NC Medicine

MUDr. Andreas Zehetner

MUDr. Andreas Zehetner

CO-Founder of futuredoctor

Reading time: 12 Minuten
Last updated: 4 June 2024

☝️ The most important facts in brief

  • The numerus clausus (NC) for medical studies is 1.0 in most federal states.
  • A new allocation procedure has been in place in Germany since 2020: 30 % of study places are now allocated according to A-level grades, 60 % through individual selection procedures and 10 % via the additional aptitude quota.
  • Since 2022, a waiting period no longer plays a role in the allocation of medical study places
  • Studying medicine abroad offers the opportunity to bypass the strict quotas in the admission procedure in Germany.

📖 Table of contents

Competition for a place on a medical degree programme is extremely high. With two exceptions, the NC for all federal states is 1.0, meaning that despite opportunities to improve their own NC rate and the additional criteria, many applicants have no realistic chance of gaining a place. 

Going abroad is therefore a sensible alternative for many applicants who do not want to give up their dream of studying medicine and do not want to have to wait for years.

Are you interested in studying medicine?

We will be happy to advise you free of charge about your options for studying medicine, including a Medical studies abroad (EU), which is fully recognised in Germany.

Together for success - futuredoctor and studying medicine abroad

Do you want to study medicine abroad and are looking for the most suitable university for you and don't really know where to start looking for the right country and a good university? futuredoctor is happy to support you!

Besides the Student advisory service In addition to selecting the university and accompanying you to the desired on-site appointments, futuredoctor also offers support during the application process and preparation for possible aptitude tests, as well as orientation at the place of study - including the search for accommodation! Get your application quickly and easily free info pack!

How high is the numerus clausus for medicine?

The Numerus Clausus (NC) for the study of medicine has been consistently high in recent years and is close to 1.0. Since the A-level grades of the various federal states are relevant for the allocation of places, the NC that applies to you depends on the federal state in which you obtained your university entrance qualification. 

In the current NC for the winter semester 2023/24, only Schleswig-Holstein (1.1) and Lower Saxony (1.2) were an exception. Anyone who completed their Abitur in Rhineland-Palatinate, Mecklenburg-Western Pomerania, Baden-Württemberg or another federal state must fulfil a numerus clausus of 1.0.

Study places are not allocated solely on the basis of A-level grades

In order to gain the coveted place to study medicine and To study medicineIt is not only an excellent A-level grade that is required. Rather, in Germany, various criteria determine whether applicants to medical degree programmes in the Human Medicine, Dentistry and Veterinary medicine get a place. 

The requirements are demanding, but you have various options to increase your own chances of getting a place at university. In addition to the classic Abitur quota, the Additional suitability quota and university quota play a decisive role in the allocation of the limited number of study places. 

We will now take a closer look at the individual components of this system and show which criteria ultimately determine your admission to study medicine in Germany.

The Abitur quota

In order to allocate study places fairly, it is taken into account that the Abitur has different requirements in each federal state. For the Baccalaureate quota your Abitur result is therefore compared with that of other applicants from your federal state in order to guarantee fairness. These regional rankings are included in a list for the whole of Germany. In this way, 30 % of the study places are allocated directly to the candidates with the best Abitur.

The additional suitability quota

If your A-level average is below the required NC, you have the opportunity to improve it via the additional aptitude quota. This is possible in several ways:

  • You can take the so-called "test for medical degree programmes" (TMS). This is subject to a fee and can only improve your chances. If you do badly, this will not result in any disadvantages.
  • Completed vocational training or professional experience in the healthcare sector can also increase your chances of getting a place to study medicine.
  • Other extracurricular qualifications can also help to improve your chances under certain circumstances.

A further 10 % of students can begin their studies in this way, even if they do not fulfil the actual NC.

The universities' internal selection procedures

60 % of the study places are allocated directly by the universities. They have their own criteria according to which they will assess your application and, if necessary, conduct an interview with you. Decisive factors may include personal motivation, social commitment or your performance in an internal test at the university.

The aim is to select candidates who have the potential and personality for the demanding profession of doctor, rather than focussing strictly on the NC. However, it is also difficult to obtain a place to study medicine directly through the university. The number of study places is scarce and around 5 candidates apply for each available place.

Targeted preparation for entrance tests for medical universities

Regardless of whether you want to take the central test for medical degree programmes (TMS), an internal test of a German university or the entrance examination of various universities abroad: it makes sense to prepare specifically and research information about the criteria of the test in question. This will increase your chances of being among the applicants after the test who are within the selection limits and can begin their studies in the next semester.

We also want you to fulfil the required quota and therefore provide you with the necessary information as well as a practice platform with a large number of learning videos to prepare for the test.

The Rural Physicians Act as an alternative route to studying medicine

In some federal states, the Landarztgesetz (state doctor law) offers you access to medical studies without a top-level NC. 

This regulation is intended to promote medical care in rural areas by awarding medical study places to applicants who commit to working as GPs in underserved regions after graduation. 

In return for such an acceptance, you can be given preferential treatment in the allocation of places for the medicine degree programme, regardless of your NC.

The condition: After your studies, you must complete further training to become a family doctor and then work as a doctor for statutory health insurance patients for 10 years in an area for which the federal state in question has determined that there is a particularly urgent need for family doctors. 

However, bear in mind that you could face a high financial penalty of up to a quarter of a million euros if you breach this contract.

