Step 2: Complete a doctors’ residency (ST) with BT foundation period (BT)

A doctors’ residency (ST) is a supervised form of further training. This training must be equivalent to full-time hours for at least 5 years and 6 months full-time. ST must begin with BT foundation period (BT) for at least 6 months. BT is part of the new ST, and the BT foundation period counts towards the minimum time for the ST as a whole.

This page is intended for applicants in accordance with the new rules, HSLF-FS 2021:8.

If you are covered by the transitional provisions below, you must instead submit an application in accordance with regulations SOSFS 2015:8 or SOSFS 2008:17.

Please note that the option of completing an ST and submitting an application in accordance with SOSFS 2008:17 ends on 30 April 2022.Your application must be submitted to the Swedish National Board of Health and Welfare by 30 April 2022, and your ST must be completed. After 30 April 2022, you will be able to apply for a certificate of specialist expertise in accordance with SOSFS 2015:8 or HSLF-FS 2021:8.

Transitional rules for the 2021 regulations with BT and ST

Not everyone will be covered by the new system immediately. Doctors in the following groups will still be able to obtain certificates of specialist expertise in accordance with the old rules when the new rules have come into force (which includes the 2015 descriptions of learning objectives, with a minimum period of 5 years and no BT foundation period (BT)):

  • doctors who have completed Swedish medical internships (AT)
  • doctors who have started but not completed a doctors’ medical specialty training residency (ST) before 1 July 2021.

As of 1 July 2021, only these two groups will be able to have their applications for certificates of specialist expertise examined in accordance with the old rules. This is regulated in the transitional provisions to the Patient Safety Regulation (in Swedish).

If an ST doctor starts the other elements of their doctors’ residency while completing their BT foundation period (BT) at the same time, the training should be planned so that an application for a certificate of approved BT can be made within the first two years of full-time training. The Swedish National Board of Health and Welfare does not make decisions on matters concerning the organisation of ST or BT and does not provide advance notification. The Head of Department is responsible for developing a personal training programme.

Here’s how to proceed

  1. Apply for a doctors’ residency (ST) with BT foundation period (BT) with a healthcare provider.
  2. The Head of Department in charge is responsible for devising a personal training programme and appointing a principal supervisor.

Roles and responsibilities

Several different people are responsible for doctors’ residencies. Information on the responsibilities of the various people is provided here.

Responsible ST, in accordance with HSLF-FS 2021:8

Healthcare provider

The healthcare provider that accepts doctors for medical specialty training residencies must ensure that conditions are in place to allow such training residencies to maintain high and consistent quality.

This responsibility must include ensuring access to

  • a Director of Studies
  • supervisors to the extent necessary to meet the need for supervision
  • employees who can provide the necessary instructions on department-specific techniques and procedures.

Head of Department

The Head of Department at the training location where an ST doctor is to perform their main duties must hold overall responsibility for the ST doctor’s medical specialty training residency.

The Head of Department must stand responsible for ensuring, for each ST doctor, that

  • a training programme is devised
  • a principal supervisor is appointed.

Director of Studies

The Director of Studies must have specialist expertise and have completed supervisor training. The Director of Studies must coordinate the internal and external training activities for BT and ST doctors. The Director of Studies should also provide organisational support for the Head of Department, supervisors, BT doctors and ST doctors.

Supervisors and principal supervisor

Each ST doctor must have access to a supervisor for each part of their training and a principal supervisor who holds overall responsibility for supervision throughout the training residency.

Supervisors for ST doctors must

  • be licensed doctors
  • have relevant specialist expertise
  • have completed supervisor training.

The principal supervisor must hold a certificate of specialist expertise in the specialty that the ST doctor is aiming to achieve.

The principal supervisor and a doctor designated by the healthcare provider must make a joint assessment of whether the ST doctor meets the expertise requirements outlined in the descriptions of learning objectives for the specialty before issuing a certificate of specialist expertise or a certificate of expertise for specialised doctors of medicine from a third country.

