Step 2: Complete a doctors’ residency (ST)

If you have received a licence to practise as a doctor of medicine prior to 1 June 2015, you can apply according to the 2015 Regulations SOSFS 2015:8 – descriptions of the learning objectives (in Swedish). In order for you to be able to do this, all of the requirements in the 2015 description of learning objectives for the specialty must be fulfilled. An application is to always be made based on the certificates belonging to the rules in the Regulations that you follow with when applying. If you have certificates belonging to previous Regulations, the principal internship supervisor is to transfer the information from the previous certificate and indicate the intermediate learning objective(s) of the 2015 description of learning objectives which the training activity relates to.

The healthcare provider is to be responsible for ensuring that in such activities that receive physicians for doctors’ medical specialty training, the prerequisites for carrying out doctors’ medical specialty training of high and consistent quality are available. This is to be ensured via a systematic review and evaluation of the activities. The healthcare provider should ensure that the director of studies has relevant specialist expertise.

The healthcare provider is responsible for ensuring that there is access to

• a director of studies
• internship supervisors who fulfil the needs with supervision and tutorials
• employees who can provide the necessary instructions concerning activity-specific techniques and approaches.

The Director of Studies should constitute an organisational support function to the administrative director, internship supervisors and resident doctors doing medical specialty training. This individual participates in the work of developing, following up and revising the resident doctors’ individual training programmes, and one of the task and responsibilities should be to develop an induction programme for resident physicians.

The Director of Studies should also remain aware of the continuous assessment being made of the development of the expertise of the resident doctor and participate in consultation with the certification of the acquired specialist expertise (Appendix 2 or 8b).

The Administrative Director at the workplace where the resident doctor primarily carries out his/her doctors’ medical specialty training is to be responsible for:

• the individual programme is developed, regularly followed up and, if necessary, revised in consultation with the director of studies, internship supervisors and the resident doctor
• a principal internship supervisor is appointed for the resident doctor
• the continuous assessment is documented.

The administrative director should hold regular development discussions and performance reviews with the resident doctor.

The principal internship supervisor must have specialist expertise in the specialty that the resident doctor intends to achieve and must have completed medical intern supervisor training. The principal internship supervisor should be working where the resident doctor primarily carries out his/her doctors’ medical specialty training.

The internship supervisor is to continuously support, guide and assess the resident doctor regarding his/her professional development with the description of learning objectives as a starting point. The supervision of the internship and tutorials should be scheduled into the regular work and duty schedules.

For each training period, the resident doctor must have access to an internship supervisor who must have relevant specialist expertise and must have completed medical intern supervisor training. This may be the principal internship supervisor or a current internship supervisor.

If you are already a specialist, you can be given credit for certain training activities from previous doctors’ medical specialty training. It is primarily the principal internship supervisor and the administrative director who assesses what you can be given credit for.

A doctors’ medical specialty training is to always consist of a minimum of five years of clinical training as a supervised doctor. If you are a specialist and want to gain specialist expertise in an additional basic, branch or supplemental specialty, there is a ceiling on how much of your former doctors’ medical specialty training you can be credited with. This means that doctors’ medical specialty training 2, 3, or 4 will always be a minimum of 2.5 years.

A prerequisite for you to be given credit for previous doctors’ medical specialty training is that you fulfil all the expertise requirements in the description of learning objectives.

A doctor may receive credit for up to four years’ clinical training as a doctor in an EEA country other than Sweden or in a third country if he or she:

• has completed the clinical training taking place under supervision
• has received a certificate of clinical training from an administrative director equivalent in the country where the clinical training was performed
• according to an internship supervisor in Sweden, fulfils the expertise requirements in the intermediate learning objectives in the description of learning objectives
• has completed the clinical training after being authorised to practise the medical profession in the country where the clinical training was performed.

Clinical training completed abroad encompasses all internship duties that takes place under supervision carried out in a country outside of Sweden after the date on which authorisation to engage in the medical profession has been obtained in the country where the clinical training was performed.

According to SOSFS 2015:8 (Chapter 6, § 4) the following applies: If a doctor has a certificate of specialist expertise from a third country after completing a minimum of three years of doctors’ medical specialty training and has subsequently worked as a specialist to such an extent that the total length of clinical training in the speciality or the period of specialisation is a minimum of five years, that doctor may obtain a certificate of specialist expertise in the corresponding specialty in Sweden. However, this only applies if he/she

1. completes a minimum of one year of doctors’ medical specialty training in Sweden after receiving a Swedish licence to practise
   and
2. fulfils all expertise requirements in the description of learning objectives.

