Working as a doctor in Spain: a complete guide for foreign medical professionals

Spanish healthcare is short of staff, and doctors with foreign degrees are in demand. You can come from scratch, with no connections and no European education. The difficulty is not competition but bureaucracy: between your degree and the right to practise there are several mandatory procedures, and the order in which you complete them matters.

A foreigner can work as a doctor in Spain, but the road is long: homologation of the degree, Spanish at C1 level, recognition of the specialty or the MIR exam, collegiate registration and a work permit. By law the ministry has six months to decide on the homologation of a degree, and here silence means refusal; after that the timing depends on whether you go through the MIR exam or through recognition of a specialty you already hold. The general procedure for recognising degrees (which professions are regulated, what documents are needed and what the authority’s silence means) is covered separately: recognition of foreign degrees in Spain. Below is each step in order, with timescales, documents and ways to live in Spain legally while the process is under way.

Why Spain needs foreign doctors

To understand how realistic it is to move to Spain and work as a doctor, you need to see the market as a whole.

According to the Spanish Ministry of Health (December 2025), 176,918 doctors work in the SNS (National Health System), and their number grows by 3–4% a year. At the same time the country faces a serious structural shortage. A FACME study (2024) estimates the shortfall at more than 9,000 specialists, while the Ministry of Health puts the figure at 5,874 vacant posts. Some experts speak of 25,000 missing doctors, counting those who leave the profession or emigrate.

Reasons for the shortage:

• Mass retirement: by 2035 around 69,000 specialists will retire, almost 25% of the entire medical workforce. The average age of a doctor in Spain is 47.5.

• Brain drain: Spanish doctors leave for Germany, the UK and France, where pay is 40–100% higher. In 2024 alone, 395 specialists officially gave up their collegiate status to work abroad.

• Imbalance between specialties: the greatest need is for family doctors and paediatricians in primary care, as well as anaesthetists, psychiatrists, radiologists and trauma surgeons.

• Geographical imbalances: Andalusia, Castilla-La Mancha, Extremadura and rural areas are chronically short of medical staff. The difficulty of finding work varies from region to region: competition is higher in big cities, while the provinces have more vacancies and fewer rivals.

In 2025 more than 30% of candidates for the MIR exam were foreigners, representing 87 nationalities. The MIR medical exam, the main gateway to specialisation, has long been international. Against this background some regions (Madrid, the Canary Islands) have dropped the Spanish citizenship requirement for a number of posts.

Two routes: EU or non-EU

The path to practice depends above all on your citizenship.

Citizens of the EU / EEA / Switzerland

If your degree was obtained in an EU country or recognised there, the principle of automatic mutual recognition applies (Directive 2005/36/EC). If you qualified in Germany or Romania, you apply for recognition to the Ministerio de Sanidad. Doctors cannot get a European Professional Card: among the health professions it is available only to pharmacists, general care nurses and physiotherapists. For most specialties on the list of automatically recognised ones (internal medicine, surgery, obstetrics and gynaecology, paediatrics, anaesthesiology, ophthalmology), it is a matter of a few months. In other words, a European degree is already a major advantage.

Recognition of an EU degree: how to apply through RETUEX

Since 1 July 2022 the Ministry of Health deals with qualification recognition electronically only, and applications are accepted only through the RETUEX platform. Paper filed through a registry office or a Spanish consulate is rejected. A specialty is recognised only after the basic medical degree has been recognised.

• Access. You need a digital certificate or Cl@ve, and for those a Spanish DNI or NIE. If you have neither, a representative can file for you. They do not have to be a lawyer: the authority is registered in the REA power-of-attorney register or given in a mandate signed by both of you.
• Documents. Passport or ID card, the degree, a certificate of good standing from the medical council issued within the last three months, and a certificate from the competent authority of the issuing country confirming that the degree meets Directive 2005/36/EC. Each needs an official translation into Spanish.
• Certified copies. You upload copies to RETUEX. The Ministry may verify them and ask for certified copies. Accepted are copies verified against an official register or a platform of the issuing country, copies certified by a public official, digital documents with a verification code (CSV), notarial certification, legalisation or an apostille, which is not required within the EU but is accepted.

