1. Who This Test Is For

The BIG-register’s English-language guidance describes a Certificate of Competence procedure for healthcare professionals whose diploma was obtained outside Europe. Doctors, dentists and nurses in this route take a professional content test (BI-toets). The test assesses whether their knowledge and skills are comparable with the Dutch level.

After the BI-test, there is in most cases an advisory interview with the Commission for Foreign Healthcare Graduates (CBGV), which assesses the application and the candidate’s qualifications.

For doctors, dentists and nurses following the non-European diploma route, the BI-test is part of the process towards a Certificate of Competence and ultimately BIG registration.

This article covers the non-EU/non-EEA diploma route. Diplomas covered by EU professional-qualification rules follow different recognition procedures and should not be compared directly with this fee structure.

2. The Proposed Fee Path to €5,371.50

The following figures are based on the BIG-register tariff proposal and the DutchNews report published on 9 September 2026.

Important: the €5,371.50 figure is currently a proposed tariff and is not yet the final legally confirmed price. BIG-register says the proposed tariffs are expected to become final after the consultation and publication of the regulation, likely around November 2026.

DutchNews reported that the fee is planned to rise from €1,700 to €5,371.50 in March 2027 and eventually to the full cost of running the test, described as just over €7,000.

The ministry’s stated reason for the increase is to make the tests more cost-covering and help fund additional test capacity.

Non-EU-trained dentists are also facing a substantial proposed increase in their professional-test fee.

For applicants already waiting for a test, the applicable tariff is determined by the date of the exam rather than the date the applicant joined the waiting list.

3. 72 Places Now, Up to 120 in 2027

DutchNews and Trouw reported the following situation:

• There are currently around 72 doctor BI-test places per year.
• No doctor test places were available at the time of the September 9 reports.
• Waiting times have reached up to two years.
• A new university contract is expected to increase capacity to up to 120 candidates in 2027.
• The additional capacity is expected to reduce waiting times by about one year.

The BIG-register’s professional-test page currently states that there are no doctor test places available and that it is not known when new participants can be scheduled.

Paul Herfs of the VBGA, an association representing foreign-trained doctors, told Trouw that the route for international doctors remains difficult and lengthy. Even if waiting times fall, demand may continue to exceed available places.

Earlier reporting by Arts en Auto described a significant backlog under the previous testing arrangement. That reporting provides background to the current capacity problem, while the new 2027 contract is intended to increase the number of available places.

4. Language First, Then the BI-toets

Before submitting a Certificate of Competence application, candidates must provide evidence of the required Dutch language proficiency and English reading skills.

For an academic-level profession such as medicine, the BIG-register requires Dutch at B2+ level. This is higher than B2 but lower than C1.

Applicants following the Certificate of Competence procedure must also demonstrate English reading skills at B2 level for an academic profession such as medicine.

The Dutch language certificate must demonstrate reading, writing, speaking and listening skills. Language certificates generally cannot be more than two years old when submitted.

The former AKV general test was abolished from 1 January 2024. Language proficiency is now demonstrated through the required language certificates as part of the recognition procedure.

Once the application is complete, BIG-register says the certificate-of-competence procedure itself can take an average of six months to 1.5 years. Preparation for the BI-test and waiting for an available test place can add further time.

After the assessment, the CBGV may advise additional training, education, an internship or work experience if differences between the candidate’s education and the Dutch level need to be addressed. Additional training can, depending on the case, last from several months to two years.

Practising independently as a doctor without the required BIG registration is not a workaround. The recognition and registration requirements must be followed before practising independently in the regulated profession.

5. How Many Finish the Route

CIBG figures reported by Trouw and DutchNews on September 9, 2026 show the following outcomes among doctors, nurses and dentists from outside the EU over the reported eight-year period:

More than 6,000 doctors and nurses from outside the EU arrived in the Netherlands during the eight-year period covered by the figures.

The percentages describe how many obtained the required paperwork to work in the Netherlands. They should not be interpreted as a measure of clinical quality or professional competence.

6. Shortage Next to the Queue

The DutchNews and BNR reporting places the BI-test backlog against wider shortages in Dutch healthcare.

Capaciteitsorgaan advice to the Ministry of Health also describes continuing pressure on healthcare staffing and discusses training capacity for doctors and other healthcare professions.

This article does not assign a single national number to vacant GP positions. Closed huisarts lists and shortages in individual regions are separate issues from the recognition bottleneck facing non-EU-trained healthcare professionals.

The proposed policy response combines a substantial increase in the BI-test fee with an increase in the number of available test places.

7. EU Diplomas Are a Different Route

A medical diploma obtained in an EU/EEA country may fall under automatic recognition or another EU professional-qualification procedure. It should therefore not automatically be treated as part of the €1,700–€5,371.50 BI-test fee structure described in this article.

EU/EEA applicants may still need to meet Dutch language requirements and, depending on their qualification and profession, specialist recognition requirements.

The BIG-register has three main recognition procedures for foreign diplomas, including automatic recognition for certain EU diplomas, recognition of professional qualifications for other EU diplomas and the Certificate of Competence procedure for non-EU diplomas. Applicants should use the BIG-register Advice Wizard to determine which procedure applies.

UK-qualified applicants should also check the current BIG-register procedure for their specific qualification and circumstances rather than assuming that every UK diploma follows exactly the same route.