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US Doctors Practicing Medicine in Spain

I had to go digging deep for this post because most of the information shared on forums was inaccurate. The rest is written by recruitment agencies which intentionally make the process seem complicated. So here it is, the guide for US doctors practicing medicine in Spain.

I am not sure how many US doctors practice abroad but I suspect we never hear from these individuals. They take a trip to Europe and they decide to stay. Somehow they figure out how to become a doctor there and that’s that.

Becoming a Doctor in Spain

Now, you’re not trying to become a doctor, you already are one. But it was interesting to read what it takes to become a doctor in Spain.

You go straight from high school and take a placement exam where you have to earn quite a high score in order to get into a medical school. It’s considered to be the hardest profession to get into and the most sought-after.

Med school is a 6-year process with the first 3 years being basic sciences, along with the didactic portion of pathophysiology, microbiology, and my favorite, pharmamotherfuckingcology – which I failed in medical school.

The next 3 years are rotations and that’s when you try to figure out what kind of specialist you want to be. And just like in the US you can start claiming that you’re a doctor right after med school, in hopes of getting laid.

Next, you must take the MIR exam in order to place into a particular specialty. In Spain, as of this writing in 2018, geriatrics and EM and anesthesiology are the fields which have the biggest physician shortages.

Practicing Medicine in Spain

The Spanish healthcare system is considered fairly strong with most patients quite happy with it. That has been my impression so far when talking to people.

Spanish physicians, referred to as médicos, recognize that other countries don’t necessarily have a better healthcare system but that doesn’t stop them from leaving for other countries.

The nice thing about the EU is that once you have done your medical school and residency in one country, you can take those credentials to another country in the EU and it will be recognized. I’ll get into the income side of things a little later.

These doctors get their medical licenses and can practice for the public or private system. I don’t have a medical license in Spain, yet. But this article is to help me figure out how to go about it – that’s how I learn most things, researching it and writing about it.

Spanish Doctors Practicing Abroad

The headline of a recent newspaper referred to the 3,500 Spanish physicians who have applied for work in other countries.

  • 830 left to practice in the UK.
  • 540 to France.
  • 215 to Ireland.
  • 200 to Germany.
  • 125 to Portugal.
  • 90 to the USA.
  • 75 to the Emirates.
  • 60 to Canada.

These numbers have increased over the past few years, mostly because the income for Spanish doctors is quite low. But some have also expressed frustration with how slow-moving the medical system is.

This is referred to as the mañana phenomenon.

Public and Private Healthcare

The majority of healthcare is public in Spain. The rest is made up of large private medical groups. Practicing medicine in Spain as a US doctor means we’ll be competing in the private space, not the public. Though both are valid options.

You don’t have to pay for public healthcare in Spain. But you have to pay a little every month in order to get access to private clinics and hospitals. This can range anywhere from 20-50 euros.

To give you an idea, I have a Cadillac plan for 55 € a month. For this price I have a zero copay, a zero deductible, access to public hospitals, and access to private clinics. I also have optical care but would have to pay 10 € extra a month for dental coverage.

I didn’t get the dental because, from what I understand, you still have to pay 50% of the cost of the service.

Geriatrics

Geriatric care has become a big burden on the Spanish doctors. Elderly care, whether in the ER or in psychiatry, is becoming more and more time-consuming and requiring more specialized care.

I couldn’t confirm this but apparently the prescription rate in Spain is high. As in, many of the elderly Spanish citizens are on multiple medications.

There is also the sentiment among physicians that these elderly individuals end up coming to the public clinics for mundane matters out of boredom.

Practicing medicine in Spain means you have to learn the culture there. And there will always be some negative sentiment towards some group. But there are also amazing healthcare being delivered in Spain.

Physician Income in Spain

You can earn a gross income of 60,000 € a year as a public doctor in Spain. This number will vary up and down, depending on your specialty. You might find a primary care doctor who early 2,500 € a month.

I’ve read reports of public jobs not being reliable. You might be employed some months and be furloughed the next. That’s why many work in the private sector on the side.

One orthopedic trauma surgeon I spoke to at a bar said that he made 90,000 € a year as the head of the department and his hours were long but nothing as bad as what his US colleagues endured.

Some physicians will work the public sector in the morning and finish their day by working the private clinics. It’s not hard to pull in north of 120,000 € for these workhorses.

A US physician practicing abroad likely isn’t going to want to work 15-hour days. But it’s worth discussing how medicine is practiced in these European countries.

The Clinical Workload in Spain

The need for a doctor, and specifically the urgent need for a doctor, is much lower in Spain. Where in the US it’s common to find primary care doctors and specialists who work on weekends, here it would be uncommon.

Work also tends to start a little later in the morning, with the common 2-hour siesta break in the middle of the day. After that the doctor returns to the clinic or the hospital and resumes work until 6:00-8:00 pm.

Volumes can be high. Some doctors practicing medicine in Spain report seeing the kind of volumes we are used to seeing in the US.

The most important thing here is that the paperwork and documentation, lawsuits, and investigations are all quite minimal. The majority of the time is spent with the patient.

And – interestingly – there is very little emphasis on customer service. This is probably aided by the fact that the Spanish culture is a very warm and friendly one, generally speaking. So I’m sure the doctors aren’t giving their patients the middle finger but science is valued higher than bedside manner which is …. just … fucking shocking.

It’s the difference of going to a Jiffy Lube to have your oil plug stripped off with a smile or going to an excellent mechanic who may never make eye contact with you.

Lawsuits have gradually risen as Spain has tried to privatize healthcare more and more. But it’s still incredibly rare to hear about a lawsuit unless a doctor tried to intentionally harm a patient.

