Examination Law in the Medical Degree at Bielefeld University: Equivalency Assessments, Attempts, Deregistration

The nationwide rules first: what the ÄAppO sets out for everyone

The framework is the same at every German medical faculty. The Licensing Regulations for Physicians (Approbationsordnung für Ärzte, ÄAppO) govern the state examinations:

• Three attempts per section: The individual parts of the First and Second Sections of the Medical Examination may be resat twice. The same applies to the Third Section.
• Nationwide effect: A permanent fail applies across all of Germany – transferring universities changes nothing.
• No restart: Starting a new medical degree does not create a further attempt.
• Model clause: Section 41 ÄAppO allows faculties to replace the First Section with their own, equivalent examinations. Bielefeld makes exactly this choice.
• No re-sitting for a better grade: A passed examination section may not be repeated.

Everything before that – module exams, coursework, attendance – is regulated individually by each faculty. And Bielefeld regulates it differently from almost everywhere else.

Bielefeld's special feature: no Physikum, but twelve equivalency assessments

The governing document is the Study and Examination Regulations for the Model Degree Programme in Medicine at Bielefeld University leading to the “Medical Examination” qualification, dated 16 May 2025 (Official Gazette 06/54). It took effect for the winter semester 2025/26 and replaced the 2021 regulations; Section 29 sets out transitional provisions for students already enrolled. Anyone who started before 2025 should therefore first check which version applies to their own cohort.

The programme is structured as follows (Sections 6, 7):

• Standard period of study: six years and three months – 12.5 semesters – with a total of 360 credit points.
• First stage of study: semesters 1 to 6, an introductory module plus six thematic modules organised around organ systems and life stages.
• Second stage of study: semesters 7 to 10, deepening of the thematic modules, practical placements, a research module.
• Clinical year: semesters 11 and 12.
• No First Section of the Medical Examination with the state examination office. Its place is taken by the equivalency assessments under Sections 22 to 25. M2 is taken after ten semesters, before the clinical year, and M3 afterwards (Section 26).

The decisive point is in Section 22: the First Section is replaced by six written module-component examinations (written or e-exam) from the six thematic modules, and six oral-practical module-component examinations from module 5-I-MED-M1. According to the regulations, these are taken “generally on a semester-by-semester basis” – so one written and one oral-practical equivalency assessment per semester of the first stage of study.

The six thematic modules are:

• Musculoskeletal System I (5-I-MED-SBA)
• Metabolism, Digestion & Regulation I (5-I-MED-SVR)
• Circulation, Respiration & Immune System I (5-I-MED-KAI)
• Nervous System, Psyche & Senses I (5-I-MED-NPS)
• Urogenital System & Start of Life I (5-I-MED-UGSLA)
• Life Circumstances & End of Life I (5-I-MED-LELE)

One student put it exactly this way in a public review dated 23 February 2026: “No Physikum, but two equivalency exams per semester instead.”

How many examination attempts do you get at Bielefeld University?

The answer has two parts. For ordinary module examinations, Section 13 of the regulations states literally: “Module exams, module-component exams and coursework may be repeated without limit.” For the equivalency assessments, however, Section 24 applies: up to three attempts to complete each individual equivalency assessment – counted separately for the written and the oral-practical component.

Two details from Section 24 that cost time, money and nerves in practice: only equivalency assessments passed on the first attempt count towards the final transcript – resits to improve a grade are excluded. And on the final resit, a second examiner also assesses the result – the four-eyes principle on the last attempt is a legal safeguard worth knowing about if you want to challenge a grade.

If you are not sure how many attempts you have left in your case, let's look at it together – book a free consultation here.

Why “repeatable without limit” doesn't mean nothing can go wrong

The short answer: because the twelve equivalency assessments are twelve independent grounds for exclusion. Section 24 puts it unambiguously: “If no further resit opportunities remain for a given equivalency assessment, the First Section of the Medical Examination is deemed permanently failed.”

That is a different risk profile than the phrase “repeatable without limit” suggests. At a traditional faculty, there is one Physikum with three attempts. In Bielefeld, there are twelve individual hurdles with three attempts each – and failing just one of them three times is enough. The sheer number of attempts goes up, but so does the number of points at which the degree can end.

There's also a requirement rarely stated this openly. Section 23 of the regulations notes: “The requirements of the equivalency assessments go beyond the level and examination content of the assessments under the ÄAppO.” So anyone who assumes a model degree programme is automatically the easier route will find the opposite stated in the regulations themselves.

How are examinations graded in Bielefeld?

The written exams are papers or e-exams, taken digitally on site. On grading, Section 14 states: the grading scale runs from 1 to 5, with intermediate values possible by lowering or raising by 0.3. A pass is a performance “which, despite its shortcomings, still meets the requirements” – the module grade “sufficient” falls in the range of 3.6 to 4.0.

A fixed percentage pass threshold, or a sliding scale along the lines of “mean minus one standard deviation,” is not set out in the Study and Examination Regulations. What applies in an individual case is stated in the relevant module description – not in forums.

The oral-practical examinations and the OSCE

The second half of the equivalency assessments is practical. It comes from module 5-I-MED-M1, “First Medical Examination,” and is taken each semester during the first stage of study. The format is the OSCE – objective structured clinical examination – with practical tasks at stations. What's assessed is not recalled knowledge but action on a model or simulated patient: examination technique, history-taking, informed consent, practical skills.

For many, this is the more pleasant exam format – and for some, the more dangerous one. An OSCE cannot be crammed the night before. If you haven't practised the station, you cannot pass it, however solid your textbook knowledge is. And because this too ends after three attempts, the practical component is exactly as legally strict as the written exam.

