© Gunther Eysenbach 1998
Unauthorised redistribution without consent of the editor is not allowed. Vervielfältigung ohne Erlaubnis des Herausgebers nicht gestattet.
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Eysenbach, G. (ed.):
Medicine and Medical Education in Europe - The Eurodoctor,
Stuttgart-New York: Thieme 1998,
ISBN 3-13-115221-4
Medicine and Medical Education in Europe
Table of contents
1 Medicine in Europe
1.1 Europe and the European Union
1.2 Freedom of mobility for doctors in Europe
1.2.1 Working as a doctor in the EU
1.2.2 Formal requirements needed to practise as a doctor in any state in the EU
1.2.3 Minimum training requirements in the EU leading to basic medical qualification
1.2.4 Medical specialities recognised in EU countries, specialist training
1.2.5 Mimimum training requirements for a general practitioner in the EU
1.2.6 Actual mobility of doctors
1.3 European medical bodies and associations
1.3.1 Standing Committee of European Doctors (Comité Permanent - CP)
1.3.2 European Forum of Medical Associations and WHO (EFMA)
1.3.3 European Medical Association (EMA)
1.3.4 European Union of Medical Specialists (Union Européenne des Médecins Spécialistes - UEMS)
1.3.5 European Union of General Practitioners (Union Europeéne de Medicine Ordinaire - UEMO)
1.3.6 European Association of Senior Hospital Physicians (AEMH)
1.3.7 European Federation of Salaried Doctors (Fédération Européenne des Médecins Salariés - FEMS)
1.3.8 Conference Internationale des Ordres (CIO)
1.3.9 Permanent Working Group of European Junior Hospital Doctors (PWG)
1.3.10 WHO Regional Office for Europe
1.3.11 Association for Medical Education in Europe (AMEE)
1.3.12 World Federation for Medical Education (WFME)
1.3.13 Association of Medical Schools in Europe (AMSE)
1.3.14 International Federation of Medical Students' Associations (IFMSA)
1.3.15 European Medical Student Association (EMSA)
1.3.16 Standing Committee of the Hospitals of the European Union (Hospitals for Europe - HOPE)
1.4 Exchange programmes for European doctors
1.4.1 HOPE Exchange Programme For Hospital Professionals
1.4.2 European Centres of Excellence Exchange Scheme
1.4.3 SOCRATES/ERASMUS
1.5 Medical Manpower in Europe
1.5.1 The Big Bang
1.5.2 Surplus or deficit - employment or unemployment?
1.5.3 Immigration of doctors from Eastern European countries
1.5.4 Summary
2 Health Care Systems in Europe
2.1 Introduction
2.2 History of health systems in Europe
2.3 Medicine and health
2.4 Generalists and specialists
2.5 Financing health care systems
2.6 Health provision
2.6.1 Levels of provision
2.7 Overview of country health systems
2.7.1 Insurance based health care
2.7.2 National health services
2.7.3 Belgium
2.7.4 Denmark
2.7.5 France
2.7.6 Germany
2.7.7 Greece
2.7.8 Ireland
2.7.9 Italy
2.7.10 Luxembourg
2.7.11 The Netherlands
2.7.12 Portugal
2.7.13 Spain
2.7.14 United Kingdom
2.7.15 Commentary
3 Working abroad as a doctor
3.1.1 General registration
3.1.2 Specialisation
3.1.3 Language requirements
3.1.4 Problems
3.2 Finding Work
3.2.1 Finding contacts
3.2.2 Job applications
3.3 Setting up practice
3.4 Practising medicine
3.4.1 Generalists and specialists
3.4.2 Codes of conduct
3.4.3 Investigations, diagnoses and treatments
3.4.4 Complementary medicine
3.4.5 Library services
3.5 Living abroad
3.5.1 Tax
3.5.2 Car
3.5.3 Health
3.5.4 Language
3.6 Sources of information
3.6.1 Embassies
3.6.2 The European Commission
3.6.3 Medical organisations
3.6.4 Commercial guides
3.6.5 Expatriate services
3.7 Culture shock
3.8 Coming home: "reverse culture shock"
3.9 Useful addresses
4 Postgraduate and Continuing Medical Education
4.1 Introduction
4.1.1 Stages and duration of training
4.2 Postgraduate medical education
4.2.1 Differences and common ground
4.2.1.1 The structure of postgraduate medical education in Europe
