Know complete details about Medical Residency in Spain....
Feb 01, 2023 04:39:50
Thinking about specialist training in Europe with a public healthcare system, modern university hospitals, and a paid resident contract? Spain’s MIR pathway offers structured residency across the Sistema Nacional de Salud (SNS)—and it’s open to international graduates who meet the entry requirements. Here’s a practical, SEO-friendly guide for non-Spanish and non-EU doctors.
Paid training: Residents (Médico Interno Residente – MIR) are salaried hospital employees.
Strong university hospital network: Extensive exposure in teaching hospitals and regional referral centers.
Direct entry to specialty: You choose your specialty at the time of the MIR selection, not after a generic core.
EU recognition: Spanish specialist titles are aligned with EU directives (facilitating mobility across many EU countries).
Quality of life: Mediterranean lifestyle, great public transport, and comparatively reasonable living costs outside Madrid/Barcelona.
Entry exam: MIR (Médico Interno Residente)—a national, competitive exam with a single ranking list used to pick specialty + hospital.
Duration: Typically 4–5 years depending on specialty.
4 years: Family & Community Medicine.
5 years (common): Internal Medicine, Pediatrics, General Surgery, Anesthesiology, Cardiology, Gastroenterology, Neurology, Psychiatry, Radiology, Orthopedics & Trauma, OB-GYN, Dermatology, Urology, ENT, Ophthalmology, etc.
Structure: Rotations through wards, ICU/ER, outpatient clinics; on-calls (guardias), simulation, journal clubs, research/QI, and progressive responsibility under an accredited tutor (tutor de residentes).
Assessment: Annual evaluations, procedure logs, competency milestones, and university/teaching modules per specialty program.
Contract: Residents sign an employment contract with salary, guardia pay, vacation, CME time, and social security coverage.
ACE – Área de Capacitación Específica: focused post-specialist training in niche areas (e.g., Critical Care within Anesthesia/Medicine, Palliative Care, Vascular Risk, etc.; availability varies by year and specialty).
Hospital fellow posts / advanced training: department-run positions for sub-specialty skills (structure and recognition vary).
Academic track: research contracts and PhD options via university departments.
Yes—international graduates (including non-EU) can sit the MIR and, if they rank competitively, select a residency seat. There are quota limits for certain non-EU categories, so planning is crucial.
Degree recognition (Homologación) of your MD/MBBS to the Spanish medical degree via the Ministry of Universities.
MIR application (submit dossier, pay fee, and sit the national exam).
Language: Strong Spanish (B2–C1); the exam paperwork is in Spanish and clinical work is fully Spanish-speaking.
Legal/immigration: NIE (foreigner ID) and the appropriate residence/work authorization for the resident employment contract.
Good standing & health checks: Police certificate, medical fitness, vaccination records (Hep B, MMR, Varicella, Tdap, TB screening).
Note: EU/EEA graduates typically have smoother recognition and mobility, but all candidates compete on the same MIR ranking.
Homologate your degree
Gather notarized/translated diploma, transcript, internship proof, syllabus if requested.
Prepare for the MIR
The exam is highly competitive and knowledge-dense. Many candidates enroll in dedicated prep academies in Spain (or online).
Register for the MIR call
Submit your dossier within the official window; choose exam location; track any quota category relevant to you.
Sit the exam & obtain ranking
Your global rank determines which specialty/hospital you can select during the allocation phase.
Choose specialty & hospital
Selection is done in rank order; be strategic with lists (city vs. training quality, guardia burden, research options).
Onboard with your hospital
Sign your resident contract, complete occupational health, vaccinations, credentialing, and start rotations.
Guardias (on-calls): Paid shifts in ER/ICU/wards; compensatory rest per regulations.
Education: Weekly seminars, grand rounds, simulation, journal clubs; attendance is mandatory.
Portfolio: Procedures, EPAs/competencies, audits/QI, and at least one research/poster/paper encouraged in many departments.
Lifestyle: EU duty-hour framework (target average ≤48 hours/week), annual leave, and academic leave for courses/exams.
Resident salary: Fixed base by autonomous community + guardia pay; increases with R-year.