US Doctors Practicing Medicine in Spain

US doctors who attended accredited medical schools in the US and completed a residency program can practice medicine in Spain without taking any particular exam.

I just finished retaking my family medicine board exam (as of November 2020), so I’m excited to not have to take yet another test.

From my research and talking to sources here, you do not have to take the MIR or any other such test to be allowed to work as a doctor in Spain.

There is a difference between the public and private sector – this is important to grok. If you want to work in the public sector then you have to take a placement test in order to determine where in the country you’ll end up for a job. If you want to work in a private clinic or open your own, you just have to have your credentials accepted by Spain, as we’ll get into below.

You do not need to redo a residency, you do not have to take the MIR, or any other exam in order to start practicing. Some specialists can start practicing primary care in Spain while they wait for their credentials to be approved. This can take a year and even long.

You may have to be supervised the first year you work. I haven’t been able to get enough information on this. But it’s not like you have to be attached at the hip to another doctor. It’s more of a mentorship.

Language Barrier

The authorities here make a big deal of language competency but from my understanding, it’s fairly easy to get to a competent speaking level within 4 months. This level is enough to pass the language exam. Of course, I’m talking about studying 6-8 hours a day – not just doodling on Duolingo. The levels are in the C1-C2 range.

The diploma you receive for your language level is what you’d submit to Madrid in order for your medical degree to be convalidated or for homologation.

Jobs for US Physicians Practicing in Spain

A lot of physicians from Latin America move over to Spain for the better income. So, there are fairly obvious paths which many of these doctors have taken, most of us just have to follow in their footsteps.

From what I have gathered here is that the Spanish people prefer to have Spanish doctors. Some believe that the quality of care they receive from the Latin American doctors isn’t as good.

It’s becoming more normal to see older people here with obesity, diabetes, and of course a laundry list of medications. Beta blockers, ACE-I’s, statins, and metformin, and insulin are gaining traction.

As a US doctor practicing in Spain you’ll be competing with all other doctors from all other countries.

Process of Getting Licensed in Spain

The summary is below in Spanish, as I’ve found on other reliable websites. If someone could translate it for the rest of us, please do so in the comment section below.

  1. La Solicitud cuyo formulario debe de ir debidamente cumplimentado.
  2. Acreditación del pago de la tasa, Modelo 790.
  3. Copia compulsada del documento que acredite la identidad y nacionalidad del solicitante.
  4. Copia compulsada del título cuya homologación se solicita o de la certificación acreditativa de su expedición.
  5. Copia compulsada de la certificación académica de los estudios realizados para la obtención del título, en la que consten, entre otros extremos, la duración oficial en años académicos del plan de estudios seguido, las asignaturas cursadas y la carga horaria total de cada una de ellas expresada en horas o en créditos ECTS (europeos).
  6. Acreditación de la competencia lingüística necesaria para el ejercicio en España de la correspondiente profesión regulada. Esta acreditación no la necesitaría tu hijo, porque el título obtenido lo ha realizado en una universidad de lengua hispana.

1. Contact Ministry of Education

The first department you’ll have to wrestle with is the Ministry for Education, located in Madrid. The main website is at Ministerio De Educación Y Formación Profesional. The website changes a lot so just search for it online. 

From there you will need to find the education section. Then navigate over to the University section (Universitarios) and then over to Foreign Titles (Títulos Extranjeros).

When I first wrote this article everything was done over snail mail. Now you can supposedly submit your stuff electronically, but you may need to be present in Spain because it requires a digital certificate. You can get this from the social security office as long as you have an NIE number. 

Next, you will need to navigate over to the homologation – homologación. If this link is broken then just do the search above until you find the page. 

Apparently you can submit your application to a Spanish consulate in the US as well. But it’s recommended that you submit it to Madrid either in person or mail it within Spain or do it digitally.

They will need to verify all your diplomas and licenses from the USA. Apparently it can take up to 12 months for this to take place. So buckle down, get ready. 

The process is quite streamlined but there is also a huge backlog of physicians who are waiting to get approved to work in Spain. Check out this headline below.

Homologación refers to the process of transferring all your credentials from your country to the Spanish Ministry of Education. Below I have the addresses worth having on hand.

Ministerio de Educación de España. Centro de Información y Atención al Ciudadano. Sección de Información Educativa
Calle Alcalá, 34
28014, MADRID
T: 917 018 000 (centralita), 902 21 85 00
F: (91) 701 86 48
Subdirección General de Títulos, Convalidaciones y Homologaciones, Servicio de Homologación de Títulos Extranjeros Universitarios
Calle Paseo del Prado, 28
28014 Madrid
T: (91) 420-16-94 , (91) 420-07-67

2. Register with The OMC

Next comes the OMC, about which you can read a little wiki. It’s called the Organizacióon Médica Colegial De España. It’s the medical college and it’s depended on which province you’re in.

This is the email I received from my local OMC, below. I have attached the pdf here.

The Spanish Medical College Organization regulates the medical profession in each particular region. I’m living in Galicia, so I’d do it there.

The entire list can be found here. There are 52 regions.

The OMC will need to give you permission to work in their region. They will also need to give you a particular number with which you can prescribe medication.

I believe they are also responsible for selling you practice insurance. I don’t think they call it malpractice insurance – interestingly enough. It’s all quite cheap.

3. Work for One Year Supervised

I referred to this above. You’ll see your own patients. You’ll be completely independent but you’ll be working under supervision. I’ll write more on this as I get closer to it.

As of 2020 when I’m updating this post I haven’t yet gotten my medical license in Spain. In fact, I missed a great window during the pandemic when the Spanish government fast tracked anyone who was in the pipeline.

Work Permit, Visa

Very few US physicians are trying to leave their $300k US jobs for 30k euro jobs in Spain. That’s why all this information was a pain in the ass to come by.

