Studying medicine abroad: UK, Ireland, Italy, Spain and the rest

Costs: our cost tool's 2026/27 yearly figures (tuition + 12 months of living in a typical student city + compulsory extras) multiplied by the length of the degree; see §6. They exclude flights, a foundation or repeated year and inflation (+2–5% a year). ¹⁸

• Inside the EU, medical degrees that meet the training conditions of Directive 2005/36/EC are recognised automatically in every member state (Article 21): a doctor trained in Italy or Spain can register in France, Germany or Ireland without retaking exams. ¹ The same rules extend to Iceland, Liechtenstein, Norway and, through its agreement with the EU, Switzerland. ¹
• The minimum training is at least 5 years and 5,500 hours of theoretical and practical training at a university (Article 24). Every EU medical degree in this guide meets it; programmes elsewhere in the world are not covered. ¹
• Automatic recognition covers the degree, not the job. The doctor still registers with the national medical council and usually needs the local language at a professional level (B2–C1). ²
• UK degrees after Brexit. The UK left the Directive on 1 January 2021. A UK medical degree obtained since then is a third-country qualification in the EU: each country recognises it under its own rules (sometimes with exams or extra training), and it only becomes valid across the EU after 3 years of practice in the first EU country that recognised it. ²
• EU degrees in the UK. The GMC still accepts EU medical qualifications for registration, but post-Brexit rules can change. ² And since the Medical Training (Prioritisation) Act 2026, UK Foundation Programme places (the two paid training years after medical school) go first to graduates of UK medical schools (whatever their nationality), and of medical schools in Ireland, Iceland, Liechtenstein, Norway and Switzerland. Graduates of Italian or Spanish medical schools come after them. ^{3 3}
• The US, Canada and Australia each require their own licensing exams and residency or internship, with priority for local graduates. A European degree is not a shortcut there. ¹⁷

What this means: a student who wants to practise in the EU should study in the EU. A student who wants to practise in the UK is best served by a UK or Irish medical school. A non-EU student who wants to go home should check first how their home country's medical council treats the degree.

United Kingdom

• How it works: a 5–6 year degree (MBChB, MBBS, BMBS) straight from school. Apply on UCAS by 15 October (18:00 UK time; 15 October 2026 for 2027 entry), with at most 4 medicine choices out of 5. ⁴
• The UCAT (University Clinical Aptitude Test): taken in the summer before applying (testing window 13 July – 24 September 2026 for 2027 entry; about £70 in the UK, £115 abroad). Almost every UK medical school uses it. ⁵
• Interviews: almost always, often as MMIs (multiple mini interviews: 6–10 short stations testing communication, ethics and motivation), from November to March. ⁴
• Grades: typically AAA–A\*AA with chemistry and usually biology, or IB 36–40 with HL chemistry. Work experience or volunteering in a care setting is expected. ¹⁸
• International places are capped: in England and Wales international students may fill at most 7.5% of medicine places, so only a few hundred places a year are open to international applicants across the UK. ⁶
• Who pays what: EU citizens without settled or pre-settled status pay international fees: about £45,000–£55,000+ a year (Edinburgh £54,560 for 2026-27; Exeter £48,900). The home fee in England is £9,790 (2026/27). ⁷

Ireland

• EU students apply through the CAO (normal closing date 1 February 2027, 17:00) and sit the HPAT-Ireland aptitude test in February. ⁸ HPAT registration opens in November and closes in mid-January (16 January for the 2026 test, late registration to 26 January; fee €164). The 2027 dates are not yet published. ⁹ An HPAT score is valid for one entry year only. ⁹
• Selection is on a combined score out of 865: Leaving Certificate points (or the converted foreign diploma), with points above 550 counting only partly, plus the HPAT out of 300. ⁸
• Non-EU students do not go through the CAO: they apply directly to each medical school (RCSI, Trinity, UCD, UCC, Galway), or through the Atlantic Bridge programme for North Americans. ¹⁰
• Fees: EU students who qualify for Free Fees (3 of the last 5 years in the EEA, the UK or Switzerland) pay the student contribution (€2,500 at most). ⁸ Non-EU medicine costs about €52,000–€60,000 a year; RCSI lists €62,000 for 2027/28. ^{10 10}
• Length: 5 or 6 years (6 with a foundation or pre-medical year). ¹⁰

Italy: IMAT (medicine in English)