Benefits: Social security, paid leave, CME allowances (program-dependent), conference support in some departments.
Cost of living: Highest in Madrid/Barcelona; more affordable in Valencia, Seville, Granada, Zaragoza, Murcia, Valladolid, Oviedo, and many coastal or mid-sized cities.
Madrid: Hospital Universitario 12 de Octubre, La Paz, Gregorio Marañón, Ramón y Cajal.
Barcelona/Catalonia: Hospital Clínic, Vall d’Hebron, Bellvitge, Germans Trias i Pujol.
Valencian Community: La Fe (Valencia), General de Alicante.
Andalusia: Virgen del Rocío (Seville), Reina Sofía (Córdoba), Clínico San Cecilio (Granada).
Basque Country / Navarre / Galicia: Cruces, Donostia, CHN Pamplona, CHUAC/CHUS.
(Seat availability and competitiveness vary every year—your MIR rank is decisive.)
Specialist title: Issued by the Ministry of Health upon successful completion of the specialty program.
EU mobility: Recognized under EU directives (always check the exact rules of the destination country).
Outside the EU: Confirm with your home medical council whether a Spanish residency meets return-to-practice/board exam requirements.
ACE (post-residency focused training) through the national system.
Departmental fellow posts for high-skill procedures (recognition varies).
University Master’s/PhD programs aligned to your clinical interest (hepatology, oncology, transplant, data science, etc.).
Short-term observerships (non-hands-on) to gain exposure if you’re still learning Spanish or exploring programs.
Strong MIR score (primary filter for seat allocation).
Spanish fluency suitable for ward rounds, consent, and documentation.
Clear specialty commitment: electives, audits/QI, research output, society memberships.
Professional references from recent supervisors.
Flexibility with location to maximize your chance of landing a high-quality program.
Can non-EU doctors do residency in Spain?
Yes. Non-EU graduates can sit the MIR, subject to degree homologation, quota rules, and immigration compliance.
Is training paid?
Yes—residents are salaried employees with additional compensation for guardias.
Do I need Spanish?
Absolutely. Daily clinical care is in Spanish; aim for B2–C1 before starting.
How long is residency?
Most specialties are 5 years; Family Medicine is 4 years.
Is there a fellowship system after residency?
Spain offers ACE (focused post-specialty training) and departmental fellow posts; research/PhD tracks are widely available.
Will my Spanish training be recognized back home?
Often, yes—but confirm with your home medical council regarding recognition and any additional exams.
Start homologación early—processing can take time.
Prepare strategically for the MIR (question-bank practice + timed mocks).
Build Spanish fluency with clinical vocabulary; practise documentation and handovers.
Keep a clean dossier (translations, police checks, vaccine titers).
Be location-flexible to improve your odds of matching your desired specialty.
Feasibility review (homologación, language, timing)
MIR study plan and resource mapping
City & hospital shortlisting by specialty outcomes and guardia exposure
CV (Spanish format), recommendation strategy, and dossier review
Pre-arrival checklist (NIE, empadronamiento, banking, SIM, housing, healthcare)
With its rich cultural heritage, profound aestheticism, and exceptional quality of life, Spain is a fantastic choice for expats. A great place to experience and have a favourable work-life balance, Spain provides for one of the best living experiences in the world. The low cost of living and numerous job opportunities make it an even more popular destination. Medical training and medical residency in Spain has become a popular choice by many students worldwide. The country also offers many training and study programs for ambitious students in the field of medicine. Any student hoping to start their career as a medical practitioner would have multiple doors of opportunities when going for a medical residency in Spain.
Anyone pursuing a medical residency in Spain is destined for a highly respectable career. However, the path to achieving a medical residency is laced with competition. Getting a medical residency in Spain can take upto years, and can be difficult even for native speakers. Due to the high number of candidates and tough competition, one needs to prepare beforehand in order to get a medical residency in Spain.
