With strong demand for physicians in both the public healthcare system and the supplemental (private) healthcare sector, Portugal is relatively open to receiving medical professionals trained abroad.

Although bureaucracy and processing timelines vary depending on where a physician completed their training — with a smoother pathway for those who graduated in an EU member state — the country has a clear and well-regulated process for recognizing international medical qualifications.

Below is a step-by-step guide for validating medical degrees and specialties, visa pathways, and strategies for finding professional opportunities in Portugal.

Equivalency Exams

To practice medicine in Portugal, physicians trained abroad must have their academic qualifications officially recognized. The process differs based on the country of training.

Graduates from institutions in the EU, the European Economic Area, and Switzerland follow a simplified pathway. In these cases, the process is largely administrative: reviewing required documentation (such as a diploma copy and criminal background certificate) and proving proficiency in Portuguese.

These recognition requests must be submitted directly to the Ordem dos Médicos — Portugal’s national medical council. If all documents meet the legal requirements, recognition is granted automatically.

Physicians trained outside Europe must undergo a more extensive diploma-recognition process, including an evaluation of academic and professional training, a theoretical exam, a practical assessment, and submission of a final written work. This process typically takes at least 1 year.

Recognition for non-EU graduates is carried out by public universities with medical schools, following a schedule set annually by the Council of Portuguese Medical Schools.

Each medical school conducts its own assessments under university autonomy. Document requirements vary but generally include a medical diploma, academic transcript and workload, and course syllabi.

Universities publish details on their dedicated recognition pages:

• Faculty of Medicine, University of Lisbon
• Faculty of Medical Sciences | NOVA Medical School (Lisbon)
• Faculty of Medicine, University of Porto
• Abel Salazar Institute of Biomedical Sciences, University of Porto
• Faculty of Medicine, University of Coimbra
• School of Medicine, University of Minho
• Faculty of Medicine and Biomedical Sciences, University of Algarve

Thanks to bilateral agreements, physicians trained at the University of São Paulo and the Federal University of Rio de Janeiro benefit from a simplified recognition process via the University of Lisbon — bypassing additional exams.

All documents must carry a Hague Apostille, an international certification that verifies the authenticity of official documents for use in countries that are part of the Hague Convention. Documents in Portuguese do not require translation, nor do those in English, Spanish, or French. Materials in other languages require a sworn translation into Portuguese.

For those undergoing the full recognition process, the first step is submitting the application to the Directorate-General for Higher Education, attaching all required documents and indicating the university where validation will take place.

Applications are forwarded to the chosen institution, which begins the review once the fee is paid.

Applicants with approved documentation proceed to the first stage: a written exam of 120 general medicine questions, taken in person. A minimum score of 50% is required.

Next is the practical exam, in which physicians are evaluated while caring for a patient. This is also administered in person, but dates are flexible and arranged between the candidate and university.

Candidates must prepare a clinical encounter report detailing history-taking, requested complementary tests, and other relevant information. Again, a minimum score of 50% is needed.

The final step is submission and presentation of a final work, which may take the form of a dissertation, an original article (published or ready for publication), or a detailed curriculum report of academic and clinical experience.

A university panel assigns a grade from 0 to 20; 10 is the minimum for approval.

Once all stages are passed, the physician receives recognition of a foreign higher education degree, which must be presented to the Ordem dos Médicos when applying for professional registration.

Professional Autonomy

In Portugal, medical autonomy is not automatic. Newly recognized physicians gain independent practice rights only after completing a period of supervised practice called Formação Geral — the first year of residency.

When processing registration for physicians with recognized degrees, the Ordem dos Médicos also determines whether the applicant qualifies for immediate autonomy.

Physicians who can document at least 2 years of clinical experience within the past 5 years receive autonomy directly.

Lack of autonomy does not prevent working. Physicians may still practice under supervision in hospitals and other healthcare institutions.

Foreign-trained physicians can also obtain autonomy by completing Formação Geral, similar to recent Portuguese medical graduates.

Language Proficiency

Physicians trained in Portuguese-speaking countries (such as Brazil) are exempt from language testing. Others must demonstrate Portuguese proficiency.

