Resident Doctor Salary in Germany 2026: Assistenzarzt Pay by Year

Last reviewed: 5 October 2026 · Researched by the Welcare Overseas team (Bengaluru) against official German sources · How we research

What is residency (Assistenzarztzeit) in Germany?

Residency in Germany is postgraduate specialist training (Weiterbildung). You are employed by a hospital as an assistant doctor, work on the wards under supervision, rotate through the stations your speciality requires, and finish with a specialist exam at the regional medical chamber. Most specialities take 5 to 6 years. It is a salaried job, not a course: there are no tuition fees, and you pay tax and social insurance like any employee.

To start residency you need a licence to practise: the full Approbation or, at first, a temporary Berufserlaubnis. International graduates should read our step-by-step Approbation guide first.

Resident salary year by year (TV-Ärzte/VKA, 2026)

Most residents in municipal (city and district) hospitals are paid under the collective agreement TV-Ärzte/VKA. Pay group Ä1 covers assistant doctors, and your step goes up with each year of medical experience.

Source: TV-Ärzte/VKA pay tables as published by Haufe (see sources below). These are basic salaries. Night, weekend and on-call duty is paid separately.

After residency: specialists and senior doctors

Heads of department (Chefärzte) usually have individual contracts outside these tables.

Gross vs net: what you actually take home

German salaries are quoted gross. From the gross figure, your employer deducts income tax and the solidarity surcharge (only at high incomes), and church tax if you are registered with a church. It also deducts your share of health, long-term care, pension and unemployment insurance. For a single resident in tax class I without church tax, net pay is roughly 60 to 63 percent of gross in the first year, around €3,400 to €3,600 a month. Married residents in tax class III take home more. The Federal Ministry of Finance’s official calculator gives an exact figure for your situation.

On-call, night and weekend pay

Hospitals run around the clock, and duty hours are paid on top of the basic salary:

• On-call duty in the hospital (Bereitschaftsdienst) is paid per hour at rates set in the agreement. How much depends on how busy the duties typically are.
• Night and weekend shifts attract supplements.
• Overtime is either paid or given back as time off.

Depending on the department, duty pay can add several hundred to well over a thousand euros a month. Surgery, internal medicine and anaesthesia usually have more duties than outpatient-heavy specialities. Ask how many duties per month are normal before you accept a post.

Other employers: university, church and private hospitals

• University hospitals pay under their own agreements (TV-Ärzte for state employers, or local agreements). The levels are close to the VKA table.
• Church-run hospitals (Catholic and Protestant) use church pay rules (AVR), broadly comparable to the public tables.
• Private hospital groups have company agreements or individual contracts, often similar at resident level. Always compare the total package: basic pay, duty rates, training budget and working hours.

Does the state you work in change your salary?

Within the same agreement, no. A resident on TV-Ärzte/VKA earns the same in Saxony as in Bavaria. What changes is cost of living. Rent in Munich, Frankfurt or Hamburg takes a much larger share of a resident’s net pay than in Thuringia or Saxony-Anhalt. For international doctors, smaller hospitals in lower-cost regions often mean a faster start and more money left at the end of the month. See which German states are best for medical residency.

Pay on a temporary licence (Berufserlaubnis)

Doctors working on a Berufserlaubnis while they prepare for the knowledge test are normally employed as assistant doctors, and many hospitals pay them in Ä1. Some employers pay less until the Approbation is issued. Check the pay group in your contract, and whether this period counts towards your specialist training.

Lifestyle and cost of living

A first-year net salary of about €3,500 comfortably covers rent, food, insurance and transport in most German cities. Many residents save a meaningful part of their income from the first year, especially outside the most expensive cities. The bigger adjustment is usually the workload in the first two years, with duties, documentation in German and a new system, rather than the money.

Tips for international medical graduates

• Reach B2 general German and pass the Fachsprachprüfung before you apply widely. Interviews are in German.
• Apply to accredited training departments, so your years count towards your specialist exam.
• Ask about duty frequency, rotation plans and support for your exam preparation in the interview.
• Keep copies of every certificate and employment reference (Arbeitszeugnis). The chamber will need them for your specialist registration.

Sources

• TV-Ärzte/VKA pay table valid from 1 June 2026, with the previous table from 1 August 2025: haufe.de
• Marburger Bund, the doctors’ union that negotiates TV-Ärzte: marburger-bund.de
• Federal Ministry of Finance, official income tax calculator: bmf-steuerrechner.de