4.3 Continuing medical education
4.3.1 Definition, History, Declarations and Recommendations
4.3.2 The range of CME systems in European countries
5 The European Hospital doctor
5.1 Hospitals in Europe - differences
5.2 Status of junior doctors in hospitals
5.3 Labour conditions in European public hospitals
6 Austria
6.1 Factsheet
6.2 General Information
6.3 Population
6.4 Education
6.4.1 Historical Development of Higher Education in Austria
6.4.2 Structure of the higher education system
6.4.3 Access and Selection
6.5 Health
6.5.1 Health care system
6.5.2 Medical manpower
6.5.3 Ethical and legal codes for doctors
6.6 Postgraduate and Continuing Medical Education
6.6.1 Postgraduate specialist training (Turnus zum Facharzt)
6.6.2 Training opportunities in Public Health and International Health
6.6.3 Continuing Medical Education
6.7 Working possibilities for Foreign Medical Graduates
6.7.1 Working Possibilities
6.7.2 Formalities
6.7.3 Working conditions
6.8 Addresses
6.8.1 General Information
6.8.2 National Health Services
6.8.3 Professional Organisations
6.8.4 Getting a job
6.8.5 Medical Schools
6.8.6 Major Hospitals
7 Belgium
7.1 Factsheet
7.2 General Information
7.3 People
7.4 Education
7.4.1 Historical Development of higher education in Belgium
7.4.2 Structure of the higher education system
7.4.3 Access and selection
7.5 Health
7.5.1 Public health
7.5.2 Health care system
7.5.3 Medical manpower
7.5.4 Ethical and legal codes
7.6 Postgraduate/ Continuing Medical Education
7.6.1 Training in general practice
7.6.2 Specialist training
7.6.3 Further postgraduate training opportunities
7.6.4 Continuing medical education
7.7 Working possibilities for foreign medical graduates
7.8 Addresses
7.8.1 General Information
7.8.2 National Health Services
7.8.3 Professional Organisations
7.8.4 Getting a job
7.8.5 Medical Schools
7.8.6 Major Hospitals
7.8.7 Authorisation to practise
8 Czech Republic
8.1 Factsheet
8.2 General country information
8.3 People
8.4 Education
8.4.1 Historical Development of Higher Education in the Czech Republic
8.4.2 Structure of the higher education system
8.4.3 Access and selection
8.5 Health
8.5.1 Public health
8.5.2 Health care system
8.5.3 Medical Manpower
8.5.4 Ethical and legal codes
8.6 Postgraduate and Continuing Medical Education
8.6.1 Postgraduate medical education in Communist times
8.6.2 Postgraduate medical education today
8.6.3 Continuing medical education
8.7 Addresses
8.7.1 General Information
8.7.2 National Health Services
8.7.3 Professional Organisations
8.7.4 Postgraduate Medical School
8.7.5 Schools of Public Health
8.7.6 Major Hospitals
9 Denmark
9.1 Factsheet
9.2 General information
9.3 People
9.4 Education system
9.4.1 Structure of the higher education system in Denmark
9.4.2 Access and selection
9.5 Health
9.5.1 Public Health
9.5.2 Health care system
9.5.3 Medical Manpower
9.6 Postgraduate and Continuing Medical Education
9.6.1 Pre-registration training (turnus)
9.6.2 General structure and recent reforms of specialist training
9.6.3 Career pathway to general practice
9.6.4 Training in hospital specialities
9.6.5 Further postgraduate training opportunities
9.6.6 Continuing Medical Education in Denmark
9.7 Working possibilities for foreign medical graduates
9.8 Addresses
9.8.1 General Information
9.8.2 National Health Services
9.8.3 Professional Organisations
9.8.4 Getting a job
9.8.5 Medical Schools
9.8.6 Schools of Public Health
9.8.7 Major Hospitals
10 Finland
10.1 Factsheet
10.2 General Information
10.3 People
10.4 Education
10.4.1 Historical Development of Higher Education in Finland
10.4.2 Structure of the higher education system
10.4.3 Access and selection
10.5 Health
10.5.1 Public health
10.5.2 Health Care System
10.5.3 Medical manpower
10.6 Ethical and legal codes
10.7 Postgraduate and Continuing Medical Education
