4 de February, 2019
Today I’m going to talk about what it’s like to be a doctor in Portugal. I still remember, in mid-2011, the day I said, “Mom, I don’t want to live in Brazil anymore. It was a panacea, a collective discomfort in family and friends! Yes, at the time Portugal was in crisis and Brazil seemed to prosper. I, a young doctor, supposedly with a promising future ahead of me in Brazil.
But my desire to live the new, in a fairer, safer place where my work was valued not only for its monetary value, but also for the dignity of the workplace and patient care was such that I set up my strategy.
It was a long process of planning and research to be able to practice medicine on this side of the Atlantic (I started in 2011 but only came to Portugal in 2013!). There wasn’t so much information available and in fact I only met one person who had done the process before me and who, ironically of fate, I met through a Portuguese friend who lived in Brazil at the time.
I called almost all the colleges in Portugal, sent several e-mails and the answers were coming and I structured the best plan at that time. There was no support as there is today, either via social networks or through companies that dealt with the subject with such efficiency and seriousness. Yeah, that would have made my way a lot easier. There would have been a lot more objectivity, less time would have been lost and less stress would have been worth every penny invested!
Check in this article some fundamental information for those who also want to follow this path, as well as the main challenges we need to overcome in order to become a doctor in Portugal and conquer our “place in the sun” on this side of the Atlantic.
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The course of medicine in Portugal has the same duration, 6 years, and curriculum structure similar to those of the current bachelors in medicine in Brazil. But, unlike our case in Brazil, students in Portugal already finish with a master’s degree in medicine.
The integration of the Degree with the Master’s Degree in Portugal is a reflection of the “Bologna Treaty”, whose aim was to create university courses with similar curricular structures throughout the European Union, not only to be equated between the various Member States, but also to become internationally competitive.
See how to get a student visa for Portugal here.
If you have not studied medicine in Portugal, you will have to go through the equivalence process of your Degree/Graduation in order to have your title recognized in the country. In fact, at the end of the process, your foreign title will be recognized as equivalent to the degree of master in medicine in Portugal (even if you do not have the title of master in the country of your training).
Since 2018, the Portuguese Medical Schools have created a commission and a single regulation that standardizes and governs the new process of equivalence to the degree of master in medicine at national level. Previously, equivalence was the responsibility of each Medical School, with individual rules and criteria.
In short, the process is currently carried out in 4 steps:
1. documentary stage, with the submission of the necessary documents in the application;
2. Theoretical Test, which became unique and held on the same date in all Portuguese Medical Schools members of the committee;
3. Practical Test, to be held if the candidate has passed the previous stage;
4. Public Test, which is characterized by the presentation of a scientific paper before a jury of teachers (for those who have a master’s degree, is the defense of their respective dissertation).
For more details about this process, check out our full article on medical degree equivalence in Portugal.
After completing the process of equivalence of a medical degree in Portugal, the colleague is able to register with the Portuguese Medical Association and practice medicine in the country. It is a documental process and it can be a little time-consuming given the need to evaluate the documentation submitted by a commission of the Order of Doctors, since there are often requests for autonomy in the exercise of our profession.
The newly qualified doctor always has the great initial challenge of not being able to work even if he obtains the equivalence in Portugal. Unlike what happens in Brazil, in Portugal recent graduates do not have the autonomy to practice medicine and need at least one year of compulsory supervised medical practice (the year of general training) in order to be able to work independently in emergencies, for example, as we often do in Brazil.
Therefore, students who finish the school year between June and September can only begin the practice of medicine in January of the following year after the medical specialty access exam (equivalent to our medical residency exams in Brazil), which, as a rule, takes place in mid-November of the year of completion of the course.
Therefore, if you intend to come to Portugal, know that if you have less than 3 years of medical practice in Brazil you will be obliged to pass the same process as the Portuguese recent graduates and take the exam for access to the specialty and start working as an intern (resident) of the year of General Training, so that at the end of this year, having been approved in all internships, you can request autonomy from the Portuguese Medical Association.
However, if you have been practicing medicine in Brazil for more than 3 years, you may request recognition of your autonomy from the Order of Physicians even if you have not completed any medical specialty.
