I've been reading many of your posts and am hoping to find some information since my case is somewhat particular.
I am a physician from South America (Venezuela), who after tumbling around in the world, decided to settle down in Sweden (I have a Swedish wife).
I don't have a specialty yet but I do have a USA certification (passed the USMLE Steps I and II) and have an EU medical lisence (from Spain). My swedish is currently in level B1 and I expect to clear level C2 in four to five months at most.
My questions are:
1. Do I apply to Socialstyrelsen as a EU-physician or as a non-EU physician?
If I have to apply as a non-EU:
1. Will my EU lisence be taken into consideration or will I still need to pass the TULE and/or complete AT?
2. Does the fact that I have competed the USMLEs help me waive the need to pass the TULE if needed?
Thank you very much for your help.
Your situation is indeed peculiar, which made it even more interesting in finding the answers to!
First, lets make one thing clear; if possible, you want to apply as a EU-physician, thus not having do neither TULE nor AT (allmäntjänstgöring). This route will be a lot faster than that of the non-EU-physician, since the process is more standardised.
From what I understand from reading both the Swedish and English pages at Socialstyrelsen, you might be able to apply as a EU-physician. Here's why:
At the bottom half of the the Swedish page for Medical license for EU-physicians (link #1), there is a section named Om du är utbildad utanför EU och sedan fått ett erkännande i ett EU-land / If you're educated outside the EU and has then received a medical licence in a EU country. This section implies that you, with your non-EU medical education and licence to practice in Spain, may be able to apply though the EU route. There will be some additional documents that you will need do file, but otherwise it should be fine.
However, there is no info about this on the English page (link #2), which is why I am not able to, with 100% certainty, tell you that you are able to go the EU-physician route. Ask your wife to help you with translation of the Swedish page.
My recommendation is that you call Socialstyrelsen and ask the about what applies in your situation.
+46 (0)75 247 30 00 (link #3)
You can either ask for Information service or Authorisations Unit, the first can answer broadly about questions, and the second more specific questions. Please, do note the specific telephone hours. In order to shorten the waiting time (and thus phone bills), I recommend that you call as early as possible, i.e. the first minutes after they open.
Good luck, and please let us know what the tell you!
https://www.socialstyrelsen.se/ansokaom ... eiz/lakare
https://www.socialstyrelsen.se/applicat ... ofmedicine
https://www.socialstyrelsen.se/applicat ... utlicenses
Apparently I need to have at least 3 years of work experience in the EU country that provided the license (Spain) which unfortunately is not the case.
Do you know any instances where at least the TULE exam could be waived given that I had passed considerably more demanding tests such as the USMLE I and II? and also considering that I do have a EU license.
It feels that all of the hard work that I have done before does not count in Sweden because of some rigid classification of applicants. I have been set back considerably since graduating and I don't think that I can afford to wait even more time. Right now I am sitting on almost one year since I moved to Sweden and will have to wait at least 5 more months for SS to answer my application and then wait around 1 more year to get an AT spot which will last at least 18 months. This is a total of almost 4 years until I can start my residency and just for things that I had already cleared, it is so outrageously long that I feel desperate. And this is without taking into account the time it will take to register, study and write the TULE test.
I would like to know if there is someone who has been in a similar situation before and if Socialstyrelsen does consider this special situations and grant some exceptions.
Sorry for the rant, and thanks again for your help!
Unfortunately, I do not think it is possible to bypass the TULE exam.
Doing the AT internship, although it takes 18+ months, would however give you a solid introduction to the Swedish physician job routines which you would otherwise miss. The AT time is also an opportunity to get contacts and referrals for future ST applications. If you find some way to get on a fast track for a Swedish medical license, you would still have to spend time developing those skills and getting good referrals.
It is also possible that you may be able to get an AT position with much less delay than a full year, depending on how geographically flexible you and your wife can be.
How long would you have to work in Spain to reach the full 3 years?
Is your wife open to the idea of possibly living in Spain (or the USA) for a limited time?
(A word of advice - I would avoid using the abbreviation "SS" when communicating with Socialstyrelsen, even though it makes grammatical sense, since it was used by a rather infamous organisation in Germany about 75 years ago.)
In you're rather unique situation it seem that you've got three options, all mentioned by Nils in his post earlier.
1. Do TULE and then apply for AT.
As soon as you passed the TULE and the language proficiency test (C1-level), you can then start applying for AT, which, depending on geographic flexibility, will take roughly 6-24 months of working as "vikarierande underläkare / junior physician" before you can start the 18-21 month long AT. So we're looking at roughly 3±1 years, from when you pass TULE and the language proficiency test to Swedish medical license and possibility to start residency (ST).
2. Go to Spain and practice for a total of 3 years.
If I understand the phrasing on Socialstyrelsens webpage correctly, you only have to prove that you've been practicing for a total of three years. Thus, time you've already spent working in Spain counts! Once you've "served your time" and gotten a Swedish medical licence, you have the possibility to start ST in Sweden.
3. Go to the US and do residency.
The matching process, lengthy working hours and eventuell competitiveness aside, I am unsure if this route will allow you to, once you finished residency (3 years for internal medicine, longer for surgery), apply for a specialist licence in Sweden.
Does Nils or anyone else have knowledge that might help us confirm this?
Anyway, you will definitely be able to get a Swedish medical license, after 3 years in the states.
Let's be honest, non of these options are ideal and practically means you'll have to ""suck it up", regarding "lost" time. You'll have to weigh in where you and your spouse wants in terms of location, working hours, quality of life, opportunity to visit friends and family, and so on. So it is indeed a tough decision. What ever you choose, I hope your wife, family and friends will support you in your decision.
If you do decide to do TULE, here is a link to a bunch (40ish) of old exams, in order to give you a feel for the test.
http://cid-5a524940b7014adc.skydrive.li ... ule%201-39
Still, I *guess* that at the very least a completed residency in the USA would allow an applicant to bypass the AT and instead do a half-year probationary service. As to whether it would also be possible to get USA specialist qualifications recognised in Sweden, instead of having to redo a residency, it would probably be better to ask Socialstyrelsen than me about it.
I suppose that another, hypothetical, option would be to examine if any other EU/EEA country recognises USA specialist qualifications and then apply to Socialstyrelsen using that EU/EEA country's specialist certificate instead.
You can read more about it on Umeå University's webpage (in swedish):
It is different from the TULE test, for example:
1. It's computer based multiple choice questions (no writing down the answer)
2. It includes more subjects than TULE (pre clinical subjects are included now)
3. It is being taken only in Umeå university for now
4. It has 3 parts:
- Clinical and Preclinical knowledge
- Clinical Cases
- Scientific Article Reading and Comprehension
5. You need to pass the three parts in order to pass the tests
6. It will be taken 4 times a year (instead of 2 times like TULE)
It's a fairly new test. It has only been done 2 times as of now (oct 2016 and jan 2017). So there are not many test examples. A good swedish level is advised as the reading comprehension in this type of test is crucial.
here is socialtyrelsens webpage (they have updated it recently) in english:
https://legitimation.socialstyrelsen.se ... iency-test
a lot of changes compared to the Tule test