Doctors: Specialty training in Switzerland and how to apply for it

Swiss Medical Specialty Training System: How to Apply and Life as a Doctor in Switzerland.

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 about what it’s like, I break it down for you here:

 

Swiss Medical System & Training pathway: Cross-recognition in the UK

After medical school, graduates can apply 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 the training is cross-recognized between UK and Switzerland, (you can check with the individual Royal Colleges in the UK if you want to be 100% certain it also applies to your specialty) and after attaining Facharzt in Switzerland one would be elgible for CCT in the UK and could theoretically then work directly as a consultant:

If your chosen specialty is a surgical or medical one, it is often desireable to have a year’s experience in General Surgery or General Medicine respectively, before applying to the specialty of choice. This is particularly true for competitive and specific specialties. For instance if you aspire to become an ENT / Plastic/ or Neuro surgeon, your training pathway may look so:

Medical School -> Assistenzarzt in General Surgery (1 year) -> Assistenzarzt in ENT / Plastics / Neurosurgery (5 years) -> Facharzt in ENT / Plastics / Neurosurgery

It’s of course possible to skip the year of general surgery and go straight into your surgical specialty. Vis-a-vis skip general medicine and go straight into medical specialty. But for competitive specialties this is difficult and rare, and you’ll have to impress the Chief doctor with your CV.

However:

Most medical graduates straight out of medical school in europe DO NOT have any publications. By this I include even international poster presentations and small abstract publications. So coming from the UK, where most medical students already have a handful of publications/posters/etc by the time they graduate – it looks pretty impressive in comparison.

Duration of Specialty Training in Swizterland:

Specialty training lasts between 5-6 years for a single specialisation, of which 2 years have to be spent a category A hospital:

Hospitals are categorised into A, B, or C depending on size/caseload and academia. You can do most or all of your training at a single large teaching hospital (category A), but the maximum time that can be spent at a category B and C hospitals is 3 and 1 years respectively. This is to ensure that all trainees spend at least a portion of their training in a large teaching hospital as well as a smaller hospital. You can find a list of which hospital is which category in the SIWF-register I link to below. It also has information on how each department within a hospital is categorised.

Having said this, Switzerland is so small that you will have at least one category A, B, and C hospital within 30 min of each other, so you can very easily and realistically NEVER MOVE HOUSE THROUGHOUT YOUR ENTIRE TRAINING even if you switch hospitals. I think that’s a pretty big deal that needs to be emphasised.

Flexibility of Speciality Training in Switzerland:

Dual-Specialisation

In Swizterland it’s not uncommon to be dual-qualified in two related specialities and receive two “Facharzt” or specialist titles.  Usually the duration for dual-specialisation is full training time + 3 years. For instance if one does 5 years of internal medicine and qualifies as Facharzt in Internal Medicine, a further title of Facharzt in Gastroenterology can be obtained by only 3 more years in Gastroenterology specialty training.

For certain specialties with more niche-procedures, the list of surgical competencies can be difficult to complete (most commonly due to rarity), sometimes requiring prolongation of training time until you complete all the required competencies. I’ve heard that for very very rare procedures that you have to complete in Neurosurgery some surgeons wait a few years (at smaller hospitals) for them to come around.

Time-Flexibility

Training can be interrupted and resumed at any point, unlike in the UK. If you start at a hospital and don’t like the town or the hospital after a few months – you can quit, and there’s nothing wrong with that. (But it’s advised to apply for another position first if you don’t want a break in between, obviously.)

If you want a sabbatical or even just a few months of unpaid leave, this is certainly possible too, you just need to ask your own department chief for their approval. For instance a colleague in my ENT department now is taking 4 months unpaid leave in the summer for a very long honeymoon. Chief said okay no probs.

The reason this is possible is because in Swizterland training doesn’t happen in fixed year blocks. The year doesn’t start and end at the same time for all trainees in the country like in the UK. You can start and stop anytime anywhere, and all the time worked just accumulates in your own personal portfolio (which is free by the way) until you’ve done the required time and competencies.

You have complete control over your own training in Swizterland, Austria, and Germany. This is in my opinion the most attractive feature of specialty training in German-speaking Europe. Nobody asks questions about taking up to 6 months off between posts – that’s considered a perfectly reasonable break time. Interruption in training of more than 6 months you’d probably need to explain in interview, but that’s about it.

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” straight out of foundation training in the UK. You’ll have likely done enough of other specialties in your F1 and F2 rotations, and certainly after core training to satisfy departmental Chiefs that you have enough general experience.

Once you’ve entered the system here it’s advisable to complete all of your specialty training in Europe (non-UK) as the pathways within non-UK Europe are similar and largely interchangeable.

