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Practicing Medicine Abroad

My plans to practice medicine in Spain got delayed because I had to deal with my medical board investigation. That happened in 2018 but it’s just now that I feel recovered enough to pursue my medical license abroad. Practicing medicine abroad is an incredible opportunity which I want to take advantage of in this lifetime.

I have already written an article that highlights some of my research when it comes to applying for a medical license in Spain. This article is going to offer an overview of practicing medicine abroad more generally but I’ll touch on Spain as well.

US Physician Licensure

In order to practice medicine in the US, you must graduate from an accredited medical school and complete a residency. You must pass certain examinations to determine you are fit for practice and you’re off to the rat races.

Each state in the US requires its own medical license and each process is a little different but rather recognizable, nonetheless. It’s a lot of hoops to have to jump through but it isn’t hard to get multiple state medical licenses.

In order for this licensure to be recognized abroad, you have to have your medical school education homologated (approved). Your residency training may or may not fall into the homologation jurisdiction.

Practicing Medicine Abroad

The first question I get a lot on this website is whether you have to take some sort of test. The answer right now is that most countries won’t require you to take a test.

However, looking at the UK, starting 2024 there will be a test which you’ll have to take in order to practice medicine there as a foreigner.

The other consideration is public versus private. In most countries where healthcare is a right and not a privilege, you’ll have to compete with locals for public jobs. This means taking public exams (non-medical) in Spain and facing stiff competition since only a small percentage of non-locals are offered public positions.

The private sector is much easier to navigate. You can set up a private office in most countries. The question then becomes whether you have something worthwhile to offer for someone to pay privately. This isn’t tough these days with the shambles of western medicine worldwide.

The Visa Dilemma

You need to be sponsored to get a visa. This has to be by your employer or someone else who wants you to work with them or for them. This can be lengthy and tricky in most countries. But that’s what lawyers are there for.

If you start your own practice it’s generally easy to get a work visa. These are sometimes called lucrative visas or entrepreneur visa. You may have to submit a business plan but others have done it for far less established sectors.

You may also apply for non-lucrative visas or retirement visas which are common all over the world. Once there you can convert these visas to a work visa once you decide to open a medical practice or get hired somewhere.

The Language Dilemma

In order to get through the homologation, you often won’t need a language certificate. That’s good because the homologation process takes a while.

You may want to open a private practice in Spain serving mostly English-speaking individuals. Regardless, you would likely still need a language proficiency level which each autonomous region (state) will ask for.

The certificate level needed is often somewhere around a C1. For sure you would need this if you are going to work in the public sector. And you may need it not just for Castillian Spanish in Spain but also for Galician or Catalan in certain regions.

There are schools which can take you from A1 to C1 in 6 months. This will include the DELE exam you’ll likely pass with their help. Alternatively,

The Homologation Process

The UK uses the same organization for homologation as the US uses, ECFMG. That makes it kind of easy and since most medical schools in the US are accredited, that’s one less hoop you’ll have to jump through.

In Spain the hoomlogation is done through Ministerio de Educacion Y Formacion Profesional. You need to navigate to something along the lines of:

Servicios al ciudadano > tramites y servicious > universitarios > titulos extranjeros. The current link for this resides here.

Other countries have you submit your education-related documents to their ministry of education for verification. Once this information is confirmed then you are given approval from the ministry of education that you are convalidated.

With a convalidation, you can apply for your medical license abroad. You would apply to a particular medical college depending on which state you want to practice in.

I live in Galicia so I would apply to COMC – Colegio Oficial de Médicos da Coruña.

Practicing Medicine Abroad in Galicia, Spain

Once you get the homologation done in Madrid, you can submit the following documents to your local state for obtaining a medical license.

So, remember, there are 2 sets of applications you’ll do. One will be handled in Madrid for homologation and the other will be obtaining your license once homologation is complete – which is done in your local state (for me, Galicia).

