Trained as a Nurse Abroad? In Cologne, Münster Checks Your Degree and Bezirksregierung Köln Licenses You
Nursing is a regulated profession, so a foreign nursing qualification needs two separate decisions before you may work as a Pflegefachfrau or Pflegefachmann in Cologne. First, the Zentrale Anerkennungsstelle (ZAG-PuG) at the Bezirksregierung Münster, which handles all of NRW, decides whether your training is equivalent. Second, the Bezirksregierung Köln (Dezernat 24, Pflegeberufe) issues the Erlaubnis to use the title, for a fee of 60 euros according to its form. Stadt Köln's own Gesundheitsamt does not do this for Pflegefachfrau or Pflegefachmann. Münster states that after a complete application the review takes about two to four months, and a degree from outside the EU normally ends in a Kenntnisprüfung or an Anpassungslehrgang.
Two Decisions, Two Offices
Germany treats nursing as a regulated profession. The words Pflegefachfrau or Pflegefachmann can only be used with a state permit, and the permit rests on two steps. Many newcomers in Cologne look for the city’s Gesundheitsamt first, and that is the wrong door for this profession.
| Step | Office | What it decides |
|---|---|---|
| 1. Equivalence of the training | Bezirksregierung Münster, ZAG-PuG (Dezernat 241) | Whether your foreign training is equivalent, or what you must still prove |
| 2. Compensation, if needed | A recognised nursing school, with the exam organised by Münster | Kenntnisprüfung or Anpassungslehrgang |
| 3. Permit to use the title | Bezirksregierung Köln, Dezernat 24 Pflegeberufe | Erlaubnis to work as Pflegefachfrau or Pflegefachmann (60 euros) |
| Not responsible | Gesundheitsamt Köln | Other health professions, such as physiotherapy or speech therapy, not nursing |
The Stadt Köln page on health professions lists the professions the Gesundheitsamt handles (Neumarkt 15-21), and says that for Pflegefachfrau and Pflegefachmann the Bezirksregierung Köln has handled exams and the Erlaubnis since 1 January 2020. The Bezirksregierung Köln confirms that it issues the Erlaubnis after the equivalence decision and names Münster as the office for the equivalence step. For the first step, Münster’s ZAG-PuG covers all of NRW.
Step 1: The Application to Münster
The application form for training outside the EU, EEA and Switzerland is dated May 2026. Münster’s FAQ says digital applications are not possible and that documents may not be sent by e-mail, so plan for paper by post.
What you should prepare:
- the signed application and a tabular CV in German
- a simple copy of your passport or ID
- your diploma and certificates, each as a German translation by a sworn or state-authorised translator plus a simple copy of the original
- proof that you intend to work in NRW, which is a special point worth reading twice below
- for the detailed comparison only: an hours breakdown per subject (Stundennachweis or Diploma Supplement), proof of work experience and your licence or register entry from your home country
Do not send original diplomas, because the documents become part of the file and are not returned. The Merkblatt also tells you not to send police certificates, medical certificates or language certificates now. Münster’s page says to send complete documents, because requests for missing papers slow the case down. This site’s guide to what certified translations cost helps you plan that budget.
The NRW Proof That Surprises People
Münster wants proof of a concrete intention to work in NRW. The form accepts a job offer or contract in NRW. If you do not have one, it accepts proof of at least three written contacts with potential employers in NRW (including invitations to interviews), a location note from the Zentrale Servicestelle Berufsanerkennung (ZSBA), or a business concept for self-employment that clearly shows NRW as the location. People who live in the EU, EEA or Switzerland can usually give a declaration instead. A hospital or care home in Cologne is therefore the most useful first contact.
Fees and Timing
The form says the processing is subject to a fee of up to 277.50 euros, and that the fee is also due in part if the application is rejected or withdrawn after work has begun. Münster’s FAQ gives a wider range of 112.50 to 350 euros, usually in two fee notices. It says you receive a confirmation of receipt within one month, then two to four months for the assessment once the documents are complete. A prioritised processing is not possible. The two figures for the fee do not match, so treat the Bescheid as the only reliable number.
If you want funding, ask first. The Münster form says grants may have to be requested before you apply for recognition. This site’s guide on the Anerkennungszuschuss shows one federal option.
