Deficit notice

Are you recruiting international nursing staff and have to deal with the recognition of foreign qualifications in this context? Recognition of qualifications obtained abroad is an important step for international skilled workers to be allowed to work in Germany in their profession. However, it is often the case that the recognition process does not lead immediately to full equivalence with a German qualification, in which case a so-called Defizitbescheid (deficit notice) is issued. In this article, you will learn what exactly a deficit notice is, who needs it, how to apply for it and what happens afterwards.

International skilled workers can receive a deficit notice, also known as a statement of comparability, in the course of the recognition of their qualifications – especially in the nursing care sector. Recognition means here that the foreign qualification is to be equated with a German one. After the qualification has been evaluated, the applicant receives an assessment notification. If this notification is a deficit notice, the qualification has not been or has only been partially recognised. In other words, deficits were found compared to the German reference occupation.

Generally speaking, the recognition of foreign qualifications is required for all regulated professions in Germany. These include medical and nursing professions, teachers, craftsmen, etc.

Skilled workers, particularly those in the nursing professions (e.g. nurses, doctors), often receive a deficit notice. Why is that? Nursing staff qualifications in Germany are subject to strict requirements, which is why follow-up training measures are often necessary in this case.

Strictly speaking, you do not apply for a deficit notice as such, but rather for the recognition of a qualification. In other words, skilled workers apply for recognition of their qualifications by submitting all the necessary documents and certified translations. You can find out more about this process in our article “Recognition in Germany”.

1. Submitting an application

All professionals from third countries who wish to practise a healthcare profession in Germany must submit an application for the recognition of their qualifications. You must submit your application to the relevant authority. Use the Federal Government’s Recognition Finder to find out which authority you need to contact.  

All documents, including certified translations, must be submitted with the application. The sooner the authority receives a complete application, the sooner professionals will receive their deficit notice.

2. Document review & equivalence assessment

The authority will now check all documents for completeness and carry out an equivalence assessment. This process aims to equate the foreign qualification with a domestic one.

3. Deficit notice

In the healthcare sector, deficits are commonly identified in the equivalence assessment. This means that the foreign qualification cannot be fully equated with a domestic one. This is referred to as partial recognition. The deficits must be addressed through an adaptation measure or a knowledge test.

The deficit notice is applied for at the authority responsible for the federal state and the profession. You can use the Federal Government’s Recognition Finder to find out which recognition body is responsible for your profession.

The word deficit notice may sound very negative at first. However, this is generally not the case at all, since it only points out deficits that will require some post-qualification.

Determination of differences: The deficit notice determines differences between the foreign and the German qualification.  

List of deficits: The notice also sets out all theoretical and practical deficits.  

Post-qualification measures: Finally, the notice specifies which post-qualification measures are necessary in order to obtain full recognition.

The time it takes to receive a deficit notice varies and depends on the relevant authority, as well as on how well the documents were prepared. However, the process usually takes between two and six months.

Deficit notice will suggest measures that the skilled worker must complete in order for their qualifications to be fully recognised. These could be, for example, training courses, additional examinations or in-company adaptation qualifications. You will find suitable qualification offers for your skilled workers on the website of the Federal Government.

For nursing staff, an adaptation course, a knowledge test or an aptitude test is often necessary. A lot of the time, the deficit notice will even list suitable providers of these compensatory measures. It is often possible for the skilled workers to already work as assistants while undergoing these qualification steps.  

Once the required measures have all been successfully completed, the skilled workers receive a certificate that they must then submit to the competent authority. The requirements for the professional licence are then checked again and, ideally, your skilled workers can then work in their learned professions.

In the adaptation course, any gaps in knowledge must be addressed through specific measures. This means that additional knowledge must be acquired.

The knowledge test simply assesses whether the skilled worker already possesses the knowledge required to practise the profession.

If a skilled worker’s profession has not yet been fully recognised, they are usually not yet able to work in the profession they have trained for. However, in most cases there are certainly other roles within the company that they are permitted to carry out. A qualified nurse, for example, may initially work as a nursing assistant.

Is your skilled worker still abroad and has only received partial recognition of their qualifications? Skilled workers with a visa for the recognition of foreign professional qualifications can already come to Germany anyway for post-qualification and start the measures here. However, this is subject to a number of conditions:

Proof of partial recognition

Your skilled worker must provide proof of partial recognition. This is possible on the basis of the deficit notice.

Confirmation of registration for qualification measures

Your skilled worker must also have already registered for a qualification measure and provide proof of this. For predominantly practical measures, skilled workers need a further training plan from you as an employer.

Proof of German language skills

In order to obtain the visa, skilled workers must be able to demonstrate German language skills to at least level A2 of the Common European Framework of Reference for Languages (CEFR).

Ideally, you will check all the requirements and decide together whether this visa is suitable for you.