REGULATION on the recognition of professional qualifications of healthcare practitioners from other EEA Member States, No. 461/2011.

REGULATION on the recognition of professional qualifications of healthcare practitioners from other EEA Member States, No. 461/2011. CHAPTER I General Provisions. Article 1 Aim. The aim of this Regulation is to implement rules on the right to use the professional titles of regulated healthcare professions in Iceland in accordance with the EEA Agreement and Directive 2005/36/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualifications and its Annexes at any given time (cf. Appendix 1), hereinafter named the Directive, or in accordance with the Nordic Agreement on a Common Nordic Labour Market for Specific Healthcare and Nursing Professions and Veterinary Surgeons (cf. the Advertisement in Division C of the [Icelandic] Government Gazette [Stjórnartíðindi], No. 36/1993, cf. Amendment No. 6/2001). Article 2 Scope. This Regulation covers the right to use the professional titles of regulated healthcare professions in Iceland as regards applicants from an EEA Member State who have acquired satisfactory professional qualifications in another EEA Member State and who wish to work as such in Iceland under the Healthcare Practitioners Act, the Recognition of Professional Qualifications for Employment Act and regulations issued under those Acts. Article 3 Definitions. In this Regulation, the following terms are used as defined below. 1. EEA Agreement: The Agreement between the European Union and Iceland, Norway and Liechtenstein which was signed on 2 May 1992 and took effect on 1 January 1994. 2. Nordic Agreement: The Agreement between Iceland, Denmark, Finland, Norway and Sweden on a Common Nordic Labour Market for Specific Healthcare and Nursing Professions and Veterinary Surgeons, which was signed on 14 June 1993 and took effect on 1 January 1994, with subsequent amendments. 3. Regulated profession: Professional activity within the health services, authorisation for working within which, or for using the professional title of which, is covered by legislative or administrative provisions regarding special professional qualifications. 4. Professional qualifications: Qualifications attested by special evidence of formal qualifications, an attestation of formal qualifications, an attestation of competence and/or professional experience (cf. Appendix II). 5. Evidence of formal qualifications: Examination certificate (diploma), certificate or other official evidence certifying successful completion of professional training. 6. Competent authority: Any authority or body responsible for issuing or receiving examination certificates (diplomas) and other documents or information relating to applications for the recognition of professional qualifications. 7. Regulated education and training: Any training which is specifically geared to the pursuit of a given profession and which comprises a course or courses complemented, where appropriate, by professional training, or probationary or professional practice. 8. Professional experience: The actual and lawful pursuit of the profession concerned. 9. Adaptation period: The pursuit of a regulated profession in Iceland under the responsibility of a qualified member of that profession, possibly with the addition of further training. 10. Aptitude test: A test of the applicant s professional knowledge, administered by the competent authorities in Iceland with a view to assessing the applicant s ability to pursue a regulated profession. 11. The Directive: Directive 2005/36/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualifications, with subsequent amendments and annexes. 1

Article 4 Effects of recognition. A healthcare practitioner who is a national of a Member State of the European Economic Area, or of a state with which an agreement has been made on the mutual recognition of professional rights, is entitled to a licence under this Regulation and to practise within a regulated healthcare profession, or to provide temporary services in Iceland, according to the same requirements as apply to Icelandic nationals, providing he or she meets the conditions of: a. the Directive, including its Annexes at any given time, or b. the Nordic Agreement. CHAPTER II Automatic recognition, issue of licences and specialist licences on the basis of coordination of the minimum training conditions. Article 5 Licensing on the basis of evidence of formal qualifications. Applicants shall be entitled to licences as doctors, nurses, midwives or pharmacists if they submit evidence of formal qualifications: a. for doctors in accordance with Annex V to the Directive, V.1., Doctor of Medicine, point 5.1.1. and, as appropriate, attestation of further study (internship [kandidatsár]), b. for nurses in accordance with Annex V to the Directive, V.2. Nurse responsible for General Care, point 5.2.2, c. for dental practitioners in accordance with Annex V to the Directive, V.3. Dental Practitioners, point 5.3.2, d. for midwives in accordance with Annex V to the Directive, V.5. Midwife, point 5.5.2, e. for pharmacists in accordance with Annex V to the Directive, V.6. Pharmacists, point 5.6.2. Applicants who submit evidence of formal qualifications which does not correspond to the titles set forth in the first paragraph shall be entitled to licences if they submit confirmation from the competent authority in the EEA Member State which issued the evidence of formal qualifications stating that the training is in accordance with the requirements of the Directive and that the evidence is equivalent to the evidence named in the Directive. Licences as a midwife under the first and second paragraphs shall only be granted if the evidence of formal qualifications meets one of the following conditions: a. full-time training in midwifery for at least three years: 1. the applicant shall either be in possession of an examination certificate, attestation or other evidence of qualifications granting access to a university or higher educational institution, or otherwise confirming an equivalent level of knowledge or 2. the applicant shall complete a further two years of professional practice confirmed by a certificate in accordance with the fourth paragraph, b. full-time training in Midwifery lasting at least two years or 3,600 hours, providing that the applicant is in possession of evidence of formal qualifications as a nurse responsible for general care as described in point 5.2.2 of Annex V to the Directive, c. full-time training in Midwifery lasting 18 months or at least 3,000 hours, providing that the applicant is in possession of evidence of formal qualifications as a nurse responsible for general care as described in point 5.2.2 of Annex V to the Directive, followed by professional practice confirmed by a certificate in accordance with the fourth paragraph. The certificate referred to in item 2 of indent a, or in indent c, of the third paragraph shall be issued by the competent authority of the state which issued evidence of formal qualifications. It shall confirm that, after receiving evidence of formal qualifications as a midwife, the holder has practised for two years in a satisfactory manner as a midwife in a hospital or healthcare institution approved for that purpose. A certificate issued by a competent authority confirming that the applicant has, in a satisfactory and lawful manner, pursued the profession of midwife during at least two continuous years during the five-year period immediately preceding the issue of the certificate shall be equivalent to a certificate in accordance with item 2 of indent a, or with indent c, of the third paragraph. 2

