Ultimate Guide to Practicing Medicine in the Netherlands

The Netherlands has been ranked among the top 5 happiest countries, known for a bike- and family-friendly lifestyle. It also boasts famous artists, such as Van Gogh and Rembrandt, as well as famous physicians and scientists, including Boerhaave, Roentgen, and van Leeuwenhoek. Living among tulips, canals, cheese, and a thriving coffee culture might be appealing to many American-trained physicians looking for a modern society, rich with cultural and historical significance, and relatively low threshold for adapting to a new environment (more than 90% of the population speaks at least some English). Now would be a good time for a koffie and stroopwafel!

Dutch Healthcare System

A core principle in The Netherlands is the principle of solidarity. It’s this principle which is the foundation for all social and health services provided in the country. All residents of The Netherlands must purchase compulsory insurance, and all insurance is private. Compared to the US, the Dutch system prioritizes first-line care, eerstelijnszorg. Part of first-line care is the huisarts, or general practitioner (GP), who has studied or been recognized in huisartsgeneeskunde, or Family Medicine. Huisarts are the gatekeepers in the Dutch system. Learn more about the Dutch Health Care System. 

Medical License/Registration

There is no automatic recognition of foreign medical training in The Netherlands, even if you have an EU/EEA medical degree, know professional-level Dutch, and can prove it by passing an official Dutch language exam.  The typical time frame to complete the registration process is 3–6 years, with a probable median between 4–5 years, including learning the language. This timeframe could be shorter if you already speak Dutch fluently (even conversationally), speak another Germanic language as the grammar may be similar, have a taalknop or a tendency to learn languages quickly, do well on exams, and have the required time for clinical supervision. Learn more about the 8 Steps to Dutch Professional Recognition for an American Doctor and the process of Specialty Recognition.

Finding a Job

In general, Linkedin is a popular way for professionals to engage in the Dutch labor market, so having an updated profile and connecting with others and following companies that have a Dutch presence can be helpful. Aside from the traditional clinical pathway, non-clinical work in the Netherlands at any stage is always a consideration. For example, non-clinical work that could still be possible as a physician at any stage, with or without registration locally, could include working for a pharmaceutical company, health insurance company, or a health technology or health information technology vendor.

If you have aspirations to work as an academic physician (clinical or non-clinical) in The Netherlands, for example, as a clinician-researcher or clinician-educator, having a PhD is virtually mandatory. Learn more about Finding a Job in the Netherlands. 

Salary & Work Culture

As a general rule of thumb, the salary for a full-time position at a given level of training or specialty is less than the salary you would expect for that same position in the U.S. However, the value of benefits that you gain is likely much higher, considering the leave and occupational health benefits above, along with additional societal benefits.

Salaries are always reported as bruto maandsalaris or nettoloon, your take home pay after taxes. A basisarts salary, the salary for an individual who has graduated medical school and has not completed residency training, is approximately 3,026-4,749 euro’s per month (post-tax), or about 57,000 euro’s annually, just over $68,000 annually (using a conversation rate 1 euro = $1.20 USD).  For specialists (if you have your RGS recognition as a specialist), salary depends on your work setting (academic or non-academic), years of experience, and academic appointment such as a professor. According to the Dutch Hospitals Association, the 2020 maximum bruto maandsalaris is just above 15,000 euro’s per month (post-tax), or 180,000 euro’s annually, or $215,160 USD (post-tax). This is for a professor-level specialist physician at an academic medical center; unfortunately, I have yet to identify a non-Dutch physician who has such a position.

In general, Dutch labor laws, which must comply with EU labor laws, are more protective of the individual worker than in the U.S. The principle of solidarity in Dutch culture drives laws ensuring reasonable worker supports and accommodations, such as paid parental leave, sick leave, and vacation. Also, the Netherlands values time off from work. The most generous employers give up to 40 days of vacation per year, in addition to several public holidays, most of which are recognized days off, especially for public institutions. Dutch work culture often embraces the motto of “leaving work at work,” protecting your personal and family time.  Learn more about Salary & Work Culture. 

Immigration

Your strategy for visa application will depend on your family circumstances (if you have a partner with Dutch or EU/EEA nationality) and personal/professional preference (if you have aspirations to work in academia either as an instructor or researcher, have special additional skills to offer, or might wish to register a Dutch business which may or may not be healthcare related). Learn more about Immigration to the Netherlands.

Bottom Line

The road to transitioning to the Netherlands is long, slow, and hard. It’s best suited for those who are making a permanent move.

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Tiffany I. Leung, MD, MPH, FACP, FAMIA, FEFIM is a U.S.-trained Internal Medicine physician and Assistant Professor at the Faculty of Health, Medicine and Life Sciences and PhD candidate at the Care and Public Health Research Institute at Maastricht University in The Netherlands. Her PhD work focuses on understanding and mitigating job distress among physicians especially when healthcare systems undergo redesign.

She has a special interest in physician suicide prevention, and promotion of physician well-being, gender equity, and diversity and inclusion in medicine. She is Co-executive Producer of The DEI Shift, a podcast promoting diversity, equity, and inclusion in medicine, and Editor-in-Chief of the Society of General Internal Medicine’s official newsletter SGIM Forum. Read more about Dr. Leung’s work on her website, find her on Twitter and Instagram @TLeungMD, and learn more about her experience with the Dutch Healthcare System.  She has an active state medical license in the U.S. and maintains U.S. board certifications in both Internal Medicine and Clinical Informatics.