With which A-levels to study medicine

MUDr Andreas Zehetner

MUDr Andreas Zehetner

CO-Founder of futuredoctor

Reading time: 13 Minuten
Last updated: 30 April 2024
with which A-levels to study medicine

☝️ The most important facts in brief

  • The Numerus Clausus (NC) is one of the decisive criteria for admission to medical studies.
  • In addition to the A-level average, university selection procedures, aptitude tests and an existing profession can influence the chances of getting a place.
  • Different requirements may apply depending on the federal state and university.
  • At private universities and abroad, the Abitur grade does not usually play a significant role when it comes to the allocation of medical study places.

📖 Table of contents

In Germany, an A-level is required to study medicine. The Numerus Clausus for this degree programme is high and many applicants are therefore not offered a place. However, only 30 % of the places are allocated via the Abitur quota. Under certain conditions, you therefore have a good chance of getting a place on the degree programme even if you have a less good Abitur.

Are you interested in studying medicine?

We will be happy to advise you free of charge about your options for studying medicine, including advice on studying medicine in another EU country, which is fully recognised in Germany.

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What is the current numerus clausus for medical studies?

The numerus clausus for studying medicine is not a fixed value from the outset. It is determined each semester anew from the A-level grades of the applicants who, thanks to these grades, receive a Medical study place have received. 

The NC value corresponds to the Abitur grade of the applicant who was the last person on a list sorted according to Abitur performance to gain a place. As both the number of applicants and their grades vary each year, the NC is only finalised once the allocation procedure has been completed.

It is therefore possible that high school graduates who would have gained a place on a medical degree programme last year with their grades will miss out in the current application process. Conversely, however, it is just as possible that an Abitur will suffice this time, with which there is no place in the previous semesters. Study medicine would have been allocated.

The required Abitur grade depends on the federal state

In order to ensure the fairest possible allocation of study places for medicine, the Foundation for University Admissions first draws up a separate list for each federal state in the admissions procedure, on which the applicants are ranked according to their A-level grades.

Only in the next step is this list then summarised into an overall list covering all federal states. For this reason, you will need fewer points if you obtained your Abitur in Schleswig-Holstein than applicants who took their Abitur examination in Rhineland-Palatinate or Mecklenburg-Western Pomerania.

Is it possible to study medicine with any school-leaving certificate?

The numerus clausus (NC) for medical studies is high, so it can be very difficult to be successful with your application for this degree programme. However, this does not mean that Study medicine is not possible with an average or even poor Abitur.

Although according to the NC you need an A-level, the so-called Abitur best quota is by no means the only factor according to which places are allocated in medical degree programmes at universities.

There are two other main quotas in the allocation procedure and a whole range of alternative options. We would now like to explain the most important options for studying with an Abitur average below the NC.

With zEQ and AdH, more than just the Abitur average counts

In admission-restricted degree programmes such as human medicine and dentistry, places are allocated centrally by the Foundation for University Admissions and its online portal hochschulstart.de. Only 30 % of the places are allocated solely on the basis of A-level grades. 

The additional suitability quota

A further 10 % of the study places for human medicine are then allocated via the additional aptitude quota (zEQ). It is not the Abitur that is decisive here, but other qualifications. These include, for example

  • Completed training in the medical field and experience in the profession
  • Completed aptitude test such as TMS or HAM-Nat
  • Voluntary services such as FSJ
  • Special awards in relevant competitions such as Jugend forscht

When applying for a place to study medicine, be sure to state if you have one or more of the additional qualifications mentioned. These can significantly increase your chances of gaining one of the coveted study places.

The university selection process

The majority of places for admission-restricted degree programmes with a central application via hochschulstart.de are allocated in the university selection procedure (AdH). 60 % of places on medical degree programmes are filled in this way.

This quota takes into account both the Abitur and criteria defined by the individual universities. As with the zEQ, criteria such as completed training, professional experience, completed aptitude tests and other aspects are taken into account.

If you can impress with other very good qualifications, there is a real chance of getting a place to study medicine via this quota, even with a rather mediocre Abitur.

Improve your chances of getting a place at university with TMS and HAM-Nat

The "Test for Medical Study Programmes" (TMS) is the most widely used aptitude test that you can use to improve your chances of studying medicine. It can be taken for a fee of 100 euros and can be repeated a maximum of once.

With a good result in the TMS, you can collect points for the zEQ and the AdH. However, if your TMS result is poor, this will not have any negative consequences for you. Incidentally, the TMS not only improves your chances when applying for a place to study human medicine. Study places for dentistry, veterinary medicine and pharmacy are also allocated according to the same principle and applicants with a good TMS can also score points here.

Another well-known study aptitude test that is often used in internal university selection procedures to assess applicants is the Hamburg Natural Science Test (HAM-Nat). This is a multiple-choice test designed to help universities filter out candidates who are particularly suitable for studying medicine.

Paving the way to medical school with an apprenticeship

If you want to study medicine in Germany and Become a doctor but your Abitur is not sufficient for the NC, it may be a good decision to do an apprenticeship in a medical profession first. If you then apply to study medicine, your vocational training will be recognised with additional points in the zEQ and AdH.

However, this is not the only advantage that training and, if applicable, professional experience can bring. It not only gives you an advantage when it comes to admission, but also during your actual medical studies. Those who have already worked in the field usually have a completely different perspective on many things and can often adapt more easily to the procedures in a clinic later on. Unlike a freshly graduated high school graduate, you have a lot of additional information, knowledge and skills with vocational training.

