Diploma and specialist title: how recognition works in Switzerland

Anyone hoping to start work in a Swiss hospital with a German or Austrian medical degree has three things to settle before the first day, and they are regularly mistaken for one another: recognition of the degree and the specialist title, the licence to practise, and entry in the register of medical professions. They sit with different authorities, they partly depend on one another, and confusing them means waiting for an answer that the office you asked was never going to give.

Who decides

Recognition is decided by MEBEKO, the medical professions commission at the Federal Office of Public Health. It examines whether a foreign medical degree and a foreign specialist title can be treated as equivalent to the Swiss ones. Its decision is a federal one and therefore holds good throughout the country.

Permission to actually treat patients lies elsewhere. The licence to practise, the Berufsausübungsbewilligung, is issued by the canton your workplace lies in, usually through the health directorate or the cantonal medical officer. This split is the most common source of confusion. A recognised title on its own does not entitle you to practise, and a cantonal licence is no substitute for recognition.

What applies to EU and EFTA qualifications

Degrees and titles from EU and EFTA states fall under the agreement on the free movement of persons. Anyone trained in Germany or Austria is therefore on a well-worn path: those qualifications can as a rule be recognised, and MEBEKO sees them routinely.

How long the procedure runs depends above all on whether the papers are complete. What is usually asked for is the medical degree, the specialist title, proof of identity and evidence of the training route, with translations and certified copies depending on the case. If a document is missing the application simply waits until it arrives, and that waiting time accrues at your end rather than at the authority's. Which version of a certificate will do, and what the fees are, MEBEKO publishes itself.

When the specialty is drawn differently

The degree is normally the straightforward part. The specialist title can take more work, because some specialties are drawn differently in Switzerland than in Germany or Austria. A title that names a field of its own at home may be a subspecialty within a larger field here, and it also happens the other way round.

In those cases MEBEKO decides in the individual case whether, and as what, a title is recognised; it may also require further training time or evidence of particular content. There is no general rule to quote: what applies depends on the field, on the training route and on the year of qualification. If you work in one of those fields, it is worth settling the question early, while your start date is still open.

The order of things

The usual sequence has three stations:

1. Recognition by MEBEKO. It does not depend on a particular post, so it can be started first.
2. The cantonal licence to practise. It is valid in that canton alone. The requirements differ from canton to canton and according to whether you work under professional supervision or on your own professional responsibility. Proof of language belongs to the file, usually level B2 in the official language of the workplace.
3. Entry in the register of medical professions (MedReg). This public federal register brings degrees, postgraduate titles and licences together, and an employer can look you up in it.

Alongside all of that, and quite separately, runs immigration law. If you move to Switzerland, you register at your new municipality after the move, and it forwards the application for a residence permit B to the cantonal migration office. If you keep your home just across the border and travel in for your shifts, you need a cross-border commuter permit G, which the employer normally applies for at the migration office, with the State Secretariat for Migration behind it. Both routes require a signed employment contract.

What an employer wants to see

Whoever is filling the post wants to know two things: whether you fit the job, and whether you can start on the date agreed. The second is settled by the procedures. So a dossier should say where you stand: whether the application to MEBEKO has been filed, whether the decision has come back, what language level has been proven, and which canton will be responsible for the licence.

A start date that allows for the procedures still running is worth more than an earlier one that will not hold. Hospitals that have recruited from abroad before expect these timescales anyway; what they take badly is a date that slips shortly before the day itself.

When to begin

As early as you can, and in any case before you commit to a start date. Recognition is the only one of the three steps you can set in motion without a contract; the cantonal licence and the immigration permit both need one. Bringing recognition forward shortens the end of the chain.

If you are not sure which step comes first in your case, we look through your papers at the outset and tell you what to expect. Binding information about your own procedure, though, comes only from the authorities responsible for it.