How doctors from Russia can get their diploma recognized in the Czech Republic: a complete guide to the approbation exam

The country’s appeal

The Czech Republic is facing a shortage of doctors, particularly in primary care (dentists, general practitioners, pediatricians) and in regions outside of Prague and Brno. This creates significant opportunities for foreign medical specialists willing to relocate to smaller cities.

Key challenges

Bureaucratic: The entire recognition process (nostrification + approbation) takes, on average, 1.5 to 2 years, and often longer.
Examination: The main hurdle is the approbation exam. First-attempt success rates are low: in 2023, only 68% of medical doctors and 52% of dentists passed. You are given a total of 5 attempts to pass the entire exam cycle.
Financial: It is crucial to have a sufficient financial buffer to support yourself throughout the recognition period, as opportunities for legal work in the medical field are extremely limited during this time.
Integration: Regardless of your previous experience or seniority, you will have to begin your career at an entry-level position.

Diploma and specialization recognition

The path to licensure (approbation process)

The process consists of two distinct stages:

Step 1: Diploma nostrification (academic recognition). This is handled by a university (e.g., Charles University) and serves as a formal verification that your diploma is equivalent to a Czech one. This step alone does not grant the right to work as a doctor.

Step 2: Approbation exam (professional licensure). Conducted by the Ministry of Health, this is the main and most difficult stage. It consists of three parts, all conducted exclusively in the Czech language:

Written part: Two computer-based tests covering general medicine and the Czech healthcare system/legal framework. A minimum score of 70% is required on each test.
Practical part: A six-month supervised practice in an accredited hospital. Doctors are responsible for securing this placement themselves.
Oral part: An examination before a board on four core disciplines (Internal Medicine, Surgery, Pediatrics, and Gynecology & Obstetrics), plus a defense of one of five clinical case studies prepared during the practical training.

Recognizing your specialization

This is a separate process that begins after you have successfully passed the approbation exam and obtained your basic medical license. It is managed by the Czech Medical Chamber (Česká lékařská komora), not the university. The procedure is complex, and often, a more straightforward path is to start a new residency program (specializační vzdělávání) in the Czech Republic.

Approbation document checklist

Application to the Ministry of Health
A notarized copy of the nostrification certificate for your diploma
A notarized, translated copy of your medical diploma (into Czech)
A medical certificate confirming fitness to practice (no older than 3 months)
A certificate of no criminal record (no older than 3 months)
A copy of your identification document
Proof of payment of the administrative fee (2,000 CZK)

Integrating into the system

Job-seeking tools

The six-month practical training is a key strategic tool. Similar to the German Hospitation, it’s a critical opportunity to showcase your skills to a potential employer, adapt to the local healthcare system, and build a professional network.

Labor market

The highest demand is for general practitioners, pediatricians, and dentists, as well as orthopedists, dermatologists, and neurologists, especially in regional areas.

Career ladder

Clinical career

Hierarchy: A career in a Czech hospital typically progresses as follows: lékař-absolvent (medical graduate) -> lékař v přípravě (doctor in training/resident) -> atestovaný lékař (certified doctor/specialist) -> vedoucí lékař (Head of Department) -> primář (Chief of Service/Clinic).

Finances: A doctor’s salary is heavily dependent on overtime. While base salaries are relatively low, total earnings can be significantly higher with on-call duties and bonuses. The average gross monthly salary for a doctor in the Czech Republic (including all supplements) is between 80,000–93,000 CZK.

«Global passport»: A Czech medical license is an EU license, opening doors to work in any European Union country with minimal additional requirements.

Alternative careers («plan b»)

Industry leaders

Pharmaceutical and MedTech giants like Pfizer, Novartis, Sanofi, Merck, and Abbvie have a significant presence in the Czech Republic.

Innovative startups

The country is home to numerous medical startups, for example:

Kardi AI: Developing an AI-powered home heart monitoring system for early diagnosis.
Carebot: Creating an AI solution to assist doctors by analyzing chest X-rays.
Upheal: An AI-based platform for mental health professionals that automates note-taking and session analysis.

Positions and salaries

Roles like Medical Science Liaison (MSL) or Medical Advisor offer competitive salaries. The average gross annual salary for an MSL is approximately 1,145,743 CZK, while a Medical Advisor can earn between 64,000 and 153,000 CZK gross per month.

Conclusion

The Czech Republic offers a viable, though demanding, path to a European medical career. For a high school graduate, enrolling directly in a Czech university is the more predictable strategy. For a licensed doctor, the recognition path requires immense dedication—especially to language learning—and a sober assessment of one’s personal and financial resources.

Common mistakes

Underestimating the language barrier: The most frequent error is assuming a conversational level of Czech is enough. Fluency in professional medical terminology is essential for the approbation exam.
Confusing nostrification with approbation: Many mistakenly believe nostrification is the final step, when it is merely the prerequisite for the primary hurdle: the approbation exam.
Poor financial planning: Underestimating the time required for the entire process often leads to doctors depleting their savings before they can legally practice.

Practical tools: a visual roadmap

Path for a high school graduate: Russian School Certificate → Apostille & Translation → Certificate Nostrification (+Exams) → 1-Year Preparatory Course (Czech + Science) → University Entrance Exams → 6 Years of Study → EU Medical Diploma

Path for a licensed doctor: Russian Medical Diploma → Apostille & Translation → Diploma Nostrification (at a university) → Application for Approbation (Ministry of Health) → 1. Written Exam → 2. Practical Training (6 mo.) → 3. Oral Exam → EU Medical License

Егор Кугно