Practising in the Czech Republic: the approbation exam and recognition route

Medical and health education in Czechia

General medicine in Czechia is a six-year single-cycle Master’s degree awarded as MUDr. It is taught at eight medical faculties belonging to Charles University (in Prague, Plzeň and Hradec Králové), Masaryk University in Brno, Palacký University in Olomouc and the University of Ostrava. Dentistry is a five-year programme, pharmacy a five-year Master’s, and nursing a three-year bachelor’s. Programmes are accredited by the National Accreditation Bureau for Higher Education, and the Ministry of Health oversees clinical training. Most faculties also run English-language programmes, which draw many international students.

A new graduate holds the professional qualification to start working under supervision, and continues straight into postgraduate specialty training with a basic trunk and then an atestace exam. Independent practice in a specialty follows that training. Doctors register with the Czech Medical Chamber, which is compulsory for practising. There is no separate national licensing exam for Czech graduates; the final state exam (státní závěrečná zkouška) is part of the degree. Graduates from outside the EU, including those who trained in English here, need the Ministry of Health to recognise their qualification, and often an adaptation or aptitude test, before practising in Czechia.

A system built around paperwork first

In many countries the exam is the hard part and recognition is a form. In the Czech Republic it runs the other way round. The Ministry of Health decides whether your qualification is equivalent, and the exam exists to close the gap if it is not. Candidates who prepare for the written test but have not started recognition often lose a year.

So the order of work matters more here than the content of any one paper. Think of it as a sequence of gates, each of which has to open before the next.

Who needs what in the Czech Republic

Czech graduates finish the university's state final exam (státní závěrečná zkouška) and register on the strength of the degree. The "atestace" you will hear about is a specialty exam taken after training. It is not a licensing step.

EU, EEA and Swiss graduates are recognised under Directive 2005/36/EC. They do not sit the approbation exam. The exam applies to graduates from other countries, which the ministry calls "third countries".

Doctors, dentists and pharmacists: the aprobační zkouška

The approbation exam is the same in outline for all three professions. It has three parts:

1. Written test. A multiple-choice paper on the core clinical and basic science subjects of your profession.
2. Practical part. A period of supervised practice in a hospital or clinic, assessed by the supervising staff.
3. Oral exam. Questions put by an examining panel on clinical cases and professional rules.

Before any of that, you need a decision on nostrification of your diploma, which is the formal recognition of a foreign degree as equivalent to a Czech one. The ministry's page for qualifications obtained outside the EU sets out the documents. Expect certified translations into Czech, an apostille or legalisation for some countries, and a transcript of subjects and hours. The detailed list changes, so use the ministry page and not a summary.

A Czech language exam is required first. That is a separate gate, and it is the one that takes candidates by surprise. You cannot pass an oral clinical exam in Czech without genuine clinical Czech, so budget months for language, not weeks.

Nurses, midwives and physiotherapists

For these professions, the ministry's page on non-physician professions is the route. A non-EU graduate must receive a ministry decision before practising. The decision either recognises the qualification or sets a compensation measure. A compensation measure can be an aptitude test or an approbation-style exam: written, practical and oral components as set by the ministry.

Because the measure is set case by case, we cannot give you a fixed format for these three professions. We say so plainly. Czech graduates register by diploma, with no exam. Czech language is needed throughout.

Language

Czech is the language of the whole process: the documents, the language exam, the written test, the practical work and the oral exam. There is no English-language route for third-country graduates that we have found in the ministry's pages. If you have seen one advertised, ask for the ministry's own source.

Comparing the routes

A sensible order of work

Start the nostrification file first, because it has the longest waiting time and the most documents. Begin Czech at the same time. Look for a supervising hospital while the ministry processes your application. Leave intensive MCQ preparation for the months just before the written test, but do a first pass of the syllabus early so you know your weak subjects.

Most candidates in this situation are already qualified doctors, dentists or pharmacists. The MCQ preparation is therefore revision and calibration to Czech practice, not first-time learning. Mixed-difficulty question blocks and a focus on Czech guidelines and legislation are the efficient use of that time.

Common questions about the Czech route

How long does the whole process take?

We cannot give a reliable figure, and nobody can until they have seen your file. The stages run one after another: recognition, language, the written test, supervised practice, the oral exam. Candidates who finish within a year to two are usually those who started language study and the hospital search at the same time as the paperwork.

Can I practise while I wait?

Not independently. Supervised practice is part of the approbation exam for doctors, dentists and pharmacists, and you are working under supervision, not as a registered professional. Ask the ministry what work you may do in the meantime.

What about specialty training afterwards?

Specialisation in the Czech Republic ends with an atestace. That is a postgraduate matter and it is not what the ministry requires you to pass to begin.

Does a Czech diploma from a university teaching in English change anything?

Several Czech faculties teach medicine in English. Graduates of those programmes hold a Czech degree and register by the degree. Czech remains the language of the hospital, so many of them still study the language during their course.

Last reviewed October 2026