Article 6 Licensing on the basis of acquired rights. Applicants for licences who are in possession of evidence of formal qualifications which are not named in Annex V to the Directive shall be entitled to licences as doctors, nurses, dental practitioners, midwives or pharmacists if they submit: a. evidence of formal qualifications that was either issued prior to, or covers training which commenced prior to, the reference date stated in Annex V to the Directive: 1. for doctors, in point 5.1.1, 2. for nurses responsible for general care, in point 5.2.2, 3. for dental practitioners, in point 5.3.2, 4. for midwives, in point 5.5.2, 5. for pharmacists, in point 5.6.2 and b. a certificate confirming that the applicant effectively and lawfully engaged in the activities in question for at least three continuous years during the five-year period immediately preceding the issue of the certificate. In the case of nurses responsible for general care, the activities shall have included full responsibility for the planning, organisation and administration of nursing care delivered to patients. Applicants for licences who are in possession of evidence of formal qualifications from the former German Democratic Republic, the former Czechoslovakia, the former Soviet Union and the former Yugoslavia shall be entitled to licences after meeting the conditions set out in Appendix III. Article 7 Licensing on the basis of special acquired rights. Applicants in possession of evidence of formal qualifications as nurses from Poland and Romania which was either issued prior to the dates set forth in point 5.2.2 of Annex V to the Directive or which refer to training which commenced prior to those dates shall be entitled to licences as nurses only if the conditions stated in Appendix IV are met. Applicants in possession of evidence of formal qualifications as dental practitioners from an EEA Member State which does not meet the conditions of Articles 5 and 6 shall be entitled to licences if the conditions stated in Appendix V are met. Applicants in possession of evidence of formal qualifications as midwives from the territories of the former German Democratic Republic, Romania or Poland shall be entitled to licences as midwives only if the conditions stated in Appendix VI are met. Article 8 Special provision regarding doctors and nurses from Bulgaria. Holders of evidence from Bulgaria (feldsher) issued prior to 31 December 1999 shall not be entitled to recognition of their formal qualifications within the EEA Area as doctors or nurses responsible for general care. Article 9 Specialist licences on the basis of evidence of formal qualifications. Applicants shall be entitled to licences as specialists in medicine or dentistry if: a. the specialist discipline is recognised in Iceland, b. the applicant holds a licence as a doctor or dental practitioner under Article 5, 6 or 7, c. the applicant submits evidence of formal qualifications in accordance with point 5.1.2 and 5.1.3 of Annex V to the Directive as a specialised doctor and point 5.3.3 of Annex V to the Directive as a specialised dentist and d. the applicant submits, as appropriate under the circumstances, an attestation of professional practice (internship kandidatsár). An applicant who does not meet the requirement of indent c of the first paragraph as a specialist in the field of medicine shall nevertheless be entitled to a licence as a specialist if he or she meets the conditions of Icelandic rules for specialist recognition. When an assessment is made, the length of the applicant s studies, and their content, and also the applicant s professional practice and further studies in the field of medicine shall be taken into account. Specialised studies may only have been pursued in healthcare institutions approved for such special studies in the applicant s home country. 3

An applicant who submits evidence of formal qualifications as a specialist in medicine or dentistry and who does not meet the requirements of the first paragraph shall be entitled to recognition as a specialist if he or she submits confirmation from the competent authority of the EEA Member State that issued the evidence. The confirmation shall attest that the specialist studies and the evidence correspond and are comparable with the demands made in the Directive. Article 10 Specialist recognition on the basis of acquired rights. An applicant for a specialist licence which is not listed in Annex V to the Directive shall be entitled to approval as a specialist in medicine or dentistry if: a. the specialist discipline is recognised in Iceland, b. the applicant holds a licence as a doctor or dental practitioner under Article 5, 6 or 7 and submits a certificate stating that he or she has effectively and lawfully practised within the relevant specialist discipline for at least three continuous years during the five-year period immediately preceding the issue of the certificate and c. the evidence of formal qualifications was issued prior to, or covers training which commenced prior to: 1. the reference dates stated in Annex V, points 5.1.2 and 5.1.3 for specialised doctors 2. the reference dates stated in Annex V, point 5.3.3 for specialised dentists. Applicants holding evidence of formal qualifications from the from the former German Democratic Republic, the former Czechoslovakia, the former Soviet Union and the former Yugoslavia shall be entitled to licences after meeting the conditions set out in Appendix III. An applicant in possession of evidence of formal qualifications as a doctor from Spain, who completed specialist studies prior to 1 January 1995, shall be entitled to a specialist licence even though the minimum requirements laid down regarding training in Article 25 of the Directive are not met. The evidence of