In which federal state is it possible to obtain a place to study medicine via the Landarztgesetz?

The State Physicians Act now applies in 9 federal states, after North Rhine-Westphalia introduced it for the first time in the 2019/20 winter semester. The following list shows you whether your federal state is included:

  • Baden-Württemberg
  • Hesse
  • Mecklenburg-Western Pomerania
  • Lower Saxony
  • North Rhine-Westphalia
  • Rhineland-Palatinate
  • Saxony
  • Saxony-Anhalt
  • Thuringia

In Bavaria, Berlin, Brandenburg, Bremen, Hamburg, Saarland and Schleswig-Holstein, it is unfortunately not yet possible to improve the chances of admission to the medicine degree programme in this way.

NC quota not met? Alternatives to studying medicine

As this article shows, places at universities are scarce and demand is high. If your A-level average is not sufficient for the required numerus clausus (NC) for medicine, other specialisations may offer exciting prospects in the healthcare sector.

However, the pharmacy and dentistry degree programmes are only a limited alternative, as they also have a high NC. Bachelor's degree programmes with specialisations such as biomedicine or emergency services can be a good option, however. 

Under certain circumstances, it may then be possible to go on to study medicine after completing the degree programme, as the specialist knowledge acquired in the first degree programme makes it easier to gain admission.

Universities abroad as an alternative

A university abroad can be a good opportunity to realise your dream of studying medicine after all, even if your A-level results are not sufficient for the NC. Universities in other countries have different admission criteria to those in Germany. For example, medical degree programmes such as medicine, dentistry or pharmacy often do not have a numerus clausus as in Germany.

However, this does not mean that everyone who is interested in these degree programmes is automatically accepted by the university. Rather, other criteria count here, such as a personal application or aptitude test. There are also costs that students have to pay. 

Overall, however, studying medicine or dentistry, veterinary medicine or other medical degree programmes are good alternatives to the strict NC quotas that apply in Germany.

Things to consider when deciding to study medicine at universities abroad

Before you decide to study abroad, you need some important information. It may be much easier to get a place without a waiting period, but everything else also needs to be organised. By the time you start university, you will need a flat, have completed all the formalities and, ideally, have already made friends with other students at your new university.

We support you not only with information, but also actively by taking care of the applications at the university for you, among other things. So you can start the semester relaxed.

Also bear in mind that studying in another language can be difficult even if you are very interested in that language. It can therefore be worthwhile choosing a university where all or at least part of the teaching is in English.

Pay attention to the German recognition of medical studies at a foreign university

The high NC Medicine has prompted you to decide in favour of studying at a university abroad? Then you need to find out in advance whether and under what conditions your degree will be recognised in Germany. At the universities we recommend in other EU countries, the result of your final examination is generally equivalent to the German state examination.

Improve NC through education, 3 disadvantages. There are many ways in which you can improve your ABI average in order to avoid the difficult NC of the medical degree programme. Each of these paths has its pros and cons and you should be aware of each of them.

Improve NC: What's the point of an apprenticeship anyway?

The Numerus Clausus for medical studies varies from university to university. In general, however, it can be said that from an average of 1.2 it can be difficult to get a place immediately.

For this reason, some people decide to train in the medical field. This gives you, in the Selection procedure of the universities additional points, so that nothing stands in the way of your place at university.

However, an apprenticeship is not absolutely necessary for a very good A-level average. It only gets really interesting when your average is around 2 - 2.5. You can find out exactly which strategy suits your NC here:

Improve NC through training? 3 Disadvantages

Are you ready to start a 3-year training programme before studying medicine? Then you should definitely be aware of the following disadvantages.

1. training before medical school: the loss of time

As already mentioned, training that can actually be recognised takes 3 years. Then there are 6 years of medical studies and 5-6 years of training as a specialist. After 14-15 years you are finished and can become a self-employed doctor.

This is an extremely long period of time and certainly not for everyone. So without an apprenticeship, you save yourself a lot of time and energy. The saying "time is money" also applies here, which brings us to the next point.

2. training before studying medicine: shortened working life span

The salary of a German doctor is definitely not bad. As a basic specialist, the average annual salary is already €80,000. This salary naturally rises over the course of a lifetime and is open at the top. As a chief physician, however, €300,000 is not unusual.

So let's assume you do a 3-year training programme before studying medicine. Then that's 3 years that you'll miss out on in your later working hours. If we "only" take the salary of a medical specialist, that's already €240,000 that will be taken away from you.

So if you don't want to do the apprenticeship for reasons of experience, but simply because you want a place at university, then it may make sense to invest the money in a private degree programme so that you can start straight away. This way you have to take on debt first, but you save a lot of money afterwards.

3. training before studying medicine: work and study

Training in a medical field, such as the emergency services, is no walk in the park! You are thrown into working life from day 1 and when you're not learning, you're working.

So you don't just do an apprenticeship just like that. You're in for an extremely tough time. If you then have the stamina to study medicine, we have huge respect for you.

So be honest with yourself and don't stumble blindly into an apprenticeship without realising that it means a lot of work.


Improving your NC through training - those were the 3 disadvantages. An apprenticeship is by no means a bad thing. That's why we want to draw your attention to our other article:

If the only reason you are in favour of an apprenticeship is that you want to improve your NC, then think about it all the more carefully. If you want to save yourself some time and effort and at the same time need insider information, then take a look here:

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