Medical specialty access in EU/EEA countries

Purpose of the study Access to postgraduate medical specialty training differs markedly across European Union (EU) and European Economic Area (EEA) countries. This review mapped and compared national pathways into medical residency training across all EU/EEA states. Study design Data were collected using a standardized template based on official governmental, university, and hospital sources, verified as current in October 2025. Results Five main access models were identified: immediate access through a national examination; immediate access without a national exam; delayed access following general medical training; delayed access with an additional examination; and mixed systems depending on the specialty. Conclusions Each model presents distinct strengths and limitations. National Examinations promote transparency and merit-based selection but may limit individual choice, whereas direct access models enhance flexibility while risking inequality. Delayed access systems support professional development but may prolong training and delay workforce availability. This overview provides a concise reference to support informed decision-making on postgraduate training and mobility within Europe.