vejledningeng120705pdf2009

7/29/2019 vejledningeng120705pdf2009

1/14

1

Guidelines concerning the authorization

of doctors trained outside Denmark

1. INTRODUCTION

These guidelines are intended for the use of foreign-trained doctors, immigrationauthorities, health insurance- and hospital-authorities, county social servicesauthorities, and others.

The purpose of these guidelines is to give information about the rules that govern theauthorization of persons whose medical training has been outside Denmark, and whowish to practise medicine in Denmark. The guidelines also contain advisoryinformation about the documentation, which must be submitted as evidence of studiescompleted, language and other requirements.

Persons whose medical training has been outside Denmark (including those from theNordic countries and the EU/EEC countries) must hold Danish authorization to be

able to practise medicine in Denmark, Greenland, and the Faroe Islands. Special rulesgovern the performance of medical services by EU/EEC doctors, see Councildirective 93/16/EEC (as amended).

As a result of international agreements, different rules govern the recognition byDenmark of medical qualifications obtained abroad, depending on the applicantscountry of citizenship, and where the training took place. For this reason, applicantsare divided into three groups.

Nordic citizens holding Nordic authorization (Nordic doctors) are covered bythe Agreement of 14 June 1993 between Denmark, Finland, Iceland, Norwayand Sweden concerning a common Nordic labour market for certain groups ofpersonnel within the health care and veterinary sectors (see the Danishgovernments Executive Order no. 81 of 8 September 1994).

EU citizens with an EU primary medical qualification or citizens of a countrywith an agreement of free movement of persons (EU-doctors) are covered byCouncil directive 93/16/EEC (as amended) concerning the promotion of thefree movement of doctors and mutual recognition of their certificates, diplomasand other evidence of formal qualifications in medicine. This is referred to as


2/14

2

The Doctors Directive; for further information about its application toDenmark, see the Danish governments Executive Order No. 402 of 8 June1989 (as amended) regarding access by EU citizens to practise medicine in

Denmark.

Third country doctors are those whose primary medical qualifications havebeen granted in countries, which are not covered, by the EU Doctors Directiveor the Nordic Agreement. Third country doctors may apply for authorizationon the basis of an individual assessment.

Aliens who wish to reside and work in Denmark require residence and work permits.However, this rule does not apply to Nordic citizens and EU/EEC citizens are notsubject to such strict rules as other aliens with respect to being permitted to reside andwork in Denmark.

EU/EEC citizens who wish to practice medicine in Denmark should contact theDanish States local administrative offices (Overprsidium in Copenhagenmunicipality, and Statsamt in each county elsewhere in Denmark) for informationregarding the rules for residence and work. Aliens who are neither Nordic norEU/EEC citizens must contact the Danish Immigration Service(Udlndingestyrelsen), or a Danish Embassy or Consulate, to obtain informationconcerning requirements for residence and work permits.

2. NORDIC DOCTORSEither the Nordic Agreement or the EU/EEC provisions may apply to Nordic doctors.Applications will be dealt with according to the code of practice most favourable tothe applicant.

2.1. Temporary authorization

Temporary authorization can be granted to Nordic citizens if they have acquired theirprimary medical qualification in Finland, Iceland, Norway or Sweden but are lacking

practical training in their country of education (internship).

A temporary authorization with a duration of 24 months can be granted when theapplicant has received a firm offer for a position as a medical doctor at a hospital orother treatment institution, or with a doctor who is practising under the NationalHealth Insurance System. A temporary authorization of 24 months can only begranted once, unless special circumstances apply. Application form can be found onwww.sst.dk.


3/14

3

2.2. Permanent authorization as a doctor and permission to practise medicine

independently

Permanent authorization to practice medicine and permission to practise medicine

independently as a doctor in Denmark are issued together (two documents) by theDanish National Board of Health to applicants who provide evidence of thefollowing:

Citizenship of a Nordic country Authorization as a doctor in a Nordic country.

2.3 Permission to assume the title of specialist

A permission to assume the title of specialist is issued by the Danish National Boardof Health to doctors who have been recognized as specialists in Finland, Iceland,

Norway or Sweden. As preconditions, the doctor must have already obtained fromthe Danish National Board of Health both permanent authorization to practicemedicine in Denmark and a permission to practice independently, and the area ofmedicine in which the doctor wishes to be licensed must be recognised as a specialityin Denmark.

