From Austria to Switzerland: working as a nurse (DGKP), doctor or Ordinationsassistent/in

Which body assesses your Austrian qualification

In Switzerland, no single body assesses all health professions. Nursing is the responsibility of the Swiss Red Cross (SRK), doctors fall under the Federal Commission for the Medical Professions (MEBEKO), and medical practice assistants (MPA) under the State Secretariat for Education, Research and Innovation (SERI, SBFI in German). The legal basis for Austrian qualifications is EU Directive 2005/36/EC, which Switzerland applies through Annex III of the Agreement on the Free Movement of Persons.

In nursing, the year you qualified and your field determine the procedure: the EU-harmonised procedure requires that your qualification is listed in Annex V of the Directive and was obtained after the reference date given there. For the Austrian DGKP diploma, that date is 1 January 1994. If these conditions are not met, the SRK assesses your qualification in the ordinary procedure.

DGKP: recognition by the SRK step by step

For nursing, recognition of a foreign diploma is a legal requirement. The SRK carries it out on behalf of the Swiss Confederation. For a DGKP diploma or an FH bachelor's degree in general nursing, the EU-harmonised procedure has five steps:

1. 1PreCheck: this mandatory first step is free of charge and takes place online. Once all documents have been submitted, the SRK decides within four weeks at most; you receive the result by email. In our experience, a positive PreCheck often comes through within ten days of applying.
2. 2Application documents: after a positive PreCheck, the SRK sends you the application documents by post, together with the full list of required documents.
3. 3File: all documents go to the SRK together with the signed application form, and the invoice is paid. The file only counts as complete once all documents have been received and the payment has been booked.
4. 4Decision: from the point your file is complete, the SRK decides within four months at most. If documents are missing, it takes longer.
5. 5Register entry: after recognition, you are entered in the Register of Health Professions (GesReg) and automatically receive a GLN (Global Location Number). The entry is mandatory; the SRK charges a one-off fee of CHF 130 for it, and later changes are free of charge.

Coming from Austria, these are the main documents you need for the application after the PreCheck:

• Certificate of Current Professional Status (CCPS) or Letter of Good Standing: issued by the authority of the country in which you last worked in the profession, and no more than three months old when you submit the application. You do not need it yet for the PreCheck.
• If your diploma was never registered, for example because there is no register or because you never worked in the profession in the country where you trained, the SRK instead requires a Certificate of Non-Registration and an extract from the criminal record that is no more than three months old.
• EU certificate: in it, the competent authority in Austria confirms that your qualification complies with Directive 2005/36/EC. The SRK needs it as an original or a certified copy; the authority can also send it directly to the SRK by email.
• As a rule, copies or officially certified copies are sufficient. The SRK does not accept an apostille as certification. Certifications and translations must be in German, French, Italian or English, and translations must come from recognised translators.

If your diploma goes through the ordinary procedure, for example because you qualified before 1 January 1994 or because it only covers paediatric or psychiatric nursing, the SRK compares it with the Swiss Pflegefachfrau/Pflegefachmann HF or the Bachelor of Science in Nursing (FH). If there are substantial differences, it requires compensation measures: an adaptation period, possibly with additional training, or an aptitude test with a written and an oral part. You have two years to complete the compensation measures. The providers of these measures charge for them directly, and the procedure takes correspondingly longer.

According to the SRK, whether and for how long you may work without recognition while the procedure is under way is decided by the cantonal health department or the cantonal medical officer's service; there is no Switzerland-wide rule. Under the Health Professions Act, you only need a cantonal licence to practise (Berufsausübungsbewilligung) if you work on your own professional responsibility, meaning self-employed, in a senior position or without supervision by a professional of the same profession. Cantonal rules may apply in addition.

Once recognised, your diploma has the same effect for practising in Switzerland as the corresponding Swiss qualification, and the recognition is valid for your entire working life. You may call yourself Pflegefachfrau or Pflegefachmann (registered nurse) or use your Austrian title with the country stated, but not the Swiss titles HF and FH. The SRK recommends that employers hire recognised professionals on the same terms, including pay, as those trained in Switzerland; this is not a statutory pay rule.

Doctors: Dr. med. univ. and specialist titles at MEBEKO

Doctors fall under the Federal Commission for the Medical Professions (MEBEKO), an extra-parliamentary federal commission whose secretariat is based at the Federal Office of Public Health (FOPH, BAG in German). In human medicine, recognition of an EU diploma is a simplified procedure: if your training meets the EU minimum requirements, the diploma is recognised automatically, without additional conditions, even if its duration or scope differs from Swiss training.