formal qualifications shall be accompanied by a certificate issued by the competent Spanish authorities stating that the person in question has passed a test establishing particular competence in the subject and held on the basis of the extraordinary measures concerning recognition which are prescribed in Royal Decree No. 1487/99. Article 11 Licensing as a general practitioner. (Evrópulæknaleyfi.) Applicants shall be entitled to licences as general practitioners if they: a. are in possession of licences as doctors according to Article 5 or Article 6 and b. submit evidence of formal qualifications in accordance with point 5.1.4 of Annex V to the Directive. Validity equal to that of the evidence required under indent b of the first paragraph shall be accorded to a certificate issued in an EEA Member State confirming that, by the reference date specified in point 5.1.4 of Annex V to the Directive, the applicant: a. has practised as a doctor in an EEA Member State in accordance with the provisions of Article 21 of the Directive on automatic recognition, or of Article 23 on acquired rights, and b. was entitled to practice as a general practitioner within the framework of the social security system (cf. Regulation No. 374/1996, on the payment of health insurance for general medical assistance). Article 12 Licence to operate a pharmacy. Training undergone by an applicant in another EEA Member State which fulfils the requirements of Article 5 or Article 6 shall be regarded as equivalent to the training undergone by pharmacists in Iceland in connection with applications for pharmacists licences in Iceland. If additional requirements regarding professional experience in a pharmacy in Iceland are made in connection with applications for licences to operate a pharmacy, then corresponding professional experience in another EEA Member State shall be taken into account. The Medicinal Products Act, No. 93/1994, with subsequent amendments, shall apply regarding licences to operate pharmacies. 4

Article 13 Licensing when the requirements of Chapter II are not met. Applicants holding evidence of formal qualifications as doctors, specialised doctors, nurses responsible for general care, dentists, specialised dentists, midwives or pharmacists which does not meet the criteria for licensing under Articles 5-12 shall be entitled to have their qualifications assessed in accordance with Articles 14 and 16. CHAPTER III General system for the recognition of evidence of training and the issue of licences and specialist licences when minimum training standards are not coordinated. Article 14 Licences and specialist licences on the basis of evidence of professional qualifications. Applicants shall be entitled to licences and, as appropriate, specialist licences, within the authorised health professions in Iceland as alcohol and drug addiction counsellors, social workers, chiropodists (podiatrists), radiographers, chiropractors, occupational therapists, biomedical scientists, pharmaceutical technicians, medical secretaries, diet cooks, food scientists, biologists in the healthcare services, nutritionists, dieticians, administrative dieticians, osteopaths, psychologists, opticians, emergency medical technicians, licensed practical nurses, massage therapists, physiotherapists, prosthetists/orthotists, speech therapists, dental hygienists, dental assistants and social educators if they submit attestations of competence or evidence of formal qualifications required in another EEA Member State to practice there within the regulated healthcare professions listed above. An applicant whose training is more than one level lower, in terms of the grouping of professional qualifications into levels under Article 11 of the Directive (cf. Appendix II), than the corresponding training in Iceland shall not be entitled to a licence under the first paragraph. If training in Iceland consists of a course of least four years duration at university level corresponding to indent d of Article 11 of the Directive, then the applicant s training must at least correspond to indent c of Article 11 of the Directive (cf. Appendix II). Article 15 Requirements that may be made if a profession is not regulated in the state from which the applicant comes. An applicant who has practised within a profession listed in the first paragraph of Article 13 in another EEA Member State where the profession is not regulated shall be entitled to a licence or specialist licence if he or she has practised in the other EEA Member State for at least two years in full employment, or for a corresponding period in part-time employment, during the preceding ten years, providing that he or she submits one or more attestations of competence or evidence of formal qualifications to pursue the profession. The same applies to training under the second paragraph of Article 14. If the application is made for a licence in a profession that is regulated in the other EEA Member State and the applicant s training meets the requirements of indents b, c, d or e of Article 1 of Appendix II, professional practice in accordance with the first paragraph above shall not be required. Article 16 Compensation measures. The Medical Director of Health may demand that applicants complete either an adaptation period of up to three years under supervision or that they undergo an aptitude test if: a. the training period, completion of which is attested in the evidence they submit, is at least one year shorter than is required in Iceland, b. the training they have received is substantially different, in terms of its contents, from that which is required in Iceland, or c. the profession which is regulated in Iceland does not correspond to the applicant s profession, the difference lying in special training that is required in Iceland and is substantially different, in terms of its contents, from the training that lies behind the applicant s attestation of competence or evidence of formal qualifications. Applicants shall be given the right to choose between an adaptation period and undergoing an aptitude test. 5

