Table 1.

Licensing and registration

Legislation	Responsibility	Registration with NMA	Licensing requirements	Education	Licensing exams	Re-registration/revalidation
GERMANY
The Medical Licensure Act (Approbationsordnung) and the 1961 Medical Practitioner’s Act (Bundesärzteordnung)	Government and NMA	Doctors must be registered to practice with the Ärztekammer (State Chamber of Physicians) of the Lander in which they wish to work.	License to practice is awarded by the State Minister of Health following the completion of the basic medical qualification which includes one year practical training.	6+ years undergraduate medical education	Yes	Reaccreditation or re-licensing is not an official requirement in Germany. However, State Medical Associations require physicians to complete continued medical education.
ISRAEL
1976 Physicians’ Ordinance	Government	No requirement	Medical education plus 12 month internship, no criminal record, citizenship or permanent resident status, basic command of Hebrew, exams for foreign medical graduates.	6 years undergraduate medical education	Only for foreign medical graduates	Permanent Licenses are issued for an indefinite period. Israel does not have mandatory re-registration or revalidation requirements.
NETHERLANDS
Individual Healthcare Professions Act (BIG Act)	Government	No requirement	Physicians must hold a valid diploma, be permitted to practice the profession without restrictions, pay the appropriate registration fee, and have not been placed under supervision due to a psychological disorder.	6 years undergraduate medical education	No	Permanent licenses are subject to re-accreditation.
UK
Medical Act 1983	GMC	No requirement	Physicians automatically receive a license once they are registered. In order to receive full registration physicians must submit a Certificate of Experience (completed by their medical school) displaying proof that their internship year was successfully completed.	5 or 6 year undergraduate medical education	No	Permanent licenses are subject to revalidation (beginning December 3, 2012).
US
Most states have their own Medical Practice Act.	State Medical Boards	No requirement	Physicians must present proof of education and training, details of their work history, and pass a licensing examination. They must also provide information about their medical history and any arrests or convictions to their State Medical Board.	4 years postgraduate education	Yes	In most states, physicians must periodically re-register and fulfill continuing medical education requirements