The doctor appointed by the healthcare provider must

  • be a licensed doctor
  • hold a certificate of specialist expertise in the specialty that the ST doctor is aiming to achieve
  • have completed supervisor training.
Responsible BT, in accordance with HSLF-FS 2021:8

Head of Department

The Head of Department at any training location where a BT doctor is completing their training or another person with an organisational position appropriate for this purpose must hold overall responsibility for the BT doctor’s basic training.

They are responsible for ensuring, for each BT doctor, that

  • a training programme is devised
  • a principal supervisor is appointed.

Director of Studies

The Director of Studies must have specialist expertise and have completed supervisor training. The Director of Studies must coordinate the internal and external training activities for BT and ST doctors. The Director of Studies should also provide organisational support for the Head of Department, supervisors, BT doctors and ST doctors.

Supervisors, principal supervisor and external assessor

Each BT doctor must have access to a supervisor for each part of their basic training and a principal supervisor who holds overall responsibility for supervision throughout the basic training.

The BT doctor’s supervisor must

  • be a licensed doctor
  • have a certificate of specialist expertise or be an ST doctor
  • have completed supervisor training.

The principal supervisor must monitor the development of the BT doctor’s expertise throughout the basic training, consult with other supervisors and have access to the assessments of the other supervisors.

The BT doctor’s supervisor must assess the development of the BT doctor’s expertise on an ongoing basis, based on the description of learning objectives for basic training and the personal training programme. These assessments must be documented.

For each period of training, the supervisor must make an overall assessment of the BT doctor’s expertise on the basis of the description of learning objectives for basic training and the personal training programme. This assessment must be documented.

The principal supervisor, together with an external assessor, must make an overall assessment of whether the BT doctor meets the expertise requirements in the description of learning objectives before issuing a certificate of basic expertise.

The external assessor must

  • be a licensed doctor
  • have a certificate of specialist expertise
  • have knowledge and skills in the field of expertise assessment.

The external assessor must not have trained at the same time as the BT doctor at the same healthcare unit, nor have participated in any other way in the BT doctor’s basic training.

Receiving credit for previous expertise

Credits, BT

If you have trained as a doctor under supervision after your medical degree before obtaining a licence to practise as a doctor in Sweden, or an equivalent certificate of expertise in another country, you may credit up to 6 months of that training towards your doctors’ medical specialty training residency (ST). This also includes training in primary care and emergency care. Doctors who have a Swedish doctoral degree are unable to credit training time in their BT.

You may credit up to 4 years and 6 months of training from an EEA country other than Sweden or a third country, provided that, as an ST doctor

  1. you have completed your training under supervision
  2. you have received a certificate from a Head of Department or equivalent in the country in which you trained, including a description of the content and scope of your training
  3. you meet the expertise requirements in the intermediate objectives in the description of learning objectives according to a supervisor in Sweden 
  4. you have completed your training after having obtained authorisation to practise medicine in the country in which you trained.

If such training includes training in primary care or emergency care, this may also be credited.

Already a specialist

If you are already a specialist, you have the option of crediting up to 2 years and 9 months of your previous medical specialty training residency. If you hold a certificate of specialist expertise in accordance with older regulations, you are exempt from the requirement for an external assessor to make an overall assessment of whether you meet the expertise requirements in the description of learning objectives for basic training. The certificate of basic expertise then only needs to be signed by the principal supervisor. Otherwise, you will need to apply for BT and ST in accordance with the new rules for 2021.

Receiving credit for foreign training

You may credit up to 4 years and 6 months of training as a doctor in an EEA country other than Sweden or a third country if

  • you have completed your training under supervision
  • you have received a certificate of training from the Head of Department or equivalent in the country in which you trained
  • you meet the expertise requirements in the intermediate objectives in the description of learning objectives according to a supervisor in Sweden
  • you have completed your training after having obtained authorisation to practise medicine in the country in which you trained.

Foreign training includes all supervised training conducted in a country outside Sweden after the date on which you became qualified to practise medicine in the country in which you trained.