In the instances referred to in indent a of the first paragraph, applicants may be required to complete the adaptation period or undergo an aptitude test if they intend to pursue the activities independently or as directors of enterprises where knowledge and the application of special rules specific to the country are required. Where the competent authorities in Iceland grant their own nationals access to such activities, it shall be obligatory to demand a knowledge of, and the application of, these rules. As regards the application of indents b and c of the first paragraph, substantially different training refers to training content that is of fundamental importance in the profession, with a substantial difference between the content and length of the applicant s training and that of the training required in Iceland. Before requiring the applicant to complete an adaptation period or undergo an aptitude test, the relevant authority shall establish whether the knowledge that the applicant has acquired in the course of professional practice in the Member State, or in a third state, is such as to cover, completely or in part, the substantial difference referred to in the third paragraph. Article 17 Adaptation periods. Adaptation period refers to the pursuit of a regulated profession under the supervision of a fullyqualified member of the profession. The period of supervised practice shall be organised by the head of the institution involved, together with two fully-qualified members of the profession in question, and the period shall be assessed subsequently. Following completion of the supervision period, the applicant may have to undergo further training. The Medical Director of Health shall issue further rules on adaptation periods and their assessment and also on the status of applicants working under supervision in Iceland. Article 18 Aptitude tests. Aptitude test refers to a test in which an assessment is made of whether the applicant s professional knowledge is sufficient for the pursuit of a regulated profession in Iceland. Tests shall be organised and held by the relevant educational institution in consultation with the Medical Director of Health. The Medical Director of Health shall draw up a list of the subjects which, on the basis of a comparison of the education and training required in Iceland and that received by the applicant, are not covered by the diploma or other evidence of formal qualifications possessed by the applicant. Aptitude test shall cover subjects which are selected from the list and which are necessary in order to pursue the profession in question in Iceland. Furthermore, the test may test the applicant s knowledge of the rules applying in Iceland to the profession in question. Article 19 Waiving of compensation measures. Compensation measures may not be required if the applicant meets the common platform requirements under Article 15 of the Directive. CHAPTER IV Provision of services by healthcare practitioners. Article 20 Principle of free provision of services. Healthcare practitioners who operate lawful health services in an EEA Member State and who propose to provide the same regulated services on a temporary basis, or intermittently, in accordance with healthcare legislation, legislation on the recognition of professional qualifications and administrative provisions issued thereunder may offer their services in Iceland without being in possession of licences or specialist licences in Iceland (cf., however, Article 22). If the profession is not regulated in the state in which the healthcare practitioner pursues lawful healthcare activities, the professional may offer the services on a temporary basis in Iceland without a licence or specialist licence if he or she has practised lawfully in the state of establishment for two years during the preceding ten years. When assessing the nature of services provided on a temporary basis, or intermittently, attention shall be given in each case to the duration, frequency, regularity and continuity of the service. 6

Healthcare practitioner who wish to have invoices settled by a health insurance institution shall inform the institution in advance of the services they intend to provide; this may be done afterwards in the case of emergencies. In other respects, the Regulation No. 374/1996, on the payment of health insurance for general medical assistance, shall apply. Before commencing activities, a healthcare practitioner who intends to provide services in Iceland on a temporary basis or intermittently shall send the Medical Director of Health a written declaration stating, amongst other things, what the service consists of, the length of time involved and details of insurance cover. Such a declaration shall be renewed for each year during which the healthcare practitioner intends to practise in Iceland. Article 21 Required documentation. When services are provided for the first time, or in the case of a substantial change as compared with documentation already submitted, the following documents shall be submitted: a. proof of the nationality of the healthcare practitioner, b. an attestation of the operation of lawful healthcare activities in an EEA Member State, certifying that the healthcare practitioner is licensed to pursue the activity in question and that he or she is not prohibited from practising it at the time of submission of the attestation (letter of good standing), c. an examination certificate testifying to the applicant s qualifications for gaining a licence, or evidence of formal qualifications, d. a certificate stating that the healthcare practitioner has pursued the activity concerned for at least two years during the preceding ten years (cf. the second paragraph of Article 20), e. a certificate of professional liability insurance valid in Iceland (patient insurance) f. a criminal record statement if this is required of Icelandic nationals. Article 22 Procedure; monitoring of professional qualifications. The Medical Director of Health may examine healthcare practitioners professional qualifications before professionals provide services within a regulated profession for the first time. Preliminary examination of this type is permissible when its purpose is to prevent serious impacts on patients health and safety as a result of deficient qualifications on the part of the healthcare practitioner and when the examination does not exceed whatever is necessary for this purpose. This shall not apply to the rights of doctors, dentists, nurses, midwives or pharmacists who receive licences under Chapter II. The Medical Director of Health shall inform the healthcare practitioner within a month of the receipt of the necessary documentation either that no examination of his or her professional qualifications is to be made or else of the outcome of such an examination. If problems arise which could result in a delay, the Medical Director of Health shall inform the healthcare practitioner within one month of the reasons for such delay and of when the outcome may be expected. The outcome shall be made known within two months. When there is a substantial difference between the applicant s professional qualifications and the training required in Iceland, such as may constitute a hazard to patients safety, the healthcare practitioner shall be given the opportunity to demonstrate, chiefly by means of undergoing an