Medical Residency in Spain is a wonderful opportunity, however, one needs to fulfil numerous terms and conditions to attain it. One needs to demonstrate a strong understanding and speaking skills in the Spanish language, and score at least C1 in the Spanish language test. Furthermore, one needs to have valid medical school degrees and diplomas, certified by the Ministry of Education, and valid training and speciality certifications, certified by the Ministry of Health. One who wishes to get a medical residency in Spain, must ensure to have fulfilled all the above mentioned requirements. There are many other requirements and conditions, mentioned below, to help you get a better grasp of understanding how to get a medical residency in Spain.
Before moving on to medical residency in Spain, it is important to take into consideration the state of medical education and sector in the country. All citizens of Spain have access to a high-quality healthcare system. Some Spanish healthcare facilities and clinics provide both private and public medical care to its patients. The health care sector is very advanced in the country with numerous treatments and services offered at comparatively affordable costs. The National Health System of the country has a robust structure and is fragmented and arranged over the regions.
The Ministry of Health of Spain is the one who decides the budget allocation and policy formulation. Being a resident or worker in Spain, they are eligible for free access to the country's universal and advanced healthcare system. The country’s hospitals are renowned especially for their high quality of care and cutting-edge technology, earning the country a reputation for having some of Europe's top healthcare. It has a first-rate social security system that pays for medical expenses for all citizens as well as non-citizens, making it a desirable location for students searching for medical residencies and education. According to the 2018 Euro Consumer Health Index, Spain is the nineteenth healthiest country in Europe.
Spain is an attractive location for all international students looking to get a medical residency. Equipped with advanced medical facilities and trained medical practitioners, students get a plethora of opportunities to learn, grow, and achieve high success in their medical careers. The Spanish medical residency program offers five different specialized domains in the field of medicine. One can choose from any of these five specialized domains: Surgery, Obstetrics or Gynecology, Internal Medicine, Emergency care and Pediatrics.
In order to obtain a medical residency in Spain, the candidates need to have an undergraduate degree from a recognised educational institution. After that they will have to get their MD (Doctor of Medicine) degree. After completing a residency program, they would be eligible for being a medical practitioner. Spain has 47 recognised medical specialisations in Spain, each of which requires 4-5 years of training to obtain. After completing the MIR exam, which is administered by AEMIR, candidates are eligible for admission into medical residency programmes.
Foreign doctors in Spain have the option to practice as an employee or work freelance or even be self employed. However, you would have to get the NIE number (Número de Identificación de Extranjeros), for you to be able to open a bank account, make real estate purchases, get tax benefits, insurance benefits, and much more.
The first step to getting a medical residency in Spain is to have your medical or dental qualification degrees and diplomas certified by the Ministry of Education of Spain. However, any candidate graduating from the universities mentioned in the list of exempted institutes is exempted to have their documents certified. All the other candidates must fill out the form as soon as possible to avoid any delays. To do this, one must do the following:
- Fill out the application form
- Submit all your documentation
- Pay the required amount of fees
- Submit them in the public office of either the Federal government or the Regional Offices or Local offices.
- Collect your certified documents and certificate
Process for the Residency Entrance Test
After getting a equivalence certificate from the Ministry of Education, Spain, start preparing for the Residency Entrance Examination (MIR). Candidates from different regions have to follow different processes. These processes are as follows:
- Graduates from the European Union, European Economic Area, and Switzerland
These candidates should go for "Recognition of professional title to Ministry of Health of Spain" instead of going through the certification process. It is a shorter route, and then one should apply for the MIR test after receiving a recognition certificate. To register for the residence examination, one must submit the application form, pay the registration fee, and submit the documents required.
The candidates are required to submit the following documents:
- Qualifications in basic medicine or dentistry from an accredited educational institute
- Must have earned the right to use the title of doctor from the Spanish Ministry of Health
- Spanish language ability up to and including the C1 level
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- Non-European Union Dental and Medical School Alums
Such candidates must first of all go for the certification procedure and submit the required documentation as soon as possible. Keep a note of the deadlines and keep checking the official notice to keep track of all the procedures.