Specialist from a third country

If you have a certificate of specialist expertise from a third country, you must obtain a certificate of specialist expertise in the corresponding specialty in Sweden if

  1. you have completed at least three years of specialist training and subsequently worked as a specialist to the extent that the total length of training in the specialty or the period of your medical specialty training residency is at least 5 years
  2. you have completed at least 1 year of medical specialty training residency in Sweden after having obtained a Swedish licence to practise
  3. you meet all the expertise requirements in the description of learning objectives for basic training and the specialty.

Foreign training includes all supervised training conducted in a country outside Sweden after the date on which you became qualified to practise medicine in the country in which you trained.

The foreign training to be credited must be recorded in the training record and on the certificate of intermediate objectives. The application must be accompanied by a certificate from the foreign training, translated into Swedish or English.

Receiving credit from postgraduate studies

You can count credits from postgraduate studies towards your doctors’ medical specialty training residency. If you have a Swedish doctoral degree, you can credit 6 months of the time for your ST, provided that the requirements in the description of learning objectives are met. This also applies to any foreign doctoral degree that a Swedish university, a Swedish higher education institution or the Swedish Council for Higher Education has deemed to be equivalent to a Swedish doctoral degree.

Documentation instructions

More information about the various documents included in the application for a certificate of approved BT foundation period and a certificate of specialist expertise is provided below. The instructions for BT and ST include more detailed information on how to complete your application.

Instructions for Application for a certificate of approved BT foundation period for doctors in accordance with HSLF-FS 2021:8 (in Swedish) 

Certificates related to HSLF-FS 2021:8 (BT)

APPLICATION for a certificate of approved basic training

This is where you enter your personal data, contact details, place of work and the date when you graduated with a medical degree. You also indicate whether you have previously received a Swedish or foreign licence or certificate of eligibility.

The list of attached certificates is filled in if you wish to clarify your application by numbering the attachments. The form must then be signed by the applicant.

Application for a certificate of approved basic training (PDF)

CERTIFICATE relating to intermediate objectives of basic training

Fill in the applicant’s name and personal identity number. The certificate must indicate the intermediate objectives to which the certificate refers (e.g. BT1, BT2) and the training activities completed in order to achieve the intermediate objectives. If the certificate relates to a number of intermediate objectives, the certificate must describe which training activities relate to which intermediate objectives. The certificate must also include a description of how your achievement of intermediate objectives (e.g. clinical care assessments or course examinations) was verified. If the certificate relates to a number of intermediate objectives, the certificate must describe which checks relate to which intermediate objectives.The certificate must be filled in and signed by the supervisor who has assessed your achievement of the intermediate objectives to which the certificate relates.

Certificate relating to intermediate objectives of basic training (PDF)

CERTIFICATE of completion of basic training

Enter the applicant’s name and personal identity number.Enter the training location, period and extent of the basic training. The certificate must also indicate which part was/which parts were completed in primary care and emergency care. The certificate must be filled in and signed by the Head of Department in charge or equivalent.

Certificate of completion of basic training (PDF)

CERTIFICATE of basic expertise

Fill in the applicant’s name and personal identity number.The certificate must be filled in and signed by the principal supervisor and an external assessor. The doctor holding a certificate of specialist expertise in accordance with older regulations is exempt from the requirement for an external assessor to make an overall assessment of whether he or she meets the expertise requirements in the description of learning objectives for basic training. The certificate of basic expertise then only needs to be signed by the principal supervisor.

Certificate of basic expertise (PDF)

Certificates related to HSLF-FS 2021:8 (ST)

APPLICATION for a certificate of specialist expertise

This is where you enter the specialist expertise to which the application relates, your personal data, contact details, place of work and the date when you graduated with a medical degree. You also indicate whether you have previously received a Swedish or foreign licence or certificate of specialist expertise, as well as the date of the certificate of approved basic training. The list of attached certificates and other documentation is filled in if you wish to clarify your application by numbering the attachments. The date on which the fee is paid must also be filled in. The form must then be signed by the applicant.

Application for a certificate of specialist expertise (PDF)

CERTIFICATE of completion of doctors’ medical specialty training residency

Enter the specialty to which the application relates and the applicant’s name and personal identity number.