aptitude test, that he or she has acquired the knowledge or competence that was lacking. In all situations, it must be possible to provide the services within a month from the taking of a decision (cf. the second paragraph). If no response is received from the Medical Director of Health within the time-limits stated in the second and third paragraphs, the healthcare practitioner may commence service activities. Article 23 Information for the patient. If the service is provided under the professional title used in another Member State where the healthcare practitioner operates a lawful health service, or on the basis of the professional s professional qualifications, the patient shall be informed in writing of the following: a. the name and address of the supervisory authority in the state where the professional operates a lawful health service activity, if the profession is regulated there, and b. information on the insurance cover or other personal or collective protection applying to employees as regards professional liability. 7

The Medical Director of Health shall ensure unhindered access to the necessary information regarding the handling of complaints and charges lodged by patients. Article 24 Legal requirements made regarding service activities. Provisions of legislation and regulations on healthcare practitioners shall apply on other matters regarding healthcare practitioners who are entitled under this Chapter to provide temporary healthcare services in Iceland. Furthermore, legislation and regulations from the Ministry of Education, Science and Culture on the recognition of professional qualifications for practising in Iceland shall apply as appropriate. CHAPTER V Procedure. Article 25 Processing by the Medical Director of Health of applications for licences. The Medical Director of Health shall grant licences or specialist licences in accordance with the provisions of this Regulation. The Medical Director of Health shall confirm receipt of applications within one month and inform the applicant if any documentation is lacking, and if so, what is lacking. Applications shall be processed as promptly as possible, and at the latest within three months of the receipt of all necessary documentation. Applications under Chapter III shall be processed at the latest within four months of the receipt of all necessary documentation. Article 26 Rejection of applications for the issue of licences or specialist licences. Even if the requirements of Chapters II and III are met, the applicant shall not be entitled to a licence or specialist licence if reasons exist which could result in its revocation. Article 27 Licences and specialist licences on the basis of training in a third state. Applicants with training from a state outside the European Economic Area (a third state) shall be entitled to licences or specialist licences if they hold: a. evidence of formal qualifications or an examination certificate issued in the third state which meets the minimum requirements of the Directive and b. a certificate of three years professional practice from an EEA Member State which has recognised the evidence. If an applicant who does not have professional practice in accordance with indent b of the first paragraph submits evidence of formal qualifications issued in a third state together with confirmation from an EEA Member State that it has recognised the evidence, the Medical Director of Health shall assess the applicant s training in accordance with Chapter III when processing an application for a licence or specialist licence. The Medical Director of Health shall also assess professional practice that is certified as having taken place in an EEA Member State. Article 28 Language skills. A healthcare practitioner who receives a licence or specialist licence in Iceland, or who intends to provide services on a temporary basis or intermittently in accordance with Chapter IV, shall possess the language skills necessary to be able to pursue the profession in a satisfactory manner in Iceland. The employer shall, as appropriate, assess whether the healthcare practitioner s language skills are of sufficient calibre as to guarantee patients safety and interests. Article 29 Information. Applicants for licences under this Regulation, or those who intend to provide services under Chapter IV, shall apply to the Medical Director of Health for information concerning this Regulation and its application. The Medical Director of Health shall ensure that applicants receive information on the relevant Icelandic healthcare legislation. 8

Article 30 Documents to be submitted with applications. The Medical Director of Health may demand that applicants for licences and specialist licences submit the following documents listed in Annex VII to the Directive: a. Proof of the applicant s nationality. b. A certified affirmation of competence or evidence of formal qualifications granting access to the profession in question. c. Confirmation of professional practice in accordance with the provisions of this Regulation. d. Information on suspension, restriction or revocation of approval, or other similar sanctions arising from serious professional violations or mistakes (letter of good standing). These documents may not be more than three months old. e. A certificate from the competent authorities in the applicant s home state, or the state issuing evidence of formal qualifications, stating that the documents are in conformity with what is laid down in the Directive. f. A criminal record statement if this is required of Icelandic nationals. Applicants shall, on request, submit the necessary information to make it possible to verify whether their training is substantially different from that administered in Iceland. If applicants are unable to submit the information referred to, they shall provide information concerning the competent authorities or another public institution in the state from which the documents originate. If there is a legitimate doubt as to whether attestations of competence or evidence of formal qualifications are valid, and suspicion that the applicant does not meet the minimum educational requirements according to the Directive, the Medical Director of Health may demand confirmation from the competent authorities in the EEA Member State in question concerning the legitimacy of the evidence and stating that the applicant meets the educational requirements laid down in the Directive. If there is a legitimate suspicion that evidence of formal qualifications issued by the competent authorities of an EEA Member State refers to training that took place entirely or partly in an educational institution in another EEA Member State, the Medical Director of Health may demand