Direct recognition has three requirements: you or the person you are married to hold the citizenship of Switzerland or an EU/EFTA state, your diploma bears the designation given in Directive 2005/36/EC, and it was issued by the authority named there. The diploma and the specialist title are two separate applications, each with its own forms and decision: the diploma goes to the Education section (Ressort Ausbildung), the title to the Postgraduate Training section (Ressort Weiterbildung). You may submit the documents together, and you can apply for the title before your diploma has been recognised, provided the diploma application is enclosed.

This is what MEBEKO requires from doctors with an Austrian diploma:

• The certificate conferring the degree of Doktor/in der gesamten Heilkunde (Dr. med. univ.), as a certified copy in the original language. A certificate of conformity is not needed for Austrian diplomas, unless you only have a provisional confirmation of your diploma.
• A certified copy of your passport or identity card; a Swiss residence permit is not accepted as identification. In addition, a current, signed CV and the dated, signed form.
• For the specialist title: a certified copy of your specialist diploma (Facharztdiplom) and additional form 1.1. Only the titles listed there can be recognised; MEBEKO describes the list as exhaustive.
• Certifications may be made by notaries, municipal, city and district administrations, courts, diplomatic missions, and the issuing body for its own documents. Certifications by hospitals, banks, the post office, health insurers, translators or yourself are not accepted.
• Do not send originals: MEBEKO does not return any documents. It only accepts applications on paper, by post.

MEBEKO does not give a binding deadline. On its website, it currently states up to six months for the diploma and up to five months for the specialist title, in each case counted from the acknowledgement of receipt. Applications are processed in the order in which they are received and cannot be expedited. In our experience, the whole recognition process takes around three months. You receive the decision by registered post; at the same time, you are entered in the Medical Professions Register (MedReg) and receive a GLN.

The fees are set as a range by the Medical Professions Ordinance: CHF 800 to 1,000 each for the diploma and for every specialist title, with the exact amount depending on the work involved. TakeCare covers the costs of recognition.

Without an entry in the MedReg, you may not work as a doctor in Switzerland, and your employer must check the entry before hiring you. With the entry and the necessary language skills, you may work under supervision, for example as a resident doctor (Assistenzärztin or Assistenzarzt). If you work on your own professional responsibility, including as an employee in a practice, you also need a recognised specialist title and a licence from the canton in which you work. Whether resident doctors themselves need a licence is up to each canton: Bern exempts them from the licensing requirement, as does Zurich in hospitals (in a practice, the employer needs a resident licence, Assistenzbewilligung), and in Ticino every medical activity requires a licence.

If you do not yet have a specialist title, you can complete Swiss postgraduate training leading to the title once your diploma is recognised; under federal law it takes at least two and at most six years, longer if part-time. And a recognised specialist title does not guarantee the same billing options under Swiss compulsory health insurance (obligatorische Krankenpflegeversicherung, OKP) as in Austria.

Ordinationsassistenz: recognition as an MPA only for X-rays

In terms of duties, the Ordinationsassistenz is close to the Swiss medical practice assistant (Medizinische Praxisassistentin or Medizinischer Praxisassistent, MPA EFZ), a three-year initial vocational training; there is no official equivalence. Foreign MPA qualifications are the responsibility of SERI, not the SRK and not MEBEKO. According to SERI's recognition portal, whether you need recognition to work as an MPA depends on a single question: will you be taking X-rays in Switzerland?

• Without X-rays, the work is not regulated. You do not need recognition and can apply directly; voluntary recognition is nevertheless possible.
• With X-rays, you need recognition from SERI. According to the FOPH, you can obtain the authorisation for low-dose X-rays (chest and extremities) as part of this procedure. Fluoroscopy, CT and mammography are not part of the X-ray work of MPAs.

For Ordinationsassistent/innen from Austria, this question is decisive, because under the Austrian Medical Assistant Professions Act (Medizinische Assistenzberufe-Gesetz, MABG) the profession does not include X-rays; in Austria, these belong to the separate profession of Röntgenassistenz (X-ray assistant). The Ordinationsassistenz covers assisting, rapid tests (point-of-care testing), venous blood sampling except in children, looking after patients, hygiene and administration, with training of at least 650 hours. SERI has not published how it assesses an Ordinationsassistenz in comparison with the MPA EFZ. Whether compensation measures are needed is only decided by SERI after it has examined the complete file.

