Wasted Potential
- Jun 9
- 9 min read
Austria is short of doctors, yet well-trained Ukrainian physicians wait years for their diplomas to be recognized. A look at Germany and Poland shows why this happens, and what a coordinated program could look like.
Austria is desperate for doctors and at the same time leaves fully qualified physicians stuck in a holding pattern for years. How do those two things fit together? The Medical Chamber recently spelled out just how wide the gap is. In mid-2025, 311 public-insurance positions sat vacant, 175 of them in general medicine, and in many rural areas practices go for months without anyone to take them over.1 The Chamber also warns that a large cohort of baby-boomer doctors will soon retire, and it stresses that the country does not have too few doctors overall. What it lacks are doctors willing to work inside the public system.2
This is exactly where an opportunity sits that has barely been used. Living in Vienna are Ukrainian women doctors with completed degrees, specialist training, and years of experience who are not allowed to treat patients, because their diplomas have not yet been recognized in Austria. Getting there takes years and costs several thousand euros. None of this is a law of nature. It happens because the various forms of support do not work together, and a look at Germany and Poland shows how it could be done better.
Badly Needed, Left Waiting
The OECD devoted a full chapter to the subject in its latest migration report, and its conclusion is unambiguous. The biggest barrier is the recognition of foreign qualifications, because the procedures are complicated and drawn out, so many trained doctors end up in simpler, lower-paid jobs.3 The same pattern shows up in Austria. The Safavi Impact Institute works with 32 Ukrainian women doctors in Vienna and estimates the cost of returning to the profession at 3,000 to 4,000 euros per person, not counting language courses and living expenses.4 The problem is rarely their clinical skill, which is usually solid. What trips them up is money, and the fact that almost no one has a clear view of the path from start to finish.
Why the Austrian Path Takes Years
Anyone who earned their medical degree outside the EU has to have it recognized in Austria. To do that, a university examines whether the foreign degree is equivalent to an Austrian one. It rarely comes down to a single exam. Usually it is a whole series of individual exams that the university sets anew for each case, and there can be many of them. Often they include subjects that have little to do with the doctor's own field, such as forensic medicine or pharmacology. The university allows up to eight semesters for this.
The tuition itself is currently waived, because Ukrainian doctors, like all students, are exempt from it and pay only the student union fee of a few dozen euros per semester.5 On top of that come the Medical Chamber's fees, which run between 290 and 1,884 euros depending on the workload, the language exam at 919 euros, and certified translations.6 7 One more hurdle weighs especially heavily during the war. Applicants must submit the original diploma with official certification, the so-called apostille. From Ukraine it can neither be mailed safely nor collected in person without risk.4
Nowhere is the problem clearer than with language. A language certificate, even a very good one, is no guarantee that someone can speak with confidence on the job. In the standard courses, you learn the language mainly for the exam, not the specialized medical German you need in a hospital. That medical German is something doctors can hardly learn anywhere except in private courses they have to pay for themselves. And they cannot practice it either, because as long as their diploma is not recognized, they may neither work as doctors nor take part in the medical networks where that language develops. The result is a loop that is hard to break out of. Recognition requires the specialized language, yet without recognition there is almost no way to learn it and use it.
Just how much this weighs is clear from the case of a reproductive-medicine specialist supported by the Safavi Institute, who ran her own clinic in Kyiv and speaks fluent German. She passed the required specialist exams long ago. All that remains is the Medical Chamber's specialized-language exam, which she failed on her first attempt. There is nowhere she can prepare specifically for this last hurdle, and every further attempt costs money all over again.
“No one prepares you for this exam, and yet I pay for every attempt all over again. It is the only exam I have left.”4
The Bridge That Once Existed
Austria did once have a faster route. In March 2020, the second COVID law added a provision to the Medical Practitioners Act that allowed doctors to start working before all the formal requirements were met, as long as they were supervised by a licensed physician and had registered with the Chamber.8 When the first Ukrainian doctors arrived in 2022, the Medical Chamber pointed explicitly to this route, which let them begin working quickly.9 And so a pandemic stopgap became, for a while, a bridge for refugees.
