Quick Facts
- Nurses needed: ~100,000 to reach EU average
- Doctor shortage: ~9,000 projected by 2027
- Homologación time: 6-24 months
- Labor market test: Not required (shortage occupation)
- Regional programs: Andalucía, Madrid, Galicia, Valencia
- Language requirement: Spanish B2 for most positions
Spain needs healthcare workers
The numbers tell a clear story: Spain needs approximately 100,000 more nurses to reach the European Union average, and faces a projected shortage of 9,000 doctors by 2027. These aren’t projections from advocacy groups. The Ministry of Health has published these figures, and regional governments across the country are actively working to recruit foreign healthcare professionals to fill the gaps.
For nurses and doctors trained outside Spain, this shortage creates genuine opportunity. Several regions have opened fast-track hiring programs specifically targeting international healthcare workers, and the standard requirement for employers to prove they couldn’t find a local candidate doesn’t apply to most healthcare positions. The government recognizes the shortage and has removed barriers accordingly.
Specialties in highest demand
While healthcare workers are needed across the board, certain specialties face particularly acute shortages. Understanding where demand is strongest can help you target your job search and maximize your chances of finding a position quickly.
Medical specialties
Family Medicine and General Practice face the worst shortages, especially in rural areas and smaller towns. A significant portion of Spain’s current GPs are over 60 years old, and retirement rates are outpacing the supply of new specialists. Anesthesiology and Radiology both have substantial gaps across hospital systems throughout the country. Psychiatry is expanding as mental health services receive increased attention, with particular demand for child and adolescent psychiatry specialists. Geriatrics is growing rapidly as Spain’s population ages, creating sustained demand for specialists in elder care.
Nursing roles
General registered nurses are needed in all regions of Spain. Mental health nursing, ICU and emergency nursing, and primary care nursing are all areas with particularly strong demand. The nursing shortage is so significant that some regions have implemented special recruitment programs specifically to attract international nurses.
Regional fast-track programs
Healthcare hiring in Spain is decentralized. Each of Spain’s 17 autonomous communities runs its own regional health service with independent hiring authority. This means opportunities and processes vary by region, and some have created specific programs to recruit foreign healthcare workers more efficiently.
Andalucía: Nationality exemption program
The Junta de Andalucía has implemented a nationality exemption for non-EU nurses and specialist doctors, allowing the Servicio Andaluz de Salud to hire foreign healthcare workers who have completed their homologación. This program has been in place since 2023 and is currently extended through 2026.
The numbers demonstrate how significant this program has become: Andalucía went from hiring just 65 non-EU doctors in 2018 to over 1,150 in 2023. The program covers specialist doctors and nursing positions in areas designated as “hard to fill.”
There is a catch to be aware of: these are classified as “exceptional” contracts. The regional health service hires non-EU workers only after exhausting local and EU candidates, and contracts include a clause allowing replacement if an EU-qualified candidate becomes available later. For many healthcare workers, though, it provides a valuable entry point into the Spanish system.
Madrid: SERMAS positions
Madrid’s regional health service, SERMAS, announced 7,600 healthcare positions for 2025, including 3,369 nursing roles. These positions are filled through the concurso-oposición system, which combines an examination with a merit-based scoring process. To apply, you need to have your homologación complete.
Other regions
Galicia’s SERGAS health service has 1,980 nursing positions available through similar processes. Valencia and Cataluña are both high-demand areas with ongoing recruitment, though they don’t currently have the formal nationality exemption that Andalucía offers. Rural areas across all regions are generally easier to get hired in than major urban centers like Madrid and Barcelona.
The homologación requirement
This is the step that most foreign healthcare workers find challenging: you cannot practice nursing or medicine in Spain without getting your degree officially recognized through a process called homologación. The process takes time, typically between 6 and 24 months, though 2025 reforms have created priority channels for some applicants.
