Complementary program for physicians with a degree from outside the EU/EES and Switzerland

The purpose of the programme is for the student, upon completion, to demonstrate the knowledge and skills required to practise medicine in Sweden. Successful completion of the programme provides eligibility to apply for a Swedish medical licence through the National Board of Health and Welfare (Socialstyrelsen), which determines the conditions for licensure.

The programme is intended for physicians who have completed their medical education in countries outside the EU/EEA and Switzerland, and who have not otherwise obtained a Swedish medical licence or eligibility to undertake general or basic medical training (AT or BT). The programme is governed by Ordinance (2008:1101) on higher education programmes that complement completed foreign qualifications.

The programme builds on the student’s previous knowledge, skills, and competencies, and presupposes solid medical knowledge and clinical skills acquired through prior medical education completed in a country outside the EU/EEA and Switzerland.

A medical degree from a country outside the EU/EEA and Switzerland. A decision (approval) issued by the National Board of Health and Welfare (Socialstyrelsen) for assessment in the form of a proficiency test for physicians. Demonstrated proficiency in Swedish in accordance with the requirements for general eligibility for first-cycle studies, corresponding to Swedish 3 or Swedish Level 3.

Students in the Complementary Programme for Physicians with a Medical Degree from outside the EU/EEA and Switzerland all hold a foreign medical degree; therefore, no degree is awarded upon completion of the programme.

A student who has successfully completed the programme with a passing grade (G) in all courses receives a certificate of completion, which may serve as the basis for an application to the National Board of Health and Welfare (Socialstyrelsen) for a Swedish medical licence. The National Board of Health and Welfare determines the conditions for licensure.

The Complementary Programme for Physicians comprises 120 higher education credits (ECTS) and is largely structured around semester-long courses corresponding to those in the regular Medical Programme, where instruction is provided at the advanced level. The programme is offered on a full-time basis.

The education is conducted within a complete academic environment with strong research links, in close collaboration with the healthcare sector and the wider community. The programme includes well-structured clinical placements designed according to specific learning outcomes. Throughout the programme, subject-specific teaching runs in parallel with training in Professional Development (PU).

The teaching aims to promote the students’ responsibility for their own learning and to encourage reflection and critical thinking. The programme is based on a broad pedagogical approach founded on student-centred learning, incorporating a variety of educational activities such as lectures, group exercises, simulation training, clinical skills practice, and in-depth studies.

The design and implementation of the education ensure progression in students’ knowledge, skills, and professional attitudes, providing both breadth and depth across the programme’s subject areas. Basic medical sciences and clinical subjects are integrated throughout the courses.

The clinical components of the programme are conducted in close collaboration with the healthcare services in Region Västra Götaland and Region Halland. Clinical placements take place at all hospitals within these two regions as well as at primary healthcare centres. Training and assessment of students’ professional activities—encompassing essential knowledge, skills, and professional attitudes expected upon graduation—are carried out according to the national competency framework Entrustable Professional Activities (EPA), both during clinical placements and in simulated settings.

The programme follows a fixed study plan, meaning that courses must be taken in the prescribed order outlined in the curriculum.

Programme Structure and Course Sequence

Semester 1
Introduction to Swedish Health Care, 30 credits

Semester 2
Complementary Clinical Theory and Practice 1, 30 credits

Semester 3
Complementary Clinical Theory and Practice 2, 30 credits

Semester 4
Professional Application and In-depth Studies, 30 credits

Professional Development (PU)

An important element of the programme is Professional Development (PU), which is divided into six areas:

• Communication skills and self-reflection
• Leadership and teamwork
• Ethical approach
• Human rights and gender equality
• Scientific approach
• Sustainable development

Teaching within PU aims to continuously train students to assess, develop, and adapt their medical and professional competencies. The programme also reflects ethical attitudes, a commitment to human health, collaborative ability, and lifelong learning. Emphasis is placed on students’ capacity for reflection and maintaining a professional approach.

Students are also trained to apply their competencies in patient encounters and from a societal perspective. Upon completion, the licensed physician should be able to integrate scientific knowledge, clinical skills, and a scholarly approach to provide person-centred, patient-safe, and equitable healthcare. The student is also expected to demonstrate knowledge of Swedish regulations necessary for practising medicine in Sweden.