What the Result Looks Like
§ 40 PflBG sets the logic for training from outside the EU, EEA and Switzerland. Training is equivalent if there are no essential differences from German nursing training. If equivalence cannot be established, or only with disproportionate effort, you must prove an equivalent level of knowledge in one of two ways, and you choose:
| Route | What it is | Notes from the official pages |
|---|---|---|
| Kenntnisprüfung | Exam on the content of the state final exam | Practical part with four care situations in one care area, oral part of 45 to 60 minutes. Each part may be retaken once. Münster organises it with a school |
| Parcoursprüfung | Alternative to the Kenntnisprüfung for Pflegefachfrau or Pflegefachmann | Named in Münster's FAQ |
| Anpassungslehrgang | Course of at most three years ending with an exam | Scope depends on the differences found, in German, ends with a closing interview |
| Modular Anpassungslehrgang | Only after waiving the detailed comparison | 680 theory hours and 1,440 practice hours, per Münster's FAQ |
The exams and courses are in German. Münster says a preparation course of several months is sensible for the Kenntnisprüfung and that courses are offered by some institutions in NRW. It publishes lists of providers on its site. The FAQ also says there is no fixed exam date or waiting time, because dates depend on registrations and on schools being able to host exams.
If you fail the repetition, the application is rejected, and the FAQ says a recognition is then no longer possible anywhere in Germany. That is worth knowing before choosing the faster waiver route.
Step 2: The Erlaubnis from Bezirksregierung Köln
Recognition alone does not let you work. Münster says plainly that the Bescheid does not allow work and that the Erlaubnis is applied for with the competent authority afterwards. For a nurse who will work in Cologne, that is the Bezirksregierung Köln. Its Merkblatt for a foreign qualification asks for:
- a signed application in German
- proof of identity (passport, ID, visa or residence permit), usually officially certified for foreign documents
- an extended police certificate (type OE) if you have been in Germany more than six months, which needs a certificate from the Bezirksregierung that you request by e-mail with the subject Gleichwertigkeit
- criminal-record extracts from every country you lived in during the last five years
- a medical certificate on fitness for the profession
- proof of German at B2, including specialist language, such as a telc B2 test or an ÖSD certificate
- the equivalence Bescheid
Its form states an administrative fee of 60 euros. Submission is by post, because the Merkblatt says documents sent by e-mail cannot be processed, and the office warns that it currently gives no phone or personal consultations. One more point from the Cologne office: the responsible Bezirksregierung is the one for your place of residence, or the future workplace if you live abroad. If your job is in another NRW district, check the Bescheid.
While You Wait
Münster’s FAQ is blunt. You may not work as a Pflegefachfrau or Pflegefachmann before the Erlaubnis, and it calls that an administrative offence. As a care helper, supervised work is possible once the Ausländerbehörde has permitted it.
Your residence permit is a separate question. § 16d AufenthG provides permits for recognition measures: up to 24 months for a qualification measure, extendable to three years in total, with work of up to 20 hours per week unrelated to the measure. A separate route in the same section covers qualified employment during recognition for people with a state-recognised foreign qualification and a concrete job offer, and it has a special rule for care employers. Which Cologne office handles your permit depends on your postcode, as the guide on the Ausländeramt split explains, and the appointment guide shows how bookings work.
Money From NRW
The state pays a one-off Willkommensgeld NRW of 1,500 euros to nurses from outside the EU who have completed recognition. The MAGS page lists the conditions: a recognition Bescheid from an NRW authority, the Urkunde on the Erlaubnis issued within the six months before you apply, a residence permit for recognition or for working as a nurse (§ 16d or § 18a AufenthG), a main residence in NRW, and no earlier funding under the 2022/2023 or 2024 Willkommensgeld programmes. Applications go online to the responsible Bezirksregierung. The page names no application deadline or end date, so check it when you are close to the Erlaubnis.
Step by Step
- Get a job lead in NRW.A contract or offer is the strongest proof of intent. Without one, document three written contacts.
- Collect and translate documents.Use sworn translators, keep originals.
- Choose the procedure.Detailed comparison, or waiver with a Kenntnisprüfung or modular Anpassungslehrgang. Remember the waiver is final.
- Post the application to Münster (Dezernat 241, ZAG-PuG, Domplatz 1-3).
- Complete the compensation measure with a recognised school, if the Bescheid requires one.
- Prepare B2 German, medical certificate and police certificates for the Erlaubnis.
- Apply to Bezirksregierung Köln for the Erlaubnis (60 euros), by post.
- Start work only after the Urkunde arrives, then apply for the Willkommensgeld NRW if you qualify.