The first step is to obtain a Swedish medical licence. The doctor is to then go to a hospital or other healthcare provider to apply for doctors’ medical specialty training in the same specialty as the one from a third country. He/she must then complete a minimum of one year of doctors’ medical specialty training residency in Sweden after receiving a Swedish licence to practise. During doctors’ medical specialty training in Sweden, the administrative director and the principal internship supervisor must check that the expertise of the third-country specialist corresponds to the expertise required for specialist expertise in Sweden. During the doctors’ medical specialty training in Sweden, the administrative director and internship supervisor must check that the expertise of the third-country specialist corresponds to the expertise required for a Certificate of specialist expertise in Sweden.

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.

Application form

Application form for Certificate of specialist expertise

CERTIFICATE of specialist expertise achieved

Fill in the speciality which the application relates to, and the applicant’s name and Swedish personal identity number. The principal supervisor and the administrative director must sign the certificate. The internship supervisor must be specialist in the intended specialty. If the administrative director is not a specialist in the intended speciality, he or she is to delegate the responsibilities to a person who has specialist expertise in the intended speciality, however this cannot be delegated to the principal internship supervisor. In the event of such delegation, the certificate must be signed by three persons: the administrative director, the person the administrative director delegated to and the principal internship supervisor. The administrative director and the principal internship supervisor must certify the acquired specialist expertise after consultation with the Director of studies. The Director of studies' name and place of clinical training must be indicated on the certificate, however the director of studies does not need to personally sign the certificate.

Form for Certificate of expertise obtained according to the description of learning objectives for doctors’ medical specialty training (ST)

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

All clinical training that you desire to be given credit for the fulfilment of an intermediate learning objective is to be presented on the Swedish National Board of Health and Welfare’s certificate of completed academic studies/training activity and fulfilled expertise requirements for clinical training taking place under supervision. Fill in the speciality which the application relates to, the place where the clinical training was performed and the period of clinical training, as well as a description of the clinical training. The internship supervisor responsible for the relevant clinical training fills in which intermediate learning objective(s) in the description of learning objectives to which the certificate relates and signs the certificate. The internship supervisor for the relevant clinical position must have relevant specialist expertise and must have completed medical intern supervisor training. Clinical training completed abroad must be reported both on the Swedish National Board of Health and Welfare’s certificate of clinical training and on a certification from the administrative director (or a person in the equivalent position) in the country where the clinical training was performed. Your principal internship supervisor must then sign the Swedish National Board of Health and Welfare’s certificate and indicate which intermediate learning objective(s) in the description of learning objectives the clinical training relates to. You must attach a certified copy of the certificate or diploma that you received from the internship conducted abroad to the Swedish National Board of Health and Welfare’s course certificate. The certificate must contain a description of the contents and scope of the clinical training and the certificate is to state that the clinical training has been conducted under supervision.

Form for Certificate of completed academic studies/training activity and fulfilled expertise requirements with regard to supervised clinical training

CERTIFICATE of completed academic studies/training activity and fulfilled expertise requirements – Auscultation

Fill in the speciality which the application relates to, place where the clinical training was performed, period of auscultation, and a description of the auscultation training. The responsible internship supervisor for the relevant auscultation fills in which intermediate learning objective(s) in the description of learning objectives which the certificate relates to. Note that the credit for auscultation training activity can only be given in the intended intermediate learning objective when the follow-up box is filled in for auscultation.

Form for Certificate of completed academic studies /training activity and fulfilled expertise requirements for auscultation

CERTIFICATE of completed academic studies/training activity and fulfilled expertise requirements – Course

All courses that you desire to be given credit for in your doctors’ medical specialty training is to be presented on the Swedish National Board of Health and Welfare’s certificate of completed academic studies/training activity and fulfilled expertise requirements for the course. Fill in the speciality which the application relates to, the subject of the course, the course leader’s name, the period of the course and description of the course content. The course coordinator or internship supervisor fills in which intermediate learning objective(s) in the description of learning objectives which the certificate relates to and signs the certificate. If you as a resident doctor have taken and passed a course abroad, this is to be reported both on the Swedish National Board of Health and Welfare’s course certificate and via the course certificate from the course taken abroad. Your principal internship supervisor must then sign the Certificate of the Swedish National Board of Health and Welfare and indicate which intermediate learning objective(s) in the description of learning objectives the course relates to. You must attach a certified copy of the course certificate or diploma that you received from the course taken abroad to the Swedish National Board of Health and Welfare’s course certificate.

Form for Certificate of completed academic studies and training activity and fulfilled expertise requirements concerning courses

CERTIFICATE of completed academic studies and fulfilled expertise requirements – Independent written work according to scientific principles

Fill in the speciality which the application relates to, the subject in title format, and a brief description of the paper. It is important that the contents and format of the paper are clearly indicated in the certificate. If you have written the paper together with another colleague, it will also need to be clarified what your own work in the paper was. The Swedish National Board of Health and Welfare does not have any specific requirements concerning the subject or discipline for the paper and does not impose any requirements on the scope of the paper. The written individual paper should have a basic scientific/scholarly form, however other than this, it is primarily up to the internship supervisor and administrative director to decide what is required to achieve the relevant intermediate learning objective. Papers written before the doctors’ medical specialty training can be reported provided that the administrative director and internship supervisor approve the work.