Course Descriptions

Semester 1 – Introduction to Swedish Health Care (30 credits)
The course aims to develop and adapt students’ medical knowledge and skills to the Swedish context and working methods, and to provide an overview of the Swedish healthcare system. The course includes instruction in consultation skills, cardiopulmonary resuscitation (CPR), interprofessional learning and collaboration, academic integrity, confidentiality, infection control, workplace communication, and academic speaking and writing. It also covers Swedish healthcare legislation and organisation, as well as ethical principles and prioritisation frameworks within Swedish healthcare. Additionally, the course introduces the foundations of the Swedish system of government.

Students practise identifying, locating, and interpreting regulations and other legal sources through practical exercises.

The course also includes psychiatry and thematic days with lectures, seminars, and case discussions in geriatrics, neurology, infectious diseases, immunology, microbiology, venereology, rheumatology, allergology, otorhinolaryngology, ophthalmology, clinical genetics, and dermatology, focusing on the management of common, serious, and acute conditions.

Teaching methods include lectures, seminars, case discussions, written assignments, consultation and examination exercises at the Clinical Training Centre, and clinical placements.

Semester 2 – Complementary Clinical Theory and Practice 1 (30 credits)
This course corresponds largely to the course Clinical Theory and Practice 2 in the regular Medical Programme (360 credits) at the University of Gothenburg, offered during semester 6.

The course covers general internal medicine, emergency medicine, diabetology, endocrinology, gastroenterology, hepatology, haematology, cardiology, pulmonology, nephrology, general practice, paediatrics, clinical pharmacology, clinical chemistry, clinical physiology, and radiology/radiation protection. Teaching focuses on the management of common, serious, and acute internal medicine conditions. Clinical placements account for 15 credits, including 4 credits in primary care.

Semester 3 – Complementary Clinical Theory and Practice 2 (30 credits)
This course corresponds to Clinical Theory and Practice 3 in the regular Medical Programme (360 credits) at the University of Gothenburg, offered during semester 7.

The course consists of theoretical and practical components in the following areas: surgery (gastrointestinal, breast, endocrine, hand, vascular, and plastic surgery), including trauma, as well as elements of gastroenterology and hepatology. It also includes orthopaedics, urology, anaesthesiology with intensive care, radiology/radiation protection, and oncology.

Students are expected to be able to diagnose and manage common, serious, and acute conditions within these fields. Clinical placements account for 18 credits, including 3 credits in primary care.

Semester 4 – Professional Application and In-depth Studies (30 credits)
This course largely corresponds to Professional Application and In-depth Studies 2 in the regular Medical Programme (360 credits) at the University of Gothenburg, offered during semester 12.

The course includes general practice, emergency medicine, geriatrics, gynaecology and obstetrics, and clinical practice. The learning outcomes focus on common, serious, and acute medical conditions, and students train to perform key professional activities by managing patients and making medical decisions.

Clinical placements during the semester account for 25.5 credits, of which 10.5 credits are within primary care. Students also complete a quality improvement project during this semester.

General Objectives

The objectives of the Complementary Programme for Physicians are the same as those stipulated for the Degree of Master of Science in Medicine (Läkarexamen), in accordance with the Higher Education Ordinance (SFS 1993:100, Annex 2 – Degree Ordinance). The aim is for the student to demonstrate the knowledge and skills required for eligibility as a licensed physician.

Knowledge and Understanding

Upon completion of the programme, the student shall be able to:

• demonstrate both broad and in-depth knowledge within the field of medicine,
• demonstrate knowledge of the scientific foundation of the field and insight into current research and development work, as well as understanding of the relationship between science and proven experience in professional practice,
• demonstrate knowledge of fundamental scientific methods within the field and insight into their possibilities and limitations,
• demonstrate knowledge of ethical principles and their application in health care as well as in research and development,
• demonstrate knowledge and understanding of societal factors that affect the health of individuals and groups from both national and global perspectives,
• demonstrate knowledge of men's violence against women and violence in close relationships,
• demonstrate knowledge of the Swedish health care system, including its organisation and governance, and familiarity with health care systems in other countries, as well as understanding of strategies for equitable access to health care,
• demonstrate knowledge of patient safety, quality, and prioritisation in health care, as well as methods for evaluating medical activities, and
• demonstrate knowledge of relevant legislation and regulations.

