Doctors: How to apply for specialty training in Austria
How to apply for a medical or surgical specialty training post in Austria with a UK/Foreign medical degree:
It’s no secret that the UK no longer has the greenest pastures for doctors or those considering a career in medicine. Applications to UK medical schools keep falling year on year and more doctors drop out of medicine entirely or leave the UK during or after foundation training.
If you’re one such dispairing junior doctor then you’re not alone:
During my F2 (PGY2) year I decided to quit and apply to continue my training in German-speaking Europe. A couple of months (and a few much needed holidays) later I got a great training job in a Swiss university teaching hospital. Since then I’ve received endless questions from friends and colleages on how to do the same. Whether you’ve made a decision to go abroad or are just curious, I break it down for you here:
Austrian Medical System & Training pathway:
After medical school, newly graduated doctors undergo 9 months of “Basisausbildung”, roughly equivalent to UK’s F1 year. Thereafter one applies directly to the specialty of choice for training, which lasts on average 6 years, after which one becomes “Facharzt” or a Specialist. For most specialties these are cross-recognized between UK and Austria, and after attaining Facharzt in Austria one would be elgible for CCT in the UK.
Medical School: 6 years
Basisausbildung: 9 months
Specialty Training: 5-6 years
Unlike in the UK, doctors are not forced to rotate periodically at fixed intervals throughout their training. You can stay in one Hospital/city/town for your entire specialty training should you choose to. Where you work for how long is entirely up to you. Don’t like your current department/hospital/city? Just apply elsewhere and continue. Love it and ready to settle down in one place, buy a house/get a dog/keep your friends? Stay.
Hierarchy and Equivalent nomenclature:
Assistenzarzt/in = Resident, doctor in Training for specialty
Facharzt = Specialist
Oberarzt = Consultant
Chefarzt = Departmental Lead doctor
Entry after Foundation training (F1 & F2) or Core Training in the UK:
You can likely enter straight into the specialty of your choice as Assistenzarzt year 1. You’ll have likely done enough of other specialties in your F2 rotation, and certainly after core training to satisfy departmental Chiefs that you have some general experience. It’s then advisable to complete all of your specialty training in Europe (non-UK) as the pathways are similar and largely interchangeable.
Entry at SpR/registrar levels:
The Österreichische Akademie der Ärzte publishes details on each specialty and on how to get training from abroad recognized. You’ll be credited to your level and complete specialty training in the appropriately reduced time.
Life as a doctor in Austria
As anywhere, hours worked vary greatly by specialty, but overall hours worked are significantly less than in the UK. Quality of life is exceedingly important to austrians, and austrian doctors are no exception. It’s not uncommon to finish work by 3:30pm in some specialties, with the rest of the day free to cultivate a life outside of medicine and work.
Most clinic days finish by about 3:30pm. Resident on-call days are much fewer and far between compared to the UK. Like other European countries, Austria frequently trains highly specialised nurses who cover night on-calls and out of hours instead of doctors. Doctors are usually on non-resident on-calls instead, and only come in when necessary.
White Coats and Uniforms:
Since 2007, doctors in the UK no longer wear white coats. This was because the NHS identified dirty coat cuffs as a major risk to the spread of infection in hospitals. Since then, NHS doctors have had to adhere to a strict “bare below the elbow” policy, which allows all doctors to wash their hands and forearms between each patient encounter.
Unlike in the UK, doctors in most of continental Europe still wear white coats. In Austria doctors are given a scrub-like uniform (but with more and better pockets) and white coats, which must be worn at work.
It seems strange that this topic even deserves addressing. But the sad reality is that the culture of free healthcare in the UK has created a sense that high-quality healthcare is a right, not priviledge.
Increasingly, the relationship between a doctor and a patient in the NHS resembles more that of a client and service provider. Pressures on the NHS mean that patients are often already unhappy before their encounter with you: they’ve waited months for a specialist referral, or they’ve been sitting in A&E for 4hrs, or a busy triage nurse did not seem to be listening to them.
In Austria, doctors are still treated as highly respected professionals. Being spoken to curteously by staff and patients at all times came as a shock to me, but is the expected norm.
There is slight variation between individual Hospitals and different parts of the country, but as a general ball-park figure expect between €5000-€7000 monthly for a junior doctor in the first 1-3 years of training. Salaries are paid out 14 times a year.
Yes, you read that right. Twice a year, in December (Chrismas bonus) and June (Summer holiday bonus), you receive double pay. These exta payments are also nearly tax-free. To work out the Annual salary, multiply your expected monthly by 14.
Example Monthly Salary at a university hospital in Vienna (Years 1-3 of specialist training):
On-calls and overtime are paid separately on top of your base salary, so will vary from month to month depending on how many you work. Generally you are paid for all hours worked, as overtime is recorded.
Unlike in the UK where all applications are standardised and condensed into a single number by which you are ranked against your peers nationally, in the rest of Europe applications are much more old-fashioned:
Each doctor is responsible for their own application “portfolio” entirely and makes direct applications to heads of departments in their target specialty and hospital.
Your application should include:
Cover/Motivation letter – this is the most important part of your application. Ideally written in formal letter format and one page long explaining your motivations to work at that hospital/in that specialty and why they should hire you.
CV/Resume (more on Medical CVs for Europe here)
Copy of your medical degree/other degrees (English original is fine)
Send that to the “Chefarzt” or departmental lead of your desired workplace, and with any luck that will land you an interview.
My interview was short and conversational:
They know your background and academic achievements from your application. The interview will largely be to gague you as a person, and whether they want you on the team. Remember, in Europe doctors can stay at one hospital/team for several years.
Once you’ve secured a job, or simultaneously as you apply, you’ll want to get on the Austrian Medical Register, known as “Nostrifikation”:
Languages: German and English ability to B2 level. Austria administers it’s own german test for doctors, it can be booked here. You’re exempt from the test if you completed Matura (high school) or a university-level degree at a german-speaking institution, worked for 3 years in a german-speaking country, or completed a medical exit exam in a german-speaking country.
Right to work in Austria
That’s it! Good luck!
Feel free to post questions below for anything I haven’t covered and I’ll do my best to answer them.
Coming back to the UK after specialty Training in Austria / Germany / Switzerland
Whether each “Facharzt” qualification is recognized in the UK as completion of specialty training depends on each speciality’s own Royal College. Every specialty I’ve so far inquired about is mutually recognized across the UK and Austria/Switzerland/Germany (and I wager nearly all are), which means after completing specialty training in the above countries you are eligible to enter the GMC specialist register in the UK.
In theory this means you can apply for consultant postions in the UK, but in reality you’ll likely want to do a senior fellowship before you take on a consultant post.