Romania, Belgium, Spain, Croatia: medical degrees in Europe compared

When you start looking at studying medicine abroad, Romania is not the only option. Belgium, Spain and Croatia are three other destinations international students consider seriously. Each has its strengths, its weaknesses, and its traps.

This comparison is meant to help you see clearly, setting Romania against its European neighbours — always measured against Directive 2005/36/EC, which guarantees automatic EU recognition of the degree in all four countries.

The comparison at a glance

Romania: the most accessible route in

The profile

In a decade Romania has become Europe’s leading destination for students who did not get a place through their own country’s pre-med selection. Its strengths: admission without a competitive exam at most universities, tracks taught in English and in French, moderate fees compared with private alternatives, and automatic EU recognition of the degree.

Admission

• No competitive entrance exam at the majority of UMFs (Cluj, Târgu Mureș, Iași, Constanța). Admission is on file: school-leaving grades, a motivation letter, sometimes an interview.
• Bucharest (Carol Davila) is the exception: it runs an entrance examination for its English-taught track and may set additional requirements.
• No national cap on entry (numerus apertus). But note: places in the English- and French-taught tracks are limited — 50 to 100 per UMF.

The training

• Six years, with a preparatory language year for those joining the Romanian-taught track without the language.
• English-taught tracks: teaching in English throughout, with a gradual shift towards Romanian from year three for clinical placements, because the patients are Romanian.
• Quality varies by university: Cluj and Bucharest rank highest; Constanța is the newest and has the shortest track record.

Pros

• Admission without a competitive exam (at most UMFs).
• A full English-taught track.
• Total cost kept under control.
• Automatic recognition across the EU.
• Cheap flights and short travel times to most of Western Europe.

Cons

• The language barrier in year three (clinical placements in Romanian).
• Hospital infrastructure of uneven quality.
• A lingering reputational stereotype — “the fallback faculty” — which is receding but has not gone.
• Administrative steps that can be fiddly: equivalence of your school-leaving certificate, translation, apostille.

Belgium: excellence, at what price?

The profile

French-speaking Belgium attracts students for one simple reason: the quality of its medical faculties (ULB, UCLouvain, ULiège) is excellent, teaching is in French, and registration fees are low. But there is a very large “but”: access is bolted shut.

Admission

• A compulsory entrance examination for medicine and dentistry, in place since 2017 in the Wallonia-Brussels Federation.
• That examination is brutally selective: several thousand candidates for a few hundred places. The pass rate is below 20%.
• In Flanders, a strict cap with its own entrance exam (toelatingsexamen arts).
• No nationality quota at registration, but the exam filter is formidable.

The training

• Six years in French (Wallonia/Brussels) or Dutch (Flanders).
• High-level clinical training, placements in well-regarded teaching hospitals.
• No English-taught medical programme — you need French or Dutch to a very high standard.

Pros

• Excellent clinical training.
• Very low registration fees (€835/year for EU nationals).
• Automatic EU recognition.
• Central location in Western Europe.

Cons

• A punishing entrance examination. It eliminates most candidates before year one even starts.
• A strict cap in Flanders.
• High living costs, particularly housing.
• To practise in Belgium after graduating: installation quotas on reimbursement numbers, by area.

The Belgian verdict

If you have the level to pass the Belgian entrance exam, it is an excellent option — probably the best available in French. But most candidates who look at Belgium hit the wall of that exam, which is what sends them to Romania.

Spain: the Iberian dream, brutal at the door

The profile

Spain attracts people for its climate, its culture and the quality of its state medical faculties. But access to medicine there is among the most selective in Europe.

Admission

• A very strict cap. Access is determined by the nota de corte — the admission mark calculated from the Spanish school-leaving examination (EBAU) or from an equivalence for foreign qualifications.
• Foreign school-leaving certificates have to be formally recognised (homologación) by the Spanish Ministry of Education — a procedure that takes 8 to 12 months.
• The nota de corte for medicine often exceeds 12.5/14 at state universities. That is the equivalent of top-band results with distinction.
• No English-taught track. Teaching is entirely in Spanish.

The training

• Six years in Spanish, at state or private faculties.
• Very good clinical training, placements in well-regarded teaching hospitals.
• Some private universities (Navarra, for example) offer places without the nota de corte — but at €15,000 to €20,000 a year.

Pros

• High-quality training.
• Very low fees in the state system (€1,200–3,500/year).
• Automatic EU recognition.
• An attractive place to live.

Cons

• Extremely selective admission (the nota de corte).
• Recognition of a foreign school-leaving certificate: a long, tedious procedure.
• Teaching in Spanish only — no English-taught track.
• Living costs from moderate to high depending on the city.

The Spanish verdict

Spain is an excellent destination — for those who can get in. In practice the Spanish cap is even more formidable than the Belgian exam. The candidates who target Spain successfully tend to be bilingual or to hold exceptional school records.

Croatia: the emerging challenger

The profile

Croatia, an EU member since 2013, has been actively developing English-taught medical faculties to attract international students. It is Romania’s most direct competitor for “medicine in Eastern Europe, taught in English”.

Admission

• On file or with an entrance exam depending on the university (Zagreb, Split, Rijeka, Osijek).
• Croatian universities generally expect strong school-leaving grades and a motivation interview.
• English-taught programmes only for international students — there is no French-taught track.
• Fewer places than in Romania: a few dozen per university.

The training

• Six years in English (international programmes) or in Croatian.
• Good clinical training, shaped by German and Austrian standards.
• Croatia has invested in its university hospital infrastructure over the past few years.

Pros

• Less selective than Belgium or Spain.
• Moderate living costs.
• Automatic EU recognition.
• An EU member state since 2013.
• An exceptional setting — the Adriatic coast.

Cons

• Higher tuition than Romania (€8,000–12,000/year for English-taught programmes).
• Croatian is hard, and you need it for clinical placements — exactly as you need Romanian in Romania.
• Fewer places overall.
• A much smaller international student community on the ground.

The Croatian verdict

Croatia is a credible alternative to Romania if the cost does not stop you. For an English-speaking applicant the choice against Romania comes down to price and scale: Croatia costs meaningfully more per year and offers fewer places, on a comparable degree with the same EU recognition.

Conclusion: why Romania stays the first choice

On the balance of quality, price, accessibility and recognition, Romania ticks the boxes:

Belgium is better — if you pass the exam. Spain is excellent — if you have near-perfect school results and fluent Spanish. Croatia is a genuine alternative — at noticeably higher cost. Romania is the only one that combines accessible admission, an English-taught track, controlled cost and European recognition.

Our advice: don’t pick a country, pick a path. Romania is not a “plan B” — it is a route in its own right, ending in exactly the same rights as a degree from home. The real variable is not the country, it is what you do with it.

Going further

• Studying medicine in Romania in 2026: the complete guide
• Your Romanian medical degree in the European Union
• Recognition in Belgium, Switzerland and Luxembourg
• What medicine in Romania really costs

Last verified: July 2026 — Sources: Directive 2005/36/EC; the official sites of the universities named; cost data collected from the UMFs and the Belgian, Spanish and Croatian universities; ARES (Wallonia-Brussels Federation); Ministerio de Educación (Spain).

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