Due to the current shortage of medical doctors in Germany, hospital administrations increasingly recruit physicians from abroad to meet their demand. Relaxed migration policies and access regulations to the medical profession enable the formal recognition of these physicians’ qualifications. However, the question remains whether these measures suffice to ensure a smooth transfer of professional knowledge and skills. Research on the migration of highly skilled migrants has thus far predominantly focused on macro-structural aspects, whereas their actual integration at the workplace remains largely unexplored. The author investigates such micro processes of integration into the work environment in the case of Central and Eastern European migrant physicians in German hospitals, and attempts to understand the relationship between formal and informal aspects of integration and recognition.