So, you got your medical school and residency paperwork approved by the Ministry. Then you got the local college to approve you to work after you demonstrated a language competency. Next, you need a work visa in order to work in Spain.

Unless your particular region is hurting for doctors, the private healthcare system may not extend a job to you and so you’ll have to resort to being an autónomo.

Interestingly, the private sector often has many more jobs and much more willing to help you get the proper work permits and visas figured out.

Private Practice in Spain

If you speak English then you’ll be highly sought after in the beach cities of Spain, especially Malaga and Cadiz.

It’s not easy finding patients for a new private practice since the advertising rules aren’t what you are used to in the US. But if you can hold out long enough then eventually you’ll get clients as a US doctor practicing in Spain.

Word of mouth is like Yelp here. All it takes is a few bad reviews and people will avoid you like the plague. Probably more so in smaller cities.

My Personal Strategy

I want to get my medical license convalidated in Spain even if I may never work in Spain. It’s nice insurance to have especially with how wonderfully things are going for me in the US.

Most medical schools in the US are recognized as valid medical schools by Spain and my residency is in Family Medicine so that shouldn’t be a problem.

Fortunately, the jobs which are least desirable here are what I like the most. I can either work in the ER as an FP or ride in the back of an ambulance as an urgent care doctor.

After I learn the language and get my credentials approved, I’ll work in the public and private sector for a year. It’s not hard finding part-time gigs in the private sector.

Practicing medicine in Spain long-term would only be attractive if I open my own small private practice from 9:00 am until noon, Monday-Thursday somewhere in Cadiz, Spain. I would add some telemedicine in there which is just barely happening at the major hospitals here.

83 replies on “US Doctors Practicing Medicine in Spain”

Great post Dr Mo!

I’ve always wondered what the process would be to get certified to work in another country like Spain.

Thank you.
If for nothing else, it’s a good idea to have an idea about such things. Never know when you might want to take a break and practice overseas. I hope that I can navigate the process to get a first-hand account of what it’s like practicing in Spain and compare it to the US.

This is such a great post! I’ve been looking for this info across a few forums and have found a lot of conflicting information. I’m currently going through med school in the US and want to eventually practice in Spain. If you could answer some questions, I would really appreciate it

1. Is it really true you don’t have to take any exams to transfer to Spain? Like you mentioned in your post, I’ve seen so many people say that you need to in order to go from US -> Spain. Have you already transferred your credential successfully? I guess I’m just a little awe-struck to hear someone say its so easy!

2. As an american student who knows they want to end up practicing in Spain, is it a better idea to go straight to Spain for residency? I can definitely see the upside of staying in the states for residency and practicing for a few years here to at least get rid of my debt and maybe accumulate some savings, AND then go to Spain.

3. You talked about specialties a little in your post, but are there any specialties I should aim for (or stay away from) assuming I’ll end up in Spain? Are any specialties in super-low demand? I assume this varies by city/region.

Thank you in advance!

1. Based on the information I gathered and as long as your medical school is accepted, you wouldn’t need to take any exams. Each district in Spain sets their own rules and they can make exception to the rule at will. But that’s not the norm. I haven’t transferred my credentials, I wouldn’t be a good candidate because I had my medical license suspended for 30 days in the US and that’s a big no-no for them.
Don’t know about easy, it’s simple, but I think that’s a bit more subjective.
Don’t be too awe struck. They would be very lucky to have a US trained physician there because they are having a tough time getting enough people interested in medicine. The majority of their doctors come from Latin America and the local crowd heavily looks down upon these doctors and the word on the street is that their care is quite subpar.
2. If you have student loan debt then I don’t see how it’s possible to go there and practice. With that much debt you might even have a hard time getting a visa. Not sure if they will look at your finances in detail but getting a work permit isn’t all too easy. I think it would be a better idea to do residency here and then transfer. But I don’t know how laws will change by then.
3. They probably will need more radiologist and anesthesiologists and fewer primary care doctors. But they are desperate for urgent care doctors and seem to need more ER doctors as well. Surgery should always be a good option.

I highly suggest you start finding a connection in the part of Spain you like to eventually practice and them be your mentor. Also, many expat doctors there so it shouldn’t be terribly hard for you to find someone also who can tell you what the license transfer process is like.

Thanks for the awesome information. I’m married to a Spaniard and we always talk about moving to Spain once the kids leave for college in a couple of years. I work in a large academic institution in Texas and wonder if I could enter the real of academic medicine there. I’m boarded in Int Med but have been practicing Oncologic Emergency Medicine for 10 years. Any information on Academic Medicine positions in Spain?

I actually think you’ll have an easier time entering academic medicine than trying to practice medicine there privately. Most of the private medicine is getting showered with foreign medical graduates from South America. Their care is considered subpar by the Spaniards and few enter academic medicine. The medical schools – such as the one in Cadiz – seem to favor the clinicians who are willing to do more teaching and publish papers. The academic doctors seem to speak a lot of English and so I don’t think you’ll have a hard time.
If I may suggest, go on any medical school website in your favorite province and start making buddies with some of the academic doctors there. I’ve never heard of oncologic emergency medicine – then again, flossing is a relatively new concept to me too – I’m sure you could generate a bit of interest there from one of the docs there and then go give a lecture. You can get a visa to be a lecturer at a university quite easily. Let me know how I can help further. Very exciting.
Oh and, what is oncologic emergency medicine?

Dr. Mo thank you for your post. I am also in the medical field and was looking for information on practicing in Spain. My wife is from Spain and we like to visit quite frequently. I am also looking to practice in Cadiz and am looking to open up another private practice in May or June of 2019. I would like to make connections with an MD who would also like to practice in Spain. If there is a way we could talk more let me know, things are happening pretty fast and it would be nice to have an MD on board.

