Non-EEA doctors in EEA countries: doctors or cleaners?

Abstract

Background: Migration of non-EEA doctors to EEA-countries has become a common phenomenon. As coordination within the EEA has not yet been established, every EEA-country is re-inventing the wheel of assessment of foreign medical degrees and developing additional programmes for non-EEA doctors. There is hardly any knowledge about assessment procedures in other EEA-countries.

Aim: To examine how 10 European Economic Area (EEA) countries deal with non-EEA doctors. Both national and university policies regarding non-EEA doctors were examined.

Methods: This was a qualitative study based on two structured questionnaires. One was used for staff members of national health departments and the other was used for staff members of university medical faculties. Staff members from the health departments of mid-European and north European countries, and staff members from universities in Austria, Belgium, Denmark, France, Germany, Norway, Sweden, UK, Spain, and The Netherlands participated in the study.

Results: There is no EEA directive concerning non-EEA doctors. Each EEA country, therefore, has devised its own policy towards non-EEA doctors. To enable non-EEA doctors to obtain a full license, thereby preventing them from ending up as unskilled labourers, the health departments in the Nordic countries and the UK have developed a ‘fast-track’ process for non-EEA doctors. In Austria, Belgium, and The Netherlands, however, non-EEA doctors are more dependent on programmes offered by university medical faculties. The situation in Germany is between these two extremes. As a rule, the programmes for non-EEA doctors in Belgium, Germany, and The Netherlands are two to three times longer than in the Nordic countries (18–36 months vs. 12–18 months, respectively). Financial aid is not available in most countries.

Conclusion: As the influx of non-EEA doctors is increasing, harmonisation within the EEA is strongly advisable. As long as there is no EEA directive about non-EEA doctors, the assessment procedures (diploma evaluation, medical-knowledge tests, language requirements, length of additional programmes, etc.) need to be coordinated.

Additional information

Notes on contributors

Paul G. P. Herfs

PAUL HERFS was a student counsellor and admissions officer at Utrecht University. He was one of the founders of the Dutch committee that has been responsible for the admittance of non-EEA doctors in the eight medical schools in The Netherlands since the mid-1990s. He has written a dissertation on non-EEA doctors in The Netherlands. He currently works as an ombudsman at Utrecht University.

Louis Kater

LOUIS KATER is a professor (emeritus) of internal medicine. He is the coordinator of the Matriculation Committee for foreign Medical Graduates at Utrecht Medical Centre Utrecht.

Jeen R. E. Haalboom

JEEN HAALBOOM is a specialist in internal medicine and especially in the prevention and treatment of cardiovascular diseases. Since the early 1990s, he has been involved with the integration of non-EEA physicians into the Dutch health care system. Together with Paul Herfs, he initiated a special medical Dutch language book that at present is an essential part of the programme non-EEA doctors have to complete before being admitted to a Dutch medical course.