Spain, like much of Europe, faces a worsening shortage of medical professionals. The issue affects nearly all of the country’s autonomous communities. A wave of physician retirements, combined with pandemic-related burnout and long-standing strain on the profession, has left many specialties and care settings short-staffed.

While long-term workforce planning — both in medical schools and in residency training slots (known in Spain as MIR, or Médico Interno Residente) — remains essential, short-term solutions are also needed. One option gaining momentum is the recruitment of specialists trained abroad.

Against this backdrop, Spain’s Ministry of Science, Innovation, and Universities recently announced that in 2025, for the first time since Royal Decree 967/2014 took effect, it resolved more applications to recognize or accredit foreign university degrees than it received. The ministry credits this shift to new tools aimed at accelerating and streamlining the process.

One of these tools is Portal Valida-TE, a digital platform designed to simplify applications and allow real-time tracking of each case, increasing transparency and efficiency. Additional technological upgrades — including the use of artificial intelligence — are also planned.

Although the ministry did not release specific figures for medical degrees, it reported resolving 32,569 cases in the first half of 2025 compared with 24,862 applications filed during that period. Applications continue to rise: The first half of 2025 saw 1863 more submissions than the same period in 2024.

Which Countries Are Sending Physicians?

Looking beyond the numbers, Rodríguez Vicente, secretary general of the Spanish Medical Association (Organización Médica Colegial, OMC), told Medscape Spanish edition:
“We can confirm that in recent years there has been a progressive increase in the recognition of medical degrees obtained outside the European Union, especially from Latin American countries. Work is also underway to improve registration systems so we can have more precise data in the future.”

This trend is supported by data from the Organisation for Economic Co-operation and Development. Between 2000 and 2022, Spain recognized 86,194 foreign medical degrees, 92.8% of them awarded in Latin American countries.

Findings from the Experiences in human resources planning for health: The case of physicians. Data and models. SESPAS Report 2024 showed that immigration of nonspecialist physicians — most of them from Latin America — is procyclical, rising with economic growth and increased public healthcare spending. Demand in the private sector is also significant, and public hospitals and primary care centers employ nonspecialists on an exceptional basis when staffing shortages are severe.

Given these realities, the speed of resolving degree-recognition cases has effectively become a national workforce strategy. As of February 2021, Spain’s National Health System employed 136,344 specialist physicians. Of these:

• 31% worked in primary care
• 21% were older than 60 years (31.8% in primary care; 16.3% in hospitals)
• 61.1% were women (65.2% in primary care; 59.3% in hospitals)
• 5.2% held foreign nationality 

A Path Full of Challenges?

According to Giovanni Provenza, president of the Spanish Association of Venezuelan Doctors, the process is far from straightforward. He told Medscape’s Spanish edition:
“You must navigate a series of administrative and bureaucratic steps, such as recognition of the general medical degree, which is handled by the Ministry of Universities and is delayed by a year and a half to 2 years.”

He highlighted further challenges for physicians who completed specialty training abroad.
“These specialists must apply for recognition of their specialty, managed by the Ministry of Health. Unfortunately, 92%-95% receive a negative response.”

He explained that the ministry often argues that training timelines abroad — such as in Venezuela — do not match Spain’s requirements.

“You also need membership in a provincial Medical College and, crucially, legal residency in Spain. It is neither simple nor easy to practice medicine in Spain if you come from Latin America,” Provenza added.

Still, Spain remains attractive because of shared language and cultural and religious similarities, especially for physicians from countries with fewer professional opportunities or more restrictive working environments.

Another barrier arises in the physicians’ home countries. “In Cuba and Venezuela, for example, doctors receive no support from their governments, making it extremely difficult to obtain even basic documents such as a certificate of ethical standing,” Provenza said.

Required Procedures

Vicente noted that foreign physicians should seek support from Spain’s provincial medical colleges, although he stressed the need to shorten recognition timelines.

He also emphasized that the requirements depend on whether the physician comes from within the EU or from outside it.

• EU-trained physicians receive automatic recognition
• Non-EU physicians must apply for degree recognition through the Ministry of Universities and apply separately for specialty recognition through the Ministry of Health

The OMC outlines key guidance on its website. It noted that the process for recognizing or declaring academic equivalence of foreign higher-education degrees under Royal Decree 889/2022 applies to anyone holding an officially valid diploma.

The application window is open indefinitely and applies only to completed official university degrees. For non-university degrees, applications must be made through the Ministry of Education and Vocational Training.

Professional recognition of non-EU health specialties is the exclusive responsibility of the Ministry of Health.

Degrees representing fewer than 3 years of study cannot usually be recognized or declared equivalent to Spanish university degrees. However, candidates may request partial credit transfer at a Spanish university to continue their studies. Recognition or validation of non-university studies may also be requested through the regional education authorities of Catalonia, Galicia, or the Basque Country, depending on the applicant’s residence.

Differences Between Recognition, Equivalence, and Validation

To practice a regulated profession in Spain (those listed in the Annex of Royal Decree 889/2022), applicants must request homologación, or official recognition of the degree, which confers the right to practice.

An equivalencia, or equivalence, establishes only an academic level (bachelor’s or master’s) and does not allow professional practice.

Equivalence may be required in public-sector hiring processes or requested by private employers to verify academic level.

Applicants may request both recognition and equivalence for the same degree, but they cannot request recognition and partial validation at a university simultaneously. Partial validation is allowed only if the recognition request has been denied.

Table 1. What Is the Difference Between Validation, Recognition, and Equivalence of Higher-Education Degrees?

Source: OMC 

Application, Format, and Required Documentation

Applications must be submitted electronically via the Ministry of Universities’ online portal, where they are registered and can be tracked throughout the process (for both recognition and equivalence).

Applicants without a digital certificate may submit their application using a username-based login option.

The portal also provides detailed instructions on required documentation. Notably, official certified copies are not required; applicants instead provide a sworn statement confirming that the submitted documents are original.

All documents must be official and issued by the appropriate authorities. When necessary, original academic documents must be duly legalized, with the legalization appearing on the original document.

When required, documents must also include an official Spanish translation, provided by:

• a Spanish diplomatic or consular office abroad
• a foreign diplomatic or consular office in Spain
• or a sworn translator authorized or registered in Spain 

This story was translated from Medscape’s Spanish edition.