Dr. Mo, thanks for the post! I am interested to learn if you have any insight about equivalency between licensing in Spain and other EU nations. More pointedly, could I as a physician follow the steps you’ve outlined to earn a medical license in Spain (up to the point of completing one year of supervised work), and then use the reciprocity that EU countries have for medical licenses to immediately go practice in France, for example (given language competency)?

I ask because I have been looking at licensing requirements and have found a lot of roadblocks for American physicians wanting to practice throughout most of Europe (i.e. needing to return to residency, etc.). If there was a way to work around these limiting restrictions by at least getting qualified within the EU by working for a year in Spain, that would make working elsewhere in Europe so much easier by requiring what seems only a work permit application to the intended other country. I’d be really appreciative if you’d let me know what your thoughts are about this.

What you are describing is very complex but in theory, yes you could. Once your medical license is accepted by any EU country then you can use it to practice in other countries and it should be accepted much faster.
But still, you won’t be an EU resident and the hardest part will never be the medical license, it will be residency, visa, language exams, and having a job offer before you practice somewhere else. Depending on the country, this can take several years. But if you are going to travel and work across Europe, your Spanish medical license should help you expedite any other licenses. You still will go through the headache of having each country verify your US medical school and residency and scores – that’s done even for EU doctors.

Dr Mo
Thank you so much for your information..
I am a Pediatrician and Neonatologist practicing in Toronto Canada for the last 10 years both at hospital and at my private practice.
I am Canadian but also EU citizen , I have practiced in Ireland for a few years.
My wife is a British/ Canadian who loves to live in south of Spain..
We have two kids 7 and 12 years.
Neither of us speak Spanish.
I wonder from where should I start?
I appreciate your guidance and your input.
Max

Is there an opportunity for you to start a telemedicine business and keep your current brick and mortar and make most of your money form the virtual side of it?
What’s your income needs once you move to Spain? Are you planning on working g full time there?

Dr Mo
Thank you so much for your information..
I am a Pediatrician and Neonatologist practicing in Toronto Canada for the last 10 years both at hospital and at my private practice.
I am Canadian but also EU citizen , I have practiced in Ireland for a few years.
My wife is a British/ Canadian who loves to live in south of Spain..
We have two kids 7 and 12 years.
Neither of us speak Spanish.
I wonder from where should I start?
I appreciate your guidance and your input.
Max

Hi Dr Mo
Thanks for the helpful info I am an American doctor living in Spain, just beginning the process of getting licensed. I have a pretty basic question: do you know where to go to get the licenses and diplomas officially verified and translated?

The medical counsel in Madrid can tell you where to go. The process usually is having your diploma and degrees notarized and then having them authenticated by the Secretary of State. You can ask around for document authentication services or asks the counsel in Madrid as to what their exact requirements are. They usually have a handout they can give you which is standardized. If you are stateside then any US translation service – often lawyers – can do the work for you.

Dear Dr Mo,
I love your post and also the kindness you have to answer in details medical personels questions.
I am student at Michigan State University, 4th year and in 2 months I will be a D.O. physician by a diploma ONLY.
Kindly asking to look at my questions:
1. As new DO, can I start residency in Anesthesia in Spain. If its so- what are the first few steps.
2. Do I need exam to enter residency.
3. Do you know by any chance, what is the salary of a medical resident?
4. Im married and we have a daughter.
What is the price of a house there?
Thank you.

Your medical school work will be accepted, the only issue will be if Spain is open to you competing for residency spots with the locals. I suspect that if you are going into a specialty you might be okay especially in a state in Spain where they can’t recruit enough doctors.
Your first steps will involve what I have outlined in previous posts and the post you read to reach out to the various medical commissions and ask what their current process is for you to get your DO credential certified and verified – this will happen centrally in Madrid. Next you’ll have to take this information to the particular state you are applying you.

I’m not sure what exam you are referring to but if you have a DO then you already took your exams. I suspect the salary will be low, in the $12-15k/year range but I have no idea, just what I’ve come across on various communities online. I suggest starting in Reddit – lots of South American doctors end up being foreign medical grads in Spain.

The house price question is rather broad so I on the low end you are looking at $40k and upwards of millions. Real estate is very location dependents and rather specific as to how far you are from a city center or if it’s flat versus detached home versus farm house.

I saw that the DO degree is not recognized in Spain on osteopathic.org
Even if ABMS board certification. Do you know if this is true?

If you want to be a DO here chances are nobody would know what you’re about. However, your medical degree might still be accepted through the homologation process. So you could get an equivalent MD here but likely not a DO.

Great post! And not 10 year old info! Thanks for sharing! I’m a few years out from my family medicine residency in the US and I’m getting close to finishing paying off my debt. I’m fluent in Spanish and I’ve thought about practicing for a while in Spain. I’m also interested in pursuing a general surgery residency, but you pretty much can’t do a second residency in the US anymore. How hard would it be to get a general surgery residency spot in Spain if I did well on the MIR? I saw there were programs to help you prepare for it, similar to USMLE World. From what I could tell, it seems like your MIR score is the main determinant for what residency spot you get and it’s pretty much first come first serve according to your national ranking on the MIR, but then there’s something about limited spots for foreigners. I wanted to see if you knew more about this. Thanks for your help.

Hey Stephen. Wish I did, I don’t know much about the specialty stuff but yes, they are rather strict here when it comes to competing for the specialty spots. That said, the competition for medical careers isn’t as fierce here in Spain as it is in the US. If you’re going to go back to residency for Gsurg I think you could do it if you can get a connection into a residency program. The way to do it is to contact your old FM program director and see if they know any of the surgery program directors and if they are willing to meet with you. Anyway, wish I had more information for you. A good place is to ask questions on the Spain reddit forums, you can find a doctor here or there who’ll give you more info. Also, a ton of docs from Latin America come to Spain as foreign medical grads so I’m sure if you set your google to South America you’ll get a far better search result than the limited shit we see in the US with google.com.

