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Medical Residency in Portugal

10 de September, 2022

Medical Residency in Portugal

To do medical residency in Portugal you need to revalidate your medical degree and register at the Portuguese Medical Association.
Reading: 9 min
Whether recent graduates or experienced doctors, when the decision is made to move to another country, it is often necessary to start over on the professional path. And this new beginning may involve entering a new medical specialty, which requires the completion of medical residency in Portugal.

Residency, which in the country is called internship, has a different structure and entry method than the Brazilian model. In this article, we will explain how it works and the step-by-step process on how to do medical residency in Portugal.

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How to do medical residency in Portugal?

In the case of foreign doctors, to do medical residency in Portugal you must, first of all, revalidate your medical diploma in Portugal and register at the Ordem dos Médicos (Portuguese Medical Association).

Then, it is necessary to follow the same procedure for Portuguese doctors, passing the National Access Test (PNA), which evaluates doctors for the beginning of residency.

What is the structure of medical residency in Portugal like?

According to Portaria nº 268/2018 (which approved the General Training training program), medical residency in Portugal is composed of two stages: the General Training Internship and the Specific Training Internship. Both stages must be attended by internal medicine physicians (residents).

The first year of medical residency in Portugal, the Internato de Formação Geral, consists of a 12-month program, divided this way:

  • General Surgery: 3 months;
  • Primary Health Care: 3 months;
  • Internal Medicine: 4 months;
  • Pediatrics: 2 months.

Medical Residency Specialties

From the second year on, the Internship for Specific Training begins. Currently, there are 48 areas of specialization, all of which are for direct entry.

The specialty areas defined in the Medical Internship Regulations(Portaria nº 79/2018) are:

  • Pathological anatomy;
  • Anesthesiology;
  • Angiology/vascular surgery;
  • Cardiology;
  • Pediatric cardiology;
  • Cardiac surgery;
  • General surgery;
  • Maxillofacial surgery;
  • Pediatric surgery;
  • Reconstructive and aesthetic plastic surgery;
  • Thoracic surgery;
  • Dermatovenereology;
  • Infectious diseases;
  • Endocrinology/nutrition;
  • Stomatology;
  • Clinical Pharmacology;
  • Gastroenterology;
  • Medical Genetics;
  • Gynecology/obstetrics,
  • Clinical Hematology;
  • Immunoallergology;
  • Immunohemotherapy;
  • Sports medicine;
  • Physical and rehabilitation medicine;
  • General and family medicine;
  • Internal Medicine;
  • Intensive Care Medicine;
  • Forensic medicine;
  • Nuclear medicine;
  • Occupational medicine;
  • Nephrology;
  • Neurosurgery;
  • Neurology;
  • Neuroradiology;
  • Ophthalmology;
  • Medical Oncology;
  • Orthopedics;
  • Otolaryngology;
  • Clinical Pathology;
  • Pediatrics;
  • Pulmonology;
  • Psychiatry;
  • Child and adolescent psychiatry;
  • Radiology;
  • Radioncology;
  • Rheumatology;
  • Public Health;
  • Urology.

Duration of medical residency in Portugal

The duration of medical residency in Portugal is different from the residency performed in Brazil.

General Training, as mentioned earlier, is 12 months of mandatory training and is part of the medical specialty program. Then the Specific Training actually begins, which can vary from 4 to 6 years, depending on the area of specialty.

The specialties of Family Medicine and Public Health, for example, last 4 years. Most medical specialties last 5 years, and finally, surgical specialties last 6 years.

Remember that the General Formation year is compulsory and, therefore, the formations last a minimum of 5 years and a maximum of 7 years.

Even if compartmentalized entry is not required, as it is in Brazil, for example, there are a number of internships that are necessary to complement the 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.

It is worth pointing out that the weekly workload of the medical internship in Portugal is 40 hours, unlike in Brazil, where, by law, it would be 60 hours a week.

These 40 hours are not of exclusive dedication, and the intern may, if compatible with his formal work schedule in the internship, work outside his institution as a general practitioner, for example, or even in other functions that are of his interest.

In this case, it is necessary to request authorization from the hospital where you work as an intern to accumulate duties, always with the authorization of the Director of the Clinical Service where you are a resident.

Doctor with a medical book
The workload of medical residency in Portugal is less than in Brazil

How to know the exact duration of the residence

It is best to consult the General and Specialized Training Program in question.

According to the Regulation of the Internship, programs must inform the total duration of training, the sequence and duration of internships, and other specifications.

Want to do medical residency in Portugal? Contact us!

What is the residency entry process like?

Entry into the specialty is divided into two stages, just as the entire residency training is organized.

After the PNA is done, the Central Administration of the Health System (ACSS) website opens, in a specific period, a deadline for choices of hospitals where one is interested in doing the General Training. This usually happens in late November or early December.

The physician makes a selection of 22 places where he/she would like to do the residency, in order of preference, through the ACSS online platform.

Seriation is done according to the normalized classification (normalized average performed by the ACSS according to the final average of the course and place of training). Thus, those with higher normalized averages have preference in the choice of training location.

General Training begins the year after the PNA, in January, and during the course of it, in November, you choose which area of Specific Training you will take.

So what will count is the final position in the list of candidates who took the PNA: the best final test scores and the best normalized averages have the priority of choice.

Example

Candidate Ricardo was in position 100, as he got 90% right on the PNA and an average of 17 values, while Carlos, who also got 90% right on the PNA, had an average of 16.9 values, placing him in position 101.

