After graduating you begin as a junior doctor (Assistenzarzt), and with your licence to practise (Approbation) a great deal changes at once: pay, rota, responsibility and often the daily tasks themselves. For your disability insurance (Berufsunfähigkeitsversicherung, BU) the question is whether your contract captures these changes and what it requires of you.
In short: With your licence to practise and the start of specialist training, the activity assessed under your disability insurance usually changes. What matters is the occupational group in your contract, not only your title. Whether a change in duties must be reported is set out in the contract. Last updated: October 2026.
The most important points
- With your licence to practise you may carry out medical work independently. This is where the assessment of your BU policy starts.
- Specialist training often involves rotations between fields with very different physical and organisational demands.
- Under § 172 VVG, your most recently exercised occupation counts. In a claim, your actual day-to-day work is what matters.
- Referral clauses can also cover activities outside the clinic, so check your contract carefully.
- Changes in your duties should be checked against the contract to see whether they must be reported.
What the licence to practise changes for your BU
The licence to practise entitles you to carry out medical activities independently. The Federal Medical Practitioners Act (BÄO) governs these requirements and the protected title. For insurers this is an important step, because the question becomes which activity you actually carry out and what risk it involves.
Many contracts place doctors in a separate occupational group, but the conditions differ in detail. Some tariffs distinguish between work with a high physical load and work with a mainly organisational or scientific share. Which rule applies to you is stated in your terms.
Typical stages of specialist training at a glance
Training to become a specialist runs in stages, and the focus of the work often shifts several times. The table below gives a rough picture of what to look out for in each phase. It describes no fixed rule, only a point of orientation.
| Phase | Typical focus of work | What to check for your BU |
|---|---|---|
| Start after the licence to practise | Ward work, emergency department, shifts | Check the occupational group in your contract and describe your activity accurately |
| Training in the hospital | Rotation between fields, sometimes surgery and night shifts | Check reporting duties for a material change in your activity |
| Later training or practice | Greater share of outpatient, administrative or management work | Check referral and reorganisation clauses in the contract |
Moves between fields matter for your policy in particular. If you move from an operative field to one with mainly outpatient work, the profile of your most recently exercised occupation changes. Whether that has an effect depends on the wording of your tariff.
A simple overview you keep yourself helps here: which posts you have completed, which duties come next, and which changes you have already reported to the insurer. Such a list makes it easier to present your situation in a claim and shows you when a query to the insurer is worthwhile.
What § 172 VVG means during junior doctor years
Under § 172 para. 2 VVG, a person is disabled if they are likely to be permanently unable to practise their most recently exercised occupation, in the form it had without the health impairment. For junior doctors this means that the concrete daily activity counts, not the job title alone.
Under § 172 para. 3 VVG, the insurer may contractually require that you also cannot carry on any other activity that corresponds to your training, abilities and previous standing. This referral clause is particularly relevant during specialist training, because the training establishes a clear professional position that the contract may take into account.
Changing roles and reporting duties
Not every move within the hospital must automatically be reported. The picture changes when the risk rating shifts significantly, for example through a change to another occupational group or to work with a different load. Your contract tells you which changes you must report. If you are unsure, a written enquiry to the insurer helps.
Our guide on disability insurance in medical school (in German) offers a useful basis for weighing these questions. It covers when to take out cover and which health details are asked.
Is it worth taking out or adjusting cover during training?
A new policy during specialist training is possible, but it does not always make sense. The health check, the premium and the chosen occupational group all play a role. A policy that already exists from your studies can sometimes be adjusted more easily once you start working, provided the tariff allows it. Which option suits you depends on your contract and your plans.
- For a new policy during training, a relatively recent health check and a clearer professional outlook can speak in favour.
- Against it: the commitment to a premium that may look different after you start working, and the risk that a new occupational group is rated less favourably.
- Existing contracts can only be adjusted if the tariff provides for it.
Frequently asked questions
Will the licence to practise automatically change my rating?
Not automatically, but the question does arise. The licence changes your training status, and insurers often assess the actual activity. Whether and how this affects your contract is set out in the terms. Check them before you start work.
Do I have to report a change of field?
That depends on the contract. A simple rotation within training is often unproblematic, but a clear change in activity can be reportable. Keep your details up to date and document changes before you inform the insurer.
Can night shifts or shift work affect my rating?
Demands in the rota can play a role in the assessment, particularly where they concern physical requirements. What matters most, however, is how your contract describes the activity. There is no blanket answer.
What happens if I break off training or change my field?
The policy remains in force, but the assessment of your occupation may change. What counts is how your tariff classifies the new occupation and whether it provides for reorganisation. A change is therefore a reason to review the contract, not a reason to cancel it hastily.
How does the post-insurance guarantee help in this phase?
A post-insurance guarantee allows you to increase cover on certain life events without a new health check. Whether it applies to your contract and which events qualify is set out in the terms. The event usually has to be used within a set deadline.
What to do now
- Read your contract and mark the occupational group and the referral clause.
- Note which activities you are likely to carry out during your training.
- Check which changes you must report to the insurer, and document them.
- If needed, clarify whether a new policy or an adjustment makes sense, ideally before you start work.
Related guides
- Disability insurance for doctors in training: clauses and occupational group
- Disability insurance for graduates: what is different
- BU dynamics and inflation protection explained
- Disability insurance in medical school (in German)
- Post-insurance guarantee: increasing BU cover after starting work
For a personal assessment of your contract, you can also contact us via our page on how we work.
Sources: § 172 Insurance Contract Act (VVG), gesetze-im-internet.de, status October 2026; Federal Medical Practitioners Act (BÄO), gesetze-im-internet.de, status October 2026.
Last updated: October 2026. This guide is general information, not individual advice.
