Regulations on the granting of licences to practise to physicians and specialists No. 305/1997

with subsequent amendments under regulations no. 340/1999, 435/2005 and 546/2007

I. Definitions

Art. 1

In these regulations the term health institution may signify a special hospital that treats patients with certain diseases (special hospital), an equivalent unit in a hospital (special ward), a healthcare centre or other institutions that the University of Iceland Faculty of Medicine deems capable of providing postgraduate training.

Applications for a licence to practice medicine, or a specialist's licence, shall be submitted to the Ministry of Health and Social Security together with certified documents from supervisors and other necessary documents.

II General licence to practise medicine

Art. 2

[In order for a person holding the degree of Candidatus/Candidata medicinae to be granted a licence to practise medicine, he/she shall after graduation have completed the additional studies specified here: He/she shall have performed the duties of an assistant physician (intern) for a total of 12 months at recognised health institutions, cp. Appendix 3 to Regulations no. 305/1997 and as advertised. Of this he/she shall work for at least four months at a department of internal medicine, two months at a surgical department, and three months at a healthcare centre.]¹⁾

¹⁾Regs. 340/1999 of 6 May 1999, art. 1

III General licence for family practice

Art. 3

[In order for a physician to gain the right to be granted a licence for family practice (European medical licence), he/she shall have completed postgraduate studies as follows:

After completing a year of internship as provided in art. 2, he/she shall have worked for at least 12 months as a physician at a recognised health institution. Of this time, he/she shall have worked at least six months under the supervision of a family practitioner or at a H2 healthcare centre. Time spent working at a H2 healthcare centre during the internship year may be used to fulfil the requirement of six months' work at a healthcare centre. Total working time after the year of internship shall however, never be less than 12 months].²⁾

²⁾Regs. 546/2007 of 20 June 2007, art. 1

IV Specialist licences

Art. 4

In order for a physician to gain the right to be granted a specialist licence, he/she must fulfil the following requirements:

a. He/she shall normally have completed a year of internship as provided in art. 2 before undertaking specialist training.
b. He/she shall normally fulfil the conditions stated in arts. 5, 6 and 7.

Art. 5

Specialist training within the meaning of art. 7 shall be carried out exclusively at those health institutions which are recognised for such specialist training in their own country. The Minister of Health grants such recognition to health institutions in this country on the recommendation of a committee of three physicians, which evaluates the institution's work. The committee is appointed by the Minister for a period of six years; one member, who also chairs the committee, is nominated by the University of Iceland Faculty of Medicine, and two are nominated by the Icelandic Medical Association, one a specialist in family practice, the other a hospital specialist. The committee shall review its evaluations at intervals of no more than four years, seeking recommendations from the Postgraduate Training Board, the relevant specialist medical associations and the heads of specialist fields in medical training.

Art. 6

The Minister has the authority to issue rules on specialist training in Iceland, on recommendations of the University of Iceland Faculty of Medicine. Such recommendations are made by the Faculty after receiving the recommendations of the Postgraduate Training Board and the relevant specialist medical association. Such rules shall specify the form of training, including such factors as whether the training be carried out via training objectives, whether a final examination is to be taken, and how much of the training may be carried out at Icelandic health institutions.

Physicians undergoing specialist training shall be employed full-time at the health institutions where they are interns. Exemptions may, however, be granted from this rule, if other study arrangements are adjudged as equally valid by the Faculty of Medicine. Studies on a specialist course may be recognised as equivalent to some specific part of the required internship at a health institution.

Art. 7

A specialist medical licence may be granted on completion of training according to the following provisions. Total training time must be no less than 4½ years in the main specialist field. In order to be granted a specialist licence in a subsidiary specialist field, the applicant shall be a specialist in the main field, and have completed two years in recognised postgraduate study in the subsidiary field. The term subsidiary field applies to further specialisation in a field of learning and work that falls largely within the limits of the main field.

Instead of one year in the main field of study as specified in item a), the Specialist Board may recognise up to one year's study at a department or institution, including scientific research, relating to the specialist field.

I . Occupational medicine:

a) 3½ years at a department of occupational medicine
b) 1 year at a department of internal medicine or pulmonary medicine.

II. Ophthalmology:

a) 4 years at a department of ophthalmology
b) ½ year at a department of internal medicine, or ½ year at a department of neurology or neurosurgery.

III. Paediatrics:

a) 4 years at a paediatric department
b) ½ year at a department of internal medicine or child psychiatry

A specialist in general paediatrics may be granted a specialist licence in one subsidiary field, such as paediatric endocrinology, child and adolescent psychiatry, paediatric cardiology, paediatric oncology, paediatric neurology, paediatric gastroenterology and nutrition, neonatal medicine, paediatric communicable diseases, paediatric allergology and immunology, etc.

IV. Child and adolescent psychiatry:

a) 3 years at a department of child and adolescent psychiatry
b) 1 year at an adult psychiatric department
c) 1 year at a general paediatric department

V. Transfusion medicine:

a) 4 years at a blood bank
b) ½ year at clinical departments, such as internal medicine, paediatrics, anaesthesiology, surgery, haematology, oncology, gynaecology, etc.

VI. Emergency medicine:

a) 4 years at an emergency department
b) ½ year at a department of anaesthesiology or intensive care unit.

VII. Orthopaedic surgery:

a) 4½ years at a department of orthopaedic surgery.
b) 1 year at a surgical department, e.g. general surgery, hand surgery, cerebral and neurosurgery, or in emergency medicine, but no less than ½ year in any department.

A specialist in orthopaedic surgery may be granted a specialist licence in hand surgery as a subsidiary field.

VIII Toxicology:

a) 4½ years at a department carrying out fundamental research in toxicology.

IX. Rehabilitation medicine:

a) 3 years at a department of rehabilitation
b) 1 year at a department of internal medicine
c) ½ year at a department of psychiatry.

X. Obstetrics and gynaecology:

a) 4 years at a department of gynaecology.
b) 1 year at a general surgical department.

A specialist in gynaecology may be granted a specialist licence in one subsidiary field, such as gynaecological oncology, female endocrinology, etc.

XI. Psychiatry:

a) 4½ years at a department of psychiatry.

A specialist in psychiatry may be granted a specialist licence in one subsidiary field, such as child and adolescent psychiatry, neurophysiology or forensic psychiatry.

XII. Oto-rhino-laryngology [ear, nose and throat]:

a) 4 years at an ear, nose and throat department.
b) ½ year at a general surgical department or specialist surgical department such as neurosurgery, thoracic surgery, plastic surgery etc.

XIII. Healthcare administration:

a) Recognised specialist in another specialist field.
b) Two years of academic studies in public health, management of health institutions or related subjects, culminating in an examination. Instead of one year of study, work may be substituted at an institution dealing with management of health issues or public health, recognised by the University of Iceland Faculty of Medicine.

XIV. Family practice:

a) 2 years at a healthcare centre or doctor's practice.
b) 1 year at a department of internal medicine.
c) Total 1½ years at the following departments: paediatrics, psychiatry, gynaecology, emergency. Minimum period at any department shall be 4 months.
d) Total ½ year at department of ophthalmology, ENT, dermatology, surgical department, orthopaedics, anaesthesiology and intensive care, social medicine, rehabilitation, geriatrics, radiology, communicable diseases, neurology or research department. Not less than three months at any department.

XV. Dermato-venereology:

a) 4 years at a department of dermatology and sexually transmitted diseases
b) ½ year at a department of internal medicine.

Time at a department of dermatology and sexually transmitted diseases may be substituted with 2½ years' work at a department of dermatology and 1½ years’ work at department of sexually transmitted diseases, or a clinic for treatment of STD. A specialist licence may be granted for either part of the field, provided that item a) has been fulfilled for the relevant special field, and item b) has also been fulfilled.

A specialist in dermato-venereology may be granted a specialist licence in one subsidiary field, such as dermatopathology.

XVI. Oncology:

a) 4 years at a department of oncology.
b) 1 year at a department of internal medicine.

XVII. Pharmacology:

a) 4½ years at a department of pharmacology.

XVIII. Internal medicine:

a) [5 years at departments of internal medicine.]³⁾

³⁾Regs. 435/2005 of 6 April 2005, art. 1

A specialist in internal medicine may be granted a specialist licence in one subsidiary field, such as haematology, endocrinology and metabolism, rheumatology, cardiology, oncology, pulmonary medicine, gastroenterology, renal diseases, allergology and immunology, communicable diseases, geriatrics, etc.

XIX. Plastic surgery:

a) 4 years at a department of plastic surgery
b) 1½ years at a surgical department.

A specialist in plastic surgery may be granted a specialist licence in hand surgery as a subsidiary field.

XX. Pathology:

1. Haematology
   a) 4½ years at a department of blood diseases, operated in connection with a research laboratory, or 3½ years at a research laboratory in haematology and 1 year at a department of internal medicine or blood diseases.
2. Clinical biochemistry:
   a) 4½ years at a department that combines pathochemistry and haematology. Alternatively, work at specialised pathochemistry and haematology departments for a total of 4½ years. Minimum time at one department shall be 1½ years.
3. Pathophysiology:
   a) 4½ years at a department of pathophysiology.
4. Pathochemistry:
   a) 4½ years at a department of pathochemistry.
5. Immunology:
   a) 4½ years at a research laboratory in immunology.
6. Microbiology:
   a) 4½ years at a department of microbiology
7. Pathological anatomy:
   a) 4½ years at a department of pathological anatomy
   A specialist in pathological anatomy may be granted a specialist licence in one subsidiary field such as paediatric pathology, cytopathology, neuropathology, etc.
8. Virology:
   a) 4½ years at a department of virology.

XXI. Diagnostic radiology:

a) 4 years at a department of diagnostic radiology
b) ½ year at a surgical department or department of internal medicine.

A specialist in diagnostic radiology may be granted a specialist licence in one subsidiary field, such as diagnostic chest radiology, diagnostic neuroradiology, diagnostic nuclear medicine, etc.

XXII. General surgery:

a) 4½ years at a surgical department
b) ½ year at a department of anaesthesiology.

A specialist in general surgery may be granted a specialist licence in one subsidiary field, such as paediatric surgery, thoracic surgery, vascular surgery, plastic surgery, urology etc.

XXIII. [Anaesthesiology and intensive-care medicine:

a) 3½ years at a department of anaesthesiology including intensive-care unit
b) ½ year at a department of internal medicine.
c) ½ year at a surgical department.]⁴⁾

⁴⁾Regs. 340/1999 of 6 May 1999, art 2

XXIV. Neurology:

a) 4 years at a department of neurology.
b) ½ year at a department of internal medicine.

A specialist in neurology may be granted a specialist licence in one subsidiary field, such as neurophysiology, neuropathology, etc.

XXV. Neurosurgery:

a) 4½ years at a specialised department in the field
b) 1 year at a general surgical department
c) ½ year at a department of neurology

XXVI. Urology:

a) 4 years at a specialised department in the field.
b) 1½ year at a general surgical department.

Art. 8

A specialist licence may be granted to a physician who has completed a recognised course of specialist study, a specialist examination, or been granted a specialist licence, in a country whose requirements for specialist training are similar to those provided in these regulations. This is permissible even if the form of study differs from that specified in art. 7. A specialist licence may be granted in other fields than those specified above, provided that the requirements of specialist training are met in the view of the Specialist Board, and that the applicant has been recognised as a specialist in another country. The Specialist Board shall rule in the same way regarding the granting of specialist licences in new subsidiary fields. Special regulations apply to specialist licences that meet the conditions of the EEA agreement, cp. Regulations no. 244/1994.

Art. 9

A physician may be refused recognition as a specialist, even if the terms of these regulations are fulfilled, if the Specialist Board of the University of Iceland Faculty of Medicine is of the view that the period of training has not been sufficiently continuous, or that an excessive time has passed from completion of continuous specialist training until the application was received.

Art. 10

The Minister appoints three physicians to examine applications for specialist licences, and to rule on them: the Specialist Board. One member of the Board shall be a faculty member of the Faculty of Medicine, and shall chair the Board. One shall be nominated by the Icelandic Medical Association, and the third shall be the supervisor of tuition in the relevant field. When applications are considered, a representative of the relevant specialist medical association shall, if applicable, be called to meet with the Board. The representatives of the Faculty of Medicine and of the Medical Association shall be appointed for four years at a time. They shall, on behalf of the Faculty of Medicine, be responsible for interpretation and revision of these Regulations, in consultation with the governing board and specialist medical associations of the Medical Association. Should disagreements arise within the Specialist Board, these shall be submitted to the Faculty of Medicine for resolution.

Art. 11

These regulations, which have been issued on the basis of proposals from the University of Iceland Faculty of Medicine, are hereby confirmed under the provisions of arts. 2 and 5 of the Physicians Act no. 53/1988 with subsequent amendments, to take force on 1 June 1997. At that time, regulations no. 311/1986 on the granting of medical licences and specialist licences shall be abrogated.

Those who hold the degree of Candidatus/Candidata medicinae, who have completed their medical studies before these regulations take force may, however, undertake general internship as provided in Section I of the previous regulations, if training has begun when the regulations take force. Physicians who have begun specialist training when the regulations take force may carry out specialist training under the terms of Section II of the previous regulations, until 1 June 2002.

Ministry of Health and Social Security, 13 May 1997

Ingibjörg Pálmadóttir

                                                                                  Davíð Á Gunnarsson

 

 

English translation Anna Yates

Updated 28 June 2007