automatic recognition

What does “automatic” actually mean?

Article 21 of Directive 2005/36/EC requires every member state to treat medical training qualifications from other member states in the same way as its own. The authority no longer reviews which subjects someone studied or how many hours were spent on pathology. It checks whether the qualification presented is listed in Annex V No. 5.1.1, whether the issuing institution matches, and whether the date of issue falls after the reference date stated there. Nothing more. The same logic applies to dentists, pharmacists, veterinarians, midwives, general care nurses, and architects. Together, these are the seven sectoral professions of the Directive.

What minimum requirements underpin this

The basis is Article 24(2): basic medical training covers at least five years and at least 5,500 hours of theoretical and practical instruction. For specialist training, Annex V No. 5.1.3 lists the specialties and their minimum durations — for example, three years for anaesthesiology and five years for general surgery. General practice is covered by No. 5.1.4 and requires at least three years under Article 28(2). According to the European Commission’s implementation report of 20 February 2026, 56 specialist qualifications fall within this regime. The lists are updated on an ongoing basis, most recently by Delegated Decision (EU) 2025/2187 of 30 July 2025.

What does this mean for graduates from EU countries abroad?

Anyone who completes a regular medical degree in Sofia, Cluj, Pécs, Zagreb, Riga, or Valletta holds a qualification listed in Annex V. The reference date is 1 January 2007 for Bulgaria and Romania, and 1 July 2013 for Croatia. The German licensing authority then no longer compares study content; licensure depends on reliability, physical fitness, and proof of language. The position is different for Serbia and Bosnia and Herzegovina: these states are not part of the EU, and their qualifications go through the equivalence review. Austria follows the same principles via the Austrian Medical Association; Switzerland does so via the Freedom of Movement Agreement.

Where it still gets stuck

Automatic does not mean immediate. Under Article 51, the authority acknowledges receipt within one month and decides within three months of submission of complete documentation, calculated from the date of completeness and not from the date of application. Certified translations, apostilles, and the specialist language examination take additional time. The states are responsible, so processing times and fees differ noticeably between federal states. The competent authority decides on each individual case.