Certified copies are where most applicants get stuck: they look for a PDF with an embedded signature from a notary or a university and cannot find one. Start by asking the university and the medical council of the country that issued the degree whether they issue digital documents with a verification code. The full list of documents and forms of certification is in the Ministry of Health FAQ.

Citizens of non-EU countries

A more complex and longer path, split into several parallel tracks. This is where the question arises of how to homologate your degree and obtain the right to work in Spain. Medical education obtained outside the EU, whether a Russian or Belarusian degree or any other higher education from a third country, requires the full homologation procedure.

Step 1. Homologation of your medical degree

The first, mandatory step is recognition of your degree in Spain through the Spanish Ministry of Education and Science (today the Ministerio de Universidades). This is the body that handles applications for homologation of university degrees.

Homologation confirms that your training is equivalent to the Spanish Grado/Licenciatura en Medicina. Without it you cannot register with a medical college, obtain a work permit or sit the MIR exam.

Who reviews the application?

The Spanish Ministry of Education and Science (Ministerio de Universidades), through its Sede Electrónica. To be precise: the document confirmed by the Spanish Ministry of Education is the resolución de homologación, without which you cannot work as a doctor in Spain.

Required documents

• Medical degree: original or notarised copy

• Academic transcript listing subjects and grades

• Curriculum showing hours/credits

• Document confirming completion of internship / clinical placements

• Copy of passport

• Hague apostille or diplomatic legalisation

• Sworn translation (traducción jurada) of all documents into Spanish if they are in another language

• Receipt for payment of the government fee, form 790 (in 2025–2026: €166.50)

If your degree was obtained more than 6 years ago, you will need proof of professional activity: letters from employers, continuing education certificates. In other words, your experience as a doctor must be documented.

How to apply

Only electronically, through the Ministry’s Sede Electrónica, with a Spanish electronic signature or through a representative holding a notarised power of attorney. You can also apply through the Spanish consulate in your country of residence. This is especially convenient for those who have not yet moved: you can start the recognition of your degree without leaving your home town.

Timescales

By law the deadline is six months from filing, and the ministry’s silence means refusal (Real Decreto 889/2022, article 18.3). Within that period: 10 working days to check the file, 10 working days to correct it (extendable by up to 35 more), up to two months for the commission’s opinion and 10 working days for access to the file. Every request for documents suspends the clock, which is why cases in practice run longer.

Attaching an employment contract does not speed up the decision: no rule gives priority for a job offer. A contract is needed for something else — for the work permit and for the route through recognition of a specialty you already hold.

Real Decreto 889/2022 aims to speed up and digitalise the process: since 2025 some procedures have moved online, and you can now track your file in real time.

An important nuance: having submitted your medical degree for homologation and having it reviewed are two different things. A medical degree obtained in a third country will be confirmed by the Spanish Ministry of Education only after all the documents have been checked. Until the procedure is complete, you cannot practise officially.

Step 2. Recognition of your specialty

If you have a specialty (surgeon, cardiologist, dentist, paediatrician, senior-grade doctor), you need to apply separately to the Ministry of Health for recognition of the effects of your foreign specialist qualification under Real Decreto 459/2010.

This is a second, independent process: in Spain a specialty is recognised separately from the basic degree.

Two possible outcomes

1. Unconditional recognition: the documents are sufficient and the specialty is accepted.

2. Conditional recognition: the assessment committee states that you must pass the Prueba Teórico-Práctica (a theoretical and practical exam). This is what happens in most cases for specialists from third countries.

The 2026 call has already been published, and results will be announced by 30 June 2026.

In practice, the path from submitting documents to actual recognition of the specialty takes 2 to 4 years.

According to Dipla Partners, of 6,000 CVs of foreign doctors analysed, only 2% achieved full recognition of their specialty. 60% could not even homologate their degree at the basic level. This is not a verdict; it is an argument for a sound strategy from the very first steps.

Step 3. Spanish: passing the exam is mandatory

To work as a doctor in Spain, learning Spanish is not optional but part of the professional requirements. Learn Spanish while you prepare your documents: time lost here cannot be recovered.