These candidates must have the following required documents:
- Qualifications in basic medicine or dentistry from an accredited educational institute
- Must get the Equivalency certification from the Ministry of Education of Spain
- Spanish language ability up to and including the C1 level
Process for getting a License and Registration:
After passing the MIR exam, the candidate should then apply for licensing and register as a medical practitioner in Spain. Again, the procedure is different for different candidates hailing from different regions. Also, candidates having a dual citizenship from the country of Spain and any other country in the European Union, are supposed to apply directly through the home country's ministry of health, rather than applying via one of its provincial offices.
- Candidates from the European Union, European Economic Area and Switzerland
The candidates from these regions must first of all get their title recognition certification from the Spanish Ministry of Health. After that, they should apply to the Provisional Physician Medical College along with the documentation required in order to get the license for their medical practice. All the specialists are also required to get a Specialist title registration from the Ministry of Health from Spain.
They must posses the following documentation in order to complete the process:
- Diploma or degree from an accredited medical or dental school
- Candidate must be a medical doctor with a valid licence from the Spanish Ministry of Health
- Have valid and credible licencing from the licensing board in one's country of origin or last place of employment
- Must have a Spanish Language proficiency and achieve up to B2 level scores
- Documentation establishing residency in the state or province where the doctor will be practising.
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- Graduates Candidates from non European Union Regions
All the foreign medical and dental graduates must apply for the NIE number along with a work and residency permit. After getting these required permit, the candidates must then go for the Equivalency certification obtained from the ministry of Education of Spain. This process is quite long and cumbersome due to the high number of applicants and competition. It can usually take upto a maximum of one year or a minimum of 6 months.
After getting the certification, the candidate must then apply for registration to the Provisional Physician Medical College along with the documentation required in order to get the license for their medical practice. The candidates must be sure to get a registration in advance so that they get their license as soon as possible, without any unnecessary delays.
Such candidates must fulfil the following document requirements in order to get registration and license in Spain:
- Must have a basic dental or medical graduation certifications from an accredited educational institute
- Must have an NIE number, Authorization to work and a residency permit to live in Spain
- Equivalency Certification obtained from the Ministry of Education of Spain
- Credentialing with the licensing/registration board in one's country of origin or last place of employment.
- Documentation establishing residency in the state or province where the doctor will be practising.
- Fluency in the Spanish language to the level of a minimum of B2.
To get recognition as a trained specialist in Spain belonging from the Non European Union regions
First of all, they must initially initiate the equivalence process, through an online application portal or by filling out the application and submitting it along with the required documentation. Following completion and receipt of the equivalence or qualification certificate, t hey need to apply for getting recognition as a licensed medical practitioner in Spain by filling in an application form along with the supporting documents to the Spanish Ministry of Health.
For such specialists from outside the European Union, they must satisfy the following documentation criteria:
- These candidates must get basic Specialist medical and dental degree certification from an accredited educational institute according to the Spanish Law.
- Engaged in an enrollment or registration process with a Spanish provincial medical college.
- A valid permit to work and live in Spain is required
- Having been awarded the status of specialist in his or her respective specialty by the Spanish Ministry of Health.
For specialists from the European Union, European Economic Area, and Switzerland, the candidates must fulfill the below mentioned documentation criteria:
- At least C1 level proficiency of the Spanish language is a must
- Getting from the Spanish Ministry of Health the recipient title of Doctor or Specialist.
- Get registered with a Spanish medical college in your province.
Examination: Parts and Patterns for different Candidates
- Examination Pattern for Specialists from Non European Union Countries
There is a set pattern of examination for Specialists trained in the Non European Union countries. There are two different sections, testing different skills and understanding levels of the specialists. Each section is worth a total of 100 points. The applicant needs to get 50 percent or more on each of the sections to successfully pass the examination. Yearly examinations are held every year. The examination pattern of both the sections is as follows:
- The first section of the examination will be comprised of questions set at a level of difficulty reflective of a specialist's typical work environment to assess conceptual, clinical, and diagnosis abilities. This section will last for 2 hours and contains 75 MCQs (multiple-choice questions), each with five possible answers, only one of which is valid.
- The second section is meant to ensure that the Specialist can make sound treatment and diagnostic choices for issues pertaining to their field of expertise. This section will last for two hours and it would be split into three case studies highlighting specialty-specific issues, each of which will be accompanied by at least three open-ended questions that need justification from the candidate.