SERI's recognition portal does not list “Ordinationsassistent/in” under MPA but as another name for Krankenpflegeassistenz (nursing assistant), for which it names the SRK. Which classification applies has not been officially clarified. TakeCare checks with you whether you need recognition.

If recognition is needed, SERI charges CHF 550 for it, not including any compensation measures, payable in Swiss francs and in a single payment. For MPA recognition, SERI states a processing time of up to four months from the complete file; at present, however, it reports a very high number of applications and, as a result, considerable delays. According to the canton of Zurich, MPAs may be employed there in a doctor's practice without a cantonal licence; the employer ensures that their training is sufficient for the tasks. If you have professional experience, you can also obtain the Swiss MPA EFZ qualification through a cantonal qualification procedure that takes experience and prior education into account.

Commute or move: cross-border commuter permit or residence in Switzerland

As an Austrian national, you are covered by the Agreement on the Free Movement of Persons between Switzerland and the EU. You only need a residence permit, which also serves as your work permit; it is issued by the canton. To enter the country, a passport or identity card is enough. Whether you commute or move makes no difference to recognition: the residence permit does not replace a licence to practise, and MEBEKO recognition is explicitly also aimed at cross-border commuters.

If you move, according to the State Secretariat for Migration (SEM) you generally register yourself with your municipality of residence and apply there for the permit. You need to bring a valid passport or identity card and your employer's written confirmation of employment, stating the duration and your workload as a percentage of full-time. You may start work as soon as the cantonal authority has received your application; you do not have to wait for the permit card.

You may stay in Switzerland for up to three months without a permit to look for work and attend interviews. If you work in Switzerland for no more than three months per calendar year, you do not need a permit; your employer registers you online no later than the day before. If, as a cross-border commuter, you stay overnight in Switzerland during the week, you do not need an additional permit, but you must register at your place of stay.

In principle, you are covered by Swiss social security as soon as you work here, even if you live in Austria; thanks to EU coordination, you are insured in only one country. AHV, IV and EO (old-age and survivors' insurance, disability insurance and income compensation) together amount to 10.6 percent of your salary, of which you pay 5.3 percent. Unemployment insurance is 2.2 percent up to an annual salary of CHF 148,200, split equally between you and your employer.

On tax, the two routes differ considerably. If you live in Austria, you pay the full Swiss withholding tax on your salary in all cantons; there is no cap at 4.5 percent for Austria, of the kind that applies under certain conditions to cross-border commuters from Germany. If you live in Switzerland with an L or B permit, your employer also deducts withholding tax directly, at rates set by the canton. If your gross earned income is CHF 120,000 a year or more, a subsequent ordinary assessment with a tax return is mandatory; if you want one voluntarily, for example to deduct contributions to pillar 3a (private pension savings), you apply for it by 31 March of the following year. If you are married to a person with a C permit or Swiss citizenship and you both live in Switzerland, you are generally not subject to withholding tax.

Language: Standard German counts, Swiss German is what you hear every day

When laws and permits require an official language, they mean German, French or Italian, not dialect. Everyday life is different: according to the Federal Department of Foreign Affairs (FDFA), Swiss German is the most widely spoken language in Switzerland and the everyday language in all areas of life, but written communication is in Standard German. According to the Federal Statistical Office (FSO), 83 percent of people in employment in German-speaking Switzerland usually spoke Swiss German at work in 2020. Note also that automatic recognition of your diploma does not remove language requirements: under the EU Directive, you must have the language skills that the profession requires in the host country.

• Nursing: the SRK accepts language certificates at level B2; for German, it lists the Goethe-Zertifikat B2, telc Deutsch B2, TestDaF (levels 3 to 5) and the ÖSD Zertifikat B2. Its information sheet on the EU-harmonised procedure links the proof to the language of training, but does not explicitly exempt people trained in German. We clarify this in the application. For the licence to practise, Zurich requires German at level B2 or higher; Bern waives proof if your main language is German and you completed your training in German.
• Doctors: the required level corresponds to B2, according to the FOPH. A medical degree that you actually completed in German counts as proof; if German is your main language, you submit a self-declaration that you have written, dated and signed yourself; in case of doubt, MEBEKO may request further proof. The language entry in the MedReg is assessed separately and charged at CHF 50 to 100. Employers and cantons may require a higher level or recent proof.
• Your own OKP admission: if, as a doctor, you want to bill compulsory health insurance yourself, the Health Insurance Act requires you to prove your knowledge of the regional language with an examination taken in Switzerland, unless your recognised foreign diploma was obtained in that language. A recognised Austrian diploma that you obtained in German exempts you from this examination in German-speaking Switzerland.
• MPA: SERI only requires proof of language skills in some cases and decides this once the application has been received.
• Romandie and Ticino: for permits, French or Italian applies in the French-speaking part of Switzerland (Romandie) and in Ticino. Geneva and Vaud require French at level B2 or higher for a licence to practise; in Ticino, as a nurse you prove your Italian, for example, with a certificate at level B2 or higher or with three years of professional experience in Italian within the last ten years. For doctors, Ticino does not require separate proof of language with the licence application, because the language skills must first be entered in the MedReg.