Thank you Dr Mo! WOW – I have been looking for this!

My questions:
– what are the language requirements if I’m planning to work ONLY on a private sector with English speaking patients?
– if I need to pass a language test, what level it would be? (e.g in Germany they would require B2 level German – anything similar/easy to measure?
– if I need to pass a language test, do I need it even before I get my EU doctor license approved, or is it mainly for to get a hospital position?
– and could you recommend some on-line language schools which would prepare exactly for this exam?

Thank you millions!

You must demonstrate Spanish competency before you are granted a license. I am not sure what grading they use here but you have to be able to have a conversation – that usually take 4 months of full-time Spanish studying for most medical professionals. Don’t hold me to it but I’m pretty sure they are looking for a C-level.
The first year of practicing medicine you will need to have supervision by another doctor – usually that means that you’ll have to work in the public sector for a year though I believe there are ways around this. You can apply for your EU license while you’re taking the classes or studying for your language proficiency test.
To get the final approval to practice you will need to pass the language test. So you can have everything else done and leave the language for the very last step.
There are a ton of such courses online. There are some which are geared towards professionals. Local universities even have these courses such as https://www.usc.es/en/servizos/clm/cursos/espanol/index.html
I don’t have any particular course that I could recommend but if I come across a good one I’ll post it here.

My medical license was suspended for 2 months, will it be difficult to transfer my credentials to Spain? I’m a psychiatrist, speak fluent Spanish and have always wanted to move to the coast in Spain.

Yes, it’s gonna be tough. Was your license suspended in all states where you were licensed? If you had a multi-state license then you could get away with using a different state report. However, depending on where on the coast you decide to live, if that particular state in Spain is in need of psychiatrists then they are likely to make an exception. But they generally prefer medical licensees with nothing on their history.

Dr. Mo

Is there any way to get a license without having done a residency? I really don’t plan to “practice” in the country per se, I am just looking to be licensed for the purpose of working for an air transport company. I graduated from med school in the Dominican Republic and have a 1 year internship.

I don’t know the answer to that though I suspect that if you won’t be practicing then you can still convalidate your credentials here.

Thank you for all the detailed information! I have a couple questions I’m hoping you could help me with. My situation is a bit unique but I’d appreciate any advice you had regardless.

I’m currently still an undergraduate student in my second year of a combined BS MD program. I have conditional acceptance to a medical school in my state. That being said, I would like to practice and ultimately live in Spain. Would it be easier to achieve this if I finished my undergrad degree in the States and attended medical school in Spain? (I’m interested in taking that route; I’m fluent in Spanish.) Would it be possible to practice in the US with a medical degree from Spain? I know there’s a homologation process for undergrad degrees as well if I wanted to apply to a Spanish med school, but I don’t know if it’s less complicated than the process for medical degrees.

Thank you in advance!

Thank you for this amazing post. Can DO’s practice medicine in Spain? I am a Board Certified Gastroenterologist . Thank you

I believe that the DO degree is accepted in all of Europe. As long as your medical school is accepted, the convalidation shouldn’t be an issue whether you’re MD or DO.

Dr Mo…
Great post, I must say.
I have a situation maybe you might be able to help. I’m currently living in Spain as a dual citizen. I have two state licenses, Florida & NY. I pretty much retired when leaving Florida anticipating not being able to validate my U.S. licenses. I did a FP residency in NY and my medical school was at UAG (Guadalajara, Mex). I did my 4 years at UAG followed by a fifth year of clinical rotations in N.Y. (Fifth Pathway). Do you have any knowledge of medical schools that are recognized here in Spain? I would like to be able to validate my licenses…maybe do something even if part time. Any suggestions?

There is a list of accredited medical school. It might be in this post somewhere if you follow all the links. You can also contact Madrid and they will tell you if your medical school is accepted. I am fairly certain that UAG would be accepted since it’s a fairly popular medical school but I don’t know exactly.

I updated this article August 2019. I’ll keep making changes as I learn more. I haven’t started my homologation process yet since I still have to get my visa finalized and get enrolled in a language school. Getting there, slowly!

Hey Dr Mo,

I have a quick question. Is it possible to practice telemedicine (seeing patients in the US) from Spain but without having a Spanish license if you are actually a resident of Spain?

Take care.

You aren’t allowed to practice medicine in Spain which is defined a seeing patients in person in Spain in an autonomous region. For now, there is no law that you cannot communicate with your patients in another country while residing somewhere else (anywhere in the world).

Fantastic information. I am a Spanish/US citizen, US-trained Interventional Pain Physician with an additional specialty in neurology. My wife went through 5 yrs of bureaucratic hell to get my medical degree accepted in Spain. It’s done. But now I want to work out how to practice as a specialist in the Canary Islands (where my dad is from, and where my wife and I would like to move to). I don’t really feel comfortable, or want to, practice primary care (it’s been too long since I did any of that). However, in your post you mention the advantage of speaking English to work in coastal areas that see a lot of tourism/expat, the Canary Islands are one such place and I had thought about tourist/expat medical needs in this region; along with Teladoc type medicine (in neurology and pain?) Fortunately I am perfectly fluent in Spanish so that won’t be an issue for me. I have begun the process of convalidation in Spain for my specialties (pain and neurology; Upenn and Columbia respectively) but would like to be able to move to and work in the Canaries while I wait for the process to be completed. From your post I got that the next step is to contact the region’s OMC and I will do that next. Any other suggestions?