UPDATE: I’ve received a lot of emails and questions regarding entering into Swiss specialty training straight out of medical school like Swiss graduates. Just to clarify, this is not possible if you’re a UK medical school graduate: FY1 is considered an extension of the UK medical school system as it’s a form of internship, equivalent to internships incorporated into medical school in Switzerland and other countries. You must complete FY1 to be at an equivalent standing to Swiss medical school graduates. Without FY1 you’re not eligible for full registration with the GMC or MEBEKO, or any other european regulator.

Entry at SpR / registrar levels:

The FMH 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.

How each specialty is credited is different, but likely involves matching the competencies you’ve completed in the UK to the competencies required for completeion of specialty training in Switzerland and then taking the equivalent time and competencies off what is remaining.

Medical Hierarchy and Equivalent nomenclature:

Assistenzarzt/in = aka. Resident, a doctor in Training for specialty
Facharzt = Specialist
Oberarzt = Consultant like in the UK
Chefarzt = Departmental Chief doctor. He or she is 100% in charge of everything in the department. They do the hiring and firing, they set the policies, etc. Their word is final in everything.

Working as a doctor in Switzerland: The every day life of an Assistenzarzt

Hours worked per week in Switzerland can be roughly the same as in the UK, and similarly will vary by specialty and hospital. The website SIWF-Register surveys all the trainees in each hospital annually and produces excellent charts rating each Hospital department on various criteria ranging from learning experience and research opportunities to hospital Culture. It’s an excellent tool to help decide which hospitals to apply to.

Salary:

There is slight variation between individual Hospitals and different parts of the country, but each hospital has fixed salary bands for all doctors of the same level, and these are often published on their website.

Example monthly salary of doctor in 1st year of specialty training:

Basic Salary                      CHF 6,981.00
Per sat/sun on-call           CHF 47.501
Per Nightshift (midweek)  CHF 47.50
Total                                   CHF 7,076.10

According to the swiss medical regulator, the average salary of trainees (across all years of training) is CHF 8.416 per month, or CHF 100,000 annually. Towards the end of your specialty training you can expect to earn approx. CHF 10,000 per month.

On-calls and overtime are paid separately on top, and each hospital will have a different policy on how overtime is compensated. Apparently there can be quite a variation:

Some pay all overtime fairly as recorded and some don’t pay but give time in lieu. There are stories of some departments erasing overtime records to avoid giving extra payments. Presumably, however, these hospitals will be rated poorly in their SIWF surveys. At my current hospital we are given a chart every month with our scheduled working hours where we can indicate day by day any extra hours we worked or lunch breaks we missed. These are then compensated.

 

Application Process

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 as a one-page formal letter 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 Swiss Medical Register, known as “Nostrifikation”:

The swiss medical regulator is known as the MEBEKO, and is where you apply to enter the register. The swiss medical association is called the FMH.

UPDATE: Since 01.01.2018 it’s compulsory for all doctors working in Switzerland to have full MEBEKO registration. Previously there may have been some flexibility for EU-trained doctors with equivalent registrations, but no longer.

General Requirements for medical registration:

  • Medical Diploma attained within the EU/ECC
  • Citizenship of an EU/ECC nation
  • Proof of German ability to B2 level through either Matura (high shool diploma) from a german-speaking institution or work-experience in a german-speaking country. Those who attained their Medical Diploma in a Germany, Austria, France, Belgium, or Italy are exempt.

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.

Processed with VSCO with q10 preset
Basel, Switzerland

 

104 thoughts on “Doctors: Specialty training in Switzerland and how to apply for it

  1. Hi Anjani !
    Thanks for your blog ,it is very informative .I am an EU doctor as well as an EU citizen and at the moment I am studying the german langauge .I would like to pursue ENT surgical training in the german-speaking Europe.I would like to ask if you could help me with any kind of advice or tips about getting an ENT job in Switzerland .And last I would like to know if there is any pecuilarities in career progress or practicing in the ENT field in each of this countries Germany ,Austria and Switzerland.
    Thank you

    Like

  2. Hello Anjani,

    I would like to ask how do you apply for jobs as a doctor? You mentioned to apply straight to the department lead. How does this work? Is there a website you can apply through?

    Thank you.

    Like

  3. Hi ,
    I actually wanted to know if it’s possible for a indian medical graduate to do her specialization in switzerland ?
    And if so, what is the procedure for applying in switzerland?
    And what are the exams to be given ?

    Like

  4. Thank you for the article! I appreciate the help. I would like to do my speciality in Switzerland, but the process is still a little confusing to me—I have heard that you needs to apply two years in advance to secure a residency at a hosptial—is that true? Also, would it be possible to transfer from Austria or Germany to Switzerland during your residency?

    Thank you again!