At private universities, the Abitur grade is much less important

If you fail the NC and are looking for alternatives to become a doctor, studying medicine at a private university may be an option. These universities set the requirements for the allocation of study places and the application process themselves. 

The Abitur usually only plays a subordinate role for admission to such a university. Much more important is the motivation that makes you want to study medicine. You usually have to convince those responsible at a private university of this first with a so-called letter of motivation and then in a personal interview or through admission tests.

This means you don't have to worry about the average grade on your A-levels if you apply to a private university. Nevertheless, not all applicants are accepted at these universities, as the number of applications is greater than the number of places. You should therefore think carefully beforehand about how you can convince a private university of your suitability to study medicine. In any case, a completed TMS cannot hurt.

Studying medicine at a private university is associated with high costs

Studying medicine at a private university in Germany is not cheap. While state universities are mainly financed by public funds and can therefore charge comparatively low semester fees, tuition fees at a private university can be several thousand euros per semester.

If you decide in favour of such a university and do not come from a wealthy family, it is therefore important to first get an overview of the financing options. There are two main options here:

  1. Attempts to create a Scholarship from the university or an external organisation.
  2. Find out about the possibility of a student loan. You can use this to finance your medical studies and then pay it back bit by bit when you are already a doctor and earning well.

Studying medicine abroad as an alternative to the German admission restrictions

The lack of places at universities and the high NC mean that more and more students in admission-restricted subjects such as human medicine, dentistry, veterinary medicine and pharmacy are opting for universities abroad after their application in Germany has been rejected.

Unlike in Germany, the NC criteria are less strict at most universities in other countries. Instead of an NC based on A-level grades, universities place more emphasis on their own entrance tests when allocating places. What exactly these look like depends very much on the individual university, but you can imagine them to be similar to the TMS.

We help you to get a place to study medicine abroad

We are very familiar with admission-restricted degree programmes and admission to study abroad. The NC in Germany should not prevent you from realising your dream of studying medicine. That's why we provide you with intensive support from the choice of country and university, through the application process and the search for accommodation, to the completion of your medical studies and beyond.

Universities for studying in German or English

Even if you decide to study medicine abroad without an NC, a new foreign language is not necessarily a prerequisite. We cooperate with universities where you can study medicine in English and sometimes even in German. And all without an NC.

Application and preparation for the admission test 

We take care of the application to your chosen university abroad for you. We will also prepare you intensively for the entrance exam with our app, numerous learning videos, helpful tips and other material. Once you've made it, we'll be delighted to hold your letter of admission in our hands.

Looking for a flat share or flat

If your path takes you to a university abroad, you will of course need somewhere to live. We know the local conditions and can help you find a flat or flat. WG that corresponds to your wishes.

During your studies

We are also there for you during your medical studies. Students of the specialisms we teach can of course contact us at any time, ask us anything and ask us to show them helpful ways of solving problems.

Returning to Germany as a doctor

After studying abroad, a large number of the students we place at universities there return to Germany to work here as doctors. Of course, the NC no longer plays a role, but you must have your medical studies completed in another country recognised here.

Degree programmes at universities within Europe usually have the best prerequisites for this. The medical degree programme at such a university meets high standards and teaches all the course content that is also required for the state examination in Germany. Recognising your degree is therefore a mere formality.

What requirements do I need to fulfil to study medicine?

As we have clearly shown, the NC is no reason to give up on your dream of studying medicine if your A-levels are not good enough. This is particularly true because the NC says nothing about how suitable you are for studying medicine. Study aptitude tests such as the TMS are much better suited for this purpose.

However, just like the NC, the tests are ultimately only a guide. Experience shows that the students who really fight for their dream of a place to study medicine and ultimately get it through alternative means are the ones who ultimately succeed in their studies.

The following list shows what you should fulfil in order to be successful in medical school:

  • Studying medicine is really your great wish and not just one of many alternatives.
  • You are prepared to invest a lot of time during your studies at the university and put other things on the back burner.
  • You are interested in the natural sciences, have a good grasp of things and can also quickly gain an overview of new topics.
  • You are good with people and don't just want to study medicine because of the good earning potential later on.
  • You can work under pressure even in stressful situations, can handle a high workload and keep a cool head.

Can you really study medicine with any school-leaving certificate?

As places to study medicine are in high demand, a good A-level grade is definitely an advantage. But even with an A-level of 4.0, you have the opportunity to be accepted if you can convince the universities with other qualifications.

After all, no-one attaches any more importance to the A-level average of a fully qualified doctor. The skills that are really important when studying medicine therefore count far more than the NC. If you want to study medicine, you have to be prepared to invest the majority of your time in learning. If you lack school knowledge in certain subjects, you can make up for it. Of course, this means extra work, but it can be done.

Conclusion: A good Abitur gives you more options, but is not a basic requirement

With a good Abitur, you have more options open to you than if your grade is in the middle or even lower range. Nevertheless, you can fulfil the requirements for studying medicine even if you do not meet the NC requirements.

High school graduates with the best grades can choose the federal state in which they would like to study or the university. If, on the other hand, you do not fulfil the NC or are even significantly below it, you must use the alternatives available to you to make your dream of studying medicine a reality.

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