Sweden's Kunskapsprov: TULE, practical tests and the four steps to a licence

Medical and health education in Sweden

Medicine in Sweden is a five-and-a-half-year programme (the Läkarprogrammet, 330 credits) taught in Swedish at seven universities: Karolinska Institutet, Uppsala, Lund, Gothenburg, Linköping, Umeå and Örebro. The Swedish Higher Education Authority (UKÄ) reviews the programmes. Dentistry and pharmacy take five years, and nursing is a three-year bachelor’s.

Since 2021 the licence (legitimation) is issued by the National Board of Health and Welfare (Socialstyrelsen) after the degree, with no licensing exam for Swedish graduates. A period of basic training (bastjänstgöring) then precedes the specialist training. Specialist training is entered by applying for individual posts. Doctors trained outside the EU and EEA follow a route set by Socialstyrelsen that includes a theoretical and a practical exam, a language test and a period of supervised practice. Confirm the current steps with Socialstyrelsen. Nursing, pharmacy and dentistry graduates apply to the same authority for their licences, and teaching throughout is in Swedish, so non-Swedish speakers should plan for language study first.

A four-part route, not a single exam

Sweden is the clearest example in this series of a licensing process built from stages. The knowledge test is only one of four. Candidates often start with the test because it sounds like the main obstacle. In practice the order is set by Socialstyrelsen, and the language comes first.

1. Swedish language. Proof of Swedish at the level the board sets (C1 per our research). Without it you cannot go on.
2. Knowledge test. Theoretical test, then practical test, in your profession.
3. Course in Swedish law. The författningskurs on health-care legislation and the structure of Swedish care.
4. Supervised practice. Required for doctors, and in some cases for other professions.

After the stages are complete, the board issues the legitimation. Check the exact order and prerequisites on its page for your profession, because they are updated.

Who needs a licensing exam in Sweden

Graduates of Swedish universities register on the degree. The Kunskapsprov is for graduates from outside the EU/EEA. For EU/EEA graduates, recognition under Directive 2005/36/EC applies, and Socialstyrelsen assesses the qualification instead of testing it.

Doctors: TULE and the practical exam

The doctors' Kunskapsprov has two parts. TULE is the theoretical test, a multiple-choice paper on medical knowledge. The practical exam assesses clinical skills in a simulated or supervised setting. You must pass the theoretical test before you can be admitted to the practical one.

The scope of TULE is the knowledge expected of a newly qualified doctor in Sweden. That emphasises general medicine, the main specialties and emergency care. Socialstyrelsen publishes information about the test and the application process on its legitimation pages. Read the current version, as the number of sittings, the application window and the fee may change.

After the tests, doctors do the legislation course and a period of supervised service before the legitimation is issued. The language requirement of Swedish at C1 applies before the process begins.

Nurses, midwives, pharmacists, dentists and physiotherapists

These five professions share a structure: a theoretical written test and a practical test, with Swedish at C1 level, the legislation course, and sometimes supervised practice. We have no exam-length or pass-mark figures that we can verify for them, so we do not give any. Ask Socialstyrelsen for the current test description for your profession.

The practical test is the part candidates underestimate. It checks whether you can work in a Swedish clinical environment, not just whether you know facts. Nurses, for example, are assessed on the way they plan and document care in a Swedish setting.

Language

Swedish is the language of the test, the course and the clinical work. The board sets the accepted language certificates and the required level. Our research gives C1. Confirm the current level and the list of accepted tests before you book anything, because it is the first gate and the one most likely to cost you months.

Comparing the routes

Preparing for the Swedish tests

For the TULE, revise by system, not by specialty label, and practise single-best-answer vignettes at exam pace. Add Swedish medical vocabulary early. Reading a question in a second language costs time, and the gain from a larger vocabulary is larger than the gain from another textbook chapter. For the practical test, rehearse structured histories and examinations out loud, in Swedish if you can.

Common questions about the Swedish route

How long does it take?

Longer than most candidates expect. The stages run in sequence and each has a waiting list: language, test application, test date, the law course and a supervised placement. A realistic planning horizon is a couple of years from a standing start, though your own file may be faster or slower.

Can I work while I prepare?

Many candidates work in unlicensed roles, such as care assistants, while they study Swedish and prepare. That also builds the vocabulary the practical test depends on. Ask Socialstyrelsen what experience, if any, counts towards supervised practice.

What if I fail a part?

Resits are possible. The board sets the rules on how soon and how often. Read them before your first attempt, so you know the cost of a failed sitting in time as well as money.

Is there any shortcut for EU graduates?

Yes. EU/EEA graduates are assessed on their qualification and not examined. The Swedish language is still expected before they take up a post.

Who should start with which stage?

Almost everyone should start with the language. If you already hold a Swedish certificate at the required level, begin the application for the knowledge test and book the legislation course in parallel. If you do not, a year of language study is not unusual, and the clinical revision can wait until the language is nearly in place. Revising medicine in English is useful, but it will not replace reading Swedish exam questions at speed.

Keep copies of every certificate, transcript and employer letter. Socialstyrelsen may ask for documents again at later stages, and certified translations take time to arrange.

Last reviewed October 2026