10.7.1 The former pre-registration year
10.7.2 Training in General Practice
10.7.3 Organisation of specialist training
10.7.4 Further postgraduate (research) training opportunities
10.7.5 Continuing Medical Education
10.8 Working possibilities for foreign medical graduates
10.9 Addresses
10.9.1 General Information
10.9.2 National Health Services
10.9.3 Professional Organisations
10.9.4 Body conferring authorisations
10.9.5 Getting a job
10.9.6 Medical Schools
10.9.7 Postgraduate Research Programmes
10.9.8 Major Hospitals
11 France
11.1 Factsheet
11.2 General Information
11.3 People
11.4 Health
11.4.1 Public Health
11.4.2 Health Care System
11.4.3 Medical Manpower
11.4.4 Ethical and legal codes
11.5 Education
11.6 Postgraduate and continuing medical education
11.6.1 Training in general medicine
11.6.2 Training as specialist
11.6.3 Specialist training in the surgical specialities
11.6.4 Specialist training in the medical specialities
11.6.5 Possible reforms
11.6.6 Further postgraduate training opportunities in International Health
11.6.7 Continuing medical education
11.7 Working possibilities
11.8 Adresses
11.8.1 General Information
11.8.2 National Health Services
11.8.3 Professional Organisations
11.8.4 Concours
11.8.5 Getting a job
11.8.6 Medical Schools
12 Germany
12.1 Factsheet
12.2 General Information
12.3 People
12.4 Education
12.4.1 Historical Development of Higher Education in Germany
12.4.2 Structure of the educational system
12.4.2.1 Primary and secondary education
12.4.3 Structure of the higher education system
12.4.4 Access and Selection
12.4.5 Finances
12.5 Health
12.5.1 Public Health
12.5.2 The Health Care System
12.5.3 Medical Manpower
12.6 Postgraduate and Continuing Medical Education
12.6.1 Pre-registration period (Arzt im Praktikum)
12.6.2 Choosing a speciality, career opportunities
12.6.3 Principles of postgraduate education and speciality training
12.6.4 Training in general practice
12.6.5 Training in Internal Medicine
12.6.6 Training in General surgery
12.6.7 Further postgraduate training opportunities in International Health
12.6.8 Continuing Medical Education
12.7 Working possibilities for foreign medical graduates
12.7.1 Formalities for foreign medical graduates
12.7.1.1 Formalities for nationals from EU/EEA member states
12.7.1.2 Formalities for non-EU/EEA nationals
12.7.2 Other Formalities for foreign medical graduates
12.7.3 Job application
12.8 Addresses
12.8.1 General Information
12.8.2 National Health Services
12.8.3 Licensing bodies
12.8.4 Professional Organisations
12.8.5 List of the Associations of Compulsory-Health-Insurance Physicians
12.8.6 Getting a job
12.8.7 Medical Schools
12.8.8 Major Hospitals
12.8.9 Other useful addresses
13 Greece
13.1 Factsheet
13.2 General information
13.2.1 People
13.3 Education
13.3.1 Structure of higher education
13.3.2 Access and selection
13.4 Health
13.4.1 Public health
13.4.2 Health care system
13.4.3 Medical manpower
13.4.4 Ethical, professional and legal codes
13.5 Postgraduate and Continuing Medical Education
13.5.1 Postgraduate Medical Education
13.5.2 Training for General Practitioners
13.5.3 Training in Internal Medicine
13.5.4 Training in General Surgery
13.5.5 Continuing Medical Education
13.6 Working possibilities for foreign medical graduates
13.7 Addresses
13.7.1 General Information
13.7.2 National Health Services
13.7.3 Professional Organisations
13.7.4 Competent authority
13.7.5 Getting a job
13.7.6 Medical Schools
13.7.7 Major Hospitals
14 Hungary
14.1 Factsheet
14.2 General information
14.3 People
14.4 Education
14.4.1 Historical Development of Higher Education in Hungary
14.4.2 Structure of the higher education system
14.5 Health
14.5.1 Public Health
14.5.2 Health Care System
14.5.3 Medical Manpower
14.6 Postgraduate and Continuing Medical Education.
14.6.1 The Postgraduate Medical University
