Norway replaced its specialist training system on 1 March 2019, and the transitional arrangements are now running out. Doctors who were already specialising in allmennmedisin or samfunnsmedisin under the old regulation keep the right to finish and apply under those rules — but the application has to reach Helsedirektoratet by 31 December 2026. For arbeidsmedisin the date is 31 December 2028. For the hospital specialities there is no application deadline at all, only a status test dated 1 March 2019.

Sources: Helsedirektoratet — ansettelseskrav, utdanningstid, fravær og overgangsregler; Helsedirektoratet — temaer det ofte stilles spørsmål om; Helsedirektoratet — regler for gammel spesialistutdanning og etterutdanning, allmennmedisin; Helsedirektoratet — regler for gammel spesialistutdanning, samfunnsmedisin.

Three different rules, not one

The transitional arrangements are often described as though a single deadline applies. They do not, and knowing which group you are in decides whether you are under time pressure at all.

  • Allmennmedisin and samfunnsmedisin — doctors who were under specialisation on 1 March 2019 may apply under the old rules until 31 December 2026.
  • Arbeidsmedisin — the same, but until 31 December 2028.
  • The hospital specialities — the test is whether you had less than three years remaining of your specialisation track as of 1 March 2019. Where that applies, Helsedirektoratet states there is no application deadline: status on 1 March 2019 is what decides it. Where more than three years remained, you are assessed under the new regulation instead.

So if you are in general or community medicine and started before March 2019, this is the last full year in which the old route is open.

What “under specialisation” actually means

The phrase does more work than it looks, and the definition is specific.

You count as having been under specialisation on 1 March 2019 if, by that date, you had taken up the service or the post, entered an agreement about service or employment, or received an offer of employment. The post itself must have been one that counted towards the old specialist track — LIS, fastlege, or sykehjemslege/KAD-lege — and it must have been at least 50 per cent for at least three months.

An offer of employment counts. That is worth knowing if your start date fell after March 2019 but the offer preceded it.

Helsedirektoratet also states the underlying test in a second way that is worth reading alongside the first: the right to complete under the old regulation applies where the speciality-specific part of the training had begun before 1 March 2019.

The trap in general medicine

This one catches people, and it is stated plainly in the rules.

For allmennmedisin, you must have begun general-practice service counting towards the old specialist track by 1 March 2019. Hospital service alone does not qualify. If, by that date, you had only started or completed hospital rotations and had not yet begun counting general-practice service, you are not treated as having been under specialisation in general medicine under the old scheme — and you follow the new specialist education instead.

If you trained outside the EEA

One condition sits upstream of all of this. Doctors holding Norwegian authorisation on the basis of education from Norway, or from a country outside the EU/EEA and Switzerland, must have completed Norwegian turnus or LIS1 in Norway in order to begin specialisation at all.

That means the population this deadline actually affects includes foreign-trained doctors who arrived some years ago, completed the Norwegian foundation year, and started specialising before March 2019. If that describes you, the transitional right is yours and the date applies.

Whether your original authorisation ran through the EEA rules or those for education from outside them depends on where you trained rather than your nationality — that distinction is set out separately, and the hub article covers the authorisation process that precedes any of this.

What the old general-medicine route requires

If you are working towards the deadline, these are the components the old rules set out.

Four years of general-medical service, of which at least two full-time equivalents must be in open, unselected general practice. At least half of weekly working time — 18.75 hours — must be curative work in open unselected practice, whether private or public. Parts of the four years can be replaced by other qualifying service.

A two-year specific education programme alongside it, of which at least one year must run in parallel with the service in open unselected practice. Anyone who started in a supervision group after 1 January 1994 must also have completed the programme in practical skills and procedures, with an attestation form signed by at least four colleagues.

Course requirements: a minimum of 100 points of subject courses — 110 if you hold the older course package — with a maximum of 30 points recognised in any one subject area, and one of them must be in emergency medicine. Two practice visits with a report add 20 points. There is also a compulsory online course in expert-witness work.

Community medicine, and a route for long experience

Samfunnsmedisin likewise requires four years, and the duration is absolute. But the rules are unusually accommodating about where the time was served.

Community-medicine work outside the health service, provided it has health-relevant content, can replace up to one year. Service averaging as little as 40 per cent community-medicine content can be approved as fully counting — down to 20 per cent for service organised within dedicated community-medicine networks — though below 40 per cent the required duration extends correspondingly. The clinical service requirement must always be met, and the supervised education programme is treated as central.

There is also a Tilleggsordning — a supplementary arrangement for doctors with long community-medicine experience who do not fully satisfy the ordinary requirements. Service at levels other than municipal or state, including work for international organisations such as the WHO or for voluntary organisations, can be brought into consideration under it.

If you miss the date

You move to the new specialist education. That is not a refusal, but it is a different structure with its own learning objectives, and time already served is assessed against those objectives rather than carried across automatically.

One further point specific to general medicine: since 1 March 2017 specialist recognition has been granted to the end date of the authorisation period, and the continuing-education programme still has to be completed to retain the right to the specialist supplement in general medicine.

If you think you qualify, the practical step is to check your own status as it stood on 1 March 2019 — the post, its percentage, its duration, and whether general-practice service had actually begun — because that is the fact the whole entitlement turns on.