Portugal: the PNA for specialty entry and a communication test for foreign doctors

Medical and health education in Portugal

Medicine in Portugal is a six-year integrated master’s degree (mestrado integrado) taught in Portuguese at about eight faculties, including Lisbon, NOVA, Porto, Coimbra, Minho, Beira Interior and the Algarve. The Agency for Assessment and Accreditation of Higher Education (A3ES) accredits programmes, and the Directorate-General for Higher Education (DGES) oversees admission. Dentistry and pharmacy take five years, and nursing four.

Graduates must register with the Ordem dos Médicos to practise. Access to specialty training (internato médico) is through the Prova Nacional de Acesso (PNA), a national ranking exam, so the exam allocates places rather than awarding a licence. There is no separate national licensing exam. Foreign degrees must be recognised, and non-EU graduates are also assessed for Portuguese language level. Confirm current rules with the Ordem dos Médicos and the Ministry of Health.

One national paper, and a language test for outsiders

Portugal looks simple on the surface: the degree qualifies you, and the professional order registers you. For most of the six professions that is the whole story. The exam is concentrated on one point, the transition from medical degree to specialty, where the PNA ranks candidates and places them. For a foreign doctor there is a second, smaller exam: a test of medical communication that is aimed at non-Portuguese speakers.

The distinctive feature is the pairing. Many systems test either knowledge or language. Portugal tests knowledge only on the way into training, through the PNA, and tests language and communication separately, through the Ordem dos Médicos. A candidate can therefore be strong on the first and still be held back on the second.

Who needs a licensing exam in Portugal

• Portuguese medical graduates: no licensing exam. They register with the Ordem dos Médicos and sit the PNA for specialty training.
• Recognised foreign medical graduates: may also sit the PNA, which is open to Portuguese and recognised foreign graduates.
• Foreign doctors who are not native Portuguese speakers: the Prova de Comunicação Médica, after degree recognition.
• Nurses, midwives, pharmacists, dentists, physiotherapists: no exam. Registration by diploma with their order.
• Non-EU graduates of any profession: degree recognition, with exams at a faculty in some cases, and proof of Portuguese.

Doctors: the PNA

The Prova Nacional de Acesso à Formação Especializada is a multiple-choice paper built on clinical vignettes. The ACSS (Administração Central do Sistema de Saúde) publishes the call, the programme and the places each year. Our research notes record roughly 150 questions, and the length has changed in the past, so confirm it against the current call. Results produce a national rank, and candidates choose specialties and hospitals in rank order.

Because the questions are vignette-based, the preparation is not just recall. You need to read a case, identify what is being asked, and choose the next best step under time pressure. That favours practice with full-length cases over passive reading.

Foreign-trained doctors

1. Apply for recognition of your degree (reconhecimento) at a Portuguese university. For non-EU degrees the university may set exams.
2. Show Portuguese. If it is not your native language, you sit the Prova de Comunicação Médica with the Ordem dos Médicos.
3. Register with the Ordem dos Médicos.
4. Sit the PNA if you want specialty training.

Brazilian graduates form a large group. Their language advantage is real, but the Ordem's test is a test of communication in a clinical setting, and European Portuguese terminology and structure differ from Brazilian usage. The rules for each nationality depend on bilateral arrangements, so check the Ordem's current notice.

Nurses and midwives

Registration is with the Ordem dos Enfermeiros, by diploma. Midwifery is a nursing specialty (Especialista em Saúde Materna e Obstétrica) in Portugal, so a midwife is first a nurse and then specialises. Non-EU nurses need recognition of their degree by a university or by the Direção-Geral do Ensino Superior (DGES), plus proof of Portuguese. No national exam exists.

Pharmacists, dentists and physiotherapists

Pharmacists register with the Ordem dos Farmacêuticos, dentists with the Ordem dos Médicos Dentistas, and physiotherapists with the Ordem dos Fisioterapeutas. Non-EU graduates need degree recognition and proof of Portuguese. Dentists from outside the EU often need exams at a faculty as part of recognition, so plan for that.

Exams at a glance

Language and recognition

EU and EEA graduates are recognised under the EU directive. Non-EU graduates go through university recognition and show Portuguese at the level the order requires. All exams and clinical work are in Portuguese. The practical advice is to start the recognition request first, since it can take months, and to study the language in parallel with the clinical preparation.

Preparing for the PNA and the communication test

For the PNA, the most useful preparation is volume of clinical-vignette practice under time pressure, with review of every wrong answer against Portuguese guidelines, such as those from the Direção-Geral da Saúde. Foreign graduates should check that their usual references match national practice, for example in vaccination schedules and screening programmes, where countries differ.

For the communication test, the skill is structured interaction with a patient in European Portuguese: greeting, open questions, safety-netting, explanation in plain words. Record yourself, and ask a native speaker, ideally a clinician, to comment on register. Brazilian candidates often need to adapt vocabulary and the formal address used with older patients.

Finally, do the paperwork first. Degree recognition and registration take longer than studying for a paper, and a delay there can push you past the PNA registration window.

One more point on timing: the PNA is held once a year, so a missed registration window means a twelve-month wait. Build a calendar that works backwards from the registration date, with recognition, language preparation and question practice each given a fixed block of weeks.

Using this page

The ACSS call for the year is the primary source for the PNA, and the Ordem dos Médicos for the communication test. TriagePass is independent of both. Where this page says a figure is approximate, treat it as a pointer to check, not a rule.

Last reviewed October 2026