For degree homologation (Ministerio de Universidades): if your native language is not Spanish, you need proof of B2 level. Precision matters here, because “or an equivalent certificate” is the most expensive mistake at this step. Articles 9.4 and 13.2 of RD 889/2022 name exactly four documents: a DELE diploma at B2 or above; a B2 or higher certificate from a state language school (escuela oficial de idiomas); a Certificado de Aptitud in Spanish for foreigners from the same school; a certificate from your university stating that at least 75% of your studies were taught in Spanish.

SIELE is not on that list, even though most guides online recommend it and even though it is issued by the same Instituto Cervantes. Sitting the wrong exam costs both money and months, and you usually find out when the ministry asks for the missing document. How the two exams differ and which one counts where is set out in our comparison of DELE and SIELE; the full document list for homologation is in the article on degree homologation.

For the MIR exam: foreigners from countries where Spanish is not an official language must present a DELE C1 certificate or an equivalent recognised by the Ministry of Health.

For collegiate registration: most Colegios de Médicos require a B2 certificate; this is set out in their regulations.

In practice: talking to patients, working in a team, understanding protocols and writing documentation all require a real C1. Doctors who arrive with B1 usually spend their first 6–12 months on extra study. Courses in Spain or online both work; what matters is regularity.

In regions with a co-official language (Catalonia, the Basque Country, Galicia), public competitions may require basic knowledge of the regional language, especially for primary care posts.

Step 4. Collegiate registration: Colegio Oficial de Médicos

Before you start practising, you must register with the Colegio Oficial de Médicos (official medical college) of the province where you plan to work. Registration is required for everyone, in both the public and private sectors. Without a collegiate number a doctor may not write prescriptions, sign medical documents or legally see patients.

Documents for first registration (non-EU foreigner)

• Passport / TIE (Tarjeta de Identidad de Extranjero)

• Original degree homologation decision: the document must be recognised in Spain

• Spanish language certificate (B2) for non-Spanish speakers

• Certificate of good standing confirming you are not barred from practice (apostilled, translated, valid for 3 months)

• 1 passport-style photo

• Criminal record certificate from your country of residence for the last 5 years

• Spanish bank account (IBAN)

• Fee: usually €150 for first registration

Once approved, you are assigned a personal collegiate number, which appears on all your medical documents in Spain.

Step 5. Work permit and residence permit in Spain

Living in Spain as a doctor means obtaining legal residence status. For third-country nationals, choosing the route is one of the key decisions. The full list of routes, including those not linked to employment, is in our overview of Spanish residence permits.

For EU citizens

Register as a resident within 3 months of arrival, get an NIE, and you can look for work. No separate work permit is required.

For third-country nationals: the main routes

1. Permit for highly qualified professionals (PAC), Ley 14/2013

The fastest option for doctors with a contract:

• Required: homologated degree + employer’s contract

• Minimum salary: about €42,000 gross/year

• Processing by the UGE (Large Companies and Strategic Groups Unit): about 20 working days

• Permit validity: up to 3 years

• Includes family reunification from day one

This is the best option for those who have found an employer and want to obtain residence in Spain as quickly as possible.

2. Tarjeta Azul UE (EU Blue Card)

• A Grado-level degree (automatically met by a doctor)

• A contract of at least 6 months

• Salary: at least €40,077 gross/year (2025–2026)

• Processing: up to 45 days

• Simplified mobility within the EU after 18 months of work

3. Standard permit for employment (cuenta ajena)

The traditional route is slower. It is processed through the Oficina de Extranjería (immigration office). It is used when the employer does not go through the UGE.

4. From study to work

A doctor came on a student visa (preparing for the MIR or doing a residency), completed their training and wants to switch to a work permit. By law this is possible after 3 years in student status. The change is made through Extranjería, and you may not practise without a permit during this period.

Start-up and digital nomad residence permits: alternative routes for doctors

These two types of permit were introduced by Law 28/2022 (Ley de Startups). Although at first glance they sound like something for IT specialists, for an entrepreneurial doctor or a doctor working remotely they open up real opportunities.