2.4. Language requirementsNo specific level of language skills is required to obtain authorization etc. However,the Danish Practice of Medicine Act lays down that every doctor must practise

medicine carefully and conscientiously, and, to comply with this provision, doctorsare required to be capable of responsible communication with patients, relatives,other hospital staff etc. The appointing authority must evaluate the extent to whichthe doctor can meet these requirements of the Practice of Medicine Act.

2.5. Application procedure and documentary requirements

Application form duly filled in accompanied by the documentation listed below mustbe submitted to the Danish National Board of Health, Islands Brygge 67, 2300Kbenhavn S.

Re. 2.1. Temporary authorization

Documentary evidence of citizenship of a Nordic country, showing name and dateof birth (e.g. in the form of certified true copies of the relevant passport pages)

Certificate for completed primary medical qualification from a Nordic country

Re. 2.2.Permanent authorization and permission to practice medicine independently Documentary evidence of citizenship of a Nordic country, showing name and date

of birth (e.g. in the form of certified true copies of the relevant passport pages) Nordic certificate of authorization


4/14

4

Re. 2.3.Permission to assume the title of specialist

Documentary evidence of citizenship of a Nordic country, showing name and dateof birth (e.g. in the form of certified true copies of the relevant passport pages). Nordic certificate of authorization Nordic permission to assume the title of specialist

The necessary documentation must be submitted in the form of original documents(which will be returned by registered mail) or of certified true copies (which havebeen endorsed on each copy to confirm their authenticity). Embassies, police, theeducational institution or Notary Public can carry out the endorsement. Each copymust be stamped and signed and state that it is a true copy of the original document.The person signing the document must be identifiable.The National Board of Healthmay require that the applicant submit original documents.

3. EU/EEC DOCTORS

EU/EEC doctors are covered by Council directive 93/16/EEC as amended.

3.1 Temporary authorization

Temporary authorization can be granted to citizens of a EU/EEC country providedthe person in question has acquired the primary medical qualification in a EU/EECcountry but due to lack of practical training (internship) in the country of trainingdoes not possess the certificates required.

A temporary authorization with a duration of 24 months can be granted when theapplicant has received a firm offer for a position as a medical doctor at a hospital orother treatment institution, or with a doctor who is practising under the NationalHealth Insurance System. A temporary authorization of 24 months can only be

granted once, unless special circumstances apply. Application form can be found onwww.sst.dk.

3.2. Permanent authorization as a doctor and permission to practise medicine

independentlyPermanent authorization to practice medicine and permission to work independentlyas a doctor in Denmark are issued together (two documents) by the Danish NationalBoard of Health to applicants who are citizens of an EU/EEC country and who, as theresult of completed training in an EU/EEC country, are in possession of the

certificates covered by Directive 93/16/EEC and its amendments.


5/14

5

3.3. Permission to assume the title of specialist

A permission to assume the title of specialist is issued by the Danish National Board

of Health to doctors who have been granted permission to assume the title ofspecialist in another EU/EECcountry. As preconditions, the doctor must havealready obtained from the Danish National Board of Health both permanentauthorization to practice medicine in Denmark and a permission to practiceindependently. Also, the speciality must be recognised as a speciality in Denmark andbe one of the specialities which are mutually recognised in the EU/EEC countries.

3.4. Language requirementsNo specific level of language skills is required to obtain authorization etc. However,the Danish Practice of Medicine Act lays down that every doctor must practisemedicine carefully and conscientiously, and, to comply with this provision, doctorsare required to be capable of responsible communication with patients, relatives,other hospital staff etc. The appointing authority must evaluate the extent to whichthe doctor can meet these requirements of the Practice of Medicine Act.


Application form duly filled in accompanied by the documentation listed below mustbe submitted to the Danish National Board of Health, Islands Brygge 67, 2300Kbenhavn S.

