Is Studying medicine in Bulgaria a good career path for Irish Medical Students?

Having finished my first year studying medicine at Varna Medical University in Bulgaria, I’ve experienced what feels like years of events packed into one. It has been a big challenge but I can definitely say I have no regrets whatsoever about coming here. I’ve yet to meet any colleagues who express regret, although I’m sure they’re out there somewhere as the location and culture isn’t for everyone. However, I’m really enjoying living in this lovely city by the Black Sea and I personally wouldn’t trade my place in Varna for a place in a university back home in Ireland. Two very important reasons for me are the beach and the glorious weather here! 

However, 6 years of sunny days and daily swims are only good if we have jobs to go to when graduation day comes around. So is studying here a wise career move for Irish students? For those with short attention spans: yes, in my opinion, it’s absolutely a good move. For everyone else, I’m going to explain why.

Getting a Job Back Home

Although there will always be a debate over which university is the best at preparing students for the hospital environment, the bottom line is that there is no shortage of jobs for doctors at hospitals in Ireland. In fact, the demand is so high that 42% of doctors in Ireland are from a foreign country. This puts Ireland in 3rd place for the highest percentage of foreign doctors in the world! Every Irish graduate from Varna that I’ve managed to contact is now working in a hospital either back home or in the UK.

Bulgarian medical degrees are recognised anywhere in the EU

This entitles you to register with the medical council of any country in the EU and practice within that country without having to take additional exams. For us Irish students, this means we can register with the Irish Medical Council as soon as we get that diploma in our hands and then apply for jobs. Or if you have language skills, you could also apply to other EU countries. In Germany, for example, you are only required to achieve a B2 level in the German Language Proficiency Test in order to be eligible to work in German hospital positions. This perk extends even as far as Switzerland, which is technically not a member of the EU, but does recognise EU medical degrees. The true value of the legitimacy of a Bulgarian medical degree really hit me this summer when I did a placement in St Marina hospital here in Varna. I met students from 3rd and 4th year from non-EU countries such as North Macedonia, Turkey, and Ukraine. When I asked them why they chose to study in Bulgaria, they all gave me the same answer: they want to be eligible to work in the EU. 

Bulgarian Medical Degrees are recognised worldwide

Incredibly, out of all European countries, Ireland has the highest level of doctors working abroad at 47.5%. That’s 10,065 Irish doctors! That’s almost the capacity of a packed Hill 16 in Croke Park in an All-Ireland Final. Just like our ancestors we continue to feel the urge to flock to countries like the USA, Canada, Australia, and the UK. Bulgarian degrees are recognised in all of these countries due to Bulgarian medical universities being listed on the World Directory of Medical Schools. Most countries recognise medical degrees based on this directory. But something to note if your desired country is outside the EU is that in most cases you will have to take that particular country’s medical licensing exam. 

UK

Now, how have things changed in the UK since Brexit? The British General Medical Council continues to recognise EU degrees and Irish students who graduated in Bulgaria can go ahead and apply. However, from 2024 all applicants will have to pass written and practical exams known as the UKMLA (Medical Licensing Assessment). This new rule applies to everybody including UK citizens who have graduated from a UK university so Irish students with Bulgarian medical degrees have no disadvantage here. 

USA & Canada

When applying to practice in the USA a similar but more difficult system known as the USMLE applies. Canada also has a very similar assessment system to this. It’s a very expensive route as travelling to the USA and completing the final assessments can add up to as much as $10,000. Students are advised to prepare for the USMLE and take the first 2 steps of exams during their 6 years of university. (Oh great….even more exams….)

Australia

However, in terms of working overseas there is one case where Irish students graduating in Bulgaria are at a slight disadvantage. This is Australia. Students who graduate from an Irish medical university are eligible to take what the Australian authorities refer to as the ‘Competent Authority Pathway’. This enables students from Irish universities to immediately apply for jobs as junior doctors. For many years, this has been a popular option for Irish graduates who want to work in a medical system with better working conditions and quality of life than Ireland. However, Irish graduates from Bulgarian universities would have to sit the AMC (Australian Medical Council) exams which are very expensive and have a high failure rate. The most popular way around this for all international medical students is to apply to the UK, take the UKMLA and complete 12 months of supervised training in a UK hospital. This would now make Irish students from Bulgarian universities eligible for the ‘Competent Authority Pathway’ in Australia. A shortcut like this is not possible in Ireland if you’ve graduated from a Bulgarian university. If you decide to find a job in Ireland straight after graduating from Bulgaria and later one day you decide that you want to transfer directly to Australia, there is still a possibility of it happening. You would have to work in Ireland for several years, become a specialist in a certain field and then apply directly for specialist positions in Australia. Yep, Australia was a tough one for me to research! 

The Course

International medicine and dentistry programs in English are available at 5 different universities in Bulgaria: Sofia, Varna, Plovdiv, Pleven, and Trakia. The courses themselves follow EU regulations, so it’ll be practically the same as the 6 year programs in Ireland and the other EU states. The courses in Bulgaria follow the usual 2 years of preclinical study, 3 years of clinical study and conclude with the internship year. One obvious difference in Bulgarian universities is the Bulgarian language course which takes place during the preclinical years. This is a great way to get your language skills up and running and prepare to speak with patients further down the line. Another key advantage that Bulgarian universities offer is the chance to study anatomy with cadavers rather than models. 2nd year anatomy practical exams are a hugely important part of the course and having realistic materials to work with is a real bonus. 

