Costs · 18 min read

Studying Medicine in Europe: costs by country and how Spain compares

When a family writes to me to compare Spain with Hungary, Italy or Romania, they are almost never comparing like with like. One figure is the English programme fee for foreigners, another is what a local student pays, and another only applies if you pass an exam in the country's own language. Here are the real prices, country by country, and what sits behind each of them.

The three things that change the price

Before looking at any price you have to separate three things that get mixed up in almost every list online: the language you study in, the nationality of whoever pays, and the type of university. The same country can cost €697 a year or €18,000, depending on your passport. Another may charge no tuition at all, but require C1 level German and a preparatory year first. If you do not separate those three variables, the comparison is useless for deciding anything.

This guide compares the destinations I am asked about most often by students from outside the European Union, using the figures published by the universities and ministries themselves. Where a university has not yet published next year's fee, I say so and give you the latest official figure that exists.

The short answer

If you only want the conclusion: Spanish public universities are still among the cheapest options in Europe for an international student, with tuition of roughly €800 to €4,200 a year depending on the region and the surcharge for non EU students. The problem is not the price, it is getting in: cutoff marks for Medicine are above 13 out of 14 at almost every public faculty.

English taught programmes in central and eastern Europe are the best known route for those who do not reach that mark or do not want to study in Spanish. They are not cheap: between €10,000 and €24,000 a year in tuition at the most sought after universities. What that money buys is a place with its own entrance exam, usually more accessible than competing for a public place in Spain, and a degree from a European Union country.

Then there are the countries where studying costs almost nothing, such as Germany or Italy, which have a different barrier: the language, and a very small number of places reserved for students from outside the EU.

Prices, country by country

The table shows the annual tuition paid by a non EU student at a reference university in each country, the teaching language and the country's overall price level according to Eurostat, where the European Union average is 100.

Two warnings to read it properly. First, the prices are those published by each university for 2025/26 or 2026/27, and almost all of them rise every year. Second, the Eurostat index measures the whole country: capitals, where almost all these faculties are, are more expensive than the national average, especially for rent.

Spain: cheap if you get in, hard to get in

At a Spanish public university, Medicine tuition is set by each region per credit. For a non EU student some regions charge the same as for a Spaniard and others apply a surcharge. Even so, six years of tuition add up to roughly €5,000 to €25,000, a figure almost no other country on this list matches for a foreigner. I explain it in detail in the cost of studying Medicine in Spain.

The trade off is competition. To get into a public faculty you need an admission score above 13 out of 14 at almost every faculty, built from your homologated school certificate and the UNEDasiss PCE exams. If you fall short, the alternative in Spain is a private university, with first year fees of €14,200 to €25,080 in 2026/27, which is exactly the price range of the English programmes in eastern Europe.

That overlap is what makes the comparison meaningful: those who do not get into a Spanish public university are usually choosing between a private university in Spain and a foreign public one in English, at similar prices. The difference lies in the language of the patients, the distance from home and what you want to do when you finish.

Italy: income based fees and very few places

Italy is the country where the price is most misleading. At state universities tuition depends on family income: it is calculated with an indicator called ISEE, which for students whose income is earned abroad is replaced by the so called ISEE parificato. In practice, most students pay between about €150 and €4,500 a year, less than almost any other destination on this list.

There are two ways in. The first is the English taught courses, accessed through the IMAT exam, which in 2026 was held at the end of September. The second is the Italian taught courses, where since 2025/26 there is no entrance test: students enrol in an open first semester, the so called semestre filtro, and the exams of that semester decide who continues. The Italian Ministry confirmed that model for 2026/27.

The real barrier is the number of places. For 2026/27 the Ministry reserved 538 places in total across all Italian taught Medicine courses in the country for non EU students living abroad. Many campuses offer five or fewer, and several none at all. If your nationality is not European and you do not live in Italy, you compete for that quota, not for the general places. The quota for foreigners is somewhat larger in the English courses, but the IMAT attracts candidates from all over the world.

Portugal: €697 or €18,000, depending on your passport

Portugal shows clearly how much nationality weighs. At the University of Lisbon, the Integrated Master's in Medicine costs €697 a year for a Portuguese or European student. For an international student the same course costs €18,000 a year, according to the fee table the university approved in 2026.