Digital nomad residence permit (Visado/Residencia para Nómadas Digitales)

Which medical professionals it suits:

• Telemedicine: a doctor who consults patients remotely through telemedicine platforms for foreign clients or employers

• Medical writer, clinical research consultant, pharmaceutical company adviser, working remotely

• Working for a foreign employer (for example, an international insurance company) from Spain

Key conditions:

• The work is done remotely, not for Spanish companies (or no more than 20% of income from Spanish sources)

• Income: at least 200% of the minimum interprofessional wage, €2,849 a month

• Insurance covering Spain

• No criminal record

Advantages for a doctor:

• Permit validity: 1 year (visa) or 3 years (residence), renewable

• The right to live in Spain without being tied to a specific employer

• The ability to pursue degree homologation, learn Spanish and prepare for the MIR at the same time, while living and working remotely in full legality

• Tax regime for digital nomads in Spain: the option of the favourable Beckham Law regime (24% IRPF instead of the standard progressive scale of up to 47%) if the conditions are met

  In practice: a doctor who consults patients through an international telemedicine platform and earns €3,000–4,000 a month fully meets the requirements. It is a real way to move to Spain from scratch, become a Spanish tax resident and pursue homologation at the same time.

How to get it:

1. Gather the documents: a contract or agreement with a foreign employer or clients, proof of income (bank statements, tax returns), insurance, criminal record certificate

2. Apply through the Spanish consulate in your country of residence (visa) or through the UGE (if you are already in Spain)

3. Processing time: up to 20 working days through the UGE

If you already have income from foreign clients or an employer, the documents and the UGE application on this route can be handled for you end to end: see our digital nomad visa application service.

Start-up residence permit (Autorización de Residencia para Emprendedores)

Which medical professionals it suits:

• A doctor who wants to launch a medical start-up in Spain: a clinic, a telemedicine platform, a medical app, an educational project

• A medical professional developing an innovative product in healthtech, diagnostics or personalised medicine

Key conditions:

• The project must be recognised as innovative by ENISA or another authorised body

• A business plan with prospects of creating jobs and/or economic value for Spain

• Income or capital sufficient to live on (a minimum of about €1,200 a month)

Advantages:

• Validity: 3 years, renewable up to 5 years

• The permit extends to family members

• You can combine entrepreneurship with employment

• A Spanish university or accelerator can act as a partner and support the application

An example for a doctor: a doctor with experience in telemedicine registers a remote diagnostics start-up, gets ENISA approval and enters Spain on an entrepreneur visa, homologating their degree at the same time. Two or three years later the start-up is running and the degree is recognised.

Worth knowing: neither the digital nomad nor the start-up residence permit in itself gives the right to practise medicine in Spain; for that you still need degree homologation, collegiate registration and authorisation to practise. But they give you legal status, time and the chance to complete all the necessary procedures in parallel without the pressure of being there illegally.

Working as a doctor in Spain for doctors from Russia

Doctors with a UK degree: what Brexit changed

Since 1 January 2021 the United Kingdom has been a third country for Spain, and a UK medical degree is recognised like any non-EU degree. The Spanish Ministry of Health’s Brexit page still says UK qualifications are recognised under EU rules, but it describes a transitional regime that has now ended.

What applied and how it ended

• The Withdrawal Agreement preserves recognition obtained before 31 December 2020 and applications filed before that date (Articles 27–28) — and only for people who lived or worked in Spain before then.
• Spain’s transitional regime (Royal Decree-law 38/2020, Article 4) accepted applications under EU rules for five years from 1 January 2021, provided training started before 2021. That period ended at the close of 2025.

So today a UK-trained doctor follows the route described above: homologation of the degree under Royal Decree 889/2022 — up to six months by law, with Spanish at B2 and a possible exam or placement — and then recognition of the specialty under Royal Decree 459/2010. For a specialist qualification (CCT, FRCR) the committee may require a placement of up to three months, further training of up to nine months, or an exam followed by a placement; the six-month decision period is suspended for that time.

If you also hold an EU passport

An Irish or other EU passport changes your status, not your degree. You do not need a residence permit: within three months of moving you register as an EU citizen and receive a certificado de registro straight away (Royal Decree 240/2007, Article 7). An EU passport also opens permanent posts in the public health system, which are reserved for EU and EEA citizens (Law 55/2003, Article 30).

