am already a nurse in my country. Do I need the Ausbildung?

Usually not. The normal route is to apply for recognition of your qualification (Anerkennung), which generally requires German at B2 level.

About the author

Daniel is a political scientist, German language teacher and ÖSD examiner at Sprachzentrum Buenos Aires, the official ÖSD exam centre in Argentina. He has guided course participants from their first level to the exam for years and knows the typical questions and hurdles of learning German.

Sources

• Pflegeberufegesetz Section 6 (length of training)
• Pflegeberufegesetz Section 11 (entry requirements)
• Pflegeberufegesetz Section 2 (German and licence)
• Pflegeberufegesetz Section 38 (university degree)
• PflAPrV Section 1 (teaching and placement hours)
• Aufenthaltsgesetz Section 16a
• Make it in Germany: Ausbildung as a nurse
• Make it in Germany: visa for vocational training
• TVAöD-Pflege pay table (from May 2026)
• Anerkennung in Deutschland: recognition of school certificates
• uni-assist: university admission check
• Hochschule Bremen: pay for nursing students since 2024
• Destatis: nursing workforce projection
• AMS Austria: nursing professions
• BMWET Austria: Pflegelehre
• berufsberatung.ch: Pflegefachfrau/Pflegefachmann HF