You are studying medicine and about to start your practical year (Praktisches Jahr, PJ). Perhaps you already have a disability insurance policy (Berufsunfähigkeitsversicherung, BU), or you are considering one. In both cases the question is the same: what changes for your cover once you start working in a hospital?
In short: The practical year usually does not change your disability insurance automatically. What matters is the occupational group in your contract and whether you already practise medicine. Under § 172 VVG, your most recently exercised occupation counts. Last updated: October 2026.
The most important points
- The PJ is part of your medical training. Before your licence to practise (Approbation), you do not practise medicine independently.
- Your occupational group is written in your contract. Read it before you answer questions about your training or duties.
- Under § 172 VVG, you are only disabled for insurance purposes once you are likely to be permanently unable to practise your most recently exercised occupation.
- A short sick note during the PJ is not automatically a claim.
- If your duties or training status change, check your reporting obligations and any post-insurance guarantee.
What the practical year means for disability insurance
The practical year is the last stage of medical training. It consists of three training blocks of 16 weeks each. Under § 3 para. 1 of the German Medical Licensing Regulation (ÄApprO), it starts in the second half of May and November. For an overview of studies, PJ and health insurance, see our guide Medical studies, electives and PJ: health insurance explained (in German).
| Training block | Duration | Content under the regulation |
|---|---|---|
| First block | 16 weeks | Internal medicine |
| Second block | 16 weeks | Surgery |
| Third block | 16 weeks | General practice or another clinical-practical field |
For your disability insurance, the PJ matters mainly because it is the first phase in which you work directly with patients. Many students therefore ask whether their rating changes. The answer depends less on the calendar than on the wording of your contract.
Am I still a student during the PJ or already a doctor?
Legally, the PJ is part of medical training. You receive your licence to practise only after the final state examination, and only then may you practise medicine independently. The Federal Medical Practitioners Act (BÄO) sets out these requirements. During the PJ you are therefore usually still a student, even if you take on responsibility on the ward or in outpatient clinics.
Insurers do not classify occupations by job title alone. They also look at the activity and the tariff terms. That is why the status “student” is not the whole picture. What counts is the wording of your contract: it states which occupational group applies and whether the rating changes as training progresses.
What § 172 VVG requires when a claim is made
The Insurance Contract Act (VVG) describes the core of occupational disability. 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, wholly or partly, because of illness, bodily injury or age-unusual loss of strength. Three terms are decisive:
- “Most recently exercised occupation”: the activity you actually carried out before the claim arose.
- “Likely to be permanent”: a short illness during the PJ is generally not enough.
- “Wholly or partly”: partial disability can also trigger benefits, depending on the contract.
Section 172 para. 3 VVG is also important. The insurer may contractually require that you also cannot carry on any other activity that corresponds to your training, abilities and previous standing. Such referral clauses often go unnoticed while you are studying, but they shape the outcome of a claim.
Taking out cover before or during the PJ: the arguments
There is no blanket recommendation. The overview below shows both sides so you can assess your own situation.
| Aspect | Argues for | Argues against |
|---|---|---|
| Health check | You are usually young and healthy, which can make the assessment easier. | Every pre-existing condition must be disclosed fully and honestly. |
| Premium | An early start can keep the premium plannable over the term. | The premium remains a binding obligation even when the budget is tight during the PJ. |
| Rating | A contract with a suitable occupational group from your studies can be advantageous. | Changing the rating later is costly or impossible, depending on the tariff. |
| Finances | An ongoing contract is easier to plan when the premium is secured. | During the PJ you often only receive an allowance, and its amount varies by federal state. |
Whether an early start suits you therefore depends on whether you can carry the premium over the long term and whether the tariff terms fit your path. Our guide on the PJ allowance by federal state (in German) can help you with the financial side.
How to check your contract documents before the PJ
Before you start the PJ, a short review is worthwhile. The points below give you orientation. They do not replace an individual check of your contract.
- Occupational group: does the contract say “medical students”, “doctors” or another wording?
- Referral: is a referral clause agreed, and how is it worded?
- Reporting duties: which changes in activity or training must you report to the insurer?
- Post-insurance: is there a post-insurance guarantee that allows later adjustments without a new health check?
What comes after the PJ
Once you have completed your studies and received your licence to practise, the view of your occupational group usually changes significantly. From that point, insurers often examine which activity you actually carry out, for example in a hospital, a practice or outside patient care. The terms of your contract decide whether and how this is taken into account.
If you are already insured before the PJ, check early whether your tariff provides for an adjustment after you start working. Our guide on the post-insurance guarantee explains the mechanism.
Frequently asked questions
Do I have to tell my insurer about the PJ?
That depends on your contract and on changes that affect your risk rating. Not every step in training is automatically reportable. Check the terms and keep your details up to date. If you are unsure, a written enquiry to the insurer helps.
Does BU cover pay out if I fall ill during the PJ?
An illness does not automatically lead to occupational disability. Benefits are only payable when you are likely to be permanently unable to practise your occupation. A short sick note is something different. Whether an incapacity clause also applies is set out in your contract terms.
Can I change my BU premium during the PJ?
Many tariffs allow premium adjustments, for example a pause or a reduction. Whether this is possible, and on what conditions, is governed by your contract. The options differ considerably and should be compared before you decide.
Is the PJ a reason to cancel the policy?
Not on its own. Cancelling a disability policy often means that a new application is assessed again, and different conditions may then apply. Before you cancel, make sure you understand the consequences for your cover.
What to do now
- Read your contract and note the occupational group and the referral clause.
- Check which changes to your studies or activities you must report to the insurer.
- Work out whether you can carry the premium during the PJ, including the allowance as income.
- If questions remain about tariffs or health disclosures, get personal advice.
Related guides
- Disability insurance in medical school: timing, health check and special features (in German)
- Disability insurance for medical students: occupational group, costs and health questions (in German)
- Disability insurance for students: costs and start (in German)
- PJ allowance by federal state (in German)
- Medical studies: electives, PJ and health insurance (in German)
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, accessed October 2026; § 3 German Medical Licensing Regulation (ÄApprO 2002), 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.