The degree itself remains a UK one. It can be recognised as an EU qualification under Article 3(3) of Directive 2005/36/EC if another EU country — Ireland, for example — has already recognised it and you have worked there as a doctor for three years, certified by that country. This falls under the general system rather than automatic recognition, so Spain may require compensation measures. Without recognition in another EU country and three years of practice there, homologation is the route. Which path is faster depends on your training dates and experience and is assessed case by case.

The Balearic Islands and Ibiza: do you need Catalan?

In the Balearic public health service (IB-Salut), Catalan is currently not a requirement for doctors but an extra point in selection: this is set out in the Balearic civil service law 3/2007, Article 30, as amended by Law 4/2025. The law sets no deadline for learning the language after hiring. The rule has been changed several times since 2023 and challenged before the Constitutional Court, so check the conditions of each selection process. Private clinics are not subject to a statutory language requirement — the employer decides, and Spanish is needed in any case.

What the MIR is and whether you need it

MIR (Médico Interno Residente) is the Spanish system of postgraduate specialisation. It is an annual national exam with competitive allocation to hospitals and specialties. Postgraduate training through the MIR is the standard route to becoming a specialist doctor in Spain.

In 2025/2026, 9,276 places were offered for doctors (out of a total pool of 12,366). In 2025 around 30% of candidates were foreigners, from 87 nationalities.

Who needs the MIR?

• Those who want to obtain a Spanish specialty in Spain or have a foreign one confirmed through an official residency

• Those whose specialty did not obtain direct recognition

• Those who came as general practitioners and want to specialise

Who does not need the MIR?

• Those whose specialty has already been recognised unconditionally (it happens, but rarely)

• Those working as general practitioners: a homologated basic degree is enough

Requirements for foreigners

• A homologated degree is mandatory by the time you apply: if you have a medical degree confirmed by the Spanish Ministry of Education, you can register

• For non-Spanish speakers: C1 level DELE or equivalent

• A TIE or resident status (or a student visa)

How to prepare

The MIR medical exam contains about 210 questions covering the whole clinical curriculum. Preparation academies (CTO, Amir, MirMadrid) offer courses, from online to in person, lasting from 6 months to a year. Getting into a Spanish hospital as a resident means a paid contract and full clinical practice.

Aesthetic medicine in Spain: you do not need the MIR

This is the most common question among doctors heading into aesthetics, and the answer is short. The MIR is not required for aesthetic medicine, because aesthetic medicine is not an official specialty in Spain at all. No specialty means no residency in it, and the MIR competition simply does not lead there. What gives you the right to inject is being a doctor: a homologated degree plus registration with the medical college.

What the rules say

Requirements for healthcare centres are set by Real Decreto 1277/2003, in the wording in force since 1 July 2026. Its annex describes each type of unit separately, and two neighbouring entries answer the question in full.

• U.48, aesthetic medicine — “unidad asistencial en la que un médico es responsable de realizar tratamientos no quirúrgicos, con finalidad de mejora estética corporal o facial”. It says simply “médico”: no official specialty is required.
• U.47, aesthetic surgery — here it reads “un médico con la especialidad en Cirugía plástica, estética y reparadora u otra especialidad quirúrgica”. For operations the specialist title is mandatory.

The line is drawn by the word quirúrgico, surgical. Botulinum toxin, fillers, mesotherapy, peels and threads are non-surgical treatments, performed by a doctor from whom no specialty is demanded. Anything that is an operation belongs to a specialist.

What changed in March 2026 — and what did not

In spring 2026 headlines went round to the effect that doctors without a specialty had been banned from aesthetics. They should not be read literally. Real Decreto 239/2026 of 25 March did tighten the rules, but it tightened them for surgery: that is where a matching specialty is now required, and that is where the cases behind the reform happened. Non-surgical aesthetic medicine stayed with the doctor.

What the new wording added for everyone: a centre must keep up-to-date records of every staff member’s training and official specialty — six months were given for that — while the autonomous communities have a year to align their service catalogues. For a doctor this means the clinic will ask for your education documents early and in detail.

How this differs from Russia and the CIS

In Russia cosmetology is a separate specialty, entered through residency: dermatovenereology first, then professional retraining. Spain puts no barrier on the profession itself — the barrier sits earlier, at the entrance to medicine as such. Until your degree is homologated there will be no injections and no other medical work either.

