Belgium: no licensing exam, but a three-layer recognition chain

Medical and health education in Belgium

Belgium trains doctors through a six-year programme of three years of bachelor's and three years of master's study, followed by specialist training of three to six years. In Flanders the universities include KU Leuven, Ghent, Antwerp and the Vrije Universiteit Brussel, taught in Dutch; in the French Community they include UCLouvain, ULB and ULiège, taught in French. Admission is controlled by an entrance exam in Flanders and a selection system in the French Community. Dentistry is a five-year programme, pharmacy five years, and nursing a three- to four-year degree.

Quality is overseen by NVAO in Flanders and AEQES in the French Community, while the federal level regulates the profession. Graduates obtain a visa from the FPS Public Health and an INAMI/RIZIV number for reimbursement. There is no national licensing exam; the diploma and visa together give the right to practise. Foreign degrees need recognition first, so check current procedures.

The country with no exam and three administrations

Belgium is the clearest case in this group of a system with no licensing paper, and it is easy to underestimate the difficulty of that. A Belgian medical student graduates, receives a diploma from a university in one of the language communities, and applies to the federal health authority for a visa to practise. Specialty selection is organised by the universities and the Belgian specialist training committees, and there is no national exam that ranks candidates as in France or Spain.

The complexity lies in who does what. The federal government (FPS Public Health, or SPF Santé publique / FOD Volksgezondheid) controls the right to practise, through the visa. The communities control education and the recognition of some titles. The result for a foreign-trained applicant is a chain of agencies, each with its own forms and its own language. In the Dutch-speaking north the Department of Care (Departement Zorg) of Flanders handles title recognition, and in the French-speaking south the Fédération Wallonie-Bruxelles does.

Who needs a licensing exam in Belgium

• Belgian graduates, all six professions: no licensing exam. Diploma, then visa and registration.
• EEA-trained professionals: recognition under the EU directive. No exam is normally required, though language knowledge matters in practice.
• Non-EEA doctors and dentists: NARIC equivalence, which frequently demands exams at a Belgian medical or dental faculty, then the visa.
• Non-EEA nurses, midwives, pharmacists and physiotherapists: NARIC equivalence (which may impose exams or extra training), then the visa. A university may require exams for pharmacists.

The recognition sequence for non-EEA graduates

1. Request diploma equivalence from NARIC in the community where you intend to work. NARIC decides whether your degree is equivalent, and may impose exams or additional training.
2. Complete any requirements. For doctors and dentists this is typically a set of exams at a faculty, which is the only point where a real exam appears.
3. Apply to FPS Public Health for the visa which grants the right to practise.
4. Apply for recognition of the professional title, through the Department of Care in Flanders or the equivalent French Community body.
5. Register with the relevant professional body and, for doctors, with the medical association (Ordre des médecins / Orde der artsen).

Doctors and dentists

There is no national or postgraduate exam in Belgium for doctors. For specialty training, the universities select candidates, and the number of positions follows the federal quota system. The exams you may meet are at a different stage: the faculty exams that NARIC can impose on non-EEA graduates for equivalence, and the entrance exams for study places. The Flemish toelatingsexamen arts/tandarts, the entrance exam for medicine and dentistry in Flanders, is only an admission test.

For a foreign doctor, the faculty exams are therefore the licensing gate in practice. They are set by a university, not by a national board, and they differ between institutions. Ask the faculty for the programme of the exams, and for dentists the same.

Nurses, midwives, pharmacists and physiotherapists

Belgian graduates of these professions register by diploma. For non-EEA graduates, NARIC may impose exams or extra training before the visa. For pharmacists a university may set exams. Physiotherapists apply to the Department of Care in Flanders for recognition of a foreign degree, using the Flemish government's procedure for non-university healthcare professions. Because the outcome depends on the file, no standard exam list exists for these four.

What exams exist, and where

Language: pick your community early

Belgium has three official languages, and the language you need follows the place you work. Flanders and Dutch-speaking Brussels use Dutch, Wallonia and French-speaking Brussels use French, and a small German-speaking community in the east uses German. Patients have the right to be treated in their language, and employers in the public sector apply language rules. The language of the diploma equivalence file is also that of the community you apply to. Choose a region before you collect translations, because a sworn translation into the wrong language is a wasted cost.

How to plan a Belgian recognition file

Because there is no exam to book, the main risk in Belgium is sequence. A sensible plan starts with the community: decide whether you will work in Flanders, Wallonia or Brussels, and read that community's recognition page. Then request NARIC equivalence, because every later step depends on it. While that file is pending, gather the documents the FPS Public Health visa will need, including proof of identity, the diploma and evidence of good standing.

If NARIC or the faculty requires exams, ask the faculty for its syllabus and exam calendar immediately. Faculty exams run in the university's calendar, not on demand, and missing a session can add months. For medicine and dentistry, prepare as for the final-year exams of a Belgian student: core clinical subjects, with emphasis on those where your own curriculum differed.

Finally, remember that title recognition and visa are different things. A visa lets you practise, and the title (for example specialist status) is a separate recognition. Check each in turn.

Using this page

If you are comparing countries, Belgium has the lowest exam burden for its own graduates and one of the least predictable recognition processes for outsiders. The Flemish Department of Care page, the FPS Public Health and the Order of Physicians are the primary sources. TriagePass is independent of all of them, and this page will be updated when the rules change.

Last reviewed October 2026