Attendance requirements and coursework: the 80 percent rule

Section 20 of the regulations governs the requirements for coursework. The default is strict: 100 percent attendance is expected for the contact hours set out in the module descriptions. Anyone who deregisters correctly needs only 80 percent attendance overall.

This is where most avoidable problems arise in Bielefeld. The 80 percent is not a generous grace margin – it's tied to a correctly submitted deregistration. Simply not showing up without deregistering doesn't automatically fall under the 80 percent rule; it fails the 100 percent requirement instead.

One student describes the lecture-hall side of things this way: “No attendance requirement in seminars and lectures, no ongoing graded assessments” (review dated 12 December 2023). Both statements fit together: the attendance requirement depends on the individual module and its description, not on every course uniformly. That's exactly why it's worth checking your own module description rather than relying on what older students say.

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When do you get deregistered at Bielefeld University?

As soon as an equivalency assessment is permanently failed. The First Section of the Medical Examination is then deemed permanently failed overall, and Section 24 of the regulations refers directly to the legal consequence: deregistration under Section 51(1) No. 3 of the North Rhine-Westphalia Higher Education Act.

The law leaves the university no discretion here. Under Section 51(1) HG NRW, anyone who “has permanently failed an examination required under the examination regulations for the degree programme, or can no longer be admitted to the examination” must be deregistered. Section 51(3) No. 6 HG NRW additionally permits deregistration where the right to sit a required examination has been lost.

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In practice, this means: transferring to another German university doesn't solve the problem. Anyone who permanently fails an equivalency assessment in Bielefeld can no longer enrol in the same degree programme in Münster, Frankfurt or Leipzig either – the higher-education laws of the other federal states contain the same ground for refusal and likewise apply it across all of Germany.

How do you find the right university – and get in?

We deliberately don't publish checklists, dates and formalities: they differ from university to university and from year to year, and a list pulled from the internet has cost more than one student a semester. Instead, send us your profile – transcript, proof of study to date if applicable, and your preferred countries.

We assess this individually and tell you specifically which university, in which country, we can place you at reliably and on a realistic timeline. For this, we draw on the largest selection of official partner universities for medicine, dentistry, pharmacy, nursing and veterinary medicine. If you've already studied, we also assess the highest possible year of entry – entry in the final two years of study is often possible.

The consultation is free and non-binding: book your free consultation here.

Where can you find past exam papers and student notes for Bielefeld?

Bielefeld is a young faculty. That has one uncomfortable consequence: there's simply no established, public archive of past exam papers of the kind you find at faculties with a century of student-body history. As of August 2026, the picture looks like this:

• AMBOSS campus licence: yes. Bielefeld University provides all human medicine students with a campus licence – free of charge, with unlimited access to the library and question bank. That's a real advantage over faculties where an individual subscription is required.
• Moodle: the official learning platform. Materials and lecture recordings are posted there; students report that documents are uploaded in full. It's the most reliable source for what's actually examined.
• Fachschaft Medizin OWL (student council): has an office on campus and its own Instagram presence. A publicly accessible archive of past exams isn't findable from outside – sharing happens through year-group chats and direct contact.
• eKVV and module database: the best open source for the formal details – which exam format, which coursework, which semester.
• Senior students: at a young faculty with small cohorts, the most important channel of all – and one that genuinely works here, because people know each other.

One note that costs attempts every year: because the regulations were rewritten in 2025 and the programme is still being built out, older notes can describe a state of affairs that no longer exists. Past papers are a study aid, not a substitute for the current module description.

What Bielefeld students say themselves

On StudyCheck, Bielefeld University's model degree programme in medicine scores 3.6 out of 5 across 26 reviews, with a 69 percent recommendation rate (as of August 2026). The picture is split – and the divide isn't about the academic demands, but about organisation.

• “Teaching organised by organ systems with clinical content from the start,” “Small cohorts mean close contact with lecturers and an almost family-like atmosphere” – review dated 12 December 2023, 4.7 out of 5 stars.
• “No Physikum, but two equivalency exams per semester instead,” plus “Sometimes quite chaotic, with seminars scheduled before the lectures covering material not yet taught” – review dated 23 February 2026, 3.4 out of 5 stars.
• “Recurring organisational problems since the start of the programme” and “There have been short-notice changes to the module sequence” – review dated 17 November 2025, 2.4 out of 5 stars.
• “All exams are written digitally and lectures are uploaded too” – review dated 13 February 2026.

For your own planning, the third point matters most. Short-notice changes to the module sequence are normal at a faculty still being built out – but they shift the entire semester schedule. Anyone who relies on a plan they read once can easily end up under pressure they didn't create themselves.

Timing matters: what you can do before your attempts run out

This is the single most important lesson from over 500 placements: between “one attempt left” and “permanently failed” lie completely different sets of options.

As long as attempts remain open, you have options – and the most important one is the one almost nobody checks in time: preparing a clean transfer to an EU university while your right to sit the exam is still intact.

After a permanent fail, exactly one reliable path to German licensure remains: a complete medical degree in the EU, starting from the first semester, with no credit transferred from prior German coursework. Recognition then runs through Directive 2005/36/EC. Anyone who instead has semesters credited towards a new programme is building on a legally exhausted foundation – and risks completing the entire degree for nothing.

And there's the option nobody thinks about at the third failed attempt: not ending up in that position at all. If you're currently weighing whether to fight through another year of selection procedures and waiting lists, you can also start without a numerus clausus in the EU – tuition fees from €1,750 a semester, smaller cohorts, more oral and practical exam formats, and direct access to lecturers. At many of our partner locations, the sea is the next stop after class, not the library. That's not a compromise – for many, it's the better route to the very same qualification.

Which option is realistic in your case depends on where you stand – first failed attempt, last attempt, or letter already in hand. That's exactly what we work through together in a consultation. It's free and non-binding: secure your appointment here.

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