On the negative side of things, I expected overall better communication between professors and students especially during rescheduling of practicals and exam announcements. In this case it’s a good idea to keep your ear to the ground at all times and ask as many questions as possible to professors and fellow students. Don’t be afraid to approach professors privately. All of them are kind and welcoming any time I knock on their door outside of seminar times to ask questions.

Clinical Training

The teaching from third year onwards takes place exclusively in clinical settings. This involves learning from doctors and also working with patients in a hospital. Gaining knowledge of basic procedures such as changing catheters and cannulas, drawing blood samples, manually checking blood pressure, etc., is essential before graduating. It is very important to be trained properly in the basics before applying for a job in your desired destination. On top of this, students must also complete 1 month-long clinical training placements in hospitals during the summer vacation period of the 3rd and 4th year. 

After hearing mixed reviews of the clinical training at our university hospital, this summer, I decided to take the initiative and apply by email for a placement as I mentioned above. I was given a prompt and very kind reply in English by a senior doctor who said that they would be more than happy to invite me to work alongside the other summer placement students during the month of July. 

After a very enlightening 4 weeks, I realised that the student’s attitude plays a big part in this area. If you act assertively and work hard at studying Bulgarian, then you will be given high responsibility tasks by the nurses. Bulgarian is the main language spoken on the floor and the main tasks are generally given to the students who can keep up with conversation. Communication is everything, especially in a hospital. Of course, as a novice Bulgarian speaker, some things were lost in translation, but as the days went by, I found my vocabulary knowledge improving rapidly and I started gaining more trust from my colleagues. This early experience has set the bar and given me the motivation to get to a higher level of Bulgarian so that I can get the most out of my training later down the line. There is a fountain of training opportunities in this hospital just a couple of kilometres away from the university. It’s just up to the students to use it. I’ve worked alongside some of the 3rd / 4th year students who don’t take these opportunities and they looked quite lost on the floor.

Change In Culture. Adding a New Language to your list.

Staying at home and being close to family through your studies can be beneficial for some students and that’s understandable. But living in Bulgaria as an Irish medical student makes you very unique and there’s so much you can do in the community. Varna is very safe with a low crime rate and there’s no shortage of activities taking place throughout the year. Having experience in social projects is something that can have a majorly positive effect on your CV and can really make you stand out in interviews. In the UK, for example, this has become an important element of the interview process for graduates. I’ve only lived in Varna for 10 months but here are 3 valuable experiences that I’ve already gained so far.

Voluntary Football Coaching

There are tons of sports opportunities in Varna. I play football with a local team called Dinamo Varna International. It’s a team intended to unite players from all parts of the international community here in Varna. Our team has players from Ireland, Bulgaria, Germany, France, Ukraine, Spain, Portugal, UK, Angola, Nigeria, Egypt, Russia, Turkey, and more. Through the main organiser of the team, I’ve become a voluntary football coach for the Dinamo Varna youth team. The head coach of the youth team likes to promote English speaking with the kids and being a native speaker, I can do some drills with them while teaching them some English phrases along the way. 

Playing Music

Having lived as a musician / music teacher in South Korea for 11 years, I still feel the hunger to continue writing and recording whenever time allows. There are plenty of cool venues and musicians in Varna so I’ve started getting involved with the local music scene. I have a back catalogue of music that I’ve written, recorded, and released back in Korea under my band name ‘The Scarlet Pillows’ and I’ve begun recruiting members in Varna to start playing live again. 

I’ve found that plenty of locals are interested in working with me because of my experience and where I come from. For such a tiny country, Ireland has produced some of the most famous, legendary rock and pop stars of all time, so of course people are intrigued.

Learning a New Language

During my summer placement that I mentioned earlier, I met fellow students from all over the world. Many of them spoke highly about the Irish medical system and showed ambition about potentially working in our country one day. Some of the students saw me as a good opportunity to improve their English so we worked out a deal: They speak only in English and I speak only in Bulgarian. As word of this deal spread across the floor, I began making new friends and boosting my Bulgarian language skills.

Since a lot of my university colleagues are German, I’ve started slowly working on some German phrases in case I want to apply for a job there someday too!  

It’s a good idea to keep in touch with all of these medical colleagues that you meet along the way to create, what the famous writer / podcaster David Perell calls, your ‘serendipity vehicle’. A good contact could potentially put you in line for a job in the future or you could be the one in search of skilled colleagues for open positions at your hospital. 

Final Thoughts

If you’re researching medical universities in Bulgaria right now, chances are that things didn’t work out for you with that awful CAO points system (shakes fist) and you’re looking at other options. You deserve to be commended for even considering moving out of your comfort zone to fulfil your dream. Bulgaria is a great backup option that will provide you with the opportunities to develop the skills necessary to land you that dream job back home or abroad. There are other options and I totally understand how overwhelming it can be to wade through all of the information online when making your decision. My advice is to search online with a fine tooth comb for any information you can find and just read, read, and read some more. There are also some YouTubers who are studying in Bulgaria and upload videos regularly. Best of luck to you in your career in medicine and feel free to comment below or email me with any questions you may have about studying in this lovely country that I’m now happy to call home.