For the homologation application which I can submit online I will need:

  1. Certified copy of passport and TIE.
  2. Certified copy of medical degree along with certified copy of the degree’s translation.
  3. Certified copy of the academic certification of medical school studies. Which must include official duration in academic years, the subjects taken, and the total hourly load of each one of them expressed in hours or in ECTS credits (European) and the corresponding official translation.
  4. Proof of payment of the model #790 fee.
  5. Accreditation of the linguistic competence (C1 level through DELE).
  6. If the medical degree to be homologated was obtained more than 6 years prior to the date of presentation of the application, it is necessary to present documentation accrediting the professional practice in conditions of practice as an autonomous doctor and not associated or supervised, or the continuous training of, at least, 3 years within the last 5 years.

Here are the requirements that I need to check off in order to get a medical license abroad in Galicia, Spain:

  1. Document certifying the identity and nationality of the applicant – NIE number.
  2. Two passport-size photographs.
  3. Spanish bank account document for the payment of the fees.
  4. Original degree in Medicine.
  5. Original document of homologation of the degree of Bachelor of Medicine (Ministerio de Educación, Cultura y Deporte).
  6. Original title/s of specialties (in case you are a specialist).
  7. Original document of homologation of the original title of specialty (verification that you meet requirements to be a specialist in this country).
  8. If MIR, photocopy of the document of award of the place (Working in public sector). Sample MIR exam is online for you to check out.
  9. Certification issued by an official body legalized by Apostille-The Hague showing that you are legally allowed to practice medicine in the USA. Valid for 3 months.
  10. Proof of payment of registration fee in Colegio Oficial de Médicos de A Coruña of 120,00 €.

Getting Help to Practice Abroad

Your best source for help is the government itself. Usually, they will respond back if you send enough emails and point you to better internal documents or someone who can help you on the phone.

Reddit is okay but not terribly useful. Instead, if you can reach out to medical colleges you’ll likely find someone in your exact same situation who is willing to walk you through the process of getting your medical license to practice abroad.

An attorney isn’t a bad idea. My experience has been that it’s hard to find someone who is willing to even take your money.

Clinical Supervision

It’s common for most countries to require you to go through a 12-18 month clinical supervision phase.

Basically, another physician is assigned to you who will have to fill out period reports. It’s not too complicated but you’ll need that level of sponsorship or oversight in order to eventually get a full, unrestricted medical license abroad.

The Income

I am not sure this is an issue for anyone, honestly. Are you going to leave the US to practice abroad for the money? Maybe. If you want to pursue a career in Sweden, Netherlands, UK, Canada, or Australia you’ll likely early an equivalent salary.

But if you practice in Spain or Latin America or Mexico or somewhere else, unless your money comes from mostly expats your income won’t be impressive.

Interestingly, in some countries as an American physician, you’ll earn more money. In Iran and Dubai and Saudi, for example, you can earn significantly more money than in the US.

Practicing Medicine Abroad in the UK

Most of these links will be useless in a few months. But you can always look up the names and you should be able to find the right destination.

Practicing medicine in the UK as a US physician requires that you go through the General Medical Counsil. They will verify your documents and offer you a license to practice.

Practicing Medicine in Iran

Since every other Iranian I know is a doctor, you can get your education and training convalidated by the ministry in Iran and you’ll get a medical license to practice there.

In order to not have my website shut down, I’ll forgo linking any websites here. The medical community in Iran is very welcoming so you can ask for a lot of help there.

Practicing Medicine in Canada

I’m a family medicine doctor and there is a direct pathway, called the reciprocity agreement (according to Hippocratic adventures) which allow me to get my board certification in FM in Canada directly.

The requirements are that I’m board certified in the US by the ABFM. There are similar things in place for other specialties but they might require you to sit for an exam to demonstrate your expertise in your specialty.

Practicing Medicine in Netherlands

Not only do you have to have a C1 level in Dutch to practice abroad in the Netherlands but you have to pass a few clinical exams.

Read more about it over at HA. The process can take 5 years. It’s definitely a dedicated adventure.

Practicing Medicine in New Zealand

You have seen locums positions advertised for NZ. I’ve heard good stories and bad stories about working there.

You don’t need a locums company to get you credentialed there. They speak English and so you can undertake the process yourself. The pathway is called the locums pathway and doesn’t seem overly burdensome as long as you have an ABMS specialty designation (including FM).

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