Those who worked under this arrangement gave the system real help. In the practices, these doctors cared above all for the many people who had come to Austria because of the war, and they did so without any interpreters. But there was a downside, one the doctors themselves describe. Nearly all their patients spoke Ukrainian or Russian, and hardly anyone spoke German. So while they solved an urgent problem, they were barely able to develop their own medical German in the process.4
That bridge no longer exists. Under a transitional rule, working this way was permitted only until July 31, 2024. Since then, entry in the official register of doctors, or some other authorization, has been required. Anyone still working at that point who had not completed recognition could continue only on a temporary basis, and only if they had filed an application for recognition by the end of 2024. That deadline cannot be extended, and the route has been closed ever since.10 The real problem is not that the rule expired. It is the way it was conceived. Austria had a model that let people work while recognition was underway, but it counted as a pandemic measure rather than an answer to the doctor shortage, and so it was allowed to disappear. What remains is the long recognition process, with no intermediate step at all.
How Germany Does It
Germany shows that there is another way. There, a fixed intermediate step exists: a temporary license to practice. It is valid for two years and lets a doctor work while final certification is still in progress, and as early as April 2022 Germany's federal states agreed to grant this license quickly to refugee Ukrainian doctors.11 12 Not everything runs smoothly in Germany either, since waiting times are long and the agencies are overstretched, but the direction is right. In March 2026, the Bundestag passed a law meant to speed up recognition in the health professions. Instead of checking case by case what is missing from someone's training, there will now be a single standardized exam through which everyone demonstrates the same professional level. It is due to take effect on November 1, 2026, provided the Bundesrat also approves it.13
Germany also takes a different approach to money. A government subsidy covers procedural costs up to 600 euros and preparation courses or exams up to 3,000 euros, regardless of nationality or residence status, so Ukrainian doctors can receive it too.14 Courses that prepare specifically for the very exams many people fail are free in many places, for instance at the University of Munich or the Charité in Berlin, and some states add to that through their own hardship funds, in Berlin up to 10,000 euros per person.15 16 Where Austria scatters its support, Germany assembles it into a single continuous path.
What Poland Shows
Faster is not automatically better, though, as Poland shows. There, Ukrainian doctors were allowed to work very quickly, through a temporary special permit and without recognition, without a state exam, and without the internship normally required, so thousands entered the health system in short order.17 The language question came only later. By May 1, 2026, they had to prove Polish at a B1 level or higher, or lose the right to work, and at the end of April more than two hundred doctors from outside the EU did in fact lose that authorization.18 19 The head of the Polish Medical Chamber points to patient safety, while hospital directors warn of staffing gaps, since emergency departments in particular rely heavily on colleagues from abroad.19
The fact that many of these doctors cared mainly for Ukrainian-speaking refugees probably helps explain why the national language remained a hurdle for some, much as in Austria. For Austria, the lesson is this: speed is not what matters. What matters is that specialized language support runs alongside from the very beginning, because when it is missing, new problems surface later on.
What a Program Would Have to Look Like
A coordinated program would have to rest on three building blocks that keep the rigor but end the slowness. The first is an intermediate step that lets people work. Nothing entirely new would be needed for this. It would be enough to revive the old pandemic rule, this time as a tool against the doctor shortage and modeled on Germany: working under supervision while recognition is underway.
The second building block is bundled financial support, and here it is worth looking closely, because Austria is not starting from zero. The Integration Fund covers the cost of recognition and the language exam, explicitly including refugees from Ukraine. The Wien-Perspektive advisory office translates the necessary documents free of charge in some cases, and the Vienna Public Employment Service can pay for courses and fees.20 So help certainly exists. The problem is that it is fragmented. A study by the Integration Fund itself describes a confusing tangle of separate funding pots, each with its own conditions, in which a large share of the costs often ends up with the doctors anyway.21 It is precisely this lack of clarity that the doctors name as their biggest obstacle. What is missing, says the reproductive-medicine specialist quoted earlier, is a single place where, from the very start, you can clearly see which steps lie ahead and what the whole path will cost.