Competence and skills

Upon completion of the programme, the student shall be able to:

• demonstrate advanced ability to professionally interact with patients and their relatives, showing respect for their integrity, needs, knowledge, and experiences,
• demonstrate the ability to critically and systematically integrate and apply knowledge, and to analyse and evaluate complex phenomena, issues, and situations,
• demonstrate the ability to independently diagnose and initiate treatment of acute life-threatening conditions,
• demonstrate advanced ability to independently diagnose common diseases from pathophysiological, psychosocial, and other relevant perspectives, and to manage these in collaboration with the patient,
• demonstrate the ability to initiate and participate in health promotion and disease prevention activities for individuals and groups, and to explain how such work is conducted at the societal level,
• demonstrate the ability to communicate orally and in writing regarding measures and treatment outcomes with relevant parties and to document these in accordance with applicable regulations,
• demonstrate advanced ability to contribute to learning within various groups and to perform supervisory tasks,
• demonstrate the ability for leadership and interprofessional collaboration both within health care and with professionals in other sectors of society,
• demonstrate the ability to initiate, participate in, and implement quality improvement work, as well as the skills required to participate in research and development activities,
• demonstrate advanced ability to discuss new facts, phenomena, and issues in the medical field on a scientific basis with various audiences, and to critically evaluate and use relevant information, and
• demonstrate the ability to use digital tools in health care as well as in research and development work.

Judgement and Approach

Upon completion of the programme, the student shall be able to:

• demonstrate the ability for self-reflection and empathy, as well as a professional approach,
• demonstrate the ability to adopt a health-promoting and holistic perspective on the patient based on a scientific approach, with particular regard to ethical principles and human rights, and
• demonstrate the ability to identify the need for continuous development of their own competence and to take responsibility for this.

Local Objectives

The objectives of the Complementary Programme are further specified and elaborated in the syllabi of the individual semester courses.

Upon completion of the programme, students shall be able to independently perform a number of profession-specific activities (Entrustable Professional Activities, EPA; see Appendix 1), and to manage a range of clinical situations (see Appendix 2).

In connection with the introduction of the courses included in this programme syllabus, the Complementary Programme for Physicians with a Medical Degree from outside the EU/EEA and Switzerland, 120 credits (M2KUL), the courses included in the former course package Complementary Programme for Physicians with a Medical Degree from outside the EU/EEA and Switzerland, 90 credits (MCKUL) will no longer be offered.

Students previously admitted to the course package Complementary Programme for Physicians with a Medical Degree from outside the EU/EEA and Switzerland (MCKUL) are entitled to participate in three examination sessions, including the regular examination, for at least one year and at most two years after the course has ceased to be offered.

For further information, please refer to the respective course syllabus.

The study programme will be followed up and evaluated in accordance with the applicable Policy for the Quality Assurance and Continuous Quality Improvement of Education at the University of Gothenburg (Policy för kvalitetssäkring och kvalitetsutveckling av utbildning vid Göteborgs universitet).

Elements of distance or online teaching may occur in some courses, which requires access to a computer, webcam, and internet connection.

Teaching is conducted primarily in Swedish, although English may also be used. Course literature in English and other Scandinavian languages may occur.

During clinical placements (verksamhetsförlagd utbildning, VFU), certain healthcare providers may require students to present an extract from the Swedish Police Criminal Records Registry. It is therefore important that students always have a valid extract available for inspection upon request. In some settings, identity verification of students may also be required.

During VFU, the confidentiality and secrecy regulations of Region Västra Götaland and Region Halland apply.

Requirements regarding clothing and hygiene follow the healthcare sector’s directives.

VFU placements are arranged within outpatient, inpatient, and primary care in Region Västra Götaland and Region Halland.

Certain parts of the VFU may entail travel and accommodation costs for the student.

Some VFU activities may take place during evenings, nights, and weekends.

The examiner may, with immediate effect, terminate a student’s clinical placement if the student demonstrates such serious deficiencies in knowledge, skills, or professional conduct that patient safety or public trust in healthcare is jeopardised. Termination of VFU in this manner results in failure of the current placement and counts as one used placement opportunity.

The reason for terminating VFU in this way must be documented, and an individual action plan must be established, specifying the activities and assessments required before the student is granted a new VFU opportunity. A student who has failed a clinical placement is entitled to one (1) additional placement opportunity within the course.

A student who follows the programme at the prescribed rate of study is guaranteed a place in the compulsory courses offered within the framework of the programme, provided that the entry requirements stated in the syllabus for each course are fulfilled.

Appendix 1 – EPA (Entrustable Professional Activities) (M2KUL)

In a national collaboration, all medical programmes in Sweden have jointly developed ten Entrustable Professional Activities (EPAs) that every physician must be able to perform with consistency and with a defined degree of independence (in relation to supervision) on the first day as a licensed physician.

The ten national EPAs listed below serve as a framework for students’ training and feedback also within the Complementary Programme for Physicians with a Medical Degree from outside the EU/EEA and Switzerland.

To clarify the contexts in which these activities are to be applied, the programme has defined 108 clinical situations (see Appendix 2).

Upon completion of the programme, the physician shall be able to be entrusted with the following nationally agreed-upon activities (Entrustable Professional Activities, EPA). Each activity comprises defined subcomponents and boundaries. These activities require that the student is able to integrate theoretical knowledge, practical skills, and professional attitudes. To clarify the contexts in which these activities are to be applied, the programme has defined 108 clinical situations (see Appendix 2).

• Obtain a patient history and perform a relevant physical examination
• Prioritise a working diagnosis among relevant differential diagnoses
• Establish an initial plan for investigation
• Formulate an initial management plan and carry out treatment 
• Identify the need for and initiate preventive measures
• Perform general medical procedures 
• Identify patients in need of emergency care and provide primary management
• Document, and issue prescriptions and medical certificates
• Collaborate within healthcare and with professionals in other sectors of society
• Contribute to a culture of safety within healthcare

Appendix 2 – Clinical Situations

1. Aggressiveness and irritability
2. Acute crisis reaction
3. Breathing difficulties
4. Loss of appetite
5. Abnormal diagnostic or incidental findings
6. Deviations from normal child development
7. Child abuse
8. Assessment of functional variation/disability
9. Blood in stool
10. Blood in urine/proteinuria
11. Bloody vomiting
12. Coughing up blood
13. Blood pressure changes
14. Bleeding tendency
15. Burns and cold injuries
16. Abdominal pain
17. Shock
18. Diarrhoea
19. Drowning or near-drowning
20. Death
21. Electrical injury
22. Fever
23. Genital discharge (female/male)
24. Fractures
25. Foreign body
26. Functional assessment in normal ageing
27. Poisoning
28. Confusion
29. Change in skin colour
30. Disturbance in fluid and electrolyte balance
31. Altered bowel habits
32. Changes in disease patterns
33. Forgetfulness/memory loss
34. Heartburn/reflux
35. Hoarseness
36. Palpitations/abnormal heart rhythm
37. Cardiac arrest
38. Cough
39. Skin disorders
40. Headache/facial pain
41. Hair and nail disorders
42. Health promotion measures
43. Hearing loss/tinnitus
44. Nausea and vomiting
45. Itching
46. Loss of strength
47. Convulsions
48. Sensory disturbances
49. Increased susceptibility to infection
50. Loss of smell and taste
51. Chronic pain/ache
52. Disturbance of consciousness
53. Menstrual problems
54. Oral cavity disorders
55. Normal delivery/breastfeeding
56. Nasal congestion/runny nose
57. Involuntary movements
58. Chest pain
59. Sore throat
60. Back/neck/shoulder pain
61. Eye pain
62. Ear pain
63. Anxiety/panic attacks
64. Palpable masses
65. Patient resisting necessary medical care
66. Personality change
67. Pigmentation changes
68. Contraception
69. Mental illness
70. Psychological effects of trauma
71. Reproduction/pregnancy
72. Risk of violence towards others
73. Movement disorders
74. Red eye
75. Screening
76. Sexual dysfunction or loss of desire
77. Pain during defecation
78. Painful and/or swollen joint(s)
79. Speech and language disorders
80. Stings and bites
81. Mood disturbance
82. Substance use and withdrawal
83. Suicide risk/suicide attempt/self-harming behaviour
84. Burning, sores, or itching in the genital area
85. Sweating/hot flushes
86. Fainting/syncope
87. Abdominal swelling
88. Swollen extremities
89. Difficulty swallowing
90. Visual disturbances/visual phenomena
91. Wounds and injuries
92. Sleep disturbances
93. Testicular pain/testicular swelling
94. Trauma (high-energy)
95. Trauma (low-energy)
96. Fatigue
97. Obsessive thoughts and behaviours
98. Thirst/dehydration
99. Vaginal bleeding
100. Delusions/hallucinations
101. Urinary symptoms
102. Weight loss
103. Violence in close relationships
104. Violence/assault
105. End-of-life care
106. Dizziness/balance disturbances
107. Eating disorders
108. Overweight/obesity