It is important for the length of training for your ST to be stated clearly in the training record. Holidays and compensation for on-call periods may be credited to the training. Parental leave may not be credited.

If you wish to credit previous training, this must be indicated in your training record. You must indicate in your application both the training you wish to be credited and the training completed during your current medical specialty training residency. This also applies to any foreign training that you wish to be credited. It must be clearly stated that your ST has involved at least 60 months of clinical medical training under supervision. The Head of Department in charge or equivalent must issue the certificate.

Certificate of completion of doctors’ medical specialty training residency (PDF)

CERTIFICATE of specialist expertise

Enter the specialty to which the application relates and the applicant’s name and personal identity number.

The principal supervisor and the specialised doctors of medicine appointed in addition to the supervisor to conduct the overall assessment must sign the certificate. Both must be in possession of specialist expertise in the specialty in question.

Certificate of specialist expertise (PDF)

CERTIFICATE of training activity completed and expertise requirements met – auscultation

Fill in the applicant’s name and personal identity number, the specialty to which the application relates, the training location, the period of the auscultation and a description of the auscultation. The supervisor responsible for the auscultation in question fills in the intermediate objective(s) in the description of learning objectives to which the certificate relates. Please note that the auscultation training activity can only be credited in the designated intermediate objective when the follow-up box for auscultation is filled in.

Certificate of training activity completed and expertise requirements met – auscultation (PDF)

CERTIFICATE of training activity completed and expertise requirements met – supervised clinical training

All training that you wish to be credited for achievement of intermediate objectives must be reported on the Swedish National Board of Health and Welfare’s certificate of training activity completed and expertise requirements met for supervised clinical training.

Fill in the applicant’s name and personal identity number, the specialty to which the application relates, the training location and period of clinical training, and a description of the clinical training. The supervisor responsible for the training in question fills in the intermediate objective(s) in the description of learning objectives to which the certificate relates and signs the certificate. The supervisor for the training in question must have the relevant specialist expertise and must have completed supervisor training.

Foreign training must be reported both on the Swedish National Board of Health and Welfare’s certificate of training and on a certificate from the Head of Department or equivalent in the country in which training was completed. Your principal supervisor must then sign the Swedish National Board of Health and Welfare’s certificate and indicate the intermediate objective(s) in the description of learning objectives to which the training relates. You must attach a certified copy of the certificate or diploma that you received from your foreign training to the certificate of training issued by the Swedish National Board of Health and Welfare. This certificate must include a description of the content and scope of the training and must state that the training has been carried out under supervision.

Certificate of training activity completed and expertise requirements met – supervised clinical training (PDF)

CERTIFICATE of training activity completed and expertise requirements met – course

All courses that you wish to be credited in your doctors’ medical specialty training residency must be reported on the Swedish National Board of Health and Welfare’s certificate of training activity completed and expertise requirements met for the course.

Fill in the applicant’s name and personal identity number, the specialty to which the application relates, the subject of the course and a description of the course. The course leader or supervisor fills in the intermediate objective(s) in the description of learning objectives to which the certificate relates and signs the certificate.

If you have taken a foreign course as a ST doctor, this must be reported both on the Swedish National Board of Health and Welfare’s course certificate and through the foreign course certificate. Your principal supervisor must then sign the Swedish National Board of Health and Welfare’s certificate and indicate the intermediate objective(s) in the description of learning objectives to which the course relates. You must attach a certified copy of the course certificate or diploma that you received from the foreign course to the course certificate issued by the Swedish National Board of Health and Welfare.

Certificate of training activity completed and expertise requirements met – course (PDF)

CERTIFICATE of training activity completed and expertise requirements met – participation in development work

Fill in the applicant’s name and personal identity number, the specialty to which the application relates, the course in the form of a heading and a description of the applicant’s participation in the work.

The Swedish National Board of Health and Welfare has no specific requirements for the subject of the work, nor does it define any requirements for the scope of the work.

