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Medical specialty access in EU/EEA countries.

Irene Bufano1, Camilla Volpi1, Román Romero Ortuño1

  • 1Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, 6th floor, MISA Building, St James's Hospital, James's Street, D08 N80H Dublin, Ireland.

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Summary

Postgraduate medical residency access varies across Europe. Five distinct national models were identified, each with unique advantages and disadvantages for training and mobility.

Keywords:
education and trainingmedical education & training

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Area of Science:

  • Medical Education
  • Health Policy
  • European Healthcare Systems

Background:

  • Access to postgraduate medical specialty training shows significant variation among European Union (EU) and European Economic Area (EEA) countries.
  • Understanding these differences is crucial for harmonizing training standards and facilitating physician mobility.

Purpose of the Study:

  • To map and compare the national pathways for medical residency training across all EU/EEA member states.
  • To provide a comprehensive overview of the diverse entry systems into postgraduate medical education in Europe.

Main Methods:

  • A standardized data collection template was employed, utilizing official governmental, university, and hospital sources.
  • Information was verified for accuracy as of October 2025 to ensure current data.

Main Results:

  • Five primary models of access to medical residency were identified: immediate access with a national examination, immediate access without an exam, delayed access after general medical training, delayed access with an additional examination, and mixed systems.
  • These models reflect different approaches to selection, training duration, and specialty placement.

Conclusions:

  • Each access model presents trade-offs between transparency, meritocracy, flexibility, equity, and training efficiency.
  • National examinations enhance transparency but can limit choice, while direct access offers flexibility but may increase inequality.
  • Delayed access models support professional development but can extend training timelines and impact workforce availability.