📋 Overseas Doctor Licensing Requirements — Country by Country
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Germany
Approbationsbehörde (State Medical Licensing Authority) + Landesärztekammer
📋 Approbation (Medical Licence) + Kenntnisprüfung for some IMGs🗣 German (C1 minimum)
Apply for Approbation (full medical licence) to the state (Landesärztekammer) where you plan to practise.
Your degree must be recognised — EU/EEA graduates get automatic recognition. Non-EU IMGs must have equivalence assessed.
Non-EU graduates may need to pass a Kenntnisprüfung (knowledge exam) if full equivalence is not granted.
German language minimum C1 Goethe certificate required — Fachsprachprüfung (medical German exam) required before Approbation.
Many Bundesländer (states) also accept a Berufserlaubnis (provisional work permit) while Approbation is being processed.
💡 Germany has one of Europe's highest doctor shortages — especially in rural areas and eastern Länder. IMGs from South Asia, Iran, Syria and Egypt are regularly recruited. Over 60,000 foreign doctors work in Germany. The Goethe B2/C1 + Fachsprachprüfung is the key bottleneck.
CNOM — Conseil National de l'Ordre des Médecins + ANDPC
📋 PAE — Procédure d'Autorisation d'Exercice (for non-EU) or automatic for EU🗣 French (B2 minimum for PAE; C1 required in practice)
EU/EEA graduates: Automatic mutual recognition — register directly with the CNOM (Conseil National de l'Ordre des Médecins).
Non-EU IMGs: Apply through PAE (Procédure d'Autorisation d'Exercice) via the ARS (Agence Régionale de Santé).
PAE involves document submission, review by national committee, and possible clinical assessment/attachment.
French language minimum B2 required; in practice C1 recommended for clinical work.
Specialist title (PAC — Praticien Autorisé à Collaborer) allows working under supervision before full authorisation.
💡 France actively recruits non-EU IMGs especially from North Africa (Algeria, Morocco, Tunisia) and Sub-Saharan Africa. The PAE process takes 6–18 months. PADHUE (Praticiens à Diplôme Hors Union Européenne) is the specific programme for non-EU doctors.
BIG-register — Beroepen in de Individuele Gezondheidszorg
📋 BIG Registration + Taaleis (Dutch Language) B2🗣 Dutch (B2 required for BIG)
Register with the BIG-register to obtain your Dutch medical licence.
EU/EEA graduates: Submit degree + EU recognition — usually straightforward.
Non-EU IMGs: Must have degree assessed by BIG or CBOG (Commissie Buitenslands Gediplomeerden Gezondheidszorg).
Dutch language B2 required (Taaleis) — assessed via NT2 exam or via Dutch language certificate.
Some hospital groups sponsor international recruitment with Dutch language course packages.
💡 The Netherlands has a significant doctor shortage, especially in general practice and psychiatry. English is widely spoken in academic hospitals — but BIG registration still requires Dutch B2. The language test is the main barrier for IMGs.
📋 Country-specific licence application + Language Requirement (varies by country)🗣 Swedish/Norwegian/Danish/Finnish/English (varies)
Sweden: Apply to Socialstyrelsen for Läkarlegitimation (medical licence). EU graduates automatic; non-EU assessed individually.
Norway: Apply to SAK (Statens Autorisasjonskontor). EU automatic; non-EU requires Norwegian language and possible assessment.
Denmark: Apply to Styrelsen for Patientsikkerhed. EU automatic; non-EU requires assessment and Danish/Scandinavian language.
Finland: Apply to Valvira. EU automatic; others require Finnish/Swedish language and assessment.
All countries: English widely used in hospitals, but national language B2 required for full licence in most cases.
💡 Scandinavia has critical doctor shortages in rural northern areas. Sweden, Norway and Denmark actively recruit from EU countries and increasingly from outside EU. Norway especially recruits from Pakistan and the Philippines for rural posts. Language courses often subsidised by employers.
Spain (EU graduates): Apply for recognition via Ministerio de Educación — then register with the provincial Colegio Oficial de Médicos.
