by Dr. Gerhard Polak

As of 2007, the European Union now has 27 member states with a total population of 485.5 mn. The national healthcare systems of the individual EU states differ greatly with respect to financing their healthcare expenditure and the service provisions of their social security and insurance systems (www.euro.who.int/observatory).

It is already possible for patients to request medical services in neighbouring EU countries, which are reconciled between the insurance systems of the relevant EU states. Furthermore, cross-border healthcare services are already provided between individual EU states, e. g. for orthopaedic operations and special medical treatments.

Recognition of Professional Qualifications
For physicians too, various opportunities have opened up (Maastricht Treaty 1992) for exercising their profession abroad in the EU. The EU promotes and supports the mobility of physicians through mutual recognition of professional qualifications. The recognition of professional qualifications is regulated as of 20 October 2007 by the new EU directive 2005/36/EC. It is the decisive directive for the migration of physicians in the European economic area and provides for the automatic recognition of formal qualifications in general and formal qualifications of specialised physicians in EU member states. A surgeon, therefore, can now work at a hospital in another EU country, or he may open an extramural surgery. Of course, there are also obstacles to the recognition of specialities; for example, if a physician with specialist medical training migrates from their country of origin into another EU country, in which this formal specialized qualification is not provided for in the EU directive, they may then be requested to complete prescribed hours of further training in the host country. Examples of this would be in the specialist areas of “accident surgery” (Germany, Austria), for which there is no equivalent in France or the United Kingdom (recognition procedure would be via orthopaedics/bone and joint surgery) or “genito-urinary medicine” which is found only in the United Kingdom, Ireland, and Malta. For more information see the website of the EU. 

How long does recognition of formal qualifications of specialised physicians take?
A procedure for recognition of professional qualifications must not take longer than three months – and acknowledgement of receipt of an application must be confirmed within one month.

Language skills in other EU countries: EU member states may also require physicians to have the language skills required to exercise their profession in the host member state. It should be noted that any assessment of language skills is done separately from the procedure for recognition of professional qualifications, and indeed after recognition, at the time of actual acceptance of professional ability in a hospital or surgery.

What are the advantages of the EU directive on mutual recognition of professional qualifications?
Physicians are allowed to do the following in every EU state:

• they may apply for situations vacant,
• they have the right to move freely for this purpose among the member states, to reside in a member state, and exercise their professional according to the applicable legal and administrative regulations (right of abode),
• they are entitled to continue to use the formal qualification acquired in their country of origin.

What is the situation now for young physicians who are endeavouring to have time-limited further training in an EU state and do not yet have an EU professional permit in accordance with the EU directive 2005/36/EC?
Several EU states such as the United Kingdom, Germany, or Sweden currently have a great need for physicians. These EU states also give young physicians the opportunity (without professional qualification) to start their further training, without having to pass a recognition test. In the United Kingdom, there is an initial phase (Foundation Year 1 & 2), in Sweden there is the Allmäntjänst (AT), an initial phase of 18 – 21 months.

In Germany you can immediately start further training (without a recognition test); however, it must be guaranteed that the further training in a speciality is recognized and credited as further training time in the EU country of origin.

Precise information on these special regulations is available from the relevant medical associations and competent recognition authorities.