2. Deficit notice: Apply for recognition from abroad

2.1 What is a deficit notice?

The deficit notice is an administrative act that determines whether and to what extent a foreign training course is comparable to a German training course and which compensatory measures (theoretical and practical instruction) are necessary in order to obtain a license to practice as a nurse. A deficit notice exists in various versions, depending on which training is to be recognized. The decisive factor in determining which training is to be recognized is always the question of which position is agreed with the nurse in the employment contract or which activities the nurse is to perform.

The starting point for determining the correct approach is always the position agreed in the employment contract

(Nurse or nursing assistant with or without training) and place of residence (Germany, European

Union, third country) of the foreigner. If the employee is already in Germany

Under certain conditions, employment without recognised training may also be possible .

The same applies to European citizens.

What are only nursing professionals allowed to do?

According to the Nursing Professions Act, the activities of nursing professionals are regulated. Nursing professionals are therefore only allowed to do the following:

• Survey and determination of individual care needs

• Organisation, design and control of the care process

• Analysis, evaluation, assurance and development of quality

2.2 Recognition procedure: Employing nursing professionals with foreign training

However, it becomes more difficult if a nursing professional or assistant without recognized training and residency is to be employed in a third country (e.g. as a nursing professional in a hospital). In this case, the recognition of the foreign training in Germany is necessary in order to obtain a visa to enter Germany (so-called deficit notice ). The deficit notice determines which compensatory measures the foreigner must take in order to be approved as a nursing professional (permit to practice the profession).

How does the recognition process work?

The recognition process for nursing professionals is as follows:

1. Submit an application for recognition: First, an application for recognition must be submitted to the responsible authority. In addition to the application, various supporting documents must be submitted.

2. Receive a deficiency notice: The recognition authority will decide on the basis of the documents submitted whether the training abroad corresponds to the requirements of training in Germany.

3. Apply for a visa: With the deficit notice, an entry visa can be applied for at the responsible foreign representation (embassy).

4. Entry and training: After receiving the visa, the caregiver can enter Germany. After entry, the visa must be converted into a residence permit by the immigration authorities.

5. Examination and professional license: After completing the training, the nurse must take an examination. If the examination is passed, the nurse receives a license to practice the profession.

6. Permanent residency: After completing the training, the foreigner is a skilled worker within the meaning of the Skilled Immigration Act. This entitles them to numerous privileges in relation to the settlement permit and naturalization.

2.3 Requirements and documents Deficit notice (application for recognition)

In order to submit the application for recognition to the competent authority, the documents listed below must be submitted. The authority will decide on the basis of the documents which compensatory measures are necessary in Germany. The documents should in any case be submitted in full and in the prescribed form in order to avoid delays in processing the application .

These documents are necessary to apply for recognition of a foreign nursing qualification in Germany:

• Passport or other international proof of identity

• Certificate of completion from abroad (e.g. diploma)

• Proof of the content of the training (e.g. diploma supplement)

• Professional CV (tabular list of training and employment)

• Proof of the planned activity in Germany and the place of activity (e.g. registration certificate)

• Employment references (if available)

• Language certificate (if available)

• Declaration that no other applications for equivalence have been submitted to date

However, it should be noted that the authority has the option of requesting additional documents if it has doubts about the accuracy of the documents. In some federal states, the recognition authorities even request additional documents as a general rule (see, for example, the information sheet on the recognition of foreign nursing qualifications in North Rhine-Westphalia). The documents should therefore be as informative as possible in order to avoid the authority requesting additional documents. Such a request can delay the recognition process by months.

The documents must always be submitted in German . Documents in foreign languages must be translated by a sworn translator in Germany. The original (and not a copy) must always be translated. The translation of the original must be certified by the translator. A list of all sworn translators can usually be found on the website of the respective embassy (see, for example, the list of sworn translators at the embassy in Manila (Philippines).