Examination pattern for the Residency Entrance Examination
The MIR test is required for entry into one of Spainish 47 official medical subspecialties. It has 225 multiple-choice questions (MCQs) and 10 "reserve" questions. There are four possible answers to each question, only one of which is correct. The examination lasts upto a total of five hours. Since there are no predetermined areas of focus for the examination, any topic concerning medicine could potentially be on the table. Ninety percent of one's overall grade is based on performance on the examination, whilst remaining ten percent is based on one's prior academic credentials. Only 4% of applicants can be international medical school graduates. In order to enter in the chosen speciality, one will have to score of about 35% on average.
Anyone interested in deepening their knowledge in the medical profession could benefit greatly from Spain’s Medical Residency Training Programs. This initiative provides numerous opportunities to pursue their passions and learn about their chosen medical field, in a country equipped with the latest medical technology and expert medical professionals.
Each resident is required to have completed a six-year basic medicine programme and scored well on the Medical Intern Residency (MIR) admissions exam before being accepted into their programme of choice.
This training programme, called the Preventive Medicine and Public Health residency lasts over four years and entails training of approved medical care providers. For practise conducted outside of the country of Spain, the candidates are permitted to obtain training for a total of 12 months throughout the course of the four years, with a cap of 4 months per year. The method of evaluation at the finish of the course includes an yearly review performed by the yearly evaluation team of the residency log.
The course has been specifically designed to meet the contemporary medical requirements, and offer specialised medical training. It contains over four sections, each touching upon differentiated medical domians.
- The first one is a Master in Public health
- Second is Primary Care for 6 months and Hospitalization for 12
- Thirdly, a period of fifteen months working for public health administrative units across the country or in a particular province
- The fourth section is a period of six months spent in a public health research unit.
A hospital-based term in preventive medicine (HAIs surveillance and hygiene) must be completed by the patient between the periods of 4 and 12 months. In addition to this, by the time the training session is over, professionals must have accomplished a range of competencies in fundamental domains such as the Health promotion, epidemic studies, environmental health and management. The Preventive Medicine and Public Health Residency Program in Spain contains about four phases, each with a differentiated curriculum.
> The first phase includes a total of nine months spent in the Master of Science in Public Health programme.
> The second phases comprises of Primary and Hospital Care with total time of 12 months.
These 12 months in the Hospital Care are to be spent with three months in the very first year of training and then nine months in the second year of training. The areas covered during this include:
- Preventative Medicine
- Management of Quality
- Administration and Management
- Health Promotion and Health Education
A total of 6 months are to be spent in the primary care. The areas coved during this duration are as follows:
- Programs for Risk Management
- Management and Administration
- Management of Medicare Quality
- Management of Medicare Quality
> The Third Phase will last for fifteen months across all Public Health Administrative Units. There would be a total of 9 units covered during this time. These units are as followed:
- Epidemiological Surveillance Units
- Registers of Mobilities and Mortalities Units
- Laboratories for Public Health
- Laboratories for Public Health
- Units for Preventive Programming
- Units for Health Care Plans
- Food and Related Items Evaluation Units for Safety
- Evaluation Units for Health Care Services
- Units responsible for Environmental Health
> Phase Four comprises of a period of six months spent in various public health research units. The units covered would be the following:
- University Departments of Public Health
- University Departments of Public Health
- Evaluation Agencies
- Other experienced Units in the field of Medical Research
Students interested in studying and working in other countries may find that doing their medical residency in Spain is an excellent opportunity. The country has a long history of medicine and the provision of medical care. The Spanish people have access to the top medical facilities at affordable rates. Because the cost of living in Spain is far lower than the cost of living in many other European nations. The Spanish government provides many tax benefits and insurance that make it is possible to live in comfort on a very small budget. Because of the low cost of living, obtaining a medical residency becomes even more promising.
One will have the opportunity to receive hands-on training from some of the most experienced doctors and nurses in the world while getting a medical residency in Spain. Warm and welcoming locals, amazing culture, picturesque sites, and the cultural delicacies are added benefits that would make one’s stay even more comfortable.