    Like

  5. Thanks for the amazing post Dr. Anjani,

    I’m 4th year Medical student in Italy, and i was wondering if they care about my grades in Uni for choosing a specialty in Switzerland.

    because here in Italy, your university grades has a big influence in landing a seat in top competitive specialties like ( Cardiology and dermatology) does that goes the same with Switzerland ?

    Thank You again!

    Like

  6. Hi this is a very informative artical
    Currently im doing my masters in Anesthesia from pakistan . Im third year resident right now
    I want to get job or training in anesthesia at switzerland

    Which exam i should pass for it

    Like

  7. Thanks for such a useful and informative blog!! I was wondering if there are any training opportunities in Italian speaking Switzerland or whether the majority of posts are in German and French speaking parts of the country.

    Like

  8. If I get speciality training in the UK then become a registered specialist is it possible to apply for a facharzt job in Swiss plz? And what are the requirements? Thank you Dr

    Like

  9. Hi,
    Thanks for the information!! I have a question regarding becoming a specialist in Switzerland. I have read that you have to do a specialist exam at the end of the residency programme. Is this correct ? Is this exam very difficult to pass ?
    Thank you

    Like

  10. Hello ,
    I am from India
    Completed my MBBS here
    Can i get into PG in medical or surgical field if i get b2 german language ?
    What are other requirements
    Please if you can throw some light it will be very helpful

    Like

  11. Hi
    thanks for your useful info you provide.
    i am an Afghan Doctor now i have been living in France as asylum seeker, i intend to work and pursue further my career in german-speaking europe( especially in Swiss) if possible, but i need assistance about the procedure, if you can please help me in this regard.
    thanks
    mshirzad7@gmail.com
    0093797417482, 0033753386529
    whatsapp

    Like

  12. Thanks for the enlightenment.
    However, my concerns are that- IF a non EU doctor like me, from India, wants to work and practice in Swiss Cantons, is it possible at all??
    Please guide me the way.

    Like

  13. Hello
    I have passed my medical degree from Ukraine and have GMC regisgtration number. I have been working in UK for 7 years.
    I am British citizen. Can i work in Switzerland.

    Thanks

    Like

  14. Dear Anjani

    Thank you so much for the detailed information. I happened to read through and its as detailed as one could mention.

    I am currently working in Austria in General Medicine after completing the nostrification process as I havent studied here. I was trying to check if this nostrification certificate is valid in Switzerland as well, as the working language is german. I could not find this information anywhere. Could you kindly let me know if you have any insight on this.

    Thanks so much again for the detailed blog.

    Best Regards,
    Dr. Srilakshmi.

    Like

  15. Thank you so much for your post Anjani! it is incredibly helpful! I’m graduate from the UK looking to train in Psych in Switzerland. I’m finishing my F1 now and I speak French so I’m basically looking at the French side. I was wondering could you let us know more about your day work? how busy your schedule is? how many night shifts do you do? especially compared to the UK. I assume ENT rota is probably quite different to Psych but at least it can give me an idea. I know the Swiss are generally good at work-life balance so would be nice to get your views on that. Btw, do you have any idea how difficult is to get a post in Psych training? Thank you! 🙂

    Like

  16. Hi, thank you for the wonderful article.
    I have just finished my three year residency in Surgery in india.
    If I were to apply for further specialisation/to work as a Surgeon in Switzerland, would it be possible? How might I go about it?

    Like

  17. Hi Anjani,
    Your article was very helpful. I have few doubts. I am an ST7 trainee in UK. My final year of rotation in Obstetrics and Gynaecology and I will be done with my CCT. However due to my husband’s job I want to move to Swiss after my CCT.
    How do you think should I go about it.

    Thank you for your help
    Regards
    Pragati

    Like

  18. Hi Anjani

    I’m a medical student in the UK who would like to work in Switzerland. I have a few questions:

    Is it better to complete F2 in addition to F1 before working in Switzerland?
    How far in advance should you start applying for B or C hospitals? A year?
    How long does it take to gain MEBEKO registration?
    Can you recommend any resources to learn medical German (I’m a native German speaker)?

    Thanks

    Like

  19. Hello! Thanks for your post! Is ir hard to get a sport? Do hospitais offer a spot for all the training? Is it hard to compete the required Numbers of procedures for residency exam in the time Set for each residency? Do doctors motivate you to do surgeries or are they not open to teach? Thank you! All the best for you!

    Like

  20. Hi there,
    Thanks so much for your post, it’s extremely helpful! I was wondering if you by any chance know how difficult it would be to apply for recognition of a UK medical degree with Brexit? Also, does choosing your specialty in Switzerland require sitting an end-of-med school exam like other EU countries?
    vielen Dank!

    Like

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