The third building block solves exactly that problem: specialized language support and steady guidance from the outset. The Safavi Institute calls this case management. A single point of contact brings together language, recognition, networking, and psychological support and tailors them to where each doctor stands, instead of many offices working side by side, each aware of only one piece.
It Pays Off
Given this doctor shortage, such a program would not be an act of charity. It would be an investment that pays for itself. A doctor working in her profession pays taxes and social contributions and helps close the very gaps created by vacant public-insurance positions and the retirements to come. The potential is there, and experience shows that it can be put to use. What is missing is the connection between training that already exists and a clear, demonstrated need. Austria already used a tool like this once, in the spring of 2022. The only question is whether it is willing to create one a second time, now deliberately, permanently, and tailored precisely to these doctors.
Sources
1. Vacant public-insurance positions as of July 2025, per a press conference of the Austrian Medical Chamber, reported among others at pressefeuer.at, October 2025. pressefeuer.at
2. Austrian Medical Chamber, Physician Statistics 2024 (52,005 registered doctors as of December 31, 2024), presented in August 2025; statement by ÖÄK President Johannes Steinhart. praktischarzt.at
3. OECD: International Migration Outlook 2025, chapter on the migration of health professionals, November 2025. oecd.org
4. The Safavi Impact Institute: Arbeitsmarkt mit Potenzial: Ukrainische Fachfrauen zwischen Qualifikation und Integration, Vienna, 2026. The doctor quoted is presented anonymously.
5. Medical University of Innsbruck, nostrification procedure (i-med.ac.at); migrare, information sheet on the nostrification of human medicine. The number of required supplementary exams is set on a case-by-case basis. As extraordinary students, displaced Ukrainians are currently exempt from tuition and pay only the ÖH student union fee of a few dozen euros per semester.
6. Austrian Medical Chamber / USP: Arzt – Qualifikation – Anerkennung, fees 2025. usp.gv.at
7. migrare, information sheet on the nostrification of human medicine; language exam of the Academy of Physicians.
8. Section 36b of the Medical Practitioners Act 1998, added by the 2nd COVID-19 Act (Federal Law Gazette I No. 16/2020). gesundheitsrecht.at
9. Medical Chamber for Lower Austria: Ärztliche Tätigkeit ukrainischer Ärzte in Österreich, March 2022. arztnoe.at
10. Austrian Medical Chamber: transitional rule for “medical activity in the context of a pandemic” (expired). aerztekammer.at
11. On the difference between a temporary practice license and full certification, see among others zm-online. zm-online.de
12. Haufe: Qualifikationen ukrainischer Ärzte sollen rasch anerkannt werden (decision of the state health ministers, April 2022). haufe.de
13. Federal Ministry of Health: FAQ on the Act to Accelerate Recognition Procedures in the Healing Professions, as of March 26, 2026; summary at Rebmann Research. Passed by the Bundestag; Bundesrat approval and entry into force (November 1, 2026) still open at the time of research. Verify status before publication.
14. Recognition in Germany (BMBF): Anerkennungszuschuss (recognition grant). anerkennung-in-deutschland.de
15. MED-International, LMU Munich; Charité International Academy. academy.charite.de
16. Hardship Fund for Professional Recognition, Berlin, presented at BIBB. bibb.de
17. Rynek Zdrowia and Rzeczpospolita on the simplified procedure for Ukrainian doctors.
18. Rzeczpospolita: proof of Polish at B1 by May 1, 2026 as a condition.
19. Rzeczpospolita, May 2026: withdrawal affecting more than 200 doctors, statements by the chamber president, warnings from hospitals. rp.pl
20. Austrian Integration Fund, Förderung Berufsanerkennung (integrationsfonds.at); meded – medical education österreich on AST Wien-Perspektive and AMS Wien (meded.at).
21. Austrian Integration Fund: Anerkennung von Berufsqualifikationen in der Pflege, research report 2024. integrationsfonds.at