The practical conclusion for a foreign medical graduate: the Spanish route is shorter by a whole residency, and longer by homologation of the degree.

What you will actually need

• Homologation of your degree. This is what turns you into a doctor in the Spanish legal sense. It is the longest step and the one to start with.
• Registration with the Colegio Oficial de Médicos where you work. Without a college number you do not practise in Spain, and professional liability insurance is usually arranged through the college.
• A course or máster in aesthetic medicine. There are no official master’s degrees in it in Spain — every programme is a título propio. The law does not require them; practice does, because without one no clinic will hire you and no insurer will cover you. It is also your real training: a general medical degree contains no injection techniques.
• An authorised clinic. You can work in a centre whose autonomous community has authorised a U.48 unit. Opening your own is a separate procedure and a later stage.
• Prescription medicines. Botulinum toxin is dispensed on prescription, and prescriptions are written by doctors. One more reason why nothing in this profession starts before homologation.

Homologation and the MIR: the 2026/27 figures

What follows is set by the rules and by the published call for applications, with no estimates.

Item	Value	Rule or source
Fee for homologating a degree	€166.50 (form 790, tasa 107), non-refundable	RD 889/2022
Decision deadline for homologation	6 months; silence means refusal	RD 889/2022, art. 18.3
Language	B2 for homologating the degree, C1 to sit the MIR	ministry requirements and the call
Missing hours or competences	Complementary requirements: supervised practice, an aptitude test, a project or courses; a four-year window, after which no new application is possible	RD 889/2022, art. 19
MIR 2026/27 call	Published 10 August 2026, applications 1–14 September 2026, exam 23 January 2027	Orden SND/854/2026
The exam	200 questions plus 10 reserve, 4 hours 30 minutes, +3 for a correct answer and −1 for a wrong one; the final score is 90% exam and 10% academic record	same call
Places	12,850 in total, of which 9,676 in medicine	same call
Quota for applicants without residence	968 places (10% in medicine); a doctor holding Spanish residence competes in the general pool	RD 589/2022, art. 17.2
MIR exam fee	€31.10 (€23.33 for nursing), form 790	the call
Collegiate registration	Compulsory for any medical work; in Madrid the joining fee is €150 and quarterly dues €20.94–60.17 on the 2025 scale	Ley 44/2003, art. 4.8.a
Recognition of a specialty you already hold	The alternative to the MIR: an application to the Ministry of Health after the base degree is homologated; up to 3 months of supervised practice, up to 9 months of additional unpaid training, or a theory-and-practice exam. Deadline 6 months; after a refusal you may reapply only after 2 years. Since 4 November 2025 applications go through the RETUEX application	RD 459/2010
Ukrainians under temporary protection	No homologation fee is charged while the case is being processed	RD 889/2022, transitional provision 2

Two frequent mistakes in other guides. First, citing Real Decreto 967/2014 — it has been repealed and RD 889/2022 applies. Second, looking for a “dental MIR”: Spain has no dental specialties, so a dentist only needs the degree homologated and collegiate registration.

Since August 2026 doctoral candidates and researchers have a route of their own — the research residence permit in Spain: filed with UGE, decided in 20 working days, granted for up to three years.

Before the degree is homologated: how to live and work in Spain

Homologation and the MIR take months, and you need a lawful status for that time. The workable options: the job-seeker residence permit, which buys time to find employment; a work visa under a contract for a role that does not require a medical licence; the highly qualified professional permit if the offer matches the level and salary; a student visa while you complete complementary requirements or courses; and the digital nomad permit if you keep working remotely for a foreign employer.

The recognition procedure itself, step by step, including documents and complementary requirements, is covered in homologation of a diploma in Spain. If it is unclear which route is faster in your case — the MIR or recognition of your specialty — and which status to hold meanwhile, it is worth going through the order of steps in a consultation before filing: a mistake in the sequence costs months.