Tips on convalidation:
-we (my wife and I) did not mail anything directly to Madrid, but used the Spanish consulate in Miami instead. My wife is a social genius and made friends with all those involved in the chain command…and still it took 5 yrs!
-Translation (courtesy of my wife)
La Solicitud cuyo formulario debe de ir debidamente cumplimentado.
The application must be completed in its entirety.

Acreditación del pago de la tasa, Modelo 790.
Payment confirmation for the appropriate amount. Application 790.

Copia compulsada del documento que acredite la identidad y nacionalidad del solicitante.
Certified copy of the document that demonstrates your nationality and identity.
(this is where doing this process at a consulate helps) “compulsada” means that the copy has been compared with the original and been found to be and identical copy. You can either notarize the document and mail it to madrid or take the copy and the original to the consulate and they will certify it there.)

Copia compulsada del título cuya homologación se solicita o de la certificación acreditativa de su expedición.
Certified copy of the diploma or accreditation certificate for which you are seeking recognition.

Copia compulsada de la certificación académica de los estudios realizados para la obtención del título, en la que consten, entre otros extremos, la duración oficial en años académicos del plan de estudios seguido, las asignaturas cursadas y la carga horaria total de cada una de ellas expresada en horas o en créditos ECTS (europeos).
Certified copy of the academic certification of the completed studies performed to obtain the diploma, this must include, among others, the official duration in academic years of the study plan followed; the classes taken, and the number of hours spent in each class expressed in hours or ECTS (european) credits.

Acreditación de la competencia lingüística necesaria para el ejercicio en España de la correspondiente profesión regulada. Esta acreditación no la necesitaría tu hijo, porque el título obtenido lo ha realizado en una universidad de lengua hispana.
Linguistic competency accreditation necessary to practice your profession in Spain. This accreditation would not be required of your child, since he/she would have obtained his/her diploma in a Spanish speaking university. (weird…what do your real or potential offspring have to do with anything?)

There you have it. (thanks to my wife 😉

Fabulous, this should be very helpful for those interested in this track.
Mike, the next step is to contact the medical authority for the region you’re interested in. If you want to practice in the public sector then you’ll have to take a test and compete with everyone else who desperately wants those jobs. The better option is to go into the private realm (once the local medical authority grants you acceptance) and set up a private office.
Telemedicine is gaining some traction here so you might as well be ahead of the curve and start that as well.
You’re a dual citizen so you’re not going to have to jump through the same hoops as a non-EU citizen. Keep us posted, curious what you find out.

Hello Mike, I was just in the Canary Islands and hoping to move there within a few years and maybe practice Internal Medicine part-time. I have started the homologation process. I am fluent in english and spanish (Cuban American, 1st Gen). Planning on just turning in all my paperwork directly to Madrid when I visit this summer. Just curious as to what you are doing and if you finally moved there and any advice for me. Thanks!

Mike super helpful! But it sounds like if one began the process now, there would be no way to have this done within a year from now based on your experience?

Hi,
Great article! I am a physician assistant looking into opportunities overseas. Are you aware of any midlevel recognition in Spain, or pockets where a PA could practice or consult in your research?

They don’t have any PA’s in Spain. Healthcare is evolving quickly here however and medications and surgeries and privatization is gaining traction. With that, usually PA’s and NP’s gain traction in such places as they have in Australia, Netherlands, and Canada.
Any insight you have in US healthcare would be incredibly valuable to the right people or in the right business model in Spain. That might be a whole post in itself so not a lot I can offer here in a comment. But you can certainly think along the lines of starting a PA school in Spain. Or you can open a clinic in Spain and hire a doctor.

Very helpful information, thanks for posting!! I’m currently finishing emergency medicine residency in NYC, planning to work here for at least a year then thinking about moving the wife and kids to Spain. We are spanish speaking and we absolutely love coastal Spain, so it makes the most sense of any euro country. I was reassured to read there was a shortage of EM docs. Have you found this to be true at the EM residencies or any particular places? Also, any developments or new info since posting this article? Where are you currently in the process of licensure there? Thanks again – very helpful!!

Ben, thank you for posting your comment. I don’t think you’ll have much of a problem with jobs, though if you are going to work in an ER for a public hospital then you’ll have to take a public exam here which is how public jobs are dispersed in Spain. It’s not just clinical questions but there is some law related questions and admin questions in there as well – the bureaucracy is absurd here in those regards.
But don’t let that intimidate you, many foreigners from latin america become doctors here. It’s just that there are a limited number of spots for foreigners so the competition is stiff.
You can always work for the private sector and work in a private hospital. You don’t have to take any exams at all for that, except your language competency.
Also, remember, you’ll make around 3,000 euros a month working as a physician here in the public sector. I can make that money with 1 day of telemedicine work. I make that money with 2 healthcare consulting clients. And I make that money with 10 phone calls with physicians who consult me about medical board investigations and other related stuff on this website.

Additional question- any developments you are aware of concerning the EM specialty in Spain? I saw there was a big push for EM training in the past few years but I’m not aware of any EM residencies. Thanks again!!

Yes, EM is it’s own specialty here from what my physician colleagues have told me. But urgent care is a lot more popular for some reason.

Hello Dr MO,

I been looking all over the internet looking for US residency grads validating their specialty in Spain. Here is my situation, I went to med school in Costa Rica which it’s easy to validate (friends in Spain work over there) being a Latin American approved school in Spain. My question is : I did my residency in the US in internal medicine and me and my wife want to eventually move to Spain but in the website it says that IM Requires a 5 year minimum of residency. Which as you know IM is 3 in the US. Funny thing is the fact that residencies in Spain have a 37.5 hr a week cap lol and US our cap is 80hrs a week during residency. What are you thoughts?