• The IMAT (International Medical Admissions Test) decides everything: the score alone ranks applicants for the English-taught medicine programmes at public universities. School grades are not used. ¹¹
• 2026: registration on Universitaly 26 August – 9 September, test on 29 September 2026 (Ministerial Decree 1005 of 6 August 2026). 3,792 medicine places in all: 2,430 for EU students (and non-EU students resident in Italy) and 1,362 for non-EU students living abroad, at state and private universities. State universities alone (18 sites, including Bologna, Milano Statale, Pavia, Padova, Roma Sapienza, Torino, Napoli Federico II) offered 1,207 EU places, up from 952 in 2025, and 845 non-EU places. ¹¹ The 2027 decree is not out yet: expect registration in summer and the test in September 2027. ¹¹
• The 2025 "filter semester" reform (open first semester, then ranking) applies to Italian-taught medicine, not to the IMAT programmes. ¹¹
• Fees: public universities set fees by family income (ISEE): about €200–€4,000 a year; without an ISEE declaration students pay the top band. ¹⁸
• Length: 6 years, EU-recognised. Clinical years need conversational Italian with patients, so plan to learn it from year 1.

Spain

• Grade out of 14: public universities rank applicants by an admission grade out of 14. A foreign school-leaving diploma is converted by UNEDasiss into a credencial out of 10; the PCE subject exams (biology, chemistry, physics or maths, taken in May–June) add up to 4 more points, weighted per degree. ¹² Without PCE a foreign applicant usually caps at 10: far too low for medicine. ¹²
• Dates (2027 entry): UNEDasiss application for the PCE in mid-March to late April 2027, exams late May to mid-June, then regional pre-enrolment in June–July. ¹² US and other non-EU diplomas first need homologation to the Spanish bachillerato, which can take months. ¹²
• Language: Spanish (Catalan is also used in some Catalan universities). A few private universities teach part of the programme in English.
• Private universities (Navarra, Universidad Europea, CEU, UIC, Francisco de Vitoria…) select on their own (school record, test, interview), with fees of about €15,000–€25,000 a year. ¹²
• Length: 6 years (360 ECTS), EU-recognised.

Germany

• Central allocation through hochschulstart.de: after the special quotas, 30% of places go by school grade only (in practice 1.0–1.1), 10% by criteria other than the grade (tests, training, experience) and 60% by each university's own selection, which mostly combines the grade with the TMS medical aptitude test (being replaced by the TMSnat from 2028/29). ¹³ About 31,500 applicants competed for 10,281 places in the latest round. ¹⁸
• Deadline: 15 July 2027 for students finishing school in 2027 (31 May for older diplomas). ¹³
• EU citizens are treated like German applicants. Non-EU citizens compete for a separate quota of about 5% of places and apply directly to each university. ¹³
• German C1 is required. Fees: no tuition in most states, only a semester contribution (about €200–€700 a year). ¹⁸
• Length: about 6 years, ending in the state exam (Staatsexamen).

Netherlands

• Medicine is taught in Dutch and capped (numerus fixus): apply on Studielink by 15 January 2027, then take each university's selection (knowledge tests, non-cognitive tests, motivation). You may apply to only one medicine programme a year. ¹⁴ Examples: Groningen 400 places, Utrecht 297 (2026-27). ¹⁴
• Structure: 3-year bachelor's + 3-year master's. EU students pay the statutory fee (€2,771 in 2027/28). ¹⁸
• For families abroad: realistic only with fluent Dutch (most universities ask for the NT2-II exam or equivalent).

France

• A new single route from rentrée 2027. The PASS and L.AS first years are replaced by one nationally harmonised first year for medicine, midwifery, dentistry, pharmacy and physiotherapy. Students must pass both a "health" block and a "subject" block (at least 10/20 each) and are ranked on the whole year, with orals encouraged. They get two chances: at the end of the first and of the second year of the licence. ¹⁵ The decrees and the name of the new year (provisionally "licence portail santé") still had to be confirmed in autumn 2026, and the medical deans asked for a delay. ¹⁵
• Applying: on Parcoursup (wishes from mid-January to mid-March 2027). Entry to the first year is broad: the selection comes at the end of it (2025: 7,809 of 26,506 first-year students went on to the second year). ¹⁸
• Language and fees: French (B2–C1). €178 + €105 CVEC a year for EU students; €2,902 + €105 for non-EU students (some universities waive it). ¹⁸

Switzerland

• German-speaking universities (Basel, Bern, Fribourg, Zurich, Lucerne, ETH) select with the EMS aptitude test (3 July 2026; expected 9 July 2027). Registration with swissuniversities runs from early December to 15 February. ^{16 16}
• Only Swiss or Liechtenstein citizens, or foreigners with a corresponding residence status, may take the EMS. ¹⁶ In practice the route is closed to students who do not live in Switzerland.
• Geneva, Lausanne and Neuchâtel do not cap the first year: selection happens at its end, in French. Their rules for foreign applicants differ by university. ¹⁶