For fellow experts, if they want to practice their medical specialty, they should know that the process is bureaucratic and can take years, or even that there is no recognition of the specialty. Unfortunately, the argument is often based on curricular structure and time of training, which in most of the specialties is superior here, but each case should be evaluated individually by the Colleges of Medical Specialties – Order of Doctors.
Each specialty has its specific criteria, many of them have structured programs with a minimum number of procedures to be fulfilled for the completion of the specialty and require a final examination of completion that is often also required from colleagues who request equivalence of the specialty (similar to an exam for a Specialist Title in Brazil, type TEG or TEP).
But don’t despair! There are also many successful cases in the process of recognition of different specialties of Brazilian colleagues. However, as said before, this will depend very much on the evaluation of each College of Specialty, its rules and the adaptation of the curriculum to the criteria requested. You have to persevere to become a doctor in Portugal!
See also how the D7 visa works to live on retirement or income in Portugal.
Very interesting fact are the constant interventions for the reduction of prescription fraud with the implementation of increasingly modern models. Today there are basically 2 methods of prescribing drugs, at least in the SNS (National Health System):
Remembering that so far we are only talking about NHS!
For more details, see the article we wrote about the National Health System in Portugal.
Infarmed (Autoridade Nacional do Medicamento e Produtos de Saúde, I.P.) is the regulatory body for medicines, medical devices and health products in Portugal, similar in mission to the Brazilian National Health Surveillance Agency.
Infarmed’s website contains a set of important information for doctors who arrive in the country and seek to better understand the rules of prescription of medicines and the availability of certain drugs in the Portuguese market. It is possible to search for medicines, as well as get an idea of the maximum price that will be charged for the medicine, its presentation and the package leaflet of medicines.
This is a question that can vary greatly from one’s personal experience, place of work (countryside or large city? Central Hospital, District Hospital or Health Unit – Model A, B or C?). I could list a number of them, but some of them were remarkable in my personal experience:
It may sound crazy, but, yes, that barrier exists at first. It is not exactly the language but the technical terms of the profession, ways of writing the medical history and communicating with colleagues, and key terms in communication that we often learn over time.
The elderly and children demand a greater degree of commitment for communication to be effective, but nothing absurd. The secret is: if you don’t know how to explain “Portuguese”, you just have to speak more slowly to understand everything.
When the barrier is overcome, we usually get a lot of praise for our sympathy and attention to patients. Especially when it comes to listening.
Of course, this linguistic issue can vary a lot from the environment in which we are inserted, since Brazilian culture is extremely popular in Portugal. Most of them have read a book by Jorge Amado or have surely seen Brazilian novels and always refer to the theme.
Understanding the functioning of the health system where we are inserted is fundamental for a good provision of care to the patient.
Therefore, before going headlong on this journey, it is always important to read and integrate how the rules work, understand in which part of the care chain we are inserted so as not to duplicate requests for Supplementary Diagnostic Methods, optimize resources and quickly forward to the next step, because in many cases losing time in treatment is also worse prognosis.
More than a mere prejudice is the notion that we are unknown and our professional quality is not immediately recognized. So at first we’ll have to prove that we’re trustworthy and that we’re capable of adapting to that reality, as well as being good elements to form that care team.
Some other occasional cases of gender prejudice can also happen and, therefore, women are prepared to have a good professional posture in face of any fact that may happen. Be firm and show your role as doctors.
The doctor’s salary in Portugal can be challenging, since medicine is not as well paid when compared to the practice of the profession in Brazil.
The amount paid per hour of emergency work, for example, is between 20€ and 25€ gross. Remember that we have to pay an average income tax of 25% and also Social Security, in some cases, if we reach certain amounts. But the values vary greatly according to the employer (public or private), degree of experience and medical specialty.
In summary, I would say that these are the main challenges faced by those who wish to become doctors in Portugal. However, at the end of the day, I believe that overcoming each of the challenges was worthwhile and today I am here on that side of the Atlantic, with the certainty that my “madness” was my best hit!
Yes, of course!
Although the transition process is not as simple and fast, with access to the right and secure information, with the sharing of experiences between colleagues and with proper planning your journey can be much smoother and more smooth. Courage! If you want to talk to an expert now click here.
Article published on the Euro Tips website: https://www.eurodicas.com.br/medico-em-portugal/
Dr. Mariana Ramalho
Associate Medical Consultant