Arriving: the deadlines after your move

If you move to Switzerland, several deadlines start running from the date of your move. The most important ones, in the order in which they come up:

1. 1Within 14 days of arrival and before starting work: register with your municipality of residence and apply for your residence permit. In the city of Zurich, for example, this can only be done in person with an appointment, and only once you have actually moved in.
2. 2Within three months of taking up residence: basic insurance with a Swiss health insurer, for each family member individually. Every insurer must accept you without reservations or waiting periods. If you join in time, cover applies retroactively from the date you took up residence, and you also pay premiums from then. If you join late, you are only insured from the date you join and, if the delay is inexcusable, you pay a premium surcharge of 30 to 50 percent. You choose your deductible (Franchise) between CHF 300 and 2,500; after that, you pay a 10 percent co-payment (Selbstbehalt), up to CHF 700 a year.
3. 3From the start of your job: your employer insures you against occupational accidents and, if you work at least eight hours a week for them, also against non-occupational accidents. You can then have the accident cover in your health insurance suspended on request, which lowers the premium. This does not happen automatically.
4. 4With your first salary: your employer deducts withholding tax, AHV/IV/EO and unemployment insurance directly. Your AHV number begins with 756 and also appears on your health insurance card.
5. 5After twelve months of residence, provided you have never spent more than three consecutive months abroad during that time: you need a Swiss driving licence. With an Austrian driving licence, you get one without a test, by surrendering the original and taking an eye test; the cost is set by the canton and is more than CHF 100.
6. 6Within two years of your move: import your household effects (Übersiedlungsgut) duty-free, provided you have used them yourself for at least six months.

When you look for a flat, landlords often ask for an extract from the debt collection register (Betreibungsregisterauszug). It costs CHF 17, or CHF 18 with delivery, and only covers the debt collection district in which you order it. The rental deposit is at most three months' rent and is held in a rental deposit account in your name. Fees connected with finding a flat, such as for reserving one, are not permitted, even if the application form provides for them.

If family members who are not in employment stay in Austria, they have a right of choice: they can be insured in Austria or in Switzerland. The cantonal authority grants exemption from compulsory Swiss insurance on application.

As an Austrian national, you receive the C settlement permit (Niederlassungsbewilligung C) after five years of lawful and uninterrupted residence, based on the Settlement Agreement with Austria. The requirement is that you are integrated; this includes knowledge of the national language spoken where you live, at least A2 orally and A1 in writing. The person you are married to and your children under 18 living in the same household are also entitled to the C permit, regardless of their nationality. Stays on an L permit generally do not count; if you later receive a B permit, however, the SEM may take your earlier stays as an employee into account.

What TakeCare does for you

• We submit the application and take care of the entire recognition process, including the costs of recognition: with the SRK for nurses, midwives and healthcare assistants (FaGe), with MEBEKO for doctors.
• If you trained in Pflegeassistenz (formerly Pflegehilfe) or Pflegefachassistenz, we clarify with you which procedure applies to you and what TakeCare takes on; the SRK has not published how it classifies these qualifications.
• For nurses and doctors, in our experience, the whole recognition process takes around three months. According to the SRK, the positive PreCheck comes within four weeks at most; in our experience, it often comes within ten days of applying.
• If you are an Ordinationsassistent/in, we check with you whether you need recognition.
• We support you with finding a flat, with insurance and with dealing with the authorities.
• We place candidates in German-speaking Switzerland, French-speaking Switzerland (Romandie) and Ticino.
• As a jobseeker, all our services are free of charge for you (Art. 9 AVG, the Swiss Recruitment Act).

What we cannot promise: how quickly the SRK or MEBEKO decides. The SRK does not process applications submitted through a representative any faster or with priority, and MEBEKO processes applications in the order in which they are received. Where we submit the application, we take the work and the costs of recognition off your hands; the processing time remains that of the assessing body.