United States

• Medicine (MD) is a graduate degree: 4 years of bachelor's (any major with pre-med courses), then the MCAT and 4 years of medical school, then residency.
• For international students the door is narrow: in the 2025 cycle, 3,404 foreign applicants applied to US MD programmes, 845 were accepted and 755 enrolled. Most international students cannot get federal loans, and some schools ask for proof that the full four years can be paid, or for the money in an escrow account. ¹⁷
• Cost: a bachelor's at sticker price ($278,000–$388,000 over 4 years with living costs, from our cost tool) and then medical school: often $500,000+ in total. ¹⁸

Canada and Australia (briefly)

• Canada: medicine is mostly entered after an undergraduate degree, and places favour residents of each province. A few Québec programmes take students straight from CEGEP, which in practice means students already in Québec. ¹⁸
• Australia: some universities admit school leavers to 5–6 year programmes with the UCAT ANZ (2026: tested 1 July – 5 August; A$405 overseas) or the ISAT for international applicants, plus interviews; Melbourne and Sydney teach a graduate MD. International fees are often A$80,000+ a year. ¹⁹

These are the numbers our "What it takes" tool and the chance estimates use.

UCAT (UK), 2025 test, total of three subtests on 900–2700 ⁵

The mean was 1891. Most medical schools consider scores around the 70th–90th percentile (2000–2200) competitive, but each school weighs the UCAT differently.

UK offer rates (2025 entry): Oxford about 16% of medicine applicants received an offer, Cambridge about 20%. ¹⁸ Our model uses about 6% (Oxford) and 8% (Cambridge) for international applicants, an estimate based on the capped places. ¹⁸

HPAT (Ireland), CAO Round 1 cut-offs 2026, combined score out of 865 ⁸

Several of these places were filled by random selection among applicants with the same score. How to read it: the Leaving Certificate part maxes out at 565 (for 621+ points), so even a perfect school result needs an HPAT of about 165–176 out of 300; a student just below the top needs more. ⁸

IMAT (Italy), 2025, out of 90, last EU applicant placed at the first allocation ¹¹

Later allocations lowered these minimums slightly. In 2025, 12,839 candidates competed for about 1,050 EU places at public universities. ¹¹

Spain, medicine cut-offs out of 14 (public universities, first allocation) ¹²

In practice: a near-perfect credencial (9.5+/10) and about 3.5 out of 4 extra points from the PCE in biology and chemistry. Catalan universities are slightly less demanding than Andalusia, Valencia or Madrid. ¹²

Germany: about 1.0–1.1 in the grade-only quota, otherwise a strong TMS score. ¹⁸

• UK: a student with top predicted grades (A\*AA / IB 38+), a strong UCAT and care experience, who wants to practise in the UK, and a family that can fund about £300,000+ at international fees (or that has UK home-fee status). The Foundation Programme priority for UK graduates is a real advantage.
• Ireland: an EU student with excellent results who wants an English-taught degree at EU cost, and is ready to prepare the HPAT seriously. For non-EU families it is an English-speaking alternative to the UK at a similar price.
• Italy (IMAT): an EU student who is strong at reasoning, biology and chemistry and wants English-taught medicine at a low price. It suits students whose school grades are uneven (only the test counts), but the competition is fierce; plan to learn Italian.
• Spain: a Spanish-speaking student with near-perfect grades who will take the PCE seriously and wants to practise in the EU. Private medical schools are a fallback for families with a budget.
• Germany: a student with C1 German and outstanding grades (or a strong TMS); almost free.
• Netherlands, France, Switzerland: mainly for students who already speak the language and, for Switzerland, live there.
• US: only for US citizens or permanent residents, or families who can fund about $500,000 and accept a long, uncertain route.
• Plan B: many families apply to two systems in parallel, for example UCAS + IMAT, or HPAT + Spain, since the calendars do not clash (see §7). A gap year to retake a test (IMAT, HPAT, UCAT) is common and accepted.

Calculated with the yearly figures of our cost tool (2026/27 prices: tuition + 12 months of living at a mid-range level in a typical student city + compulsory yearly extras, multiplied by the years of study, plus one-off visa costs). ¹⁸

Some degrees take 6 years (Edinburgh, Irish programmes with a foundation year): add one year. Capitals (London, Dublin, Milan, Madrid) cost 30–50% more to live in. After the degree, junior doctors are paid during their training in all these countries.

For entry in September/October 2028 (dates projected from the 2026–27 cycle; check each official site once the 2028 dates are published ). For 2027 entry, the UK deadline has passed but Ireland, the Netherlands, Switzerland, Spain, Germany, Italy and France are still open.