Doctor’s salary in Spain: how much doctors earn

There is no single official salary for a doctor in Spain: the rates are set by the autonomous communities. A verifiable example is Madrid: under the tables published on 9 February 2026, a first-year resident earns €21,357.70 a year and a fifth-year resident €28,737.80, both excluding on-call shifts, which are paid on a separate scale. INE statistics do not report doctors separately — they use a combined “healthcare and education” group, which cannot be called a doctor’s salary. The figures below are estimates from regional compilations, not official data. For comparison with the wider market, see average salaries in Spain by profession.

Average figures (2025–2026)

Sources: Sindicato Médico de Granada, Randstad Research 2026, Infobae España

The average salary of a doctor in the SNS is about €54,200 gross/year, or roughly €2,940 net/month. Doctors in Spain earn less than in Germany or Switzerland, but the cost of living is also lower. With on-call shifts, a doctor in Spain earns €800–1,500 a month more than the base salary. At the start of a career, a realistic figure for a resident is about €1,700 net/month including on-call shifts.

Regional differences: family and primary care doctors (net/month, 2026)

How much doctors earn in Spain is a question with very different answers depending on the region. The difference between Murcia and Asturias can exceed €2,000 a month for the same specialty and experience.

A salary means little without the cost of living: the same amount in Madrid and in Extremadura is different money. You can compare incomes, rents and infrastructure across 52 provinces on the relocation map.

Public vs private sector

• Public SNS: lower pay but greater stability. There are three-yearly increments (trienios), an exclusivity supplement and health insurance through MUFACE.

• Private sector: higher salaries for experienced specialists, but fewer guarantees. Private clinics in Spain are a good entry point for a foreigner: the employer is motivated to speed up the paperwork.

• Combining both: Spanish law allows you to combine SNS work and private practice if you do not receive the complemento de exclusividad (exclusivity supplement).

The Spanish healthcare system: where doctors work

Sistema Nacional de Salud (SNS)

The public healthcare system ranks among the best in the world for quality. Healthcare in Spain is universal: it covers Spanish citizens and legal residents, including families with residence status. It is decentralised: each of the 17 autonomous communities runs its own system. What the system looks like from the patient’s side (appointments, the talonario, emergency care, private insurance) is described in our article on healthcare in Spain.

Primary care (Atención Primaria): health centres (centros de salud) staffed by family doctors (médicos de familia), paediatricians and nurses. This level of care is where the shortage is most acute.

Hospital care (Atención Hospitalaria): university and regional hospitals staffed by FEA specialists (Facultativo Especialista de Área).

Emergency services (Urgencias y Emergencias / 112): a separate sector.

Private sector

The largest groups: Quirónsalud (180+ clinics), Vithas, HLA Hospitales, Clínica Baviera, IMQ. They actively hire foreign specialists, often without waiting for full recognition of the specialty. For a foreign doctor, getting into clinics through this channel is the most realistic way to start practising quickly.

Where to look for work as a doctor in Spain

Job portals and agencies

• Saniempleo: specialises in foreign medical professionals

• GMR Spain: support from homologation to employment

• InfoJobs.net → Sanidad y Salud section

• LinkedIn: private clinics and agencies post vacancies directly

• Bolsas de empleo CCAA: each autonomous community keeps a list of temporary posts (listas de contratación)

Spanish cities with the most vacancies for doctors

Spain’s big cities (Madrid, Barcelona, Valencia, Seville) offer the most options, but competition there is also higher. Medium-sized cities (Zaragoza, Málaga, Córdoba, Murcia) often offer better conditions with less competition. Rural areas in any region of Spain have the lowest entry threshold, but a different level of comfort.

The advantages of working as a doctor in Spain’s smaller towns: faster employment, a better chance of a permanent post and less competition for places.

Public competitions (oposiciones)

For permanent posts in the SNS. Requirements: a homologated degree, an NIE and collegiate registration. Third-country nationals take part in competitions for temporary posts; access to permanent posts is still closed to non-EU citizens (except for Ibero-American countries with agreements).

Practice: you can start sooner than you think

Many foreign doctors work in private clinics under contract while waiting for final homologation. Legally this is possible with a temporary work permit if the degree has already been submitted.