The supervisor for the quality and development work fills in and signs the Swedish National Board of Health and Welfare’s certificate of training activity completed and expertise requirements met for the eligible quality and development work. The supervisor must have specialist expertise in the field to which the work relates or in the intended specialty and have completed supervisor training.

Certificate of training activity completed and expertise requirements met – participation in development work (PDF)

CERTIFICATE of intermediate objective Sta3 – Medical science

Fill in the applicant’s name and personal identity number, the specialty to which the application relates and a description of the training activity (activities) undertaken by the applicant in order to achieve the intermediate objective. The certificate must also describe how the applicant’s achievement of the intermediate objective has been verified.

The supervisor who has assessed that the applicant has achieved the intermediate objective must fill in and sign the certificate. The supervisor must have specialist expertise in the field to which the work relates or in the intended specialty and have completed supervisor training.

Certificate of intermediate objective Sta3 – Medical science (PDF)

CERTIFICATE of intermediate objectives for specialised doctors of medicine from a third country

During the doctors’ medical specialty training residency period in Sweden, the supervisor must verify that the expertise of the specialist from a third country corresponds to the expertise required for the certificate of specialist expertise in Sweden. This certificate must include a description of the training activities undertaken by the applicant in order to achieve the intermediate objectives and how this has been verified. This verification applies to both real and formal expertise, and referring to the foreign training or the foreign medical specialty training residency will not suffice.

Fill in the applicant’s name and personal identity number and the specialty to which the application relates. The certificate may relate to one or more intermediate objectives, in which case it must describe the training activities and which checks relate to which intermediate objectives.

The principal supervisor must sign the certificate. The supervisor must be in possession of specialist expertise in the specialty in question.

Please note that the training activities completed during the doctors’ medical specialty training residency period in Sweden must always be reported on the Swedish National Board of Health and Welfare’s certificate for each training activity.

Certificate of intermediate objectives for specialised doctors of medicine from a third country (PDF)

Frequently Asked Questions

Can I do my specialty training (ST) on a part-time basis?

Yes. But if you do your specialty training part-time, the length of the clinical training is to be extended so that the total time corresponds to full-time work for a minimum of five years.

SK courses – specialist skills courses for doctors

SK courses (specialist expertise courses) are government-funded courses intended for doctors performing doctors’ medical specialty training in Sweden. The courses are listed in the specialist expertise course catalogue in our application portal, where you also apply.

The SK courses are part of the total range of courses aimed at doctors during the doctors’ medical specialty training. The courses are adapted to the latest version of the Swedish National Board of Health and Welfare’s Regulations on Doctors’ Medical Specialty Training (SOSFS 2015:8) and contributes to fulfil the expertise requirements that are in the descriptions of the learning objectives for each specialty.

What goes with signing with Certificate of Specialist Expertise?

As of 1 July 2021, the National Board of Health and Welfare will stop signing the Certificate of Specialist Expertise for doctors and dentists. We will also not sign the new certificates of approved basic service (BT).

On 1 July 2021, the new regulations on doctors' basic service (BT) will apply. The National Board of Health and Welfare will issue a certificate of approved basic service. However, the certificates will not be signed. From 1 July 2021, the Certificate of Specialist Expertise for doctors and dentists will not be signed either.

A step towards increased digital management

The change means that all decisions and certificates can be processed digitally, instead of in paper format, and thus entails a streamlining of our handling as well as a step towards increased digital handling. With the change, we also want to achieve an equal handling of all certificates from the National Board of Health and Welfare, since we don´t sign professional licences either since 2017.

Authorization is checked in the HOSP register

The primary source for checking a license is the Register of Licensed Health Care Professionals in Sweden (HOSP). It is the HOSP register that indicates the current status of an authorization. An issued Certificate of Specialist Expertise only indicates the status of an authorization on the date on which the certificate was issued.

Questions and Anwers about Doctors' BT (HSLF-FS 2021:8) in Swedish)

Do you have further questions about your application?

Contact us at the Swedish National Board of Health and Welfare. You can send an e-mail at socialstyrelsen@socialstyrelsen.se or call us at 075-247 30 00.

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