confirmation regarding the following points from the state which originally issued the evidence: a. whether training in the educational institution has received formal approval in the EEA Member State that issued the attestation, b. whether the evidence of formal qualifications is the same as would have been issued had all the training been administered in the EEA Member State which issued the evidence, and c. whether the evidence of formal qualifications grants the same authorisation throughout the territory of the EEA Member State where the evidence was issued. Article 31 Use of professional titles. Healthcare practitioners who have received licences or specialist licences under this Regulation shall use the Icelandic title of the profession in question in Iceland. In those cases where professional qualifications have been established in accordance with Chapter IV, the service shall be provided under the professional title used in Iceland. Article 32 Issue of certificates for use in another EEA Member State. At the request of healthcare practitioners who apply for recognition of their professional qualifications or to provide temporary services in another EEA Member State, the Medical Director of Health shall prepare certificates stating that the professional is entitled to practise as a regulated healthcare practitioner and, as appropriate, as a specialist or as a general practitioner. The Medical Director of Health shall revoke certificates under the first paragraph in cases where the healthcare practitioner s licence, specialist licence or licence to prescribe drugs is suspended. The same shall apply if the healthcare practitioner relinquishes or turns in to the Medical Director of Health his or her licence, specialist licence or licence to prescribe drugs. 9

Article 33 Nationals of the Nordic countries. Furthermore, the Nordic Agreement on a Common Nordic Labour Market for Specific Healthcare and Nursing Professions and Veterinary Surgeons, with subsequent amendments, shall apply to nationals of Denmark, Finland, Norway and Sweden. Article 34 Fees. Fees for the issue of licences and specialist licences shall be in accordance with Article 10 of the Supplementary Treasury Revenues Act, No. 88/1991. Special fees in addition to those covered in the first paragraph may be charged for all types of processing and handling by the Medical Director of Health of applications for licences and specialist licences under this Regulation. These shall include fees for the translation of documents, assessments by persons called on to comment on applications, examination and evaluation of documents and other administrative work. The Minister of Welfare shall issue a tariff covering charges referred to in the second paragraph after receiving proposals from the Medical Director of Health. The tariff shall take account of the scope of the work done by commentators and assessors in connection with the granting of licences and specialist licences. The Medical Director of Health may charge fees under the second paragraph before applications are subjected to substantive examination and documents are sent to persons for comment or evaluation. In such cases, a detailed statement of the costs involved according to the tariff provided for in the third paragraph shall be drawn up. Fees for aptitude tests shall be in accordance with Article 24 of the Public Higher Educational Institutions Act, No. 85/2008 and Article 45 of the Upper Secondary Education Act, No. 92/2008. Article 35 Other legislative and administrative provisions. Legislation and regulations on healthcare practitioners and Directive No. 2005/36/EC of 7 September 2005 on the recognition of professional qualifications shall apply and complement this Regulation. Furthermore, provisions of legislation and regulations from the Ministry of Education, Science and Culture on the recognition of professional qualifications for practice in Iceland shall apply as appropriate. Article 36 Commencement. This Regulation, which is issued under the second paragraph of Article 9 of Act No. 26/2010, on the Recognition of Professional Qualifications for Working in Iceland, shall take effect immediately. At the same time, Regulation No. 244/1994, on the confirmation of authorisations for some healthcare professions, etc., under the provisions of the EEA Agreement, shall stand repealed. Ministry of Education, Science and Culture, 12 April 2011. Katrín Jakobsdóttir. Ásta Magnúsdóttir. 10

Appendix I. Directive 2005/36/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualifications, as it was incorporated into the EEA Agreement by Joint Committee Decision 142/2007, which was published on 10 April 2008 in the EEA Supplement to the Official Journal of the European Union, No. 19/2008, p. 70. Appendix II. Levels of qualification according to Article 11 of Directive 2005/36/EC. Article 1 When applying the Directive, professional qualifications are divided into various levels as follows. a) Attestations of competence from the competent authorities in the applicant s home state, either: 1. of a training course that is not covered by a certificate or diploma in the sense of indents b, c, d, or e, or a special examination taken without prior training, or stating that the applicant has pursued the profession in a Member State on a full-time basis for three years, or on a part-time basis for a corresponding period, during the preceding ten years, or 2. of general primary (compulsory) or secondary education, attesting that the holder has acquired general knowledge. b) A certificate attesting to successful completion of a secondary course, either: 1. of general studies, supplemented by a course of study or professional training other than that covered in indent c have been added, and/or by probationary or professional practice required in addition to that course, or 2. of technical or professional training, supplemented, where appropriate, by a course of study or professional training referred to in point 1 and/or by the probationary or professional practice required in addition to that course. c) An examination certificate (diploma) attesting to successful completion of a secondary course, either: 1. of a one-year course of training at post-secondary level, other than is covered in indents d or e, or of a corresponding period spent in part-time studies, entry qualifications for which shall normally include successful completion of the secondary-level course required for entry to university or higher education, or completion of corresponding studies at the second secondary level, in addition to professional training that may be demanded in addition to that [post-] secondary course, or 2. in the case of a regulated profession, of