Ministerio de Sanidad: Recognition, Exams and Fees

• Recognition of the professional effects of non-EU specialist titles in the health sciences (Real Decreto 459/2010), for the specialties in annex I of Real Decreto 183/2008, such as anaesthesiology, cardiology, family and community medicine, internal medicine, obstetrics and gynaecology, paediatrics, psychiatry and radiology.
• Recognition of EU and EEA qualifications to practise a regulated health profession in Spain, under Directive 2005/36/EC and Real Decreto 581/2017.
• The annual selective tests for specialist training places for doctors, pharmacists, nurses and other graduates, run through the ministry's FSE portal.
• The ministry does not register practitioners. Registration to practise is with the provincial professional college.

• A Spanish degree, or a homologación or recognition of your foreign degree, of the type Spain requires for access to specialist training in your field (for example medicine, pharmacy or nursing).
• A specialist title obtained in a non-EU country through an official programme accredited by that country's ministry and leading to a qualifying title.
• For specialties harmonised at EU level, training of at least the minimum duration in annex III of Directive 2013/55/EU, done in the non-EU country. Training stays in Spain or elsewhere in Europe, university own titles, masters, fellowships and work experience do not count.
• Certificates of your programme from the competent ministry showing it was officially accredited, that the centre was accredited for teaching, the method of access, start and end dates, hours, rotations and their length, on-call duty and a record of procedures with your level of participation.
• A certificate that you are not barred from practice by a court ruling or final administrative sanction. If you live in Spain, the provincial college can issue it.
• Spanish language competence if you are a national of a country where Spanish is not official, unless your degree is from Spain or a Spanish-speaking country.
• All foreign documents legalised by apostille or the diplomatic route, with sworn translations into Spanish.
• No refusal of the same title under Real Decreto 459/2010 in the previous two years.

Check your route with the route finder

1. 1

   1. Homologate your basic degree

   The ministry will only consider your specialist title once your basic degree has been homologated or recognised by the Ministry of Science, Innovation and Universities. Start that procedure first, since it has its own documents, fee and time limits.
2. 2

   2. Check the EU minimum training period

   For harmonised specialties, compare your residency with the minimum years in annex III of Directive 2013/55/EU; the ministry publishes the list of harmonised specialties with their minimum durations. If your official programme is shorter, the prior check will be negative and the file cannot go further. Non-harmonised specialties go straight to the committee.
3. 3

   3. Gather detailed training certificates

   Ask the competent ministry and your training hospital for certificates covering accreditation, dates, hours, rotations, on-call duty and procedure logs. Weak or general letters of completion are a common reason for requests for more documents. Legalise and translate every document.
4. 4

   4. Apply through RETUEX or a registry office

   Since 4 November 2025 new applications can be made online through the ministry's RETUEX application with a digital certificate, DNIe, Cl@ve or eIDAS, which also shows the status of your file. You can still submit on paper at the Ministry of Health registry in Madrid, other public registry offices or a Spanish consulate abroad. Do not open a second application in RETUEX if you already have one.
5. 5

   5. Prior check (informe de comprobación previa)

   The ministry checks the formal requirements and, for harmonised specialties, whether your training meets the EU minimum. A positive report sends the file to the evaluation committee for your specialty.
6. 6

   6. Evaluation committee proposal

   The committee compares your training with the current Spanish programme and issues one of four proposals: negative; conditional on an assessed period of supervised practice; conditional on an assessed period of complementary training; or conditional on passing a theory and practice test followed by an assessed period of practice. The ministry may ask for more documents at this stage.
7. 7

   7. Sit the theory and practice test if required

   The test is called each year by a resolution published in the BOE; the 2026 call was a resolution of 3 February 2026, published on 16 February, covering 15 medical specialties. You must confirm that you will attend at least one week beforehand. The test is held at the ministry in Madrid.
8. 8

   8. Complete the supervised practice or training

   Periods of practice or complementary training take place in the autonomous communities and are assessed by a supervisor the region appoints. The committee validates the supervisor's assessment and issues a final verification report.
9. 9

   9. Receive the decision and register

   The ministry resolves the application. With a positive decision you register with the provincial college and can practise the specialty. A refusal can be appealed, and you cannot reapply for the same title for at least two years.

• Theory and practice test: part one

  In the 2026 format, a 90-minute multiple-choice paper of 70 questions plus 5 reserve questions, each with four options. A correct answer scores 1 point and a wrong answer loses 0.25. You need at least 40 out of 70 to pass, and only those who pass are marked on part two.

• Theory and practice test: part two

  Taken straight after part one: 1 hour 15 minutes to answer three written clinical cases in your specialty, each with at least three open questions and marked out of 10. You need at least 15 out of 30, and a case left blank or scored zero means you are not marked. The whole test lasts 2 hours 45 minutes.

• No set syllabus

  The ministry says there is no specific syllabus. Questions are based on the competences of the current Spanish training programme for the specialty, published by the National Council of Specialties, and the ministry publishes past papers and answer keys on its website.

• Assessed supervised practice or complementary training

  Not an exam but an evaluation: you work or train in the specialty under a supervisor in an autonomous community, who assesses your clinical and communication skills. The committee then validates the result.

• Selective test for specialist training (MIR and others)

  The alternative route for doctors without a recognisable specialist title. The ministry convenes it annually on its FSE portal, and the conditions for non-EU applicants are set in each year's call, so read the current call before you plan.

• The ministry tests Spanish, not English.
• Real Decreto 459/2010 asks nationals of countries where Spanish is not official to prove sufficient Spanish, with its annex listing DELE and Official School of Languages certificates, and exempts applicants whose degree came from a Spanish university or a Spanish-speaking country.
• The ministry's current page on Spanish language competence lists C1: DELE C1 or higher from the Instituto Cervantes, an Official School of Languages certificate at C1 or higher, a SICELE certificate of equivalent level, or SIELE at C1 equivalence in each of its four tests.
• Because the law and the current page differ, check the level the ministry asks for in your procedure before you book a test. The practice periods and the written clinical cases are in Spanish.

Estimate your total cost

• Decision: Real Decreto 459/2010 sets six months from registration of the application, but the time for supervised practice, complementary training and the theory and practice test does not count, so real timelines are much longer.
• Test: called once a year by a BOE resolution; in 2026 the call was published on 16 February and final answer keys on 19 October 2026.
• Confirming attendance: at least one week before the test date.
• If no decision is notified within the legal time limit, the application can be treated as refused for the purpose of appeal.
• Reapplying after a refusal: not for at least two years.
• The ministry does not publish average processing times, and it offers no in-person appointments; contact is by email or RETUEX.