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Magazine

The Structure of Medical School in Bulgaria – Year by Year Explained

The Structure of Medical School in Bulgaria – Year by Year Explained

28.08.2026

11 min read Lesezeit

Six years, twelve semesters, 360 ECTS – on paper, medical school in Bulgaria looks just like it does in Germany. In practice the course runs differently at decisive points: there is no preclinical block examination, but considerably more oral examinations, an annual examination pattern instead of two large block exams, and a full practical year at the end.

I studied in Sofia myself and graduated with the state examination in 2021. This is how the structure actually feels in day-to-day study – year by year, with the differences between Sofia, Varna, Plovdiv and Pleven.

The framework: what applies at all Bulgarian universities

The human medicine degree is regulated uniformly across Bulgaria. The Unified State Requirements set out what every faculty must teach as a minimum. Sofia, Varna, Plovdiv and Pleven therefore differ only in details of structure – not in the basic framework.

  • Duration: 6 years / 12 semesters
  • Volume: 360 ECTS
  • Qualification: Master's degree with the professional qualification of "physician" / Doctor of Medicine
  • Language of instruction: English throughout on the international programme
  • Legal framework: EU Directive 2005/36/EC – the qualification is recognised automatically in all EU states
  • Academic year: begins in early October, winter semester until February, summer semester until the end of May or June

Stage 1: the preclinical years (years 1 and 2)

The first two years are pure foundational training – and they are the part where most of those who do not take it seriously come unstuck.

First year

  • Anatomy (begins, with dissection course)
  • Medical biology and genetics
  • Medical chemistry and biochemistry (begins)
  • Histology and embryology
  • Medical physics / biophysics
  • Latin and medical terminology
  • Bulgarian as a foreign language (compulsory on the English-language programme)

Second year

  • Anatomy (concludes)
  • Physiology
  • Biochemistry (concludes)
  • Microbiology and immunology (year 2 or 3 depending on the university)
  • Social medicine, medical ethics
  • First aid and nursing placement

The most important difference from Germany: there is no preclinical block examination. Instead of one huge exam after four semesters, each subject is completed individually at the end of its cycle – very often orally, frequently before several examiners, and in anatomy additionally in practice on the specimen.

Anyone who finds the Bulgarian route different is right: you do not have a single catastrophic examination deciding your whole degree – but you are under examination pressure permanently. Anatomy runs across four semesters and is assessed continuously through colloquia. Fail a colloquium and you are not admitted to the semester examination at all.

Bulgarian: not a formality

Even those studying entirely in English take Bulgarian as a compulsory subject – usually in the first two to three years. This is not a token course but a plain necessity: from the third year you are on the ward, and patients speak Bulgarian. Anyone who treats the subject as a tiresome obligation will have a real problem in the clinic. Anyone who takes it seriously will be taking patient histories independently in the fourth year.

Stage 2: the clinical years (years 3 to 5)

From the third year the degree moves into the university hospitals. At most faculties, teaching follows a modular system: a subject is taught intensively in a block and examined at the end of that block.

Third year – the transition

  • Pathological anatomy
  • Pathophysiology
  • Pharmacology
  • Propaedeutics of internal medicine (the first real patient examination)
  • General surgery
  • Diagnostic imaging

Fourth year

  • Internal medicine
  • Specialist surgery
  • Infectious diseases and epidemiology
  • Dermatology and venereology
  • Urology, orthopaedics and traumatology
  • Clinical pharmacology

Fifth year

  • Paediatrics
  • Gynaecology and obstetrics
  • Neurology and psychiatry
  • Ophthalmology, ENT
  • Oncology, forensic medicine
  • Anaesthesiology and emergency medicine

The summer placements – often overlooked, always compulsory

Compulsory placements fall between the academic years, usually after the 2nd, 3rd and 4th years. They run during the semester breaks and are a condition of admission to the next year. The scope differs by location:

UniversityPlacements during the degree
Sofiaamong others, around 15 days of clinical practice after the 6th semester
Plovdiv24 working days each after the 6th and 8th semesters (12 days each in internal medicine and surgery)
Varna30 days each after the 6th and 8th semesters
Plevencomparable scope, split according to the study plan

The practically most important point for students from German-speaking countries: these placements can usually be completed in Germany, Austria or Switzerland – provided you have them approved by the dean's office in good time and submit the hospital's confirmation correctly. It is the easiest way to build up contacts at home while still studying. Anyone who waits until the sixth year gives away four years of networking.

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Stage 3: the practical year (year 6)

The sixth year is no longer a lecture year but a continuous clinical placement – the Bulgarian counterpart to the German final practical year, only broader in scope. It consists of rotations through the major specialties at the university hospitals, on the order of around 300 practical days.

Rotations are typically through:

  • Internal medicine
  • Surgery
  • Paediatrics
  • Gynaecology and obstetrics
  • General practice / social medicine and hygiene

Each section is signed off after the rotation. Only once all rotations are complete are you admitted to the state examination.

The state examination: five exams at the end

At the end come the state final examinations – classically in five subjects:

  1. Internal medicine
  2. Surgery
  3. Paediatrics
  4. Gynaecology and obstetrics
  5. Hygiene and ecology / social medicine

These examinations are as a rule oral, before a panel, often combined with a practical component involving a patient. Those who pass receive the master's degree and the professional qualification of "physician".

One point that surprises many: there is no doctoral thesis as part of the degree. The qualification is a master's, not a doctorate. Anyone who wants a German Dr. med. does that afterwards – in Germany, Austria or Switzerland.

