The Spanish Medical Association has proposed tightening the recognition system for medical degrees obtained outside the European Union by introducing a mandatory clinical examination, which must be passed to practice medicine in Spain.

The proposal emphasizes patient safety and the quality of the healthcare system.

The organization suggests implementing an objective and structured clinical evaluation (ECOE), consisting of practical and oral examinations, to assess the actual competencies of professionals trained outside the EU. This examination would need to be completed before obtaining membership in the association and commencing medical practice, regardless of the applicant’s nationality.

This change would shift the model from one based solely on document review to a system that includes actual clinical assessment. The OMC asserts that every doctor practicing in Spain must demonstrate certain minimum competencies to ensure safe practice.

Spain currently has the most lenient system for accepting medical degrees in Western Europe. According to the organization’s report, Spain does not require clinical examinations or supervised practical training periods, nor does it involve professional associations in the licensing process, unlike countries such as Germany, France, or the United Kingdom, where stricter preliminary checks are in place.

The aim of the proposal is to align the Spanish model with these European standards. It does not seek to limit the influx of foreign professionals but rather to raise the level of requirements to eliminate discrepancies between the standards for doctors trained in Spain and those coming from other systems.

Tomás Cobo, president of the OMC, defended the initiative as a guarantee for citizens: “The ECOE is essentially a commitment to the quality of medicine practiced in our country and to patient safety,” he stated.

In 2025, Spain recognized 30,303 medical degrees from non-EU countries, which translates to 4.46 for every student graduating from a Spanish university. This figure has intensified doubts about the system’s ability to adequately verify the clinical training of new professionals.

Los médicos alertan del coladero sanitario y exigen un examen obligatorio a titulados extranjeros: «El sistema español es el más permisivo de Europa occidental»https://t.co/AF8vwXreEN

— LA GACETA (@gaceta_es) April 30, 2026

The OMC also warns that the impact of recognition in Spain extends beyond the national level, as it allows for indirect access to the European labor market. According to the organization, this increases the responsibility to ensure appropriate standards before granting licenses.

The initiative also proposes strengthening the role of medical associations in the process by integrating the assessment into membership and restoring an active role for the profession in competency verification, as reported by the Spanish Gaceta.

The proposed model should be developed in collaboration with the Spanish Ministry of Health and the Medical Professional Forum. The goal is to create a system that balances the demand for professionals with the requirements for clinical safety.

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