There is no requirement that you must submit the written paper or parts of it together with the application. However, a medical expert or external assessor may desire to obtain copies of the material for review and in these cases. you will be notified by the case officer responsible for your case/file. There is nothing to prevent you from attaching an abstract or a summary to the application. It is the internship supervisor of the written work who completes and signs the Swedish National Board of Health and Welfare’s certificate of completed training activity and fulfilled expertise requirements for independent written work according to scientific principles. The internship supervisor must have specialist expertise in the field which the work relates to and have completed medical intern supervisor training. Please note that the Regulation does not require that the internship supervisor for the written work must have a specific scientific degree.

Form for Certificate of completed academic studies/training activity and fulfilled expertise requirements for independent written work according to scientific principles

CERTIFICATE of completed academic studies and fulfilled expertise requirements – Quality and development work

Fill in the speciality which the application relates to, the subject in title format, and a brief description of the paper. The Swedish National Board of Health and Welfare does not have any specific requirements on the subject or discipline for the paper and does not impose any requirements on the scope of the paper. It is the internship supervisor of the quality and development work who completes and signs the Swedish National Board of Health and Welfare’s certificate of completed academic studies and fulfilled expertise requirements for quality and development work. The internship supervisor must have specialist expertise in the field which the work relates go and have completed medical intern supervisor training.

Form for Certificate of completed academic studies/training activity and fulfilled expertise requirements concerning quality and development work

CERTIFICATE of attainment of the expertise requirements for specialist physicians from third-countries (Appendix 8a)

During the doctors’ medical specialty training in Sweden, the administrative director and internship supervisor must check that the expertise of the third-country specialist corresponds to the expertise required for a certificate of specialist expertise in Sweden. This must be certified on the Swedish National Board of Health and Welfare’s Certificate of compliance with expertise requirements for specialist physicians from third countries. The certificate must contain a detailed description of how the internship supervisor and administrative director have verified that the relevant intermediate learning objectives are fulfilled. This verification concerns both real and formal expertise and it is not sufficient to refer to the internship done abroad or doctors’ medical specialty training done abroad.

Fill in the speciality which the application relates to, the location(s) where the clinical training was performed and the period of each respective clinical training. The administrative director and the principal internship supervisor are to then describe how it has been verified that all expertise requirements in the intermediate learning objective(s) have been fulfilled. This specification can be done, for example, by specifying methods used for the assessment. The certificate may relate to one or more intermediate learning objectives and, if so, a detailed description must be made separately for each of the intermediate learning objectives which the certificate relates to. The principal supervisor and the administrative director must sign the certificate. The internship supervisor must be specialist in the intended specialty. If the administrative director is not a specialist in the intended speciality, he or she is to delegate the responsibilities to a person who has specialist expertise in the intended speciality, however this cannot be delegated to the principal internship supervisor. In the event of such delegation, the certificate must be signed by three persons: the administrative director, the person the administrative director delegated to and the principal internship supervisor. Please note that the educational activities completed during the doctors’ medical specialty training in Sweden must always be reported on the Swedish National Board of Health and Welfare’s certificate for each educational activity.

Form for Certificate of attainment of the expertise requirements for specialist physicians from third countries

CERTIFICATE of attainment of the expertise requirements for specialist physicians from third countries — Specialist expertise achieved (Appendix 8b)

This certificate corresponds to the certificate of specialist expertise achieved (Appendix 2). The principal supervisor and the administrative director must sign the certificate. The internship supervisor must be specialist in the intended specialty. If the administrative director is not a specialist in the intended speciality, he or she is to delegate the responsibilities to a person who has specialist expertise in the intended speciality, however this cannot be delegated to the principal internship supervisor. In the event of such delegation, the certificate must be signed by three persons: the administrative director, the person the administrative director delegated to and the principal internship supervisor. The administrative director and the principal internship supervisor must certify the achieved specialist expertise after consultation with the Director of studies. The name of the director of studies and place of the clinical training must be indicated on the certificate, however the director of studies does not need to personally sign the certificate.

Form for Certificate of attainment of the expertise requirements for specialist physicians from third countries with regard to specialist expertise obtained

The processing time varies depending on the specialty and takes 2–4 weeks if you have submitted a complete application. The processing time may increase with a large influx of applications and on major weekends.

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 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 HSLF-FS 2021:8) and can contribute to fulfil the expertise requirements that are in the descriptions of the learning objectives for each specialty.

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.