The medical communication exam, designed for physicians trained in non-Lusophone countries, is administered by the Camões Institute and aligned with CEFR B2 level. The exam costs €300 and includes oral comprehension and reading, followed by written and oral production. Candidates have up to 120 minutes to complete it.

Scores are “approved” or “not approved.” Those who fail may retake the exam after 3 months.

The exam is administered at the Ordem dos Médicos offices in Porto, Coimbra, and Lisbon, with registration managed by each regional board.

Recognition of Medical Specialties

After diploma recognition, physicians may request recognition of residency training completed abroad. Applications are filed with the Ordem dos Médicos, but evaluations are carried out by each specialty’s board.

As with degree recognition, the process is simpler for specialists trained in EU countries: an application form, brief curriculum, and authenticated specialty diploma (with translations if needed). The fee is €215.

For specialists trained outside the EU, the process is more rigorous. In addition to diplomas and translations, candidates must submit documentation verifying all items listed in their CV, including detailed proof of clinical duties and training hours.

Each specialty board forms a panel to review applications and may request further information. Curriculum-assessment recognition costs €370.

Visas

Physicians who are not citizens of an EU member state must obtain a visa to live and work in Portugal. The country is currently revising its immigration laws, and as of October 23, new measures have placed greater restrictions on foreign entry.

Doctors are considered highly qualified professionals, a category that maintains the right to bring family members through family reunification.

However, to be recognized as “highly qualified,” physicians must first complete recognition of their medical degree in Portugal.

The most common visa for immigrant physicians is the work visa, which requires a signed contract or employment offer from a Portuguese healthcare institution.

Applications are submitted through VFS Global, the government’s outsourced visa service. No specific processing time is guaranteed.

After obtaining the visa and arriving in Portugal, physicians may apply for family reunification — but this process can take over a year, given severe backlogs in immigration services.

Delays in documentation — even those caused by institutional issues — can create practical challenges, from opening a bank account to traveling outside Portugal.

Job Opportunities

Human-resource shortages are among the greatest challenges facing Portugal’s public healthcare system. Despite having around 55,000 licensed physicians, only just over 30,000 currently work in the Serviço Nacional de Saúde (SNS), the national public health service.

As in many countries, healthcare professionals tend to cluster in major cities such as Lisbon and Porto. However, opportunities also exist in regions such as Algarve and Alentejo, which often offer higher salaries to attract staff.

Staffing agencies that recruit for the SNS are a common entry point for foreign physicians. These companies, such as Randstad and One Healthcare Recruitment, regularly assist candidates in securing employment contracts — documents required for visa applications. 

The Ordem dos Médicos maintains a Job Bank with postings across specialties and regions. Listings may also include opportunities abroad, especially in other European countries. It is also useful to monitor the Central Administration of the Health System website, which publishes public-sector medical job openings nationwide.

Portugal’s supplemental (private) healthcare sector is also expanding. Major private hospital groups — such as Companhia União Fabril and Luz Saúde — frequently advertise clinical vacancies.

The Health System

Established in 1979, the SNS provides universal public healthcare. It is divided into five regions — North, Center, Lisbon and Tagus Valley, Alentejo, and Algarve — and operates three main levels of care: primary care, hospital care, and long-term or continuing care.

The shortage of healthcare professionals remains one of the system’s biggest bottlenecks. In recent years, staffing gaps — especially during summer holidays — have led to temporary closures of emergency departments nationwide.

This shortage also affects non-urgent services, leaving more than 1 million residents (out of 10.4 million) without an assigned family doctor.

Driven by the SNS crisis, the supplemental (private) healthcare sector is expanding. More than 4 million Portuguese now have private health insurance, and this is expected to reach 5 million soon. The surge in demand has also strained private hospitals, leading to long wait times in emergency departments, consultations, and diagnostic exams.

Giuliana Miranda holds a master’s degree in science communication from Unicamp, a Brazilian research university. A journalist specializing in health and science since 2010, she worked for more than a decade at Folha de S. Paulo, one of Brazil’s major national newspapers, and has contributed to publications in Brazil and abroad, including Superinteressante and Galileu (science magazines) and The Telegraph (UK).

This story was translated from Medscape’s Portuguese edition.