Re. 3.1.Temporary authorization Documentation of citizenship of a EU/EECcountry, showing name and date of

birth (e.g. in the form of certified true copies of the relevant passport pages) Certificate for completed primary medical qualification from a EU/EEC country An original certificate of good standing from the competent health authorities in

the most recent country of residence confirming that the applicant is legallyentitled to practice medicine and that he has not been suspended or disqualified orprohibited from practising as a doctor. The date of issue must be no earlier than

three months prior to the date on which the Danish National Board of Health hasreceived all the required documentation

Re. 3.2. Permanent authorization and permission to practise medicine independently

Documentation of citizenship of a EU/EECcountry, showing name and date ofbirth (e.g. in the form of certified true copies of the relevant passport pages)

EU diploma, certificate or other evidence of formal qualification as mentioned inthe Directive of the European Council 93/16/EEC, with subsequent amendments

An original certificate of good standing from the competent health authorities in

the most recent country of residence confirming that the applicant is legally


6/14

6

entitled to practice medicine and that he has not been suspended or disqualified orprohibited from practising as a doctor. The date of issue must be no earlier thanthree months prior to the date on which the Danish National Board of Health has

received all the required documentation.

Re. 3.3.Permission to assume the title of specialist Documentation of citizenship of a EU/EECcountry, showing name and date of

birth (e.g. in the form of certified true copies of the relevant passport pages) EU diploma, certificate or other evidence of formal qualification as mentioned in

the Directive of the European Council 93/16/EEC, with subsequent amendments Permission from the country of training to assume the title of specialist as

mentioned in the Directive of the European Council 93/16/EEC, with subsequentamendments

An original certificate of good standing from the competent health authorities inthe most recent country of residence confirming that the applicant is legallyentitled to practice medicine and that he has not been suspended or disqualified orprohibited from practising as a doctor. The date of issue must be no earlier thanthree months prior to the date on which the Danish National Board of Health hasreceived all the required documentation.

The necessary documentation must be submitted in the form of original documents(which will be returned by registered mail) or of certified true copies (which have

been endorsed on each copy to confirm their authenticity). The necessarydocumentation must be submitted in the form of original documents (which will bereturned by registered mail) or of certified true copies (which have been endorsed oneach copy to confirm their authenticity). Embassies, police, the educational institutionor Notary Public can carry out the endorsement. Each copy must be stamped andsigned and state that it is a true copy of the original document. The person signing thedocument person must be identifiable.The National Board of Health may require thatthe applicant submit original documents.

4. THIRD COUNTRY DOCTORS

A doctor who is not a citizen of an EU/EEC country or a Nordic country has no rightsguaranteed by treaty to automatic recognition as a doctor in Denmark, but may applyfor an authorization depending on an individual assessment.

Upon application, The National Board of Health assesses the third country doctorsprimary medical qualifications. If the assessment is positive, the doctor will typically

be required to pass tests and/or successfully complete probationary appointments in


7/14

7

order to obtain a permanent authorization to work as a medical doctor. The doctorsprimary qualifications are assessed as being equal to Danish primary qualificationswhen the third country doctor has passed the required tests and successfully

completed the probationary appointments.


The application form on www.sst.dkmust be filled out and sent to the National Boardof Health accompanied by the necessary documentation. The documentation must besubmitted in three copies one of which should be in the form of original documents(which will be returned by registered mail) or in the form of certified true copies(which have been endorsed on each copy to confirm their authenticity). The originalof the certificate of good standing must always be produced.Embassies, police, the educational institution or Notary Public can carry out thecertification. Each copy must be stamped and signed and state that it is a true copy ofthe original document. The person signing the document must be identifiable.TheNational Board of Health may require that the applicant submit original documents.

Documents in the original language must be translated into Danish or English. Thetranslator must seal the translated document together with the document in theoriginal language. The translation must be made the educational institution orauthority, which has issued the documents, or by a state-authorized translator.

Necessary documentation Documentation of name, date of birth, citizenship (e.g. in the form of certified true

copies of the relevant passport pages). Detailed curriculum vitae (CV), listing personal and educational data as well as

work experience Certificate of completed primary medical qualification and, if relevant, permission

to assume the title of specialist Transcript of the study programme and examinations from the university

describing the scope and contents of the programme of study, and examinations.

Clinical and theoretical training must be listed indicated in hours or weeks foreach semester

Danish Citizens Personal Registration (CPR) number, if available An original certificate of good standing from the health authorities in the most

recent country of residence to the effect that the applicant is legally entitled topractise medicine in the country of training or most recent country of residence.The certificate may not have issued more than three months prior to the date onwhich the Danish National Board of Health has received all the necessarydocumentation.


8/14

8

4.2. Temporary authorization

The Danish National Board of Health may issue temporary authorization to a doctorwho has foreign medical qualifications and where the National Board of Health has

required that the doctor passes tests and/or completes probationary appointments.

A temporary authorization with a duration of 24 months can be granted when theapplicant has received a firm offer for a position as a medical doctor at a hospital orother treatment institution, or with a doctor who is practising under the NationalHealth Insurance System. Application form can be found on www.sst.dk.A temporary authorization with a duration of 24 months can only be granted onceandit is expected that the applicant within this period fulfils the requirements forpermanent authorization. Should the applicant not have fulfilled the requirementswithin the period of 24 months, the National Board of Health may under specialcircumstances e.g. if the doctor due to illness has not been able to work - issue anew temporary authorization with a fixed duration.If the medical doctor applies for temporary authorization three months or more afterthe National Board of Health has assessed his medical qualifications, a newcertificate of good standing must be produced.

No specific tests or level of language skills are required to obtain temporaryauthorization. However, the Danish Practice of Medicine Act lays down that everydoctor must practise medicine carefully and conscientiously, and, to comply with this

provision, doctors are required to be capable of responsible communication withpatients, relatives, other hospital staff etc. The appointing authority must evaluate theextent to which the doctor can meet these requirements of the Practice of MedicineAct.

4.3. Special temporary authorization of an expert for a specific clinical function

In exceptional cases and upon the recommendation of the appointing authority, theDanish National Board of Health may issue temporary authorization to, e.g.,internationally recognised medical experts with a view to the performance of certain

functions in a specific position.

4.4. Permanent authorization as a doctorTo become permanently authorized to practice medicine in Denmark, an applicantmust be in possession of:

Medical qualification which in all essentials correspond to Danish primarymedical qualification

Positive assessments of two periods of probationary employment, each of at least

3 months duration, in different clinical departments. The National Board of


9/14

9

Health may in some cases determine another number and duration of theprobationary appointments as well as require that a period of probationaryappointment takes place within a given speciality

Pass in a verbal test of the doctors general medical knowledge andcommunication skills; Passes in three examinations (social medicine, the Danish law about the practice

of medicine, and the law about the prescription of medicines) at a Danishuniversity.

Assessment and equivalence compared to Danish medical qualificationsThe National Board of Health assesses the qualification possessed by the applicant atthe time that the application is made and decides what is required for thequalifications to be equated with a Danish medical qualification, thus enabling theapplicant to obtain permanent authorization. The National Board of Health makes theassessment on the basis of a recommendation by the Faculty of Health Sciences ofthe University of Copenhagen. No more than five years may elapse between the timethe Danish National Board of Health has communicated its assessment of theapplicants qualifications and issue of permanent authorization.

Adequate Danish language skills

The assessment of whether the applicant can communicate in a responsible mannerwith patients, relatives, hospital staff, and others, is carried out on the basis of the

verbal test and examinations and on the basis of the assessments during theprobationary appointments; there is no separate language test. To enable the applicantto become sufficiently proficient in the Danish language, the employer is expected toprovide adequate support for the language training of the doctor in question duringthe periods of probationary employment.

The Danish National Board of Health will regard the language requirement as havingbeen satisfied when the doctor has passed all of the required examinations, the verbaltest, and has completed the probationary appointments with positive assessments.

Probationary appointment with temporary authorizationIn order to assess whether the doctors professional skills can be equated with Danishtrained doctors skills, the National Board of Health may required that the doctor isemployed for probationary periods in Danish clinical hospital departments. Theprobationary appointments will typically be of three months duration in two differentclinical hospital departments. The National Board of Health may in some casesrequire another number and duration of the probationary appointments. It is aprecondition that temporary authorization for this purpose has been granted and the

contentof the appointment must be in accordance with the guidelines of the National


10/14

10

Board of Health concerning probationary appointments. Third country doctors mustthemselves obtain their probationary appointment, which is typically a position as asubordinate doctor according to the national agreement between the association of

hospital authorities and the relevant association of doctors.

Application to the Board when a probationary appointment is agreed upon

An application must be submitted to the National Board of Health. The applicantmust no later than by the end of the first month of employment submit a (udfyldt)application form to the Board. The application form is available on www.sst.dk. Inthe event that the National Board of Health does not received the application by theend of the first month of the probationary appointment, the period of employmentwill not be recognised by the National Board of Health as a probationary appointmentand will as such not be taken into consideration when processing an application forpermanent authorization.The department where the probationary appointment takes place must on theapplication form certify that the contents of the position are in accordance with theguidelines of the National Board of Health concerning probationary appointments. Itis the responsibility of the third country doctor that temporary authorization has beenobtained and that the application form for probationary appointment has beensubmitted to the National Board of Health in due time.

When the probationary appointment has terminated, the consultant in the departmentwho is responsible for medical training must, together with the applicant, complete anassessment form according to the principles in the National Board of HealthsGuidelines and evaluation in medical further training. The assessment form can befound on www.sst.dkand is also available as appendix 1 to the Boards guidelines no.45 concerning Advisory notes about clinical appointments for foreign-trained doctorswho wish to obtain permanent authorization to practise medicine in Denmark, andwho are not covered by the EU Doctors Directive or the Nordic Agreement.Positive as well as negative assessments must be forwarded to the National Board of

Health. If the applicant is required to pass the verbal test and examinations, theNational Board of Health will notify the University of Copenhagen once the Boardhas received the first positive assessment.

The verbal test of general medical knowledgeThe testing of general medical knowledge is agreed between the National Board ofHealth and the University of Copenhagen. The purpose of the test, which is carriedout in Danish, is to assess whether the applicant has the general medical knowledge

and skills, including communication ability, required of a medical graduate.


11/14

11

The test of general medical knowledge and the three examinations can be taken atone of the Faculty of Health Sciences, the University of Copenhagen. No more than

three attempts in each subject are permitted. Permission to a fourth attempt is notgranted unless special circumstances apply. The applicant is consequentlyrecommended to consult the National Board of Health should he not pass his secondattempt. All examinations must have been successfully completed at the latest threeyears after entering for the first examination. Specific rules concerning the tests areavailable upon consultation with the Faculty of Health Sciences in Copenhagen.

Before registering for the verbal test and the three examinations, a minimum of onepositive assessment of a period of probationary employment must be achieved.

4.5. Permission to practise medicine independently

In order to obtain a permission to practise medicine independently, the third countrydoctor is required to complete a period of employment corresponding to Danishinternship training. A permission to practise medicine independently can only beissued if the applicant is holding permanent authorization.

The applicant is required to complete six months of surgery, six months of medicineand six months other clinical employment. Appointments of less than three months

will not be taken into account.

If on the assessment of the Danish National Board of Health the doctor has alreadycompleted such training, the Board can grant exemption from the requirementpertaining to Danish internship training. Former appointments abroad andappointments in Denmark with temporary authorization can be taken into account. Itis thus recommended that the applicant, whenever possible, during the 24-months-period with temporary authorization takes up positions in medicine and surgery.Should the applicant (at a later stage) wish to train as a general medical practitioner,

it is recommended that, whenever possible, the third country doctor takes up sixmonths employment in a family practice during the period of temporaryauthorization.

Application form Recognition of Medical Internship/Specialist Training can befound on www.sst.dkand is used for the assessment of internship training completedabroad. The form must be filled out, stamped and signed by the administrativeconsultant (head of department), the hospital administration or the like of the hospitalwhere the training took place. The form must be forwarded to the National Board of

Health by the hospital in question. In addition to the form, the hospital must forward


12/14

12

the training programme (or the like) that applied to the training that the applicantcompleted. The National Board of Health does not accept forms or otherdocumentation submitted by the applicant.

4.6. Permission to assume the title of specialist

Permission to assume the title of specialist is issued by the Danish National Board ofHealth. As preconditions, the doctor must have already obtained from the DanishNational Board of Health both permanent authorization to practice medicine inDenmark and permission to practise medicine independently. To be granted a Danishspecialist title, the third country doctor must have completed a training equivalent tothe training required of Danish doctors who acquire permission to assume the title ofspecialist, see the current Executive Order on Training of Specialists. Applicationform and information on required documentation can be found on www.sst.dk.

4.7. Refused applicationsThird country doctors, whose applications are refused, may approach a Danishuniversity to receive guidance about the possibilities of seeking admission to medicalstudies.

5. CONCLUDING REMARKS

5.1 Additional general conditions for authorizationIn all cases, authorization of an applicant is conditional on there being none of theconditions mentioned in the Danish Physicians Act, section 2 (3) (of physical ormental disability, or other unsuitability to practice medicine).

5.2 Further information concerning authorization

Further information concerning the issue of authorization on the basis of a foreignqualification is available on the website of The National Board of Health www.sst.dk

or upon request from the Danish National Board of Health, Islands Brygge 67, 2300Copenhagen S, telephone +45 72 22 74 00.

5.3 Faculties of Health Sciences in DenmarkUniversity of CopenhagenFaculty of Health SciencesRegistration Office for Medical StudentsPanum InstituttetBlegdamsvej 3

DK 2100 Copenhagen


13/14

13

Tel: +45 35 32 79 00www.ku.dk

University of AarhusFaculty of Health ScienceRegistration Office for Medical StudentsVennelyst Boulevard 9DK 8000 Aarhus CTel: +45 89 42 11 22www.au.dk

The University of Southern Denmark (University of Odense)Faculty of Health ScienceRegistration Office for Medical StudentsCampusvej 55DK 5230 Odense MTel: +45 65 50 10 00www.sdu.dk

5.4 Residence and work permitsThe Danish Immigration Service (Udlndingestyrelsen)Ryesgade 53

DK 2100 Copenhagen Tel: +45 35 36 66 00

5.5 Work assignmentThe Danish National Board of Health cannot assist in assigning work as a doctor,including probationary appointments. Vacant positions for doctors are advertised onwww.laegejob.dk.

5.6 Complaints

A complaint concerning the decision of the Danish National Board of Health can beaddressed to the Ministry of the Interior and Health, Slotsholmsgade 10 12, DK1216 Copenhagen K. The Ministry of the Interior and Health can decide on the legalbasis of the decision and whether the administrative procedures have been correctlyobserved. However, the Ministry cannot make a decision concerning the professionalmedical recommendation on which the decision has been based.

5.7 Information processed electronically by the Danish National Board of Health


14/14

14

In connection with the administration of the application, all information anddocumentation about matters of importance pertaining to the applicants medicalqualifications including further and supplementary training will be processed

electronically by the Danish National Board of Health and, to the extent required,transmitted to experts and other authorities for purposes of evaluating the medicalqualifications of the applicant. Relevant personal information can also be registeredin the electronic record system of the Danish National Board of Health with a view toidentifying and recovering documents pertaining to the application. Pursuant to theprovisions of the Personal Data Act (Persondataloven), among other things theapplicant may exercise the following rights: a right to access to the information that isprocessed, the right to make an objection to the information being processed, and theright to demand that information that is incorrect, misleading, or processed inviolation of the Act, be corrected, struck out, or blocked. For further information seewww.datatilsynet.dk.

6. Entry into forceOn 1 July 2005, these guidelines come into force, and the Danish National Board ofHealths former guidelines no. 44 of April 2001concerning the authorization ofdoctors trained outside Denmark are then revoked. The guidelines, shall apply toapplications submitted to the Danish National Board of Health after the guidelineshave come into force.Applicants who have obtained temporary authorization according to guidelines no. 44

of April 2001 will upon application for a new temporary authorization have theapplication processed according to these new guidelines. When issuing a newtemporary authorization, The National Board of Health will deduct the months thatthe applicant has already been working from the 24 months.

All applications for permission to practice medicine independently and forpermission to assume the title of specialist, which have not been finalised at the timeat which these guidelines come into force, will be processed according to the newrules.