On top of that comes the language: teaching is in Portuguese. For a Spanish speaker the jump is shorter than to any other language on this list, but the clinical years with patients require real fluency. Brazilian students have their own admission routes, which do not apply to other nationalities.

Germany and France: almost free, but in their language

Germany charges no tuition in most of its federal states, which makes it the most exciting destination on paper. There are exceptions: Baden Württemberg has charged non EU students €1,500 per semester since 2017, and Bavaria has allowed its universities to charge them since 2024/25.

What makes it hard is everything else. Teaching is in German, with a certified C1 level. Non EU students compete in a separate quota of around 5% of Medicine places. And many school certificates from outside Europe do not give direct access to German universities: they require a preparatory year first, the Studienkolleg, and passing its final exam.

France works differently. Non EU students pay differentiated registration fees, which in 2025/26 were €2,895 a year at undergraduate level, compared with €178 for a European student, and the government has restricted exemptions from 2026/27. The first year of Medicine runs through the PASS or LAS tracks, which are very selective, and everything is in French.

In both cases the low price is real, but it is only within reach of those who already master the language or are willing to spend one or two years learning it before starting the degree.

Hungary, Czechia, Poland, Romania and Bulgaria: English comes at a price

These are the programmes that appear most in agency advertising, and for a reason: they teach the whole degree in English, with their own entrance exams and places designed for foreigners. These are the fees published by their best known universities:

• Hungary. Semmelweis University in Budapest charges €9,340 per semester, about €18,680 a year, plus one off fees: €250 for the admission procedure and €230 for enrolment.
• Czechia. The First Faculty of Medicine of Charles University in Prague charges €24,250 a year to those who started in 2025/26. In Czech, the same degree is free at the public university, but requires fluency in the language.
• Poland. The Medical University of Warsaw publishes €16,100 for the first year of its English programme and €15,900 for each of the following five.
• Romania. For Carol Davila University in Bucharest, figures circulating for 2026/27 are around €10,000 a year. In its 2022/23 contract the university itself set €7,500, so confirm the current fee before applying.
• Bulgaria. The Medical University of Sofia charges around €9,950 a year in English, according to figures published for 2026.

There is a detail agencies tend to leave out: even if you study in English, the clinical years are spent in local hospitals, with patients who speak Hungarian, Czech, Polish or Romanian. All these faculties include compulsory courses in the local language, and those who do not take them seriously notice it in fourth year, when they start taking patient histories.

It is also worth reading the small print on documents. Carol Davila, for example, requires everything to arrive translated into Romanian by an authorised translator, and apostilled or legalised depending on the issuing country. Each country has its own paperwork, on top of the visa.

Entrance exams, compared

Each country selects in a different way, and that changes who each option suits as much as the price does.

• Spain. There is no exam set by each faculty. You compete with your admission score: your homologated school certificate and, to raise it, the UNEDasiss PCE exams in the subjects each university weights.
• Italy. The IMAT for English courses, a single national multiple choice exam, and the semestre filtro for Italian courses.
• Hungary. Each university sets its own exam. At Semmelweis it is an online test in Biology, Chemistry, General English and Biomedical English, with 20 questions per part, followed by an interview, with sessions from March to June.
• Romania. At Carol Davila, an online interview of 15 to 30 minutes in English on scientific topics, plus an assessment of your school grades.
• Germany. Grades, aptitude tests and, for non EU students, the Studienkolleg first when their certificate does not give direct access.

The practical consequence is that there is no common calendar. Hungarian exams start in March, Spanish preregistration closes between June and July and the IMAT is in September. If you want to keep several options open, you have to plan from the autumn of the year before, not from the summer.

What it costs to live in each country

Tuition is only part of the budget. To compare living costs I use Eurostat's 2025 price level index, which compares what the same basket of goods and services costs in each country against the European average of 100.

Spain is at 92, slightly below average. Portugal (87) and Czechia (89) are close; Hungary (78) and Poland (73) are clearly cheaper; Romania (65) and Bulgaria (63) are the two cheapest countries in the whole Union. At the other end, Germany (108) and France (110) are more expensive than Spain, and Italy (97) sits in between.

