6 de May, 2022
Having a broad view of how medicine works around the world is just as important as the quality of training. Europe is recognised for its immense historical and cultural importance in the world, as well as the security, stability and quality of life it offers.
But have you also heard about their excellent health service delivery?
Doing a medical specialty on the other side of the Atlantic can open the door to an excellent cultural opportunity and a great training experience. Within Europe, Portugal is undoubtedly one of the most sought after countries by Brazilian doctors for continuing their studies and professional practice.
Realizing your goal of living in Europe or obtaining European citizenship can be simpler than you think. We offer personalized support to make the immigration process more accessible and uncomplicated.
Besides the excellent quality of life, low cost, safety and mild climate, Portugal has a relatively simple process for foreign doctors, associated with an appropriate residence visa for this type of professional and also an excellent quality of training in their native language.
Below we present the main steps for entering the internship (as medical residency is called in Portugal), whose structure and method of access is slightly different from the Brazilian model.
The basic criteria for accessing the medical internship in Portugal are:
For now, let’s focus on medical residency in Portugal…
To gain access to medical residency in Portugal you must take the “Prova Nacional de Acesso (PNA)”, a national exam that takes place once a year, generally in mid-November.
This is a public competition, whose application must be made online through the Medical Internship page at ACSS, normally in September of the same calendar year of the exam. For template and additional information just visit the ACSS page.
This exam is similar to the medical residency exams in Brazil: the candidate has 240 minutes to answer 150 multiple choice questions, consisting of 50% general medicine, 15% surgery, 15% paediatrics, 10% gynaecology/obstetrics and 10% psychiatry.
Unlike in Brazil, whose responsible body is the Ministry of Education, in Portugal the Central Administration of the Health System (ACSS), an entity part of the Ministry of Health, is the government body responsible for managing access to the specialty.
Medical residence in Portugal is made up of 2 stages:
The first year of residency is compulsory for all medical specialties, called the General Training Internship, and consists of a 12-month programme, of which 3 months are general surgery, 3 months primary care, 4 months internal medicine and 2 months paediatrics.
From the second year onwards, the so-called Internship of Specific Training begins, with 48 areas of specialisation, all of which are of direct entry. In other words, in Portugal no prerequisites are required, and the programmes of each specialty are well delimited as far as internship time is concerned.
Even if no compartmentalized entry is required, as is the case in Brazil, for example, there are a number of internships that are necessary to complement the training.
Example: if you want to do plastic surgery you don’t necessarily need to do the 2 compulsory years of general surgery first, but that doesn’t mean that it won’t be part of your training programme.
To choose the specialty, you will need to go through two different stages.
After completion of the PNA, the ACSS website opens a period, usually at the end of November or beginning of December, for the candidate to choose the hospital where he/she will carry out the 1st year of training, the so-called General Training. The candidate must then make a selection from 22 hospitals, in order of preference. This selection is made online, on the ACSS platform.
Seriation occurs according to the normalized classification (normalized average calculated by the ACSS according to the final average of the course and place of training, in the case of foreigners, this calculation is performed according to the grade of the equivalence of the medical degree at the Portuguese university). Candidates with higher normalised averages will have more chances of being placed in their preferred location for training, since they have preference at the time of their choice.
The General Training starts on the 1st working day of the year following the PNA, in January, and in November of the same year the Specific Training is chosen, to start the following year. For this last choice, the final position in the list of candidates who took the PNA: the best final exam marks and with the best normalised averages has priority.
Example: Pedro got position 50 because he got 96% right in the PNA and had an average of 19 values, and Nuno, who also got 96% right in the PNA, but as he had an average of 18.9 values, got position 51. Pedro will have priority of choice and so will choose his speciality first.
The 1st year of training can be undertaken in a different location from where you will undertake your specialty years.
The length of training and the contracted weekly workload are also differentiating factors of medical residency in Brazil.
In Portugal, the normal workload is 40 hours per week.
The first year of the specialty programme corresponds to the so-called General Formations, which last one compulsory year. Afterwards, the Specific Training starts, which can vary from 4 to 6 years.
The shortest duration specialties are 4 years, among these are General Medicine and Public Health. Most medical specialties last 5 years, however, surgical specialties last 6 years. Therefore, the General Training year is compulsory, totalling a minimum duration of 5 years and a maximum of 7 years for specialised training.
Example: oncology training will require 21 months of internship in Internal Medicine (Internal Medicine), 3 months of Intensive Care and only then will the doctor go on to oncology specific training. All forming part of the direct and specific entry specialty.
Just as in Brazil, some medical specialties are more sought after than others, many of these are considered “noble” specialties in several countries, such as dermatology, ophthalmology and otorhinolaryngology. Cardiology, plastic surgery and gastroenterology are also among the specialties with more competitors.
In the 2019 call for applications, the first placed candidate chose the ophthalmology vacancy at Centro Hospitalar Universitário de Lisboa Norte, E. P. E. and had a score of 100% in the exam. The last placed candidate to choose dermatology, from the total of 11 vacancies, had 96% of correct answers and was in position 64 on the list, and the training centre chosen was the Centro Hospitalar e Universitário de Coimbra, E.P.E. The second candidate to choose that year had 99% of correct answers and chose to follow the specialty of cardiology.
A very important point is the wage base, the value is uniform throughout the country and is paid by the hospital where you do your training, with the value of the working hour varying according to the year of your training.
In the first year of work or general training year, the intern’s salary is €1,585.26, with an extra hour of work of €9.15. As for older residents, from the 4th year of work, they earn €1,960.69, and an extra hour of €11.31. Remember that all these values are gross and, therefore, there will still be the deduction of social security and income tax.
Although the titles of specialty are not obligatory in Brazil, they are advisable for the exercise of a specialty after medical residency.
Although there is continuous assessment during the medical internship in Portugal, a final exam is mandatory, with all the experience lived during the years of the medical specialty. Without the exam, the specialty will not be completed.
If you have any desire to live abroad and broaden your professional horizons, medical residency in Portugal is certainly an excellent path!
Portugal has a relativelysimple process for the entry of foreign doctors, a training quality that is a reference at European and world level, taught in the Portuguese language and with relative ease for subsequent insertion in the professional market.
Finally, it is also worth mentioning that once you have completed the medical specialty in Portugal, if you are a national of any European country, it is possible to request recognition in all countries that include the European Directive of professional recognition (Directive 2005/36/EC of the European Parliament and Council of 7 September 2005), following the language criteria determined by each country. In other words, you will have your doors open to the whole of Europe.
Remembering that living legally in Portugal for 5 years you can already ask for Portuguese Nationality.
Do you have any more questions about medical residency in Portugal? Send it to Atlantic Bridge.
Text: Dr. Mariana Ramalho
Medical Doctor at the Centro Hospitalar Universitário São João, Master in Public Health from the University of Porto, Graduated in Medicine from the Federal University of Paraíba. She has been working as a Physician in Portugal since 2015 and as an Associate Consultant at Atlantic Bridge.