Interesting. From what I have gathered so far in my research is that your training is accepted which includes your residency. As long as you were considered a full-fledged internist, your shorter training won’t be a problem. Worst case would be that you’d still be allowed to practice as an primary care doctor but maybe they wouldn’t offer you the title of an internist unless you did further training. But doing further training, from what I understand, would be rather difficult because you’d have to take exams to enter the residency program and compete with others.

What is the best way for a German trained GP – speaking German and English fluently – to get a Spanish Licence ASAP. I speak actually Spanish, but not in a certified way.

Contact Madrid to convalidate your documents, take the Spanish proficiency test. Then apply to the Spanish State in which you want to work in order for them to issue you a license after our convalidation is done. You could try to hire a lawyer to see if they can expedite the process. It’s hard finding lawyers in Spain who will hustle for you – I’d recommend starting in Madrid for someone hungry enough to push the process for you faster, if that’s at all possible.

I’m an FP in Atlanta, GA. I am an American but recently was granted German citizenship but have never lived or stepped foot in Germany (long story). So, it appears that I have to apply to Madrid for homologation to be certified and show language proficiency. Presuming that eventually gets approved and I get a license, what else would I need to do and what would be the next steps looking for private work?

Once it gets approved you need a medical license in the state in Spain in which you want to practice. You would need to reach out to the medical board in that state and ask for a medical license. Then you’d either start your own practice here or apply to various medical groups to see patients for them as a family medicine doctor or in the urgent care system.

hello and thanks for this great info.

my question on the homologation process is – are certified copies and transcripts necessary for all schooling/training? ie undergrad, med school and residency?

thx in advance

Is there an agency or lawyer that can help with this process to make sure I’m doing it the right way?

Yes, there are administrative lawyers in Spain who can help you with the process and there are administrative aids – don’t know what the word for them is in Spanish, but they help you with all the bureaucratic process in Spain. Any lawyer should be able to point you in the right direction in Madrid. Most may not return your email so be diligent since they aren’t as motivated by more work and more money. But the more prestigious firms will get back to you.
I have used https://www.strongabogados.com/ and have worked with https://www.incwell.eu/ – both were great for finding a decent lawyer, no complaints. The prices are lower than the US – often less than 100 euro per hour.

Hello,

Very nice review of the steps.
Could you please explain how a US trained dentist can practice in Spain?

Hello. Thank you for the post ! I am an MD who is licensed to practice acupuncture under my MD ( not Lac). Do you know much about how I would practice acupuncture in Ibiza? Also re telemedicine, I am licensed in NY state. Am I allowed only to see patients on telehealth with in the state I am licensed? So for example, if I moved to Spain part time, can I still see my NY patients on telehealth? And am I allowed to also see patients from any where in the world? Thank you for your time and research !
EM

Don’t know much about the acupuncture restrictions for Spain. Also, each province might be a bit different. You can reach out to the Medical Counsel in Spain and they should be able to answer that for you, in Madrid. The telemedicine topic is fairly straightforward but it depends on the various factors. The easy answer is that you can be located anywhere in the world if you want to contact your patient. As in, if you’re a physician and you want to call your patient to discuss something with them, it’s legal, right? So there is no issues with you doing telemedicine from anywhere in the world, which is what I have been doing for years with different companies and with my own telemedicine practice.

Hello. I am a medical student in Spain with dual Spanish/American citizenship. I haven’t read every single one of the comments but I’ll point out several things.
1. There is in no way a shortage of doctors in Spain, there is a shortage of public hospital positions. Young doctors usually leave because of temporary contracts and inability to get work, this of course greatly varies from specialty to specialty.
2. As of today in Spain there is no such thing as an emergency medicine specialty. Emergency room tasks are carried out, depending on the hospital, by family medicine and residents, many of who are in their first year. For the most part doctors from other specialties are called down as needed.
3. I think you mention in the comments that there’s some sort of exam to get into a public hospital position, as far as I know there isn’t, it’s by points. You get said points you get by doing a master’s, working and other accredited things. But knowing somebody always helps, but that’s a more complicated story. You of course need nothing of that sort for your own private practice or working in a private hospital.
4. I have no idea about the medical license (since I will be getting mine here) but since I’ve thought about doing my residency in the US I know some about that. If you are a specialist from another country that wishes to have it “homologado” in, there is a test you have to take. I don’t know much about it but I could search some more.
5. The people in Spain who make certified copies are notaries (Notarios), but the position is very different from the one in the US, they are law school graduates.
6. There is a specific amount of spots for resdincy (after taking the MIR exam) for students that come from medical schools outside of Spain and are not Spanish nationals or are EU residents. There aren’t that many spots and many fail the exam

Hope that was helpful, I’d be happy to answer any further questions.
I’d also love to get some feedback of what it’s like to practice in the US and getting into residency there.

That’s incredibly helpful, thank you.
This has become such a wonderful resource for doctors who want to break the barriers in healthcare.

Alejandro. Hello and thanks for the info on this post. I am just beginning the process of homologación and would love to talk with you more about working as a physician in Spain. I am board certified in Pediatrics and Internal Medicine so it’s a little more tricky because the duration of residency is shorter in the US and I’m not sure if I need to be concerned about that. My family hopes to move to Spain next year so I am really working hard now on getting the ball rolling. Any help you might have would be greatly appreciated. I’m happy to also share with you what it’s like working here in the US!

Just as an extra to point 2: they are thinking about creating the position, but it’s not guaranteed and there’s no timeline.

Dear Dr. Mo
I am a board certified urologist in N.C. and am looking to stop full time practice in 2023 and then go to part time work. I did my medical school and residency in urology in the US, but speak Spanish as I grew up in Puerto Rico. My 2 questions are:

1) Which Spanish proficiency test-level is one supposed to take? and
2) How much is la tasa to pay for the application.