specially-structured training listed in Annex II to the Directive, equivalent to the level of training provided for under point 1 which provides a comparable professional standard and prepares the trainee for a comparable level of responsibilities and functions. The list in Annex II may be amended in accordance with the procedure referred to in Article 58(2) of the Directive in order to take account of training which meets the requirements provided for in the previous sentence. d) An examination certificate (diploma) certifying successful completion of training at post-secondary level of at least three and not more than four years duration, or of an equivalent duration on a parttime basis, at a university or establishment of higher education or another establishment providing the same level of training, as well as the professional training which may be required in addition to that [post-]secondary course. e) An examination certificate (diploma) certifying that the holder has completed a post-secondary course of at least four years duration, or of an equivalent duration on a part-time basis, at a university or establishment of higher education or another establishment of equivalent level and, where appropriate, that the holder has successfully completed the professional training required in addition to the [post-]secondary course. Article 2 Concerning equality of status of certificates, any evidence of formal qualifications or set of evidence of formal qualifications issued by a competent authority in an EEA Member State, shall be regarded as evidence of formal qualifications of the type covered by Article 1, including the level in question. The evidence shall attest that the holder has successfully competed training which the Member State recognises as being of an equivalent level and which confers on the holder the same rights of access to, or pursuit of, a profession or prepares for the pursuit of the profession in question. 11

Article 3 Any professional qualification which, although not satisfying the requirements contained in the legislative, regulatory or administrative provisions in force in the issuing Member State for access to, or the pursuit of, a profession, confers on the holder acquired rights, shall also be treated as such evidence of formal qualifications under the same conditions as are laid down in Article 1. This applies in particular if the Member State in question raises the level of training required for admission to a profession and for its pursuit, and if an individual who has undergone former training, which does not meet the requirements of the new qualification, benefits from acquired rights by virtue of legislative, regulatory or administrative provisions in the Member State in question. In such a case, the former training is considered as corresponding to the level of the new training when assessing whether conditions for recognition are met. Article 4 Healthcare professions rated according to Article 11 of the Directive: Professional title: Training requirements: Level under Art. 11 1. Alcohol and drug treatment counsellor. Attestation a 2. Social worker. University training d 3. Chiropodist (podiatrist). Secondary level training b 4. Radiographer. University training d 5. Chiropractor. No training available in Iceland d 6. Occupational therapist. University training d 7. Biomedical scientists. University training d 8. Pharmaceutical technician. Secondary level training b 9. Medical secretary. Secondary level training b 10. Diet cook. Secondary level training b 11. Food scientist. University training d 12. Biologist in the healthcare services. University training d 13. Nutritionist. University training d 14. Administrative dieticians. University training d 15. Dietician. University training d 16. Osteopath. University training d 17. Psychologist. University training d 18. Optician. No training available in Iceland c 19. Emergency medical technician. Attestation a 20. Licensed practical nurse. Secondary level training c 21. Massage therapist. Secondary level training c 22. Physiotherapist. University training d 23. Prosthetist/orthotist. No training available in Iceland d 24. Speech therapist. No training available in Iceland d 25. Dental hygienist. No training available in Iceland b 26. Dental assistant. Secondary level training b 27. Social educator. University training d Appendix III. Special acquired rights: applicants with training from the former German Democratic Republic, the former Czechoslovakia, the former Soviet Union and the former Yugoslavia. Article 1 Evidence of formal qualifications as provided for in Articles 2 5 of this Appendix shall grant entitlement to a licence or specialist licence if: a. the applicant submits a certificate issued by the competent authorities stating that the holder has effectively and lawfully engaged in the activities in question for at least three continuous years during the five-year period immediately preceding the issue of the certificate and b. the competent authorities in the state in question attest that the evidence of formal qualifications has the same validity in law in its territory as the evidence of formal qualifications the authority itself issues under Article 2, and [constitutes qualifications] as a pharmacist in the case of activities covered by point 2 of Article 45 of the Directive. 12

Article 2 Evidence of formal qualifications which gives access to professional activities as a doctor with basic medical training and as a specialised doctor, a nurse responsible for general care, a dentist, a dental specialist, a midwife or a pharmacist, which was issued in the former German Democratic Republic but does not meet all the minimum training requirements set forth in Articles 24, 25, 31, 34, 35, 40 and 44 of the Directive, if such evidence attests to the completion of training which began prior to: a. 3 October 1990 concerning doctors with basic medical training, nurses responsible for general care, dentists, dental specialists, midwives and pharmacists and b. 3 April 1992 concerning specialised doctors. Evidence of formal qualifications as provided for in the first paragraph shall give access to professional activities in Germany with the same conditions as apply to evidence of formal qualifications issued by the competent authorities in Germany and mentioned in points 5.1.1, 5.1.2, 5.2.2, 5.3.2, 5.3.3, 5.5.2 and 5.6.2 of Annex V to the Directive. Article 3 Evidence of formal qualifications which gives access to professional activities as a doctor with basic medical training, a nurse responsible for general care, a dentist, a dental specialist, a midwife or a pharmacist and which is held by a national of an EEA Member State and was issued in the former Czechoslovakia