14.6.2 Structure of specialist training
14.6.3 Continuing Medical Education
14.6.4 Training in General Practice
14.7 Working possibilities for foreign medical graduates
14.8 Addresses
14.8.1 General Information
14.8.2 National Health Services
14.8.3 Professional Organisations
14.8.4 Getting a job
14.8.5 Medical Schools
14.8.6 Major Hospitals
15 Ireland
15.1 Factsheet
15.2 General Information
15.3 People
15.4 Education
15.4.1 Historical Development of Higher Education in Ireland
15.4.2 Structure of the higher education system in Ireland
15.4.3 Access and selection
15.5 Health
15.5.1 Health care system
15.5.2 Medical manpower
15.5.3 Ethical and legal codes
15.6 Postgraduate and Continuing Medical Education
15.6.1 The pre-registration year (internship)
15.6.2 Structure of postgraduate training
15.6.3 General Practitioner
15.6.4 Physician (Internal Medicine)
15.6.5 General Surgery
15.6.6 Radiology
15.6.7 Continuing Medical Education
15.7 Working Possibilities for Foreign Medical Graduates
15.8 Addresses
15.8.1 General Information
15.8.2 National Health Services
15.8.3 Professional Organisations
15.8.4 Getting a job
15.8.5 Medical Schools
15.8.6 Major Hospitals
16 Italy
16.1 Factsheet
16.2 General information
16.3 People
16.4 Education
16.4.1 Historical development of Higher Education
16.4.2 Structure of the higher education system
16.4.3 Access and selection
16.5 Health
16.5.1 Public Health
16.5.2 Health care system
16.5.3 Medical Manpower
16.5.4 Ethical and legal codes
16.6 Postgraduate and Continuing Medical Education
16.6.1 Pre-registration period (Tirocinio)
16.6.2 Training in General Practice
16.6.3 Structure of specialist training
16.6.4 Continuing medical education
16.7 Working possibilities for foreign medical graduates
16.8 Addresses
16.8.1 General Information
16.8.2 National Health Services
16.8.3 Professional Organisations
16.8.4 Getting a job
16.8.5 Speciality Schools
16.8.6 Major Hospitals
17 Luxembourg
17.1 Factsheet
17.2 General information
17.3 People
17.4 Education
17.5 Health
17.5.1 Public Health
17.5.2 Health Care System
17.6 Postgraduate and Continuing Medical Education
17.7 Working possibilities for foreign medical graduates
17.8 Addresses
17.8.1 General Information
17.8.2 National Health Services
17.8.3 Professional Organisations
17.8.4 Getting a job
17.8.5 Medical Schools
17.8.6 Major Hospitals
18 The Netherlands
18.1 Factsheet
18.2 General information
18.3 People
18.4 Education
18.4.1 Historical development of higher education
18.4.2 Structure of the higher education system
18.4.3 Access and selection
18.5 Health
18.5.1 Public health
18.5.2 Health care system
18.5.3 Medical manpower planning
18.5.4 Social security
18.5.5 Ethical and legal codes
18.5.5.1 General provisions
18.5.5.2 Euthanasia in the Netherlands
18.6 Postgraduate and Continuing Medical Education
18.6.1 The structure of postgraduate training for physicians
18.6.2 Training of general practitioners
18.6.3 Training of medical specialists
18.6.4 Training of public health doctors
18.6.5 Training of nursing-home doctors
18.6.6 Masters Degrees, Courses about PBL
18.6.7 Continuing medical education
18.7 Working possibilities for foreign medical graduates
18.7.1 Un-/underemployment rates
18.7.2 Foreign applications
18.7.3 Some statistics
18.7.4 Formalities for the admission of physicians with a foreign diploma
18.7.5 Job application
18.7.6 Job profile
18.7.7 Alternative jobs
18.7.8 Research posts
18.8 Addresses
18.8.1 General Information
18.8.2 National Health Services
18.8.3 Professional Organisations
18.8.4 Getting a job
18.8.5 Medical Schools
18.8.6 School of Public Health
18.8.7 Major Hospitals
19 Norway
19.1 Factsheet
19.2 General Information
19.3 People
19.4 Education
19.4.1 General structure
19.4.2 Higher education
19.5 Health
19.5.1 Public health
19.5.2 Health care system