The overall index hides the item that weighs most in a student's life: housing. There the differences between countries are much larger than for food or transport, and a room in Budapest, Prague or Warsaw can cost a good deal more than the national average suggests. Before deciding, ask the faculty for its estimate of living costs and look up real rents in the specific city.

Adding tuition and living costs, an English programme in Hungary or Czechia comes out, over six years, in a range similar to a Spanish private university. One in Romania or Bulgaria can be considerably cheaper. And a Spanish public university, if you get in, remains the cheapest option of all.

The costs no table shows

Some costs repeat in every country and, added together, can equal half a year of tuition:

• Admission fees and deposits. Semmelweis charges €250 just to sit the exam and asks admitted students for a €2,000 deposit within 14 days, which is later deducted from tuition but not refunded if you withdraw.
• Sworn translations and legalisations of all your documents, into the language of each country you apply to.
• Visa and residence permit, with their fees, and the health insurance each country requires.
• Travel for in person exams, enrolment and every trip home.
• Language courses, compulsory in many English programmes and almost essential in the rest.

If you want to work in Spain afterwards

This is the question people ask least when choosing and that matters most when they finish. According to the Spanish Ministry of Science, Innovation and Universities, a Medicine degree from a European Union country, the European Economic Area or Switzerland has two routes in Spain. The first is professional recognition by the Ministry of Health under Directive 2005/36/EC, which for Medicine is direct and free of charge. The second is ordinary homologation, in which European degrees must include the certificate of conformity with that directive. Which route applies to you also depends on your nationality, so confirm it before enrolling, not when you graduate.

A degree from outside Europe, by contrast, goes through full homologation, with an ANECA assessment that can require additional training before it is granted.

And in every case there is a second step. A medical degree, homologated or recognised, only allows you to work as a doctor without a specialty in the private sector. For the public health system or to specialise you need the MIR, in which non EU candidates compete, with some exceptions, for a limited quota: in the latest call, 10% of places.

How to decide without getting it wrong

1. Start with your score, not with the country. If your admission score in Spain could get close to 13, a Spanish public university is almost unbeatable on price. Work it out before paying for any foreign exam.
2. Decide which language you can study in for six years. Language rules out countries faster than price does.
3. Compare the six year total, not the first year's tuition. Add housing, travel, insurance and annual tuition increases.
4. Think about where you want to work. If it is Spain, check today how your degree will be recognised and how the MIR quota works for your nationality.
5. Be wary of the price an agency gives you. Always ask for the university's official page with the fee for the year you will start.

Frequently asked questions

What is the cheapest country to study Medicine in Europe?

On tuition, the countries with almost free public universities: Germany, Italy depending on income, or France, although they require the local language and have very few places for non EU students. Among English programmes, Romania and Bulgaria are the cheapest, at around €10,000 a year. And if you get a place, a Spanish public university is still among the most affordable options.

Is it cheaper to study Medicine in Spain or in Hungary?

At a Spanish public university, yes, by a wide margin: roughly €800 to €4,200 a year against about €18,680 at Semmelweis. If only a private university is open to you in Spain, prices are similar: €14,200 to €25,080 for the first year.

Can I study Medicine in English in Europe without speaking the local language?

Yes, in Hungary, Czechia, Poland, Romania, Bulgaria or through the IMAT in Italy. But the clinical years are spent with local patients, and all these faculties include compulsory courses in the local language.

Is a Medicine degree from another European country valid for working in Spain?

Degrees from the EU, the EEA and Switzerland can be recognised under Directive 2005/36/EC by the Ministry of Health, or homologated with the certificate of conformity with that directive. For the public system or a specialty you also need the MIR, with a limited quota for non EU candidates.

How much does it cost to live as a student in these countries?

According to Eurostat's 2025 price index, with the EU average at 100, Spain is at 92, Hungary at 78, Poland at 73, Romania at 65 and Bulgaria at 63, while Germany and France are above 100. Rent in the capitals can break that average.

If you are comparing with a private university in Spain, see private medical schools in Spain: 2026/27 fees, and if you do not yet know what score you could get, start with Medicine cutoff marks in Spain.

Published on 10 November 2026 · Salam Aiach