FSP exam Germany: how to write the Arztbrief (doctor's letter)

What is the Arztbrief in the FSP exam?

The Fachsprachprüfung (FSP) is the medical German exam that doctors trained outside the EU take for their German licence (Approbation). It is run by the state medical chambers (Ärztekammern). First you take a patient history from an actor playing a patient. Then, in the written part, you write the case up for a colleague. The exam tests your written German, not your medical knowledge.

Each chamber decides what you write and calls it differently: Arztbrief (doctor's letter), Entlassungsbrief (discharge letter), Kurzbericht (short report), Epikrise or Anamnesebogen (history form). Only Brandenburg and Mecklenburg-Vorpommern ask for a full letter. The letter's structure still helps everyone, because every report follows the same logic.

How much time do you get, and in what format?

What are the five parts of the Arztbrief?

Brandenburg's licensing office, the LAVG, lists these five parts in its FSP guidance (April 2026). The example sentences are our own.

1. Adressat (recipient): name and address of the doctor who continues the care, then the greeting, for example „Sehr geehrte Frau Dr. Sommer,“.
2. Patientendaten einschließlich Aufenthaltszeit (patient details with dates of stay): name, date of birth, town and dates of treatment. Example: „wir berichten über Herrn Karl Brandt, geb. am 03.05.1961, der sich vom 14.09. bis 18.09. in unserer stationären Behandlung befand.“
3. Diagnosen, Eingriffe, Operationen (diagnoses, procedures, operations): a list, main diagnosis first. The LAVG says diagnoses must not be bare symptoms: write „akute Appendizitis“, not „Bauchschmerzen“ (abdominal pain).
4. Epikrise (summary of the course): a few sentences. Why did the patient come, what was found, what did you do, how did the patient respond?
5. Therapie und Therapieempfehlungen (treatment and recommendations): drugs with strength and dosing scheme (for example 1-0-1, meaning morning, noon, evening), plus check-ups and advice for further care.

The Brandenburg chamber also publishes two Musterbriefe (model letters), one internal medicine and one surgical case (April 2024). Between the diagnoses and the Epikrise they also contain the Anamnese (history), the soziale Anamnese (social history) and the Untersuchungsbefunde (examination findings), and they end with a closing line and signatures. Read both before your exam.

Which tense goes in which section?

This is where many candidates lose points. Both Brandenburg model letters follow one rule: what the patient told you is written in reported speech (Konjunktiv I). What the hospital saw, measured or did is written in the simple past (Präteritum).

How is the written part marked?

The Berlin medical chamber is the only one that publishes its marking sheet for the written part. It marks „das erstellte Dokument“ (the document), on eight criteria worth up to 2.5 points each. The maximum is 20 points and you pass this part with 12.

Grammar and spelling together are worth 5 of 20 points, a quarter of the part. Brandenburg gives no grade: you must pass each of the three parts, otherwise you repeat the whole exam.

What must not go into the letter?

• Nothing made up. Saxony marks whether you write down exactly what was said, without interpreting it. Bremen explicitly forbids invented text blocks, such as complaints that are only theoretically possible or an examination finding that never happened. Write only findings you were given in the exam.
• No bare symptoms as a diagnosis (LAVG Brandenburg).
• No medical jargon where the chamber does not want it. In Mainz, pages 2 and 3 of the form are not written in full sentences, and the patient's words are not translated into technical terms: „Eine Anamnese ist kein Arztbrief“ (a history is not a doctor's letter). Ignoring this costs points.
• No help from the computer. Sachsen-Anhalt gives you no spellchecker. Practise until you do not need one.

How should you split 20 or 30 minutes?

How long should the Arztbrief be?

No chamber sets a word count. By our count, the two Brandenburg model letters have about 380 to 480 words of text. For a 20-minute report we plan with about 150 to 250 words in the free-text part. Complete and correct matters more than long.

How do you practise the Arztbrief?

1. Find out your chamber's format (table above) and read its leaflet.
2. Learn the order of the sections by heart so you do not think about structure in the exam.
3. Drill the Konjunktiv I: er sei, habe, könne, müsse, nehme, leide; in the plural seien and hätten.
4. After every practice interview, write the report under real time and with the spellchecker switched off.
5. Check your text against the eight Berlin criteria, especially 1 and 8.
6. Practise all three FSP parts, sorted by chamber, in our FSP practice area.

From November 2026 the route to a German medical licence changes, but the FSP stays. Read Kenntnisprüfung 2026: what changes for foreign doctors in Germany.