Compliance Note
This page describes the procedure and fees as published by the Bezirksregierungen Münster and Köln, Stadt Köln and federal law as of October 2026. It is not legal advice. Fees, forms, postal addresses and processing times change, and your own Bescheid and residence permit decide what applies to you. Ask Münster or Köln before relying on a figure, and consult a recognised advice service or a lawyer for questions about your residence status.
FAQ & Common Pitfalls
Which office decides whether my nursing degree is equivalent?
The Zentrale Anerkennungsstelle für Pflege- und Gesundheitsfachberufe (ZAG-PuG) at the Bezirksregierung Münster, Dezernat 241, Domplatz 1-3, 48143 Münster. It checks foreign nursing training for the whole of NRW, so someone in Cologne does not apply locally for this step. The service hotline is 0251 411-2444, Monday to Friday 9:00 to 14:00. Personal consultation hours are currently not offered, and the application is handled by post.
Which office gives me the right to work as Pflegefachfrau or Pflegefachmann in Cologne?
The Bezirksregierung Köln, Dezernat 24 Pflegeberufe. Stadt Köln's page on health professions says plainly that for Pflegefachfrau and Pflegefachmann the Bezirksregierung Köln, not the Gesundheitsamt, handles the exams and the Erlaubnis since 1 January 2020. The Bezirksregierung's Merkblatt names Zeughausstraße 2-8, 50667 Köln, as the postal address and says the responsible office is the one for your place of residence, or your future workplace if you do not live in Germany. Use the address in your own Bescheid or on the office's current forms if they differ.
What will I be asked to do if my training is from outside the EU?
§ 40 PflBG says an equivalent level of knowledge must be shown if equivalence cannot be established or only with disproportionate effort. You can do that by a Kenntnisprüfung covering the content of the state final exam, or by an Anpassungslehrgang of at most three years that ends with an exam, and you choose between them. Münster's FAQ adds that for a Pflegefachfrau or Pflegefachmann a Parcoursprüfung is an alternative to the Kenntnisprüfung. Exams and courses are in German.
What does it mean to waive the detailed training comparison?
Münster's form lets you choose between an Ausbildungsvergleich and a Verzicht. With the waiver you only prove that you completed the training, work experience is not considered, and you proceed to a Kenntnisprüfung. Under the Pflegeberufegesetz you can alternatively complete a modular Anpassungslehrgang of fixed length, which Münster's FAQ gives as 680 hours of theory and 1,440 hours of practice. The office says the waiver can shorten processing and reduce translation costs, but it cannot be undone, and you cannot switch the procedure later.
How long does it take and what does it cost?
Münster's FAQ says you get a confirmation of receipt within one month, and once documents are complete the assessment takes about two to four months. Fees depend on effort: the FAQ says usually between 112.50 and 350 euros, normally in two fee notices, while the application form mentions fees of up to 277.50 euros. A Gutachten from the Gutachtenstelle für Gesundheitsberufe costs 417 euros if the reference profession is unclear and 145 euros for authenticity checks. Bezirksregierung Münster charges nothing for the exams, though schools may. The Erlaubnis in Cologne is 60 euros according to the Bezirksregierung Köln form.
Do I need a German certificate for the application to Münster?
No. The Münster FAQ says no proof of German is required for the equivalence check, and the Merkblatt asks you not to send language certificates, police certificates or medical certificates at this stage. They are needed later, for the Erlaubnis. The Köln form asks for German at level B2 including nursing language, for example a telc B2 test or an ÖSD B2 certificate, or other proof.
Can I work as a nurse while the procedure runs?
Not as a Pflegefachfrau or Pflegefachmann. Münster's FAQ says working before the Erlaubnis is an administrative offence. Work as a care helper under supervision is possible once the Ausländerbehörde has permitted employment, but independent nursing tasks are not allowed. Whether and on what basis you may stay depends on your residence permit; § 16d AufenthG covers permits for recognition measures, including up to 24 months for a qualification measure and work of up to 20 hours per week unrelated to the measure.
My application started under the old Krankenpflegegesetz. Is it still valid?
Münster's pages give deadlines for the old law. For Altenpflege, Gesundheits- und Krankenpflege and Kinderkrankenpflege, the adaptation measure had to be started or registered by 31 December 2024 and finished by 31 December 2026. If it was not, Münster says a new application under the PflBG is needed after the old one is withdrawn. Check the status of your file with Münster before you plan around this.