Ultimate Guide to Practicing Medicine in Spain

Spain is a dream come true. Whether you want to explore the beaches of the Balearic Islands, walk the historic streets of Barcelona, Madrid and Seville, revel in the exquisite cuisine or simple enjoy a relaxed lifestyle, Spain has it all. With a wonderful weather all year round, an emphasis on work-life balance, and an affordable cost of living, Spain is now considered one of the top countries to live and work for expats.

Spain’s Healthcare System

Spain’s single-payer health care system is ranked seventh best in the world by the World Health Organization. Spain has the most efficient health system in Europe and is considered the healthiest country. Spain’s healthcare system offers universal health coverage as a constitutionally-guaranteed right and no out-of-pocket expenses — aside from prescription drugs. 

Check out the blog post Spain’s Healthcare System: What you need to know for more detailed information regarding the healthcare system

Medical Registration

The recognition of the medical school diploma is done through the Ministerio de Educacion whereas the Ministerio de Sanidad takes care of recognizing specialty training. These are two completely independent processes. Importantly, you do have to demonstrate that you are proficient in Spanish, a level of C1 or above.

For more detailed information, check out How to Obtain a Medical License in Spain.

Finding a Job

To find a job, you need to be proficient in Spanish, a level C1 Spanish or above. The best way to find a job is to contact the hospital of your choice directly once all your credentials have been recognized. Some people prefer to work with certain specialized job sites or to find the best fit for them. Another option is to consult the job offers at the local “colegio de medicos” or the hospital (i.e. bolsa de trabajo) or LinkedIn.

Salary & Work Culture

The starting salary as a first year attending physician working in the public system is relatively low compared to other EU countries (around 60.000 euros/year) and increases with seniority (maximum with no supplements around 110.000 euros/year); also depends on the position (supervisor, attending physician, residency director, chair of the department). All the specialties get the same base salary for the same level physician, but salaries can be supplemented with a stipend from the medical school or the associated research institute if applicable. Because the base salaries are not very competitive, many physicians who are employed in the public sector have their own private practice or they do calls on their free time.

Importantly, the cost of living in general is lower compared to the US and medical school is very affordable costing around $1000-1500/year (total of 6 years). Salaries and the cost of life vary across regions; Catalonia and the Basque country are the regions with the highest salaries for healthcare workers, but along with Madrid, they are the most expensive areas as well.

One significant difference compared to the US is that since healthcare is free, you do not need private insurance and the employee does not regularly offer it. At the same time, retirement benefits come from the social security administration which replaces a percentage of your pre-retirement income based on their lifetime earnings (I believe that it is based on your last 25 years of earnings approximately) so there is no 401k or private retirement program offered by the employee but you can always get your own. Maternity leave is granted for 4 months but you can request a medical disability with your full salary a few months prior to the due date and the maternity leave can also be easily extended. In terms of vacation, there are approximately 22-25 days/year but the amount of days may increase with seniority plus all the national holidays (10-15 days/year). Some high-risk specialties (i.e. radiology, ID) may have additional maternity leave or days off.

You can also work for a private hospital (often referred as Clinica) but I am told that neither the salaries nor the benefits are as competitive, although it seems that for foreign doctors, it may be a bit easier to get a job there as they may be more flexible with some of the requirements.  In the private sector, you can negotiate your salary directly, and you can receive bonuses based on productivity.

Regarding malpractice insurance, Spain isn’t as litigious as the US, so there aren’t many malpractice cases against physicians, but the Colegio de Medicos does provides some legal coverage if needed

Immigration

There are a handful of visa options and citizenship opportunities to be able to live and/or work in Spain.

EU/EEA/Swiss Citizens do not need a work visa to live and work in Spain.

Family members of a Spanish/EU/EEA or Swiss citizen, can obtain a residence visa to live in Spain, provided they are joining the EU citizen in Spain.

Individuals married to Spanish citizens can apply for the Spanish nationality but you need to be married for at least 1 year and you also need to live in Spain for a year prior to submitting the application.

If you do not fit into any of the categories above, you will need to apply for a work visa which falls under the long-term visas (> 6 months). As opposed to the US, it is not difficult to get a visa through the hospital/employer if you are able to get your paperwork ready. Permanent residence can be obtained after residing in Spain for at least 5 years.

Bottom Line

While Spain is one of the best countries in terms of quality of life and culture, getting your medical and specialty training recognized can be challenging and lengthy.  Moving to Spain to practice medicine may be worth it for those who are committed to move and live in Spain long term. Buena suerte!!!

Dr. Bulbena Cabre is a US trained psychiatrist who is originally from Spain. She trained at New York Medical College, Yale University and at the Icahn school of Medicine at Mount Sinai and works as an attending psychiatrist in NYC. She has applied for her specialty recognition in Spain and hopes to receive final recognition in the coming months.

If you want to move to Spain but don’t know where to start, sign up for a Guidance Session with Dr. Bulbena Cabre. She will show you the ropes!  Sign up here!