The Netherlands
Section A. Residency System
1. Does this country accept international physicians for specialization in its hospitals?:
Yes
2. Specialties offered (name duration)::

Anesthesiology 5
Cardiology 6
Cardiothoracic Surgery 6
Company Doctor 4
Clinical Chemistry n/a
Clinical Genetics 4
Clinical Geriatrics 5
Community Health 4
Dermatology 5
Family Practice 3
Gastroenterology 6
General Healthcare n/a
Insurance Medicine 4
Internal Medicine 6
Labor & Health n/a
Lung Diseases & Tuberculosis 6
Medical Care for the Mentally Handicapped 3
Medical Environmental Studies n/a
Medical Microbiology 5
Neurology 6
Neurological Surgery 6
Nuclear Medicine 4
Nursing Home Medicine 2
Obstetrics and Gynecology 6
Ophthalmology 4
Orthopaedic Surgery 6
Otolaryngology 5
Pathology 5
Pediatrics 5
Plastic Surgery 6
Psychiatry 4,5
Radiology 5
Radiotherapy 5
Rehabilitation Medicine 6
Rheumatology 6
Social Medicine n/a
Surgery General 6
Tuberculosis Resistance n/a
Urology 6
Youth Healthcare n/a

3. Are there examinations during the residency? How are the residents’ evaluated?:

Yes, however this differs per specialty.
After 12 months the instructor evaluates the student. The student is advised whether or not to continue using a standard MSRC form. In the first year there is a progress conversation every 3 months. The student has to sign for the conclusions of this conversation. Each remaining year, except the last, the student is advised whether or not to continue using a MSRC form.
Source: www.knmg.nl, ‘Opleiding en registratie’ en dan ‘Opleiding’ en ‘Algemene CCMS besluiten’. Het besluit is Besluit CCMS No. 5- 1999, Algemene Eisen voor de Opleiding van Medisch Specialisten

4. How many hours of work per week are there?:

This depends on the specialization.
Family Practice, Nursing Home Medicine: 36 hours per week.
Medical Specialist: 46-48 hours per week.

5. What is the ratio between this country’s doctors and its population?:

Per 1000 inhabitants:
3.3 working doctors
0.5 working family practitioners
0.8 working specialists

6. Which languages are necessary for the medical residency?:

Dutch. You must pass a Dutch test that is given by the MSRC or a Committee of Experts. The test focuses on speech, writing, and listening. The candidate pays for the costs.

7. References:

Dutch Doctor’s Association: www.knmg.nl (->Opleiding & Registratie ->Opleiding)

Medical Specialists Registration Committee (MSRC): Marga van Wegen (tel. 030-2823232)

Allergology: www.artsennet.nl
Anesthesiology: www.anesthesiologie.nl
Cardiology: www.cardiologie.nl
Clinical Geriatrics: www.homestead.com/nvkg
Dermatology: www.nvdv.nl
Gastro-enterology: www.nvge.nl, www.mdl.nl
Internal Medicine: www.internisten.nl
Lung diseases and Tuberculosis: www.nvalt.nl
Neurology: www.neurologie.nl, www.nvknf.nl
Neurological Surgery: www.nvvn.org
Nuclear Medicine: www.nucleaire.nl
Medical Microbiology: www.nvmm.nl
Obstetrics and Gynecology: www.nvog.nl
Ophtalmology: www.oogheelkunde.org
Orthopaedic surgery: http://nov.orthoweb.org
Otolaryngology: www.kno.nl
Pathology: www.pathology.nl
Pediatrics: www.nvk.pedianet.nl
Plastic surgery: www.nvpc.nl
Psychiatry: www.nvvp.net
Radiology: www.radiologen.nl
Radiotherapy: www.nvro.nl
Reumatology: www.nvr.nl
Rehabilitation Medicine: www.revalidatiegeneeskunde.nl
Surgery General: www.heelkunde.nl
Thoracic Surgery: www.nvtnet.nl
Urology: www.nvu.nl

Source: http://www.euromort.rivm.nl/object_document/o494n909.html

Section B. Finance
1. A. Is there a tuition fee for the residency? If so, how much (in euro or usd)?:

Yes, you must register with the MSRC for € 265, payable to KNMG.

2. What is the annual salary (in euro or u.s.d)?:

Without completing any further education after medical school a “basisarts” earns: € 2400 - € 2750 gross per month for a 36 hour workweek.

Family practitioner resident: € 2225/month gross (36 hours).

Nursing Home resident: € 2200/month gross .

Medical Specialty resident: € 2750 (non-academic hospital) or € 2775 (academic hospital)

3. How expensive are the costs of living (average annual expenditure in euro or u.s.d)?:

This is difficult to estimate. As an indication: the minimum gross salary for a fulltime employee 23 of age or older is € 1265/month.