Spain (non-EU): Degree homologación required via Ministry of Education — takes 6–18 months.
Spain: MIR (Médico Interno Residente) is the specialist training exam — open to all graduates regardless of nationality.
Portugal: Apply to the Ordem dos Médicos for Cédula Profissional. EU graduates relatively straightforward; non-EU need degree recognition via DGES.
Portuguese: Especially welcoming to Brazilian, Angolan, Mozambican and Cape Verdean doctors — CPLP language community recognition.
💡 Spain has one of Europe's most popular IMG destinations due to language (Spanish widely spoken globally) and quality of life. MIR exam is competitive but open to all. Portugal has significant doctor shortage and actively recruits from Portuguese-speaking countries.
Italy (EU graduates): Apply for Iscrizione all'Albo (registration) with the provincial Ordine dei Medici Chirurghi.
Italy (non-EU): Degree recognition via MIUR + then Ordine registration. Italian language B2 required.
Italy: Specialisation via the national Concorso — competitive exam for residency posts.
Switzerland: Apply for Berufsausübungsbewilligung (cantonal work authorisation). EU graduates via FMH recognition.
Switzerland: All four language regions (German, French, Italian, Romansh) — language requirement of the canton applies.
💡 Switzerland offers Europe's highest doctor salaries. The Swiss FMH specialist title is among Europe's most prestigious. Italy has a significant doctor shortage (up to 30,000 vacancy deficit) — especially in public hospitals in southern regions. Italian language is the main barrier for non-EU IMGs.
Ireland: IMC / Belgium: INAMI-RIZIV / Luxembourg: Ordre des Médecins
📋 Ireland: IMC Registration / Belgium: Visa + INAMI / Luxembourg: Ordre Registration🗣 English (Ireland); French/Dutch (Belgium); French/German/Luxembourgish (Luxembourg)
Ireland: Register with the Irish Medical Council (IMC). Strong recognition for UK, Australian, NZ, South African and South Asian graduates. Language: English.
Ireland: IMGs from Pakistan, India, Bangladesh frequently recruited especially for HSE non-consultant hospital doctor posts.
Belgium: Obtain Visa d'Etablissement then register with INAMI (RIZIV). EU graduates automatic; others assessed.
Belgium: Language requirement depends on region — French in Wallonia, Dutch in Flanders, bilingual in Brussels.
Luxembourg: Register with Ordre des Médecins du Luxembourg. EU graduates straightforward. High salaries — some of Europe's best.
💡 Ireland is the most accessible EU country for South Asian IMGs — English-language practice, active recruitment of Pakistani, Indian and Bangladeshi doctors for NCHD posts. Belgium has acute doctor shortage especially in rural Wallonia. Luxembourg pays some of Europe's highest medical salaries.
Eastern Europe (Poland, Czech Republic, Hungary, Balkans, Baltics)
Respective national medical chambers
📋 National registration in each country + EU mutual recognition🗣 Polish/Czech/Hungarian/Romanian/Croatian/Serbian/Baltic languages
All EU members: EU/EEA medical graduates get automatic mutual recognition — register with the national medical chamber of the country.
Non-EU IMGs: Degree assessment + national language requirement + medical chamber registration in each country.
Poland: Register with the appropriate Okręgowa Izba Lekarska (Regional Medical Chamber). Polish B2 language required for non-EU.
Czech Republic: Czech Medical Chamber registration. Czech B2 required. MUDr (Czech medical degree) equivalence assessed.
Hungary: Register with Magyar Orvosi Kamara. Hungarian required for public hospitals; English accepted in some private/international settings.
Romania: Register with Colegiul Medicilor. Romanian B1 minimum. Actively recruits from Moldova and Ukraine.
Baltic states (Estonia, Latvia, Lithuania): Language requirement is the key barrier — Estonian/Latvian/Lithuanian. However English increasingly accepted in university hospitals.
💡 Eastern Europe offers a practical route into the EU for non-EU IMGs willing to learn an Eastern European language. Poland and Czech Republic have significant doctor shortages. Romania and Serbia have historic traditions of medical education in English/French for international students — many local graduates already speak English.