Despite knowing enough Spanish to consider myself bilingual, their websites are extremely clunky and full of Regs and orders references in legalese.
Thanks in advance.

1) You can take a test offered by any language school, and they will tell you whether they will give you a certificate or not.
2) I don’t know what the cost of the application is, usually such costs are absurdly low and nothing like the costs we pay in the US. It’s likely going to be under 100 euros or very close to that.

Dear Dr. Mo-
I am a US trained pediatric orthopaedic surgeon (I have been in practice for 10 years). My husband is French citizen, and we are planning to move to Spain for a few years (I lived there temporarily in the early 2000s). I am debating taking sabbatical versus getting my certification to practice in Spain.

Do you know of any of the rules for US trained surgeons who want to practice in Spain? I have not seen any comments on this post for surgical specialists. It seems that the private route is the easier method, but I am not sure how a surgeon would open a private practice as hospital privileges would be necessary.

Or for those of you who have gone through the process – would it be easier for me to set up a locum tenens job in the US and come back a few times each year for a coupe of weeks to maintain skills and supplement income rather than try to get Spanish certification? Thanks for any admive!

I don’t know the process for surgery. But you would definitely need privileges for surgery in the hospitals in Spain. I’m not sure if there are standalone surgi centers – not to my knowledge. I would still highly recommend coming back to the US and doing a few cases, it’ll be a lot more lucrative than getting tied down with a job there. Once you spend enough time in Spain, you’ll have far better surgical opportunities knock on your door than what anyone can share on this post’s comment section.

Hi Dr. Mo!

Great post, very insightful! Do you have any insight for IM? since like FM it is 3 years in the US, IM in Spain is 5; do we need to do additional training years, or like you mentioned for FM the specialty would be validated without further training?

Best!

Do you have any suggestions for local people who can help with the whole process and have Spanish fluency to navigate the system?

Dr Mo: Did you actually get the “homologación” for your medical degree and your specialty recognized? I would really like to talk to you about this.

Hi Dr. Mo!

Thanks for sharing!! These are some valuable information!! But do you know what is the requirement for medical provider credentialing? I have been searching for a while but I don’t see anybody talk about this.

Looking forward to hear from you. Thank you

You will need your diploma and a certificate from your state medical board to show you are in good standing. You’ll need local police reports to show you don’t have any criminal history though not every region enforces that and you might need one from your home country as well. To find out what is required for credentialing it’s best to look on the medical college website for that autonomous community in which you’ll be living. The convalidation is done nationally through Madrid but you would get your license to practice locally. For example, this is my local medical college: https://www.comc.es/

Hello. Thank you for your post. I am an MD and have my acupuncture license under my MD ( versus an LAc licensed acupuncturist). I’d like to continue my medical practice via telehealth in Ny and only do acupuncture and lifestyle/ functional medicine coaching in Spain.
Any idea how they treat acupuncture?
Also any restrictions hanging a shingle and charging cash and not participating with any insurances ?

Acupuncture is very popular here like the rest of the world.
You would need a license to practice and a work permit. These aren’t hard to get though you may be asked to demonstrate language competency for an actual license. Not always since some regions have enough English speakers that they might give you a license regardless but that would depend on the region.
They don’t really use insurance in Spain so that factor wouldn’t account for much.

Thank you for such an informative article and for all the great comments from everyone.
I am an ophthalmologist practicing in the US for 8 years. My wife is from Spain and we are considering moving back.
Are there any job sites or recruiters that post available positions? I have been searching for a while but can’t really seem to find anything.
Greatly appreciate anyone’s help.
Thanks!

Thanks for all your insight Dr. Mo ! This is such an interesting and insightful post. I have always wanted to move to Spain. I am an orthopaedic surgery physician assistant in LA, CA. I know they don’t have the PA profession in Spain , however do you think any of the doctors or surgeons in Spain , esp in private sector can hire a PA ? Thanks any thoughts are appreciated!!

Any physician here can hire a PA to do any tasks in the office or assist with procedures and they don’t have to be a physician. That’s the same as the US. A physician can train someone to be their medical assistant and do a lot of the office work. But your talents would be quite wasted as a PA, no less in orthopedics. You could make a lot, lot, lot of money and help a lot of people if you set up an acute care practice and you could run it with a physician or you could do independent assessments. Lots of ideas.

I appreciate your insight and am grateful that I landed on your posts! I recently left my job as a Family Practice MD in Northern California after 20 years, and moved to Northern Spain with my husband, a Spaniard. I am fluent in Spanish. I am well-versed in EPIC. I am comfortable with telemedicine (thank you, pandemic). I was under the impression that I cannot practice telemedicine with my CA license unless I am physically in California. Is that not correct? Or is it that the provider can be anywhere but the patient must be in California?
Also, hearing you say there is a need for geriatricians makes me want to get my license up and running here as that’s a favorite patient population of mine. Thanks for stimulating some ideas and thoughts! It’s inspiring to come across a medical maverick.

That is exciting. Welcome to Spain. There is a huge need for private physicians in Spain and especially with a strong geriatric community there is a lot to be done. As far as your medical licenses concerned if you are seeing patients who are paying you cash or basically as long as you don’t take any kind of insurance in California it does not matter where you are physically residing in the world. However if you do reside in other states such as Washington or Arizona or any other state really they may require you to have a state license in that state as well even if you are seeing patients in California. It is pretty complicated.

Thank you for your response and encouragement! I am going forward with the process. Now I just have to learn a little basque/euskera tambien. I have learned that, just as you suggested the Spaniards are suspicious of Latin American MDs, la gente del pais vasco, (mas todavia de edad mayor) prefer doctors who speak a little basque. Agur!

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