Real stories: what practice shows

Ukrainian experience, MIR 2025: according to El País (May 2025), a married couple of doctors from Ukraine (an ENT specialist and a gynaecologist) passed the MIR and got places in Seville (positions 1693 and 1698 in the overall ranking). Their path: arrival → homologation → learning Spanish to C1 → passing the MIR → allocation. Achievable in 1–2 years with good preparation.

A negative case: a Ukrainian trauma surgeon with 27 years’ experience arrived in 2022. Without homologation he could not find medical work and had to work at a recycling centre. According to El Español (2023), such cases are not unusual. The lesson is obvious: without recognition of your degree you cannot work in your profession in Spain, so a move to Spain needs to be planned 1–2 years ahead.

Latin American doctors, private sector: the most common strategy is a contract with a private clinic while homologation is still under way. The clinic is interested, files the documents through the UGE, and the permit takes 20 days. Work starts while full homologation is pending.

Typical mistakes and how to avoid them

Mistake 1: Putting off homologation until you arrive
You can start the recognition of your degree through the Spanish consulate before you move. This saves a year or more.

Mistake 2: Ignoring the language requirements
Arriving with B1 and expecting to find work is unrealistic. You need at least B2 for collegiate registration and C1 for the MIR. Learn Spanish in advance.

Mistake 3: Confusing degree homologation with specialty recognition
These are two different processes at two different ministries. Completing the first does not automatically mean passing the second.

Mistake 4: Underestimating the cost of documents
Apostilles, certified translations, government fees: the minimum budget for documents is €300–600.

Mistake 5: Working without collegiate registration
Without a collegiate number you cannot legally sign medical documents in Spain. An employer who promises to hire you “without registration for now” is breaking the law.

Mistake 6: Not considering alternative visa routes
A digital nomad or start-up residence permit is a lawful way to move to Spain and live here legally while homologation is under way. Many doctors simply do not know about these options.

How Spain compares with other countries

Germany pays more and recognises doctors’ degrees faster. The UK offers stability and high incomes. Spain is the choice if you already speak the language or want a Mediterranean lifestyle. In terms of quality of life (climate, food, safety, access to healthcare), Spain ranks among the leaders in Europe. In France a doctor with a non-EU degree first needs authorisation to practise and then a separate «talent» card with a salary of at least €41,386.48 gross a year; the conditions are in the article on the French talent card for doctors and pharmacists.

Checklist: where to start right now

• Apostille your degree and all academic documents in the country that issued them

• Order a certified translation of your degree, transcript and curriculum into Spanish

• Apply for homologation through the Spanish consulate or electronically

• Start learning Spanish: target B2 in 6–9 months and C1 in 12–18 months

• Consider the digital nomad residence permit if you have remote income from a foreign employer

• Consider the start-up residence permit if you have a medical project or a healthtech idea

• Study the calls for the Prueba Teórico-Práctica on sanidad.gob.es

• Prepare a CV in the Spanish format (chronological, focused on your specialty and the types of institutions)

• Register on Saniempleo / GMR Spain to find an employer willing to speed up the process

• Work out a budget for the move and the first 6–12 months (an MIR resident earns about €1,700 net/month with on-call shifts)

Key points on working as a doctor in Spain

Medicine is considered one of the hardest professions for foreign specialists to get recognised in Spain, but also one of the most in demand. Working as a doctor in Spain is administratively difficult, but with the right strategy it is achievable. If the medical route turns out to be too long, it makes sense to look at how the Spanish labour market works as a whole and which other professions are in short supply.

Becoming a doctor in Spain from scratch means homologating your degree, learning Spanish to at least C1, passing the MIR or having your specialty recognised separately, registering with a medical college and obtaining a work permit. Meanwhile you can use the digital nomad residence permit or the start-up residence permit as a lawful bridge between “not yet a doctor here” and “already practising”.

Key success factors:

1. Start homologating your degree before you move

2. Reach C1 Spanish before the MIR exam

3. Find an employer in the private sector: it speeds everything up

4. Work on recognition of your specialty in parallel with the basic degree

5. Choose the right type of residence permit for your situation

In 2026 Spain is a market open to foreign doctors, but only to those who come with a plan.

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Data current as of April 2026. Document requirements, timescales and fees may change: check the latest version on sanidad.gob.es and universidades.gob.es before applying.