Non-EEA doctors in EEA countries: doctors or cleaners?

Background: Migration of non-EEA doctors to EEA-countries has become a common phenomenon. As coordination within the EEA has not yet been established, every EEA-country is re-inventing the wheel of assessment of foreign medical degrees and developing additional programmes for non-EEA doctors. There is hardly any knowledge about assessment procedures in other EEA-countries. Aim: To examine how 10 European Economic Area (EEA) countries deal with non- EEA doctors. Both national and university policies regarding non- EEA doctors were examined. Methods: This was a qualitative study based on two structured questionnaires. One was used for staff members of national health departments and the other was used for staff members of university medical faculties. Staff members from the health departments of mid-European and north European countries, and staff members from universities in Austria, Belgium, Denmark, France, Germany, Norway, Sweden, UK, Spain, and The Netherlands participated in the study. Results: There is no EEA directive concerning non- EEA doctors. Each EEA country, therefore, has devised its own policy towards non- EEA doctors. To enable non- EEA doctors to obtain a full license, thereby preventing them from ending up as unskilled labourers, the health departments in the Nordic countries and the UK have developed a `fast-track' process for non- EEA doctors. In Austria, Belgium, and The Netherlands, however, non- EEA doctors are more dependent on programmes offered by university medical faculties. The situation in Germany is between these two extremes. As a rule, the programmes for non- EEA doctors in Belgium, Germany, and The Netherlands are two to three times longer than in the Nordic countries (18-36 months vs. 12-18 months, respectively). Financial aid is not available in most countries. Conclusion: As the influx of non- EEA doctors is increasing, harmonisation within the EEA is strongly advisable. As long as there is no EEA directive about non- EEA doctors, the assessment procedures (diploma evaluation, medical-knowledge tests, language requirements, length of additional programmes, etc.) need to be coordinated.