Your first post: what has to be sorted in the first three months
Chamber, Versorgungswerk, pension exemption, health insurance, liability cover. The order, and the deadlines running underneath it.
Your first employment contract starts several procedures at once, and one of them has a hard deadline. So the order is not arbitrary.
Weeks 1 to 4
- Register with the chamber of physicians of the state where you work.
- Register with the Versorgungswerk.
- Apply through the Versorgungswerk for exemption from statutory pension insurance. Under Section 6(4) SGB VI it is backdated only if you apply within three months.
- Open a bank account. If you reside lawfully in Germany and have no other suitable payment account, you generally have a right to a basic account, which helps when normal onboarding fails.
Health insurance: statutory or private
The 2026 income threshold is €77,400. Employees earning below it are generally subject to compulsory statutory health insurance.
For scale: under TV-Ärzte/VKA, entry-level base pay is about €68,664.60 a year for a doctor in specialty training and about €90,626.28 for a specialist. The first sits below the threshold, the second above it. Whether you personally cross it depends on shifts and allowances.
Liability: ask what the hospital's policy covers
The professional code of the Nordrhein chamber requires adequate professional liability cover. As an employed doctor you are usually covered through the hospital, but that policy may not cover a recourse claim brought against you personally. The Marburger Bund explains the personal recourse risk in detail. Settle this before your first shift rather than after it.
Occupational disability is not automatically covered
The Versorgungswerk includes disability cover, but its definition can be stricter than a private policy's. Nordrheinische Ärzteversorgung requires inability to practise medicine and actual cessation of medical activity before it pays the disability pension. Whether that leaves a gap for you depends on your situation and is worth checking.