The Netherlands: BIG register assessment for foreign-trained clinicians

Medical and health education in the Netherlands

Medicine in the Netherlands takes six years, a three-year bachelor’s followed by a three-year master’s, at eight university medical faculties including Amsterdam, Leiden, Utrecht, Rotterdam, Groningen, Maastricht and Nijmegen. Teaching is in Dutch, with some English-taught tracks. Admission is capped (numerus fixus) and allocated by a weighted lottery. The Accreditation Organisation of the Netherlands and Flanders (NVAO) accredits programmes. Nursing is a four-year bachelor’s at universities of applied sciences, pharmacy a three-year bachelor’s plus a master’s, and dentistry six years.

A new graduate is entered in the BIG register, the national register of health professionals run by CIBG, on the basis of the degree, with no licensing exam. Doctors then work as non-training residents (ANIOS) or apply directly to specialty training (AIOS), which is competitive and arranged hospital by hospital. GP training lasts three years. Doctors trained outside the EU must have their diploma assessed through the BIG register’s recognition route, which includes a knowledge test and Dutch language requirements, and capacity for that assessment is limited. Confirm the current steps with the BIG register.

A register, a committee and a capacity problem

The Netherlands approaches licensing differently from its neighbours. There is no state exam to pass after graduating. A Dutch doctor, nurse, pharmacist, dentist or physiotherapist becomes registered in the BIG register (Beroepen in de Individuele Gezondheidszorg), which is run by the CIBG, an agency of the health ministry. Registration is the legal basis for using a protected title.

The foreign-diploma route is where the exams appear. A committee, the CBGV, reviews your file and advises. If it concludes that your training is not equivalent, you must show competence through a test. The practical difficulty is capacity. Tests are given at a few institutions, in small numbers, and for doctors the capacity is currently exhausted. The challenge is not only to pass but to get a place at all.

Who needs a licensing exam in the Netherlands

• Locally trained professionals: none. They register on the basis of the Dutch diploma.
• EU/EEA-trained professionals: recognition under the EU directive on professional qualifications, normally without a test.
• Non-EU/EEA doctors, nurses, dentists, midwives, pharmacists, physiotherapists: a BIG assessment. The outcome varies by profession and individual file.

The BIG assessment, step by step

1. Check the route on the BIG register's roadmap for foreign diplomas (routekaart erkenning buitenlands diploma).
2. Apply for assessment by CIBG, with diploma, transcripts and proof of work history.
3. Show language competence. Since July 2023, language certificates replace the previous AKV test, as announced by the BIG register.
4. Receive CBGV advice. The committee decides whether a professional test is required, and in what form.
5. Sit the professional test (beroepsinhoudelijke toets) if advised, then the CBGV gives a final advisory interview for some professions.
6. Register in the BIG register.

Doctors

For non-EU/EEA doctors, the assessment consists of the language certificates and the professional test (BI-toets), which has a written test of basic and clinical knowledge, a skills test on test subjects, and then an advisory interview with the CBGV. The test for doctors is currently full. No new places were announced as of 2026, so check the BIG register news page before building plans around it. Dutch graduates meanwhile register without a test and then compete for specialty training places through the hospitals.

Nurses

The nurse test combines a written knowledge test, a skills test and an interview on clinical reasoning. The fee is EUR 400. Nurses should check which language certificate and level the BIG register currently accepts, because Dutch is the working language in most hospitals, whatever the entry route allows.

Dentists

Non-EU/EEA dentists take the BIG assessment with the professional test at ACTA (the Academic Centre for Dentistry Amsterdam): a written basic and clinical knowledge test and a skills test. The fee is EUR 1,500, and the test runs two rounds a year with limited capacity. That cap matters when planning your timeline.

Midwives, pharmacists and physiotherapists

For these three, the BIG register states that the CBGV advises and a professional test is required only if the committee decides so. The format is not described on the public pages we reviewed, so check with the CIBG or the BIG register before you assume an MCQ. Locally trained graduates in all three professions register by diploma.

Exams at a glance

Language

Dutch is the language of work in almost every clinical setting, and the BIG register accepts language certificates in Dutch, and in some cases English, as part of the assessment. A certificate is not the same as working fluency. Patients, nurses and colleagues speak Dutch on the ward, and handover is verbal. If your plan is to work in the Netherlands, treat the language as the main project and the professional test as the second.

Planning around capacity

In most countries the question is how to prepare. In the Netherlands the first question is whether a place exists. Doctors should check the BIG register news before they invest in preparation, because the test is full. Nurses and dentists should look at the next round dates and fees, and allow time for the language certificates, which are a precondition.

A sensible order is: confirm which route applies to your profession; obtain the language certificates the BIG register accepts; submit the file to CIBG so that the CBGV can advise; and prepare for the professional test while the advice is pending. For the written part, the basic and clinical knowledge tested is that of a graduating Dutch student, so Dutch guidelines (for example the NHG standards in primary care) are a useful reference. Skills tests on test subjects and the reasoning interview reward practice with a colleague who can play examiner.

If the doctor test stays full, some candidates choose to qualify for other roles in the Dutch health system while waiting, or consider another EU country. That is a personal decision, and the BIG register is the place to track the current position.

Using this page

The BIG register and CIBG pages are authoritative on fees, capacity and the order of steps, and they change. TriagePass is not connected to CIBG or the CBGV. We summarise public information and link to the sources below.

Last reviewed October 2026