Sweden consistently ranks amongst the best places in the world to live and raise children. Perhaps this has something to do with the five weeks of legally mandated vacation, 480 days of paid parental leave, free education including university, and heavily-subsidized child care. Here is a guide to practicing medicine in Sweden.
Sweden’s Health Care System
Sweden provides single payer, universal health insurance, funded by taxes. All residents are automatically enrolled and provided coverage for inpatient, outpatient, dental, mental health, and long term care; prescription medications are also covered. The country is divided into “Regions” that administer healthcare, typically through primary care centers and hospitals. Each region sets provider reimbursement and copayments. About 13 percent of employed people have private insurance for improved access to specialists.
Hospitals range from smaller community hospitals, to regional Länssjukhus, to tertiary care University Hospitals. A regional hospital manages most conditions except complicated surgery such as transplants or neurosurgery, complicated oncological treatments such as Bone Marrow Transplants, and subspecialized pediatric care such as extreme prematurity and some pediatric surgeries which are referred to the corresponding University Hospital. There are 6 tertiary care University Hospitals: Karolinska/Stockholm, Uppsala, Umeå, Göteborg, Linköping, and Lund.
Medical Education and Training
Medical school is free for EU/EEA and Swiss citizens. Sweden’s Medical education is changing to align with the medical training within the European Union – medical school will be extended from 5.5 years to 6 years long. After medical school, trainees complete a general internship, AllmänTjänstgöring – soon to become Bastjänstgöring after the above change – consisting of rotations in general medicine, surgery, primary care, and psychiatry over a period of 12-18 months. This general internship culminates in läkarlegitimation – a medical license, and enables progression to a junior doctor – underläkare. A junior doctor applies for a 6 month position in their specialty of interest. After these 6 months, the junior doctor can be offered a position to continue their specialized residency called specialisttjänstgöring (ST), which is typically 5 years in duration. Almost all health care centers and hospitals participate in medical training and education.
The Swedish Board of Health and Welfare, Socialstyrelsen, regulates medical licensure and registration. US-trained doctors need to go through the following steps to practice medicine in Sweden. Importantly, medical care is provided in Swedish.
Step 1: Apply for a Swedish license
Applying for a medical license typically takes between 2-4 years, unless you are already proficient in Swedish. The key steps are outlined below.
- Medical Education Assessment: The Socialstyrelsen will assess your medical education in comparison to the Swedish standard. Documents are accepted in English – you do not need to know Swedish to start this process, which typically takes about 3 months. In general, American medical school is typically accepted as long as you can prove that you took enough courses in college to make up for the fact that medical schools in Europe are six years long.
- Learn Swedish: Learning a foreign language from scratch to the graduate level typically takes about 2-4 years.
- Medical Knowledge Test: Pass a Medical knowledge Proficiency Test consisting of a written and oral test in Swedish, similar to USMLEs 1-3 and CS.
- Complete a course on Swedish Laws.
- Clinical Training: Apply for and complete 6 months of supervised clinical training.
- Apply for your medical license
Step 2: Complete Specialty Training
You must complete at least 1 year of Swedish residency training (ST) in your specialty to ensure competence and to integrate into the Swedish healthcare system.
Step 3: Certificate of Specialist Expertise
After completing medical specialty training you can apply to obtain your specialist certificate.
Finding a Job
Most jobs are found via word of mouth, or by directly contacting a head of your particular department. Many vacancies and positions are not publicly posted. You can also search the postings on Läkartidningen though it may not account for all the openings. Family Medicine doctors and Psychiatrists including Child & Adolescent Psychiatrists are in demand and therefore well-compensated.
European citizens can live and work in Sweden. Individuals married to a Swedish citizen can obtain a family visa – which you can obtain regardless of your work status. Individuals from outside the EU will need a work visa which can be challenging to obtain since you typically need a job to apply for the visa in the first place.
For me, being Swedish and having attending Swedish medical school and American residency training, returning home has been a fairly smooth ride. That said this type of transition is best suited for someone planning to live in Sweden for the long term.
Dr. Sofi Asmundsson is a Swedish and American citizen. She completed medical school in Sweden and pediatric residency in the US. She worked for a couple years in the US as an attending general pediatrician in the ED and as a neonatal hospitalist. She lives in Sweden with her family and is completing her 1 year of Specialisttjänstgöring (ST). Her husband is an American born and trained general surgeon who is going through the process outlined above.
Sweden boasts a very high quality of life and offers many social supports that make life a bit easier, especially for families. Here I share what it is like to work as a physician-parent in Sweden. To learn more about transitioning to Sweden, check out the Ultimate...