third country

Why the classification determines everything

Directive 2005/36/EC applies only to training certificates acquired in a member state. If a diploma falls outside that framework, automatic recognition is entirely unavailable. National law then applies — in Germany § 3(3) of the Federal Medical Act with the equivalence assessment and, where equivalence is lacking, the knowledge test covering the content of the final state examination. This route takes longer and costs more.

Which countries are relevant for medical students?

Bulgaria, Romania, Hungary, Croatia, Malta, Latvia, Lithuania, Estonia, Poland, Slovakia, and the Czech Republic are EU member states; their medical qualifications are listed in Annex V of the Directive. Serbia, Bosnia and Herzegovina, North Macedonia, Montenegro, Albania, and Kosovo are not. Those who study there receive a fully valid training in substance but must take the longer recognition route in Germany. The United Kingdom has also been a third country since it left the EU, so British qualifications have not been automatically recognised since 2021.

What applies in Austria and Switzerland?

Austria assesses third-country diplomas through the Austrian Medical Chamber in a procedure that includes a substantive review and additionally requires German language skills and entry in the medical register. In Switzerland, the MEBEKO decides: EU and EFTA diplomas are recognised directly under the Free Movement Agreement; third-country diplomas are only assessed for equivalence, and the federal examination frequently remains. A third-country diploma that has already been recognised in an EU or EFTA state may be indirectly recognised.

What is changing in Germany

The Act Accelerating the Recognition of Foreign Professional Qualifications in Health Professions was published in the Federal Law Gazette on 28 July 2026 and enters into force on 1 November 2026. For doctors, dentists, pharmacists, and midwives with third-country qualifications, the knowledge test will then be the standard route instead of first comparing extensive documentation. Partial professional access remains restricted to EU and EEA qualifications. Waiting times for examination dates remain, and the professional permit under § 10 of the Federal Medical Act is still only a time-limited interim solution. How this will be implemented in each federal state is a matter for the competent authority.