How to adapt as a doctor in Norway: my journey to diploma legalization

Natalia's story about life in Norway

This is a continuation of Natalia's story about her life in Norway and the peculiarities of the local healthcare system. In the first part, she shares her experiences of how she adapted to her new surroundings and found common ground with the locals.

Since childhood, I wanted to become a doctor, but I understood that I would face serious obstacles along the way. The path I chose in Norwegian medicine turned out to be extremely difficult: even though I had 16 years of experience working as a doctor, in practice, I was only going to be an assistant, and at one point, I wouldn't receive any compensation for my work at all. There were many problems, and I managed to overcome them all thanks to my perseverance and desire to succeed in my profession here.

Education in Norway

I'm wondering if it would have been easier for me if I had studied medicine in Norway. I doubt it. My daughter chose a medical career and got accepted into a university in Oslo, where, by the way, I taught for ten years. Considering what we have been through together, I can confidently say that the path to success is not easy. Nevertheless, those who complete the full cycle of education in Norway become true specialists in their field.

Advantages of the Norwegian educational system

The education system in Norway, especially in the faculty of medicine, emphasizes practical training, which I believe is a huge advantage. Students start:

• to interact with patients from the very first years of study;
• to master a variety of practical skills by the time of graduation, ranging from intubation to performing pleural and spinal punctures.

I think this approach is more logical than a year dedicated to studying chemistry, higher mathematics, and English, as it was in my curriculum in 1976.

Recognition of medical diplomas in Norway

As for the process of recognizing medical diplomas in Norway, qualifications obtained in Russia and several other countries do not receive automatic recognition. However, there is a possibility for legalization through special courses and mandatory exams. Regarding academic degrees, they are recognized without distinction between doctors and candidates of sciences. This procedure is carried out by an organization called NOKUT. To validate other medical diplomas, one must contact Helsedirektoratet, or the Ministry of Health.

Stages of diploma legalization

The diploma legalization procedure consists of several stages:

• It is necessary to pass the Norwegian language exam at a high level.
• to take a difficult medical test (which can be taken up to three times);
• to attend a course that lasts three weeks.

As for the Norwegian language, I shared my experience. The medical exam still brings back vivid memories for me, especially one question.

Example of a question from the exam

For example, I remember a case: "A patient approaches you with a slightly elevated HbA1c level. What will you do?" The answer options included:

• prescribe insulin;
• recommend diabetes medication
• Write a diet plan with analysis control in three months.

For Norwegians, the answer in this case is obvious: diet, weight loss, and a follow-up examination in three months to determine if medication is needed. Thus, it becomes clear that the process of medical training and practice in Norway requires specialists not only to have theoretical knowledge but also the ability to quickly respond to changes in patients' conditions.

To make the right choice of algorithm, it is necessary to familiarize oneself with the basics of medical practice specific to Norway. If I were to rely solely on my Russian experience, it would be difficult for me to provide an adequate answer, as such analysis was simply not conducted in Russia at that time. Furthermore, after successfully passing two exams, it is necessary to complete additional courses that last three weeks. These courses are regularly held in Oslo twice a year and cover areas such as medical terminology, social medicine, and psychiatry. The training concludes with an exam based on the material learned.

Requirements until 2017

Until 2017, there was a requirement to complete a year and a half of work as an intern, and this process was conducted through a lottery. In my case, there were 600 applicants for 400 positions, which created high competition. Those with preschool-aged children were given preference and were selected from the general list, while the others were placed randomly. In case of rejection, one had to wait about six months for the next lottery.

Employment opportunities

This lottery opened doors for work in any part of the country, including remote areas. I found myself in a small community with a population of one and a half thousand people, where I worked alongside one permanent doctor. We were on duty every day, and if necessary, we could be called even at night, although the main work schedule was during the day. On weekends, three communities would come together for joint duty, and every three weeks we would rotate our place of service among these towns from Friday to Monday.

Driving and movement

To travel between these places, having a valid driver's license was necessary. I had one, and I also had experience, but I had to relearn my driving skills—the road conditions were completely different, especially due to the constant ice. In the remote corners of Norway, the lack of a driver's license creates serious difficulties, sometimes making movement almost impossible. In emergencies, especially in small settlements like mine, a doctor needs to reach patients on their own. To avoid unnecessary delays, relatives mark critically important landmarks along the way in advance, placing stools along the road.

The process of diploma legalization

Only after such difficult trials was I, as a foreign doctor, able to legalize my diploma. I began my professional career on January 1, 2000, but I had to wait until 2002 for the necessary stamp, even though I already had 16 years of experience in medicine at that time. It should be noted that without a Norwegian license, it is impossible to claim a medical qualification and practice medicine.

Questions related to investments, migration, and purchasing real estate abroad continue to attract significant interest from many people. It is important to understand that the legalization of a diploma is just the first step on a long journey that requires further education and specialization.