4. References:

www.knmg.nl “salaris agio” -> “juridisch voorbereid op de arbeidsmarkt”
www.knmg.nl “opleiding en registratie” -> “tarieven”
www.cao.pagina.nl

Section C. Application Procedure
1. Accreditation procedure:

In principle, an EU diploma is valid anywhere in the EU. The candidate resident (both EU and non-EU) must contact “Bureau Toelating van Buitenlandse Diplomahouders” (Bureau Admittance Foreign Diploma Holders, Ministry of Health). He/she must have a foreign doctor diploma, may not be involved in a criminal lawsuits, and have good comprehension of the Dutch language. After review, the bureau will issue a statement declaring the license valid in the Netherlands.

2. Other requirements:

The candidate resident must register with the MRSC (see question B.1).

Specialization is regulated by the professional societies. The Ministry of Health only decides on the number of available slots. To apply for one of these slots you have to do a job interview. So, you write a letter and attach your CV and send it in. On the basis of these applications, a selection of candidates is invited for a job-interview with the education committee of that specific specialization. Out of these job-interviews the candidates are awarded specialization places. Once awarded a place you are an “AIOS” (Doctor In Training as Specialist).

Basically, getting into specialization in the Netherlands works the same as getting a “real” job in any other field or trade. It is a combination of good study results, scientific research, working experience, your own character, networking, references and good luck.

3. Differences in application procedure depending on country of origin:

No

4. Ratio between applicants and physicians who finally obtain a residency position:

This depends on the specialty. For some specialties there are waiting lists, and to be able to be put on the list, one must be interviewed. Important is one’s experience in medicine, experience in the specialty, and scientific experience.

Capacity per Specialty

Anesthesiology 75
Cardiology 48
Cardiothoracic surgery 11
Dermatology 30
Gastro-enterology 27
Surgery (General) 83
Internal Medicine 123
Otolaryngology 31
Pediatrics 39
Clinical Genetics 12
Clinical Geriatrics 16
Lung Diseases 35
Medical Microbiology 13
Neurosurgery 5
Neurology 56
Nuclear Medicine 9
Ophthalmology 40
Orthopaedics 55
Pathology 23
Plastic surgery 12
Psychiatry 117
Radiology 65
Radiotherapy 15
Rheumatology 14
Rehabilitation Medicine 20
Urology 26
Obst. & Gynecology 40
Total: 392

Social Medicine

Company Doctors 93
Insurance Medicine 57
Community & Health 4
Sports Medicine 8
Total Social Medicine: 162

5. Does everyone who passes the medical license examinations gain a residency position in a hospital?:

There is no medical license exam. After validation of the diploma, he/she must follow the same procedure as Dutch students (interviews etc).

6. Specialties in which it is most difficult to obtain a position:

Gynecology, Pediatrics, Surgery, and Internal Medicine.

7. Is there a waiting list for medical graduates who want to begin a residency?:

Depending on the specialty there are waiting lists. See explanation above.

8. Countries, except this one, in which the medical residency title is recognized:

All countries of the EU

9. Requirements for international physicians to be able to work in this country after completing their specialization there:

The procedure is the same as for Dutch students. He/she must register with the specialty’s registration committee after completion of the specialty. Costs: € 590 (for 5 years).

For educating and registering specialist there are different organizations:
1) The College for Family Practitioners and Nursing Home Doctors (CHVG) and the Family Practitioners’ and Nursing Home Doctors’ Registration Committee (HVRC).
2) The Central College of Medical Specialties (CCMS) en the Medical Specialists Registration Committee (MSRC)
3) The College for Social Medicine (CSG) and the Social Medical Doctor’s Registration Committee (SGRC).

The KNMG takes care of their administration and helps them with their tasks.

By the BIG Law specialist are seen as medical specialists, family practitioners, nursing home doctors, doctors for the mentally handicapped, and social medicine doctors. After finishing one of the specialties, specialists are registered with one of the registries. Registration is necessary to enable the specialist to use his by law protected and accredited title. The registration is valid for 5 years.

10. References:

Drs. H. Gierveld, University of Groningen. Tel: 050-3633209

Section E. Other References
Other references:

Verwijspunt Buitenslands Gediplomeerden Volksgezondheid (Starting point for foreign doctors wanting to practice in the Netherlands (English site))
Postbus 16114
2500 BC Den Haag
tel: 070-3406200
fax:070-3405966
e-mail: info@verwijspunt.nl
website: www.verwijspunt.nl

Bureau Toelating Buitenlandse Diplomahouders (Accreditation of Foreign Degree)
Ministerie van Welzijn, Volksgezondheid en Sport
Postbus 20350
2500 EJ ’s-Gravenhage

Medisch Specialisten Registratie Commissie (MSRC) (Accreditation of Specialty)
Postbus 20053
3502 LB Utrecht

Starting point foreign doctors: www.verwijspunt.nl
Dutch Doctor’s Association: www.knmg.nl
Ministry of Health: www.minvws.nl
Ministry of Foreign Affairs: www.minbuz.nl

Section F. Participant's Information
Name:
Menno Smit
Country:
The Netherlands