Young Internists group in the Netherlands
The Dutch Young Internist Group, called JNIV, is founded as a section of the Dutch Internist Society, called NIV, in 1978.
The goal is to look after the interests of the Dutch internists trainees and the traineeship to become an internist. The Dutch Young Internist Group/JNIV has the right to participate in all the committees and working groups of the Dutch Internist Society/NIV.
The Dutch Young Internist Group/JNIV has no own budget. All the activities of the Dutch Young Internist/JNIV are planed with the treasurer of the Dutch Internist Society.
All the Dutch Internist Trainees are part of the Dutch Internist Society/NIV, and thereby automatically part of the Dutch Young Internist Group/JNIV. Currently we have 1130 members.
The Dutch Society of Internal Medicine annually organizes a three day congress. During this congress the Dutch Young Internist group traditionally organizes an opinion session. In 2015 the subject will be ‘The Future of the Internist’. Furthermore, we annually organize an education day for trainees focussing of outpatient care, a social event (beach volleyball and barbeque). At this moment we try to create awareness for the relative high unemployment for young internists. Moreover we are creating a vision document, about our vision of the future of the internist.
Training in Internal Medicine in the Netherlands
The postgraduate medical education system:
People who graduate from medical university usually apply for a job in their field of internist in a certain hospital. After gaining some experience, they apply for a traineeship in the desired specialty in a regional academic teaching hospital, were annual selection rounds and job interviews are held. An alternative way after graduating from medical university is to apply for a research job or PhD and apply afterwards directly for a specialty traineeship (instead of gaining some experience as a medical doctor first).
The training to become internist officially still takes 6 years; 4 years of general internal medicine and rotation on different wards (1 year of general internal medicine, 1 year of outpatient clinics and consultation, 1 year of rotation in ICU, cardiology or pulmonology), followed by a differentiation of two years in one of the differentiations like hematology, nephrology, geriatrics, oncology, acute internal medicine, ICU, pharmacology, immunology and allergic diseases, infectious diseases or endocrinology. A so called multiple differentiation in the last phase of traineeship, where you chose 3 different rotations of 8 months per rotation is also possible. Cardiology, pulmonology, gastroenterology and rheumatology are different specialties in the Netherlands.
Since 2014, universities have to reduce the length of traineeships due to financial cuts by the Ministry of Health. The traineeship for becoming internist have to be reduced by a median of 7 months per internal medicine trainee. The reduction in training time is given individually at the moment, based on earlier obtained competencies.
Another change in the system started in 2014. As a pilot, 10-15% of the total pre-graduated medical students started with the so called ‘dedicated schakeljaar’ translated to ‘dedicated linking year’. In the last year of medical school, pre-graduated students will do their master research project and last internships already in their specialty of preference. This project is started to promote faster gaining of required competencies in order to reduce the length of the traineeship and thereby the costs for the government for the education of trainees. After finishing this ‘dedicated linking year’ the goal is, if the level of the student is sufficient, to start directly after graduating with the traineeship of the desired specialty.
Moving to the Netherlands to train or work in Internal Medicine
Very important before applying to a job as a medical doctor: Learn Dutch! If you are a subject of a country belonging to the European Union (EU) and your doctors diploma is obtained in membership state of the EU, a language test is often not mandatory, although following a Dutch language course is strongly advised to everyone. In order to function properly as medical doctor or specialist, you have to be able to communicate with patients and the medical staff. Dutch hospitals and other healthcare facilities may nevertheless ask a doctors to make the ‘algemene kennis- en vaardighedentoets (AKV)’ a general knowledge and skills assessment. The most important part of the assessment is language. You certainly need level NT2, but in general level C1 seems to be necessary.
Some good institutes for learning professional Dutch for non-native speakers:
Registration for Medical Doctors (for post-graduated medical doctors and medical specialists):
A graduated doctor from medical school who want to work as a doctor (trainee or specialist) has to register in the Dutch Healthcare Professionals register (BIG).
Being listed in the Dutch Healthcare Professionals (BIG) register means that:
- You may use the legally protected title(s) belonging to your profession.
- You may practice your profession independently.
- Doctors, dentists and midwives may carry out certain reserved procedures independently.
- You are subject to the disciplinary rules of the relevant profession.
- You can begin specialist training in your professional field.
See for more information: https://www.bigregister.nl/en/
The training for a medical specialist and registration in The Netherlands are coordinated by the Medical Specialist Registration Committee of The Royal Dutch Medical Association (KNMG). They are guided by rules and legislation concerning this matter of the Central College for Registration of Medical Specialists as well as national (B.I.G.-decree) and international law. For a traineeship you have to apply to a vacancy by a recognized academic training center. Academic training centers for internal medicine are: VU University Medical Center Amsterdam, Academic Medical Center Amsterdam, Erasmus Medical Center Rotterdam, Radboud University Medical Center, Leiden University Medical Center, University Medical Center Groningen, University Medical Center Utrecht and University Medical Center Maastricht. If accepted by the training establishment or by the selection committee, the physician is required to notify the Committee for the Registration of Specialists (RGS) and submit a training schedule for approval. This schedule must be in accordance with the regulations for the specialty in question.
If you have already followed a period of training outside The Netherlands, this can reduce total training period in The Netherlands. However, you have to start the complete training in The Netherlands first. After one year of training, a decision will be made concerning this matter. The total training period in The Netherlands can be reduced.
Registration as a specialist at the Dutch Society of Internal Medicine:
Application for registration as a specialist at the Dutch Society of Internal Medicine requires at least:
- A certified copy of your diploma
- Certificate of Good Standard (which says your registration as a medical specialist in your country of origin is still valid. This document should not be older than 3 months)
- A copy of the registration in the BIG-register
- Payment of the registration fee.
The Dutch Society of Internal Medicine may ask you for additional information.
For more information see webpage: http://knmg.artsennet.nl/Opleiding-en-herregistratie/RGS-1/Registratie/Buitenslands-gediplomeerden.htm
Important information and websites:
Dutch Society of Internal Medicine: www.internisten.nl
Vacancy website for medical doctors (all written in Dutch): http://artsenvacaturebank.nl/
BIG-registration is required for all medical doctors: They administer the registration of healthcare professionals in the BIG-register, doing so on behalf of the Ministry of Health, Welfare and Sport. They also issue a Declaration of Professional Competence to care providers wishing to practice on the Netherlands on the basis of a diploma awarded in another country.
Once registered you can officially work and/or follow post-gradual training in the medical field. Registration in the BIG-register is temporary. After 5 years you will be asked to re-register. Criteria for re-registration are work experience or educational requirements. Renewal of your registration for 5 years costs € 85,- (in 2015).
The Dutch Royal Medicine Association: http://knmg.artsennet.nl/Over-KNMG/About-KNMG.htm
Registration for people with a foreign diploma, information in Dutch: http://knmg.artsennet.nl/Opleiding-en-herregistratie/RGS-1/Registratie/Buitenslands-gediplomeerden.htm
This page has been prepared by Charlotte de Bree, Young Internists assembly representative for the Netherlands, April 2015.