Practising in North Macedonia: internship, state exam and chamber licence

Medical and health education in North Macedonia

The Faculty of Medicine of Ss. Cyril and Methodius University in Skopje is the oldest and largest school, and it also teaches dentistry and pharmacy. The State University of Tetovo and Goce Delčev University in Štip teach medicine and health programmes, and private universities add further options. Medicine is a six-year degree, and nursing, midwifery and physiotherapy are taught at faculties of medical sciences and higher schools.

Tetovo teaches partly in Albanian, which reflects the country's two main language communities. Skopje has also offered English-language options for international students. Check each programme's language and accreditation on its own site.

Graduation leads to an internship (pripravnički staž), the state exam and then registration with the chamber. For doctors the Macedonian Medical Chamber (Лекарска комора на Македонија) issues the licence, which is also the document foreign regulators ask for.

North Macedonia is an EU candidate, so a diploma is not covered by the directive. Many graduates go on to Germany, the UK, Switzerland and elsewhere, where the destination exam sets the terms. Check each regulator, including PLAB or an accepted route for the UK and Approbation for Germany.

A country with two languages of training

The distinctive feature of North Macedonia is that health education runs in more than one language. Skopje teaches mainly in Macedonian, Tetovo partly in Albanian. A candidate should ask the Ministry of Health in which language the state exam is available, whether the commission accepts answers in Albanian, and whether study materials exist in both. These are practical questions that regulations do not always answer on their face.

The language also matters for graduates who go abroad. A graduate trained in Albanian needs to build Macedonian or English before applying elsewhere in the region, and a graduate trained in Macedonian needs English for most destination exams.

Who needs the state exam

All six professions sit a state exam after the internship, with the Ministry of Health organising it. The format is reported as written plus oral for doctors, pharmacists and dentists, and written plus oral or practical for nurses, midwives and physiotherapists.

Doctors: the state exam and chamber licence

1. Graduate. Complete the degree at an accredited faculty.
2. Complete the internship. Work under supervision in the health system.
3. Apply to the Ministry. Request admission to the state exam.
4. Sit the exam. Written and oral parts before the commission.
5. Obtain the licence. Apply to the Medical Chamber.

Foreign diplomas must be nostrified before the candidate is admitted. The documents and fees come from the Ministry of Education and Science.

Pharmacists, dentists, nurses, midwives and physiotherapists

Pharmacists and dentists sit a written and oral state exam and register with the Pharmaceutical Chamber (Фармацевтска комора на Македонија) and the Dental Chamber (Стоматолошка комора на Македонија). Nurses have a chamber of their own (Комора на медицински сестри), while midwives and physiotherapists are handled through the Ministry. We have not verified the rules for each profession, so ask the chamber or the Ministry for the programme.

Exams in North Macedonia at a glance

Documents and timing for foreign graduates

Nostrification is the slowest part. The Ministry of Education and Science, or the university it designates, compares your programme with a Macedonian one and may ask for additional exams. Prepare the diploma, supplement, transcript, a programme description and certified translations, and ask in advance which languages the translations may be in. Only then can you apply to the Ministry of Health for the state exam.

Do not book travel or give notice at your current job until the nostrification decision is in writing. Decisions can set conditions that change the whole schedule.

Practising here or leaving

Health workers from North Macedonia are in demand in the wider European market, and the state exam and the chamber licence are the documents they take with them. A certificate of good standing from the chamber is requested by almost every foreign regulator. It has a validity period, so request it close to the date of your application abroad.

• Germany: Approbation, with a language certificate and medical-language test.
• United Kingdom: GMC registration through PLAB or another accepted route.
• Switzerland and Austria: recognition by the national authority plus language proof.
• Gulf states: Dataflow verification and the regulator's exam.

If you are still a student, use your final-year rotations to build English clinical vocabulary. Most destination exams are taken in English or German.

Language and recognition routes

Macedonian is the official language, and Albanian has official status in many contexts. Foreign graduates need nostrification and the language needed to work. There is no automatic EU recognition, and the destination country sets its own exam.

How to prepare

Keep a written log of every question you put to the Ministry and every answer you receive, with dates.

Start with the Ministry's published programme for the state exam. Build revision around the main clinical subjects, then law and ethics, then the organisation of the health system. For the oral part, rehearse answers aloud, with a colleague acting as the commission. If you intend to leave North Macedonia, begin the destination exam and language study in parallel, since both take longer than the domestic exam.

Last reviewed October 2026