After receiving authorization, medical professionals receive a "lege" mark, indicating that they are doctors, but it does not specify their particular specialization, such as pediatrician, therapist, or surgeon. After completing this stage, they need to continue their education to obtain additional qualifications.

Examples of successful legalization

Once, a friend of mine who arrived in Norway with a degree in neurology acquired new skills in orthopedics during the legalization process. This happened when she was doing her internship in the orthopedic department and showcased her abilities. There's also another example: a colleague who previously worked as a gynecologist became a popular psychiatrist after moving.

When I completed the certification process myself, I chose the path of a therapist, which in Norway corresponds to specialists in internal medicine. The training, which lasted six years, was also complemented by practical experience in a related specialty.

Internship rules and training

There are strict regulations: the internship must take place in the field where the doctor plans to specialize in the future. During this period, 12 courses must be completed, some of which are mandatory, while others can be chosen at one's discretion. It is important to ensure in advance that these courses will be relevant to the future specialty.

• For six years, three years of practice obtained in the country of origin can be counted.
• Only three years of experience will count towards the formation of seniority, regardless of the total work experience—whether it's 20 or 10 years.

Learning difficulties

However, such tight training deadlines create additional difficulties, as it is necessary to complete all 12 courses within the set period. Members of the Norwegian medical union are reimbursed for only two courses per year; if more are needed, those courses must be paid for out of pocket.

This requires additional time investment, which can be obtained by taking an unpaid leave. The positive aspect is that the courses themselves are short — ranging from two days to several weeks.

Practical skills and standards

In the course of work, it's important to develop practical skills.

• to perform functions, both spinal and neural;
• to perform ultrasound diagnostics of the heart;
• mastering a variety of other procedures.

A key point is not only the readiness of the doctor to perform such surgeries but also adherence to the necessary time standards. After completing training and practice, an important step is obtaining the signature of a specialist doctor from the hospital where the professional practice took place.

Narrow specialization

After completing the basic specialization, which in the field of therapy covers knowledge of internal medicine, a three-year stage of narrow specialization begins. This can be cardiology, endocrinology, or other areas. Personally, I chose geriatrics.

In conclusion, it can be summarized that although diplomas obtained in Russia are recognized in Norway, the process of licensing a doctor and further specialization requires significant effort and time investment. In my opinion, this is completely justified and correct.

Introduction

Lawyers from Russia will not be able to simply come to Norway to start their professional practice, as completely different legal norms apply here. This also applies to the medical field. After I achieved certain successes working in public medical institutions, I decided to establish my own private practice.

The path to opening a clinic

Throughout my professional career, I have had the opportunity to try myself in various roles, including senior physician and head of department in several medical institutions. During my work, I realized that it was time to open my own clinic. Perhaps this is related to my personal ambitions and desire for new achievements. I felt that I had reached certain heights in my field, and this feeling led to boredom.

Modern healthcare in Norway

In Norway, hospitals and laboratories are equipped with modern medical equipment, and doctors provide their patients with a wide range of free medical services.

Emergency medicine

One of the most significant aspects of Norwegian healthcare is emergency medicine, which should not be confused with urgent care. Particularly high standards of service are evident in cases of acute and serious illnesses. Citizens of Norway have strict expectations of their doctors, which gives them confidence that medical professionals will do everything possible to provide the necessary assistance.

Specialized procedures and qualifications of doctors

Unlike in Russia, where specialized procedures such as spinal punctures are performed exclusively by narrow specialists, in Norway, such manipulations can be carried out by any doctor, except in cases that require high qualifications. For example, if a patient is experiencing severe headaches, the doctor is required to perform a puncture immediately to rule out serious conditions such as meningitis or a brain hemorrhage.

Medical skills

Norwegian doctors have high skills in interpreting medical images. In my practice in Russia, I encountered situations where X-rays came with conclusions from radiologists. In Norway, however, while working in a small night hospital, I often had to analyze the images myself before sending the patient for a CT scan, in order to quickly and effectively determine the necessary treatment.

Approaches to different conditions can vary, for example, in the presence of a thrombus or in cases of hemorrhage in the brain. Although it is formally possible to call a radiologist, in practice this only happens in extreme cases.

Availability of specialists

It is noteworthy that there is no shortage of doctors in Norway. In local medical publications dedicated to employment in the healthcare sector, you can often find only three job openings for the entire country.

Only patients with serious illnesses requiring hospitalization are admitted to the hospital. Additionally, the so-called "bed days" here are very short:

• A patient with hypertension cannot be hospitalized for an extended period.
• Usually, inpatient treatment is not applied at all for such patients.
• Even the most severe cases are treated in a hospital for no more than two or three days.

Approaches to treatment

Local doctors believe that diagnosis and treatment are best conducted on an outpatient basis. In contrast, in Russia, patients stay in the hospital for an extended period, which allows them to undergo regular examinations, consult with specialized specialists, and discuss their condition with colleagues.