19.5.3 Medical manpower
19.5.4 Professional codes
19.6 Postgraduate and Continuing Medical Education
19.6.1 The pre-registration period (Turnustjeneste)
19.6.2 General structure of specialist training
19.6.3 Specialist training
19.6.4 Training in hospital specialities
19.6.5 GP Specialist training
19.6.6 Continuing Medical Education
19.6.6.1 General structure of CME
19.6.6.2 CME and recertification for specialist GPs
19.7 Working possibilities for foreign medical graduates
19.7.1 Formalities for foreign medical graduates
19.7.2 Job application
19.7.3 Job prospects
19.7.4 Salary and working hours
19.8 Addresses
19.8.1 General Information
19.8.2 National Health Services
19.8.3 Professional Organisations
19.8.4 Getting a job
19.8.5 Medical Schools
19.8.6 Major Hospitals
20 Poland
20.1 Factsheet
20.2 General Information
20.3 People
20.4 Education
20.4.1 Historical Development of Higher Education in Poland
20.4.2 Structure of the higher education system
20.4.3 Access and selection
20.5 Health
20.5.1 Public health
20.5.2 Health care system
20.5.3 Medical manpower
20.5.4 Ethical and legal codes
20.6 Postgraduate and Continuing Medical Education
20.6.1 The preregistration year after qualification (staz podyplomowy)
20.6.2 Structure of postgraduate training
20.6.3 Specialisation
20.6.4 Scientific career pathway
20.6.5 Continuing Medical Education
20.7 Working possibilities for foreign medical graduates
20.8 Addresses
20.8.1 General Information
20.8.2 National Health Services
20.8.3 Professional Organisations
20.8.4 Getting a job
20.8.5 Medical Schools
20.8.6 Postgraduate Medical Education
20.8.7 Major Hospitals
21 Portugal
21.1 Factsheet
21.2 General Information
21.3 People
21.4 Education
21.4.1 Historical Development of Higher Education in Portugal
21.4.2 Structure of the National Educational System
21.4.3 Higher education
21.4.3.1 Courses and Degrees
21.4.3.2 Students
21.4.4 Access and Selection
21.5 Health
21.5.1 Health Care System
21.5.2 Medical Manpower
21.5.3 Ethical codes for health care professionals
21.6 Postgraduate and Continuing Medical Education
21.6.1 The pre-registration period after qualification (Internato Geral)
21.6.2 Speciality Training (Internato Complementar)
21.6.2.1 Legal framework
21.6.2.2 Fields, Programmes and Training Institutions
21.6.2.3 Admission to Speciality Training
21.6.2.4 Training Programmes
21.6.2.5 Accreditation of training institutions
21.6.2.6 Assessment of specialist trainees
21.6.3 Career Opportunities
21.6.4 Job Profiles and Salaries
21.6.5 Further training possibilities in International Health
21.6.6 Continuing Medical Education
21.7 Working Possibilities for Foreign Medical Graduates
21.7.1 Registration Formalities for Foreign Medical Graduates
21.7.1.1 Physicians from EU countries
21.7.1.2 Physicians from non-EU countries
21.7.2 Registration in the Speciality Colleges of the Ordem dos Médicos.
21.7.3 Application for Employment
21.7.4 Voluntary Work
21.8 Addresses
21.8.1 General Information
21.8.2 National Health Services
21.8.3 Professional Organisations
21.8.4 Medical Schools
22 Spain
22.1 Factsheet
22.2 General Information
22.3 People
22.4 Education
22.4.1 Structure of higher education in Spain
22.4.2 University Education
22.4.3 Access and Selection
22.4.4 Finances
22.5 Health
22.5.1 Public Health
22.5.2 Health Care System
22.5.3 Ethical and legal codes
22.5.4 Medical Manpower
22.6 Postgraduate and Continuing Medical Education
22.6.1 The MIR (Médico Interno Residente) exam
22.6.2 Choosing a speciality
22.6.3 Training as General Practitioner (Medicina Familiar y Comunitaria or Medicina General)
22.6.4 Specialist training
22.6.4.1 Specialist training in internal medicine
22.6.4.2 Specialist training in general surgery
22.6.4.3 Specialist training in traumatology
22.6.5 Further training possibilities in International Health