Ricardo will have priority of choice and thus will opt first for his area of specialty in the medical residency.

What is the national residency entrance exam like?

The Prova Nacional de Acesso (PNA) is the national exam that allows access to medical residency in Portugal. It is a national competition that takes place on the same day and time throughout the country in mid-November.

Currently (according to the PNA 2021 regulation) it is carried out in the metropolitan areas of Porto and Lisbon, in Coimbra and in the Autonomous Regions.

How the proof is

The PNA is a 150-question multiple-choice exam on various areas of medicine, similar to the medical residency exams in Brazil.

The exam is 240 minutes long, in two stages of 120 minutes, and is divided in terms of content as follows:

  • Medicine 50%;
  • Surgery 15%;
  • Pediatrics 15%;
  • Gynecology/Obstetrics 10%;
  • Psychiatry 10%.

How to apply

The application must be made online through the Internato Médico page on the ACSS website, usually in September of the same calendar year of the exam.

Subsequently, the required documents must be sent by mail to the ACSS within the deadlines set in the National Access Examination Regulations, which can be consulted on the same page.

The content matrix and the bibliographic reference list for the exam are also made available in the annual PNA regulations.

Required documents

Among the documents required for registration are mandatory:

  • Application form signed by the candidate (it is generated by the platform at the time of registration);
  • If you are a foreigner, a residence permit for exercising a subordinate professional activity (or equivalent document);
  • Official document proving the Tax Identification Number (NIF);
  • Criminal Record Certificate for the purpose of entering medical school and expressly stating that it involves regular contact with minors;
  • Certificate of equivalence of the medical degree to the integrated master’s degree in medicine in Portugal with the final grade of the equivalence, document that must be provided by the dean’s office of the university where the equivalence took place;
  • Certificate of enrollment in the Portuguese Medical Association (issued no later than three months prior to application);
  • Proof of payment of the race registration fee of 90€ (2022 value).

Entity responsible for managing access to medical residency in Portugal: ACSS

The Central Administration of the Health System (ACSS) belongs to the Ministry of Health and is the government body responsible for managing access to the specialty. This is different from Brazil, where the responsible body is the Ministry of Education.

The ACSS determines whether the training meets the criteria established by law for training together with the Colleges of Specialties of the Medical Association.

And also, indirectly, through the Regional Health Administrations (ARS), it evaluates requests to change specialty, internships outside the institution, and work contracts.

What are the most popular medical residencies?

Just as in Brazil, in Portugal there is a certain preference for medical specialties that, in many places in the world, are considered noble specialties in Medicine, such as Dermatology, Ophthalmology, and Plastic Surgery.

According to the 2021 statistics of the Portuguese Medical Association, the areas with more doctors are Internal Medicine, Pediatrics, Anesthesiology, and Gynecology and Obstetrics. However, the figures consider all doctors working in the country, not only the newly graduated ones.

To give you an idea, the last person to choose the Dermatology specialty in 2021 had a final score of 129 on the PNA and ranked 38 in the order of choices.

Ophthalmology had its last vacancy chosen by a candidate with a 125 rating in the PNA, who was in 89th position. In Plastic Surgery, the last doctor who could choose the vacancy had a 123 rating in the PNA, placing 156th in the order of choice.

This contest had a total of 2462 physicians enrolled.

Medical residency care in Portugal
Many Brazilian doctors have come to work in Portugal

Is the residency final exam mandatory?

Yes, in Portugal, the end-of-specialty exam is mandatory. In Brazil, although specialty exams are not mandatory, they are recommended.

There is continuous evaluation throughout the internship, but at the end of the training years a final exam is mandatory.

In continuous assessment, at the end of each training block, an evaluation is performed on a scale of zero to 20 points, and the intern who obtains at least a score of 10 is approved.

The final evaluation takes place through a set of tests, after the conclusion of all stages of training: curricular, practical, and theoretical discussion. At the end, the intern doctor will be assigned a score between zero and 20 points.

The exam is held in February or March (regular season) or September/October (special season).

Is it possible to change specialty?

Many people wonder if it is possible to change specialty areas during residency, and the answer is yes!

Imagine you enter a specialty and realize that it was not quite what you expected and you want to change, but at the same time you don’t want to lose the security of a guaranteed position.

It is provided in Ordinance No. 79/2018 that internal medicine physicians may change specialties up to twice.

Requirements for requesting a change of specialty

In this regard, resident physicians can make the switch without having to submit a new application to the competition procedure, provided that the following conditions are met:

  • The new specialty to be attended must correspond to one of those indicated in the Medical Board’s opinion;
  • The classification obtained in the entrance examination must be equal to or higher than that of the last intern who occupied a vacancy in the same specialty at the establishment where the doctor intends to do his residency;
  • There is training capacity at the physician’s intended location;
  • An Opinion from the National Council of Internal Medicine (CNIM) regarding the suitability of the various placement options available, in light of the opinion of the Medical Board indicated in the first requirement.

Also understand how to apply for medical specialty recognition in Portugal.

Is it worth doing medical residency in Portugal?

For foreign doctors who intend to live in Portugal and work as doctors in the country, it is an excellent path, even for those who wish to do a new training in a different specialty area.

Furthermore, it is interesting to remember that, according to European Union regulations, the medical specialty obtained in Portugal can be recognized in other European countries. This is a good requirement for those who intend to work in other countries as well.

In any case, each physician should analyze his or her career path and professional intentions to conclude if it is worth doing medical residency in Portugal.

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Article originally published on the Euro Tips website.

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Author:

Atlantic Bridge

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