You apply through the Ministry of Universities with your apostilled degree, academic transcripts showing hours and credits completed, and sworn translations of all documents into Spanish. If your degree was obtained more than 6 years ago, you also need to demonstrate that you’ve worked in healthcare within the last 5 years.
New priority processing rules speed up applications for candidates who already have job offers from Spanish healthcare employers or who are already residing in Spain. This helps, but even the priority channel takes months rather than weeks. Planning ahead is essential.
Work visa options for healthcare workers
Once your homologación is complete, or in some cases while it’s still pending, you have several pathways to work legally in Spain.
Standard work visa
Any hospital, clinic, or nursing facility can sponsor you for a work visa. Because healthcare is consistently treated as a shortage occupation, employers don’t need to go through the labor market test that proves they couldn’t find a local candidate. This removes what is normally a significant bureaucratic hurdle and speeds up the process considerably.
Regional health service programs
If you’re applying to a region like Andalucía that has activated its nationality exemption program, the public health service can hire you directly into their system. These positions are typically temporary contracts initially, but they can lead to permanent positions over time and provide valuable entry into the Spanish healthcare system.
Highly Qualified Professional visa
If you’re offered a specialist medical position paying €40,000 or more annually, or €30,000+ if you’re under 30, you may qualify for Spain’s fast-track HQP visa with its 20-day processing time. In practice, this path works better for senior doctors and specialists than for nurses, whose salaries in Spain typically fall below these thresholds.
Realistic timeline
Understanding the actual timeline helps you plan effectively:
- Homologación process: 6 to 24 months, sometimes longer for complex cases
- Work visa processing: 1 to 3 months after receiving a job offer
- Professional college registration: 2 to 4 weeks after arriving
- Total realistic timeline: 9 to 30 months from starting the process to working in Spain
This timeline isn’t fast, and we’re honest about that. But for healthcare workers committed to building a career in Spain, the investment is worthwhile. Once you’re in the system, renewals are straightforward, and after 5 years of legal residence you can apply for permanent residency. Spain offers a good quality of life, and demand for healthcare workers isn’t going away.
What we help with
We guide healthcare workers through every stage of the process: preparing and filing the homologación application, navigating the work visa process once you have a job offer, handling Colegio professional registration after arrival, and advising on regional programs and which opportunities might be the best fit for your situation.
We’ve helped nurses from the Philippines, Colombia, and Venezuela, along with doctors from various Latin American countries, successfully navigate the path into Spain’s healthcare system. The process requires patience and proper guidance, but it’s very achievable.
Healthcare worker planning to move to Spain?
Book a consultation to map out your path and timeline.
Frequently asked questions
Can I start the visa process before my homologación is complete?
In some situations, yes. Private employers can sometimes sponsor your work visa while homologación is pending, with the understanding that you’ll complete professional registration once the credential recognition comes through. Regional public health programs typically require homologación to be finished before you can apply. We evaluate this on a case-by-case basis.
Do I need to speak Spanish?
Yes, for most healthcare positions. Regional health services typically require B2 level Spanish proficiency for patient care roles, and you’ll be tested on this during hiring. Some private clinics serving international patients may have lower language requirements. The homologación process itself doesn’t test language, but employment will.
Can I bring my family with me?
Yes. Standard work visas include family members. Your spouse and children receive residence permits and can work legally in Spain. Family processing happens together with your main visa application, not as a separate step afterward.
Is nursing really treated as a shortage occupation?
Healthcare roles are consistently treated as shortage occupations even when not formally listed in the quarterly SEPE catalog. Immigration authorities are well aware of the documented nursing and doctor shortages, and typically don’t require employers to prove they couldn’t find local candidates before sponsoring foreign healthcare workers.
Which region is easiest to get hired in?
Andalucía currently has the most explicit program for non-EU healthcare workers through its nationality exemption. Rural areas across all regions are generally easier to enter than major cities. Madrid and Barcelona have more positions overall, but also more competition from EU candidates and Spanish-trained professionals.