Bulgaria and Germany compared directly

FeatureGermanyBulgaria
Duration6 years + 3 months6 years
AccessNC grade cap / TMS aptitude test / waiting timeEntrance test in biology and chemistry, no grade cap
First major milestonePreclinical examination (M1) after 4 semestersnone – an examination per subject
Examination formatpredominantly written, multiple choicepredominantly oral and practical
Practical phasesClinical clerkships (4 months) + final practical yearSummer placements + practical year in year 6
Qualification3rd state examination, German medical licence (Approbation)5 state examinations, master's degree as "physician"
Tuition feesnonearound 8,000 to 10,000 euros a year

What the structure means for your planning

If you want to graduate in Bulgaria

The route is straight: six years, state examination, then an application for the medical licence in Germany, Austria or Switzerland. Because Bulgaria is an EU member state and the degree complies with Directive 2005/36/EC, recognition is automatic – without a competency examination and without an equivalency assessment. All that is required is proof of language and the usual documents.

If you want to transfer back to Germany

Here the structure suddenly matters. Because there is no preclinical block examination, the German state examination office assesses your individual credits against the German study plan. A rule of thumb from practice: a transfer only pays off after four completed semesters, once the preclinical stage is finished. Anyone transferring after one or two semesters often gets almost nothing credited.

What is binding is always the credit decision of the responsible state examination office under Section 12 of the Licensing Regulations for Doctors – not information from an agency and not a rule of thumb, including this one.

Which location suits you?

Sofia, Varna, Plovdiv and Pleven differ less in the structure of the degree than in fees, city and admission procedure. We go through your starting position in a free consultation. Book a free consultation here.

The author's view

The Bulgarian structure has a reputation that does not quite do it justice. From the outside, "no preclinical block exam" sounds easier. From inside the daily reality of studying I would say: it is not easier, it is distributed differently.

You never have that one moment in which two years of work are decided in a single day. Instead, twice a year you sit in oral examinations in which a professor asks you four questions and knows within twenty minutes whether you have understood the subject or learned it by heart. That cannot be rescued at the last minute – and that is exactly what makes better doctors in the long run.

What I most underestimated in hindsight was Bulgarian. Not because of the examination – because of the ward. And what I most recommend: consistently do the summer placements back home. It costs you semester breaks but saves months later in the job search.

Summary

Medical school in Bulgaria follows the same European framework as in Germany: six years, 360 ECTS, preclinical stage, clinical stage, practical year. The difference lies in the rhythm – no preclinical block examination, but examinations in every subject, much of it oral, much of it practical, and a full year with patients to finish.

Anyone who copes with that ends up with an EU qualification that is recognised automatically in Germany, Austria and Switzerland. Anyone planning an early transfer back should factor the structure in from the start: before the fourth semester it is generally not worth it.

  • Medical school in Bulgaria lasts six years, comprises twelve semesters and 360 ECTS and ends with a master's degree and the professional qualification of "physician".
  • There is no preclinical block examination in Bulgaria; instead every subject is examined individually at the end of its cycle, very often orally and, in anatomy, additionally in practice on the specimen.
  • Bulgarian is a compulsory subject even on the English-language programme, as a rule in the first two to three years.
  • The summer placements between academic years are compulsory and can usually be completed in Germany, Austria or Switzerland if the dean's office approves them in advance.
  • The sixth year is a continuous clinical practical year with around 300 practical days, followed by five state final examinations.
  • Because Bulgaria is an EU member state and the degree complies with Directive 2005/36/EC, the qualification is recognised automatically in Germany, Austria and Switzerland.

What our students say

You can read independently how our support works in practice: Medschool Experts reviews on Trustpilot.

Further reading

Frequently asked questions about the structure of the degree in Bulgaria

How is medical school in Bulgaria structured?

In three stages: the preclinical stage in years 1 and 2, the clinical stage in years 3 to 5 and the practical year in year six. Six years in total, twelve semesters and 360 ECTS – identical to the European framework under Directive 2005/36/EC.

Is there a preclinical block examination as in Germany?

No. Instead of one large intermediate examination, assessment is continuous: through colloquia during the semester and oral semester examinations. Anyone who fails a colloquium is not admitted to the semester examination at all. That means continuous work rather than a single day of decision.

How many state examinations are there at the end?

Five state examinations to complete the degree. They follow the practical year in the sixth year.

Are the summer placements compulsory?

Yes. They run during the semester breaks and are a condition of admission to the next academic year. The scope differs by university; in Varna, for example, it is 30 days each after the sixth semester. Many can be completed in Germany.

Do I have to learn Bulgarian?

Yes, even on the English-language programme. Bulgarian is a compulsory subject in the first two to three years, because you speak with patients during the clinical stage. The teaching is part of the curriculum.

How does the clinical stage work?

From the third year, in a modular system: block teaching in the clinical subjects with bedside teaching in small groups. Patient contact begins considerably earlier than many expect.

When is a transfer back to Germany worthwhile?

Only after four completed semesters, once the preclinical stage is finished. Anyone transferring after one or two semesters will as a rule get hardly anything credited. The legal basis is the crediting procedure under the Licensing Regulations for Doctors.

Can I do clinical clerkships in Germany?

Yes, and it is worth starting early. Anyone who waits until the sixth year gives away years in which a network in Germany could have been built. It costs semester breaks but saves months later in the job search.

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About the author

Marcel Kloos

Swiss-licensed dentist and founder of Medschool Experts

Marcel Kloos founded Medschool Experts while studying abroad; since then, over 500 study places have been secured. The Stuttgart-born dentist studied dentistry from 2015 to 2021 in Sofia and holds a Swiss dental licence.

Today he lives in Bern and runs Medschool Experts full-time as its owner.

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