22.6.6 Continuing Medical Education
22.7 Working Posibilities for foreign medical graduates.
22.7.1 Prospects
22.7.2 Registration for foreign physicians
22.7.3 Salary
22.7.4 Research posts.
22.8 Addresses
22.8.1 General Information
22.8.2 National Health Services
22.8.3 Professional Organisations
22.8.4 Getting a job
22.8.5 Medical Schools
22.8.6 Major Hospitals
23 Sweden
23.1 Factsheet
23.2 General information
23.3 People
23.4 Education
23.5 Health
23.5.1 Public Health
23.5.2 Health care system
23.5.3 Medical Manpower
23.6 Postgraduate Medical Training and Working in Sweden
23.6.1 Pre-registration Clinical Training (AT: Allmäntjänstgöring)
23.6.2 Medical Specialist Training (ST: Specialistutbildningstjänst)
23.6.2.1 Example: Anaesthesiology training at Karolinska Hospital
23.6.3 Training in General Practice
23.6.4 Research and graduate studies at the Karolinska Institute
23.6.5 Continuing Medical Education
23.6.6 Further training possibilities in International Health
23.7 Working possibilities for foreign medical graduates
23.8 Addresses
23.8.1 General Information
23.8.2 National Health Services
23.8.3 Professional Organisations
23.8.4 Getting a job
23.8.5 Medical Schools
23.8.6 Major Hospitals
24 Switzerland
24.1 Factsheet
24.2 General Information
24.3 People
24.4 Education
24.4.1 Historical Development of Higher Education in Switzerland
24.4.2 Structure of the educational system
24.5 Health
24.5.1 Public Health
24.5.2 Health Care System
24.5.3 Medical Manpower
24.6 Postgraduate Medical Education
24.6.1 Overview of postgraduate medical training
24.6.2 Principles of postgraduate training
24.6.3 Training in General practice
24.6.4 Speciality training
24.6.5 Research programmes
24.6.6 Continuing Medical Education
24.6.7 Further training possibilities in International Health
24.7 Working possibilities for foreign medical graduates
24.7.1 Practice Permit
24.8 Addresses
24.8.1 General Information
24.8.2 National Health Services
24.8.3 Professional Organisations
24.8.4 Getting a job
24.8.5 Medical Schools
24.8.6 National bodies involved in health education policy making:
24.8.7 University (teaching) Hospitals
24.8.8 Other Useful Addresses
25 United Kingdom
25.1 Factsheet
25.2 General Information
25.3 People
25.4 Education
25.5 Health
25.5.1 Public Health
25.5.2 Health care system
25.5.2.1 The NHS
25.5.3 Funding and Expenditure
25.5.3.1 Access and procedure
25.5.3.2 Doctors pay
25.5.4 Medical manpower
25.5.4.1 Medical workforce
25.5.4.2 Medical manpower planning
25.6 Postgraduate Medical Education
25.6.1 Introduction
25.6.2 Structure of Postgraduate Specialist Training
25.6.2.1 The Pre-registration year as House Officer (HO)
25.6.2.2 Senior House Officer (SHO) - basic specialist training
25.6.2.3 Specialist Registrar (SpR) - higher specialist training
25.6.2.4 Consultant
25.6.2.5 Other Hospital Grades (non-Training)
25.6.2.6 Research and academic postgraduate degrees
25.6.2.7 Flexible Training
25.6.3 Training for General Practice
25.6.4 Choosing a Speciality: Career Opportunities
25.6.5 Further training possibilities in International Health
25.6.6 Continuing Medical Education
25.7 Working possibilities for Foreign Medical Graduates
25.7.1 General remarks
25.7.2 Full Registration: EU/EEA Doctors
25.7.3 Registration for non-EU/EEA ("overseas") Doctors
25.7.4 Registration for Pre-Registration House Officer Posts
25.7.5 Other Formalities (work permit etc.)
25.7.6 Finding a Post
25.7.7 Contracts and Working Conditions
25.8 Addresses
25.8.1 General Information
25.8.2 National Health Services
25.8.3 Professional Organisations
25.8.4 Royal Colleges
25.8.5 National Advice Centre on Postgraduate Medical Education
25.8.6 Postgraduate Deans
25.8.7 Regional Advisers in General Practice
25.8.8 Getting a job
25.8.9 Medical Defence Societies
25.8.10 Medical Schools
25.8.11 Major Hospitals