When we moved to Portugal in August 2020, I knew I wouldn’t be able to practice medicine locally anytime soon.
The only Portuguese word I knew when I arrived was obrigada (thank you). And the Duolingo lessons I’d been doing on the Boston T? Turns out they were Brazilian Portuguese. I had no idea European Portuguese was different.
So when I landed in Portugal, not only did I barely speak the language, but the few words I did know were in the wrong version of Portuguese.
Over time, though, Portugal started to feel like home.
We adjusted to the small things: line drying clothes instead of using a dryer, gyms opening at 9am on weekends instead of 6am, and my kids refusing to drink anything except fresh-squeezed sumo de laranja (orange juice).
And slowly, my Portuguese improved. By 2023, I finally felt ready to start the process of getting my U.S. medical training recognized in Portugal.
Here’s what the process actually looked like and what I wish I had known before starting.
Want the more personal side of the story?
In this podcast/vlog episode, I share what the process actually felt like emotionally, the identity shift of practicing medicine in another language, and what surprised me most about rebuilding a medical career abroad.
The 7 Steps to Getting Licensed to Practice Medicine in Portugal
The first thing to understand is that the process happens in two major stages:
- Completing the Reconhecimento de Grau Estrangeiro
- Registering with the Ordem dos Médicos (Portugal’s medical board)
The Reconhecimento de Grau Estrangeiro is the process through which a Portuguese Faculdade de Medicina evaluates your U.S. medical training and determines whether it is equivalent to completing medical school in Portugal.
Only after completing the reconhecimento process can you apply to register with the Ordem dos Médicos and legally practice medicine in Portugal.
Knowing what I know now, here’s how I would approach it.
1. Learn European Portuguese
Yes, many Portuguese people speak excellent English. But this is Portugal, and people are understandably proud of their language. And no, speaking Spanish is not “close enough.”
If you truly want to practice medicine locally, learning European Portuguese is essential.
Personally, I started with an intensive Portuguese immersion course for foreigners at the Universidade de Coimbra. It was 20 hours per week for four months. After that, I continued with 1 to 2 hours of weekly lessons for several years.
I also supplemented with Practice Portuguese, an excellent online platform specifically designed for learning European Portuguese.
As your language skills improve, you can start focusing on medical Portuguese as well. One course I came across, though I didn’t personally take it, was: Português Língua Estrangeira para Fins Específicos: Medicina.
To practice medicine in Portugal, you’ll need a B2 level of fluency.
During the reconhecimento process, I had to complete a university-level Portuguese language exam focused heavily on reading comprehension and essay writing. There was no multiple-choice bubble filling here.
Despite passing the exam at the B2 level, I later learned that I would still need to complete the official DIPLE B2 language exam administered by Instituto Camões to fully register with the Ordem dos Médicos. I’ll be taking that exam in July 2026, fingers crossed.
From what I understand, the reconhecimento process no longer includes its own language exam, though you still need strong Portuguese skills to successfully complete the process itself.
2. Gather Documentation:
While learning Portuguese, start gathering your documentation early. This is much easier to do while still living in the U.S. Thankfully, documents in English, French, or Spanish generally do not need to be translated.
Here’s what I needed:
Apostilled Documents
- Medical school diploma
- Medical school transcript (including grading scale)
- Final medical school classification or ranking, if available
- Residency diploma
- Fellowship diploma
The Apostille is typically obtained in the state in which the document was issued. If you no longer live near the state where your diplomas were issued, online apostille services can help coordinate this process remotely.
Documents Signed and Sealed by Your School
- Undergraduate transcript
- Medical school curriculum and rotation schedule
- Residency curriculum and rotation schedule
- Fellowship curriculum and rotation schedule
Because medical school in much of Europe is 6 years long, I also had to prove that my total educational training met the equivalent length requirements, which is why I included my undergraduate transcript.
Additional Documents
- Final academic project, thesis, or research work, or published paper
- Passport
- CV
Be prepared to provide both physical and digital copies of everything.
Gathering old training documents took me 3 to 4 months, and I worked closely with my medical school, residency, and fellowship programs. Documentation requirements can vary slightly depending on the Faculdade de Medicina you apply to, so always check directly with the university. For me, that was the Faculdade de Medicina at Universidade de Coimbra.
RECONHECIMENTO DE GRAU ESTRANGEIRO
3. Submit your Documentation to a Portuguese Medical School
Because I live in Coimbra, I submitted my application through the Universidade de Coimbra.
For medicine, which is considered a regulated profession, you must complete the Reconhecimento Específico process. This means your training is directly compared to the Portuguese medical degree curriculum.
If you simply need your degree recognized for research or academic purposes and do not plan to practice clinically, there is a simpler Reconhecimento Automático pathway.
The reconhecimento process itself cost me approximately €1500 in administrative fees.
At Coimbra, the process followed the academic calendar, beginning in September and running through May or June.
4. Take the Medical Knowledge Exam
Once your documents were approved, I was invited to take the Exame de Reconhecimento Específico, a written medical knowledge exam conducted entirely in Portuguese.
The exam was multiple-choice and lasted 3 hours.
The content felt very bread-and-butter primary care medicine: Diabetes, Hypertension, Hyperlipidemia, Pneumonia, Heart failure, Prenatal care, Basic pediatrics, STI management. All based on European guidelines.
As a palliative care physician, let’s just say I hadn’t thought about some of these topics in years. When I asked how best to study for the exam, I imagined there would be USMLE-style review resources. Instead, I was told to read Harrison’s and Williams Obstetrics.
If I were preparing for this exam now, I would either use ChatGPT to generate Portuguese multiple-choice practice questions with explanations or reach out to Brazilian medical students to see what study resources they were using. (The majority of candidates seeking recognition of their medical training in Portugal were medical students from the former Portuguese colonies.)
Despite being years removed from primary care medicine, I passed.
I think physicians in family medicine, internal medicine, hospital medicine, or emergency medicine would likely feel very comfortable with this material.
Honestly, I was most proud that I was able to get through the exam in Portuguese within the allotted time.
5. Complete the Practical Clinical & Oral Exam
The Exame de reconhecimento específico – Prova Prática/Clínica was probably the hardest part of the entire process. Not because of the medicine itself, but because it required practicing medicine professionally in Portuguese, my fifth language.
The practical exam took place over two days.
On the first day, I was assigned a patient on the internal medicine ward. I had to complete a full history and physical, develop an assessment and plan, and request labs and imaging, all in Portuguese. I then reviewed the patient’s chart, labs, and imaging, and continued managing the case.
On the second day, I presented the patient to a jury of three physicians.
What surprised me most was that they seemed less interested in arriving at the “correct” diagnosis and more interested in my clinical reasoning process, building a broad differential diagnosis, narrowing it down, and explaining why I chose certain tests.
I also got the sense that they were more accustomed to evaluating medical students or residents from Portuguese-speaking countries like Brazil or Cape Verde than to evaluating an American physician with over a decade of experience.
The examiners were kind, though clearly curious why a U.S. physician would move to Portugal when many Portuguese physicians themselves emigrate elsewhere in Europe.
It was stressful. Very stressful. But it’s also the part of the process I’m most proud of passing.
And honestly, I got a little lucky. My patient was a geriatric patient admitted after a fall, very familiar territory for me as a palliative care physician.
6. Presenting Your “Final Project”
The final step of the reconhecimento process was presenting a Trabalho Final to another jury of physicians.
In Portugal, medical students typically complete a final academic project as part of their degree. International physicians can instead present:
- A research project
- A published paper
- Or a detailed narrative review of their professional career
I chose to present a published palliative care education research project I had completed years earlier during my fellowship.
I dusted off a presentation I hadn’t looked at in nearly a decade and updated it with European and Portuguese-specific data on palliative care education.
Because it was a research project, I was allowed to present primarily in English, though I naturally moved back and forth between English and Portuguese during the discussion.
The jury asked thoughtful questions about the research itself, but they were equally curious about my decision to leave the U.S. and move to Portugal.
After presenting, I sat outside in the hallway absolutely sweating while the jury deliberated for what felt like forever. It genuinely felt like a door was either about to open or slam shut. Thankfully, about 10 minutes later, they called me back in and told me I had passed.
And just like that, the reconhecimento process was over.
About two months later, I received an official PDF certifying that my U.S. medical education was recognized as equivalent to medical training in Portugal.
No fancy university seal, no watermark. It looked like a Word document, which I then printed on recycled paper.
ORDEM DOS MÉDICOS
7. Register with the Ordem dos Médicos
The final step is registering with the Ordem dos Médicos, Portugal’s medical board. Each region has its own branch. Since I live in central Portugal, I applied through the Centro region.
The documentation requested included:
- Reconhecimento de Grau Estrangeiro certificado
- Official B2 language certification (DIPLE exam)
- Fingerprinting from both the U.S. and Portugal
- Passport
- Letter of good standing from my U.S. medical board
- CV
- Registration fee
At the time of writing this, I am still completing this final stage myself, so more to come.
My understanding is that the Ordem will ultimately determine whether physicians can practice independently immediately or initially require supervision or additional training within their specialty.
A Few Important Notes
This was my personal experience going through the reconhecimento process as a U.S.-trained physician in Portugal. Requirements and processes can change over time and may vary slightly between universities and specialties, so always confirm details directly with the Faculdade de Medicina and Ordem dos Médicos where you plan to apply..
Bottom Line
The barrier to practicing medicine in Portugal is high. You have to truly want to practice locally to go through years of language learning, documentation gathering, exams, and licensing steps.
But for the right person, it is absolutely worth it. Especially if you:
- Love clinical medicine
- Want to integrate into the local community
- Plan to live in Portugal long-term
For me, the entire process took about three years, largely because learning Portuguese took time, and life occasionally delayed parts of it.
For someone already conversational in Portuguese, highly motivated, and organized, it can be completed in 1 to 1.5 years.
And honestly? I’m incredibly proud that I’ve made it through this process in a language that isn’t my own.
Prefer to watch or listen instead?
I also recorded a podcast/vlog episode sharing the more personal side of this journey, what it actually felt like going through the licensing process in Portugal, learning medical Portuguese, and rebuilding my identity as a physician in another language.
🎙️ Listen on Apple Podcasts or Spotify
👉Thinking about practicing medicine abroad? Join thousands of physicians exploring international careers, telemedicine, and global opportunities through Hippocratic Adventures. Grab our FREE Physician Starter Kit here.
Ashwini Bapat, MD, is a palliative care doctor and co-founder of Hippocratic Adventure. She lives in Portugal with her husband and 2 kids. When she’s not blogging, you’ll find her swimming in an Olympic-sized swimming pool, frosting a cake, or watching the Korean reality show “Single’s Inferno” with her husband. You can learn more about her story of moving to Portugal here.