or, in the case of the Czech Republic and Slovakia, if the training commenced prior to 1 January 1993. Article 4 Evidence of formal qualifications which gives access to professional activities as a doctor with basic medical training, a nurse responsible for general care, a dentist, a dental specialist, a midwife or a pharmacist and which is held by a national of an EEA Member State and was issued in the former Soviet Union or, in the case of a. Estonia if the training commenced prior to 20 August 1991, b. Latvia if the training commenced prior to 21 August 1991 and c. Lithuania if the training commenced prior to 11 March 1990. Article 5 Evidence of formal qualifications which gives access to professional activities as a doctor with basic medical training, a nurse responsible for general care, a dentist, a dental specialist, a midwife or a pharmacist and which is held by a national of an EEA Member State and was issued in the former Yugoslavia or, in the case of Slovenia, if the training commenced prior to 25 June 1991. Appendix IV. Special acquired rights: nurses from Poland and Romania. Article 1 In the case of nationals of an EEA Member State who hold evidence of formal qualifications as nurses responsible for general care that were issued in Poland or, if their training commenced prior to 1 May 2004 and the person concerned does not meet the minimum training requirements set forth in Article 31 of the Directive, the Medical Director of Health shall recognise the following evidence of formal qualifications of nurses responsible for general care if the evidence is accompanied by a certificate stating that the applicant effectively and lawfully practised as a nurse responsible for general care in Poland during the period stated below: a. in the case of evidence of formal qualifications as a nurse obtained at university level (diplom licencjata pielęgniarstwa): at least three continuous years during the five-year period immediately preceding the date of the certificate and b. in the case of evidence of formal qualifications as a nurse responsible for general care which attests to the completion of studies at post-secondary level at a medical vocational school (diplom pielęgniarki albo pielęgniarki dyplomowanej): at least five continuous years during the seven years immediately preceding the date of the certificate. 13

Article 2 The Medical Director of Health shall recognise evidence of formal qualifications in nursing issued in Poland to nurses who completed training prior to 1 May 2004 which does not meet the minimum training requirements set forth in Article 31 of the Directive providing that the applicant submits an examination certificate (diploma) covering training corresponding to a BSc degree and that this was issued following completion by the applicant of a special upgrading programme contained in Article 11 of the Act of 20 April 2004 on the amendment of the Act on professions of nurse and midwife and on some other legal acts and the Regulation of the Minister of Health of 11 May 2004 on the detailed conditions of delivering studies for nurses and midwives, who hold a certificate of secondary school education (final examination; matura ) and are graduates of medical lyceums and medical vocational schools teaching the professions of nurse and midwife, with the aim of verifying that the person concerned has a level of knowledge and competence comparable to that of midwives holding the qualifications are, in the case of Poland, defined in point 5.2.2 in Annex V to the Directive. Article 3 The Medical Director of Health shall recognise evidence of formal qualifications issued in Romania to nurses responsible for general care who do not meet the minimum training requirements set forth in Article 31 of the Directive, or if their training commenced prior to 1 January 2007, providing that the applicant submits an examination certificate (diploma) covering training for nurses responsible for general care (Certificat de competenţe profesionale de asistent medical generalist) following training at post-secondary level from a şcolalã postlicealã, if it is accompanied by a certificate stating that the holder has been effectively and lawfully practised as a nurse responsible for general care in Romania for at least five continuous years during the seven-year period immediately preceding the issue of the certificate. Article 4 The aforementioned practice referred to in Articles 1, 2 and 3 shall have involved full responsibility for the planning, organisation and administration of nursing care delivered to patients. Appendix V. Special acquired rights: dentists. Article 1 In connection with professional practice by dentists under the professional titles stated in point 5.3.2 of Annex V of the Directive, the Medical Director of Health shall recognise evidence of professional qualifications issued in Italy, Spain, Austria, the Czech Republic, Romania and Slovakia to applicants who commenced medical studies on or prior to the reference dates set out in Annex V to the Directive for the Member States in question, providing that the applicant submits a certificate issued by the competent authorities in the Member State in question. The certificate must demonstrate that the following conditions are met: a. The applicant shall have been effectively, lawfully and principally engaged in that Member State in the activities referred to in Article 36 for at least three consecutive years during the five years preceding the issue of the certificate and b. that the applicant is authorised to pursue the aforesaid activities under the same conditions as holders of evidence of formal qualifications listed for that Member State in point 5.3.2 of Annex V to the Directive. Persons who have successfully completed at least three years of study, certified by the competent authorities in the Member State concerned as being equivalent to the training referred to in Article 34 of the Directive, shall be exempt from the three-year practical work experience referred to in point a above. With regard to the Czech Republic and Slovakia, evidence of formal qualifications obtained in the former Czechoslovakia shall be accorded the same level of recognition as Czech and Slovak evidence of formal qualifications and under the same conditions as set out in the preceding paragraphs. Article 2 Medical Director of Health shall recognise evidence of formal qualifications as a doctor issued in Italy to applicants who began their university medical training during the period between 28 January 1980 and 31 December 1984, providing it is accompanied by a certificate issued by the competent Italian authorities. The certificate must demonstrate that the following three conditions are met: 14