The work of medical professionals and compliance with labor legislation

The specifics of medical work in Norway are governed by specific labor legislation. When I first started my career in this country, the workday sometimes stretched to 28 consecutive hours, and during our shifts, we had no opportunity to rest, which created significant difficulties.

Social aspects

Socially, the interaction among medical staff in Norwegian hospitals is also quite different. Doctors often don't have time to share a cup of coffee together, which highlights the intensity of their work and the need to focus on their professional duties.

Conclusion

The healthcare system of Norwaybuilt on the desire for high-quality medical care and the efficient use of resources for treating the population.

In our institution, instead of standard lunch breaks, educational seminars are held twice a week. During these meetings, one of our doctors shares their own experiences and conducts various presentations.

The unique system of Norwegian medicine

Norway has its own unique healthcare system that makes it stand out among other countries. All medical institutions, including private clinics like mine, are connected to the helsenett system. This resource allows doctors to access extensive medical databases that are funded by the government. It provides the opportunity to always have the necessary information at hand, clarify data, or conduct additional research.

Standardization of medical procedures

The standardization of medical procedures in Norway also deserves attention. For example, there are strictly defined treatment protocols for patients with diabetes, which specify glucose levels and corresponding insulin doses, as well as recommendations for adding other medications.

Training medical professionals in Norway is a very complex and lengthy process, where mistakes can lead to serious consequences, including the possibility of license revocation. However, in this country, there is no practice of public condemnation: if a doctor makes a mistake, they will not be approached with judgment in front of all their colleagues. Instead, colleagues try to help and discuss the situation privately. Mistakes in medicine are remembered, but often they occur not due to negligence, but because of the complexities of the work.

Emergency medicine in Norway

Norway stands out for its well-organized emergency medicine. For example, in our country, statistics show that cases of severe heart attacks have become less frequent, as even ambulance teams perform cardiographic studies, and the results are instantly sent to the hospital. Treatment begins even before patients arrive at the hospital, which significantly reduces the time it takes to provide assistance. A similar situation is observed in the case of strokes: rapid organization of hospitalization and the implementation of necessary measures to dissolve the clot or remove it.

Availability of medical services

Regarding the common belief that it's difficult to get an appointment with a Norwegian doctor, it should be noted that in Norway, doctors work in hospitals and have set hours for consultations in clinics. In contrast, the structure in Russia is fundamentally different: here, medical professionals often work more independently and frequently in clinics. These differences in the organization of work directly affect the availability of medical services.

Key aspects of the healthcare system

• Norway focuses on helping patients with serious illnesses.
• Other medical issues are addressed at the general practitioner's level.
• The general practitioner has extensive knowledge and experience.
• It's wrong to compare healthcare workers from different countries.
• Every country has its own characteristics, cultural traditions, and work style.

The necessity of training and development

In the context of rapidly changing realities, continuous learning and retraining have become essential for effective work. My life principle is: if you set a goal for yourself, don't waste time on pointless discussions about problems on the internet. Act wisely and refer to official sources. Create a clear action plan and follow it to achieve success in any endeavor.

Conclusion

In conclusion to my story about moving to Norway and how I managed to adapt to the local healthcare system, I want to emphasize that this journey was not only challenging but also an incredibly important stage in my life. I often think about how it would have been if I had received my medical education right in Norway. Perhaps many issues would have been resolved more quickly and easily. However, the experience I gained in Russia became a strong foundation and a valuable source of knowledge that I could rely on when facing new challenges.

Education and practice

You can only get acquainted with the Norwegian medical system starting from the first year of university. The education here is structured in such a way that students learn to interact with patients from the very first days. Comparing this to my years of study, I can say that today’s future doctors receive much deeper and more practical knowledge. This is incredibly inspiring and confirms that the Norwegian education system is truly focused on providing better quality medical services.

Diploma confirmation

The diploma confirmation and the need to take exams were a real challenge for me, especially considering that my career and my desire to continue helping people were at stake. I was glad that the Norwegian authorities understand the importance of qualified specialists and provide them with opportunities to legalize their diplomas. This process, although lengthy, opened new horizons for me.

Work in a small village

Working in a small village with a limited number of doctors eventually became a real challenge for me, but it was there that I learned to appreciate every minute spent with patients. It was a time when I could truly feel like a doctor, even though the legalization of my diploma took another two years. I realized that the most important thing in medicine is not just knowledge and experience, but also the ability to communicate, listen, and understand my patients.

Conclusions and advice

At first glance, my journey to Norway might have seemed challenging, but in reality, it was a process of self-discovery and growth. I not only found my niche in a new country, but I was also able to pass on my knowledge and experience to the next generation of doctors, including my daughter. Norway has made me the doctor I am today.

My advice to everyone who is just starting their journey in medicine in a foreign country:

• Don't be afraid of difficulties;
• Believe in yourself;
• Pursue your passion.

Every step, every challenge brings you closer to your goals.