Living in Italy

Becoming a nurse in Italy – for those who already have a non-EU degree

Already a non-EU nurse and/or nurse practitioner looking into becoming one in Italy?

I have decided to write this post because as an RN and NP that has studied/worked in the United States and moved to Italy, it has been nearly impossible for me find clear information online about this possibility. It is important to firstly note that no matter what you read, Italy doesn’t currently have the equivalent of an advanced practice nurse or nurse practitioner, so it is not possible to work as such.

Below I’ll share the technicalities of becoming a nurse if you already have a non-EU degree, my experiences, and what I have found out in the process. 

 

The general rules

The Ministry of Health is in charge of certifying the license to practice for all health professions (the “Professioni Sanitaire”), including nursing.  This entity is the one that ultimately determines the recognition of foreign healthcare degrees. The official list of documents to be submitted to get your nursing education recognized is itemized in this document, and can be consulted through their website at: Ministero della salute.  Now, if you take the time to look at the itemized document, you will immediately notice that the list is long and incredibly daunting. If you are serious about getting it done, my suggestion is to just start one piece at a time, and you will see that it is possible to di it. If you do succeed in gathering all the required documents and sending them to the Ministry of health, you then have to wait a few months to receive feedback. Their response will either be of rejection or conditional acceptance. The conditions aren’t precisely defined, but from what I gather recognition of non-EU degrees is dependent on the completion of about 400-500 hours of practical internship in a hospital and an Italian language proficiency exam.

 

My experience

To add some context, I have both Italian and American citizenship and speak both languages fluently, so you would think this process would have at least partially helped me…. but it really hasn’t. 

First of all, just the act of gathering the documents necessary for the application is extremely difficult, especially if you are not a new graduate and not able to go to your university to gather them all in person. In my case, I was already in Italy, so I used a specialized UPS service to collect my documents from the university, get them certified (with the apostille) and send them to me.  The UPS service took about a week and was relatively costly.  This step will vary depending on your needs and situation.

Once you have gathered your documents, it is time to send them to the Ministry of health and cross your fingers.  I am not sure about how it is in other Italian regions, but in Milan there is the possibility to apply through a government intermediary, called Polis Lombardia that can assist you through the whole process. I met with a very kind representative who made sure I had all the right documentation, sent it all to the Ministry via certified mail, and supported me with all communication.  I highly suggest using them or a similar agency if you have the possibility.

Here comes the not so great news: if you have any idea of how complicated the bureaucratic situation in Italy is, you will understand that getting any feedback, let alone a clear decision, is nearly impossible. Unfortunately, it is important to know that the application process to get your degree recognized is not only very, frustratingly long, but also difficult to achieve. In my case, the application process took nearly 3 years, and ultimately ended in the rejection of my application.

About 6 months after I sent all the correct documentation, the Ministry of health sent a certified letter that they did not receive some key documents that I did in fact send. This happened another 2 times over the course of a couple years. Each time I (through the assistance of the intermediary I mentioned above) sent proof that everything was sent.  You also have to keep in mind that since you are dealing with an Italian public entity, no business will get done in August and the surrounding months. 

After about 2.5 years of this back-and-forth, I received a final letter stating that I didn’t complete the 4600 hours of mandatory didactic and practical university credit hours sufficient for having a nursing degree recognized. This was the first I had heard about such a requirement, but I have looked into it and it appears to be true. I was told that often this is overlooked, but in my case it was not.

I was upset that this key piece of information was never mentioned or written anywhere in the documentation, and it seems strange that adding all the credit hours of both my undergraduate and graduate education do not sum up to the minimum credit hour requirements for an Italian undergraduate (bachelor of) nursing degree. But at this point there was nothing else I could do; I had to accept the final rejection of degree recognition from the Ministry of Health and come up with alternative options.

 

What to do if your request for recognition is denied from the Ministry of health

If you are still determined to work in healthcare in Italy, there are ultimately 2 other options in my opinion:

  1. In Italy there are 2 ways of getting a nursing degree recognized if you already have one from a non-EU country: apply for recognition through the Ministry of health (as I discussed above) or apply through a university. The university option for nursing is not technically a recognition of a foreign degree, it is actually just a simplified version for obtaining a new degree from that specific institution.

In this case you have to start from scratch: you must study for the entrance exam for health professions (“professioni sanitarie”) at applicable universities in the city you would like to study, get accepted, and start the 3 year nursing program. Once you are in, you will have the option to apply for degree/course recognition from the university while technically participating in all the classes. During the first year, your university will decide whether to recognize all or part of your previous education and possibly require you to take a language proficiency exam.  Note that if you are accepted into a 3 year program, no matter how much coursework they will recognize, you will still only be able to graduate after the established three years. In other words, you are accepted into a class and you will be allowed to graduate only with that same class.

  • You could become a consultant or clinical expert for a company that needs healthcare professionals to assist them with their services. For example, companies that work in: medical devices, pharmaceuticals, research, healthcare services for foreigners, electronic medical records, health journals, child care, international health conferences, etc..

This option will require a lot of initiative on your part, but I assure you that eventually you will find something.

 

The road I took..

While waiting 2-3 years for the verdict on my nursing degree recognition, it was important for me to continue working, so I applied to all the companies I could find that had a foundation in healthcare. I will not get into the specifics, but in 5 years I went through 3 jobs:

  1. Doing consulting for a pediatric clinic that was looking for an English speaker to assist with expanding their foreign clientele services
  2. Assisting with editing of an international gastroenterology journal based here in Milan
  3. Clinical analyst for a major company that does electronic medical records for Italian hospitals. This is where I spent most of those years.

I learned a lot from each of those jobs, