Belgium continues to attract foreign-trained physicians drawn by its high quality of life, strong healthcare infrastructure, and renowned university hospitals. To many, it is the country of chocolate, waffles, beer, and good living, but gaining the right to practice medicine there can be a complex, bureaucratic process. The steps vary significantly depending on where the medical degree was earned. Here’s what international doctors need to know to have their qualifications recognized and begin practicing legally in Belgium.

Entry and Residency Requirements

Before beginning any medical work, non-European doctors must obtain a type D long-stay visa for entry and residence. This visa is issued by the Belgian embassy in the applicant’s home country after approval from the Immigration Office of the Federal Public Service, part of the Federal Public Service (FPS) Home Affairs.

Once in Belgium, physicians must register at the local commune (municipal office) of their residence and apply for a professional residence card (A card). This document is required to register with the Order of Physicians, work in a hospital, and obtain an National Institute for Health and Disability Insurance (INAMI) number— the billing number necessary for all practicing healthcare professionals.

Degree Recognition

The process for recognizing a foreign medical degree depends on where it was obtained:

• Doctors from the EU or Switzerland benefit from automatic recognition under Directive 2005/36/EC. However, they must still register with the Order of Physicians and apply for an INAMI number.
• Doctors from outside the EU must first obtain academic equivalence from either the Fédération Wallonie-Bruxelles or the Flemish Community, depending on the region where they intend to practice.
  • In Wallonia, the responsible office is the Service de la Reconnaissance Académique et Professionnelle.
  • In Flanders, the procedure is handled through the official portal vlaanderen.be.

Licensing to Practice

After obtaining equivalence, doctors must apply for professional accreditation from the FPS Public Health, which serves as the legal authorization to practice medicine in Belgium. Depending on the candidate’s background, authorities may require an adaptation internship or an additional qualifying examination.

Processing typically takes 3-9 months. Once approved, doctors can register with the Order of Physicians and receive their INAMI number, both of which are mandatory for legal and financial authorization to practice.

Language Requirements

Belgium’s multilingual environment makes language proficiency essential. Physicians must demonstrate at least B2-level fluency in the language of the region — French, Dutch, or German — according to the Common European Framework of Reference for Languages. Some institutions, especially university hospitals, may require C1-level proficiency.

Recognized certifications include DELF B2/DALF C1-C2 for French, CNaVT for Dutch, and the Goethe-Zertifikat B2 or C1 for German. Doctors who have studied or practiced medicine in the working language may be exempt from formal testing.

Finding a Medical Position

Job opportunities vary considerably across regions:

• Brussels hosts several major university hospitals, such as the Brussels University Hospital and Saint-Luc University Clinics, as well as numerous private hospitals and clinics offering positions for healthcare professionals.
• In Wallonia, there is a strong demand for general practitioners, with some areas offering financial incentives for new installations. Certain specialties — including anesthesiology, geriatrics, and radiology — are also in shortage. Vacancies are typically listed on individual hospital websites.
• Flanders also faces shortages of general practitioners and technical specialists, particularly in Ghent, Leuven, and Antwerp.

Doctors can search for positions through national employment platforms such as Actiris, Le Forem, and VDAB, all of which feature healthcare-related listings. Hospital career pages (eg, Université libre de Bruxelles, Catholic University of Louvain, Catholic University of Leuven, Ghent University) and specialized recruitment platforms like MediJobs, LinkedIn, and Group-Optimal also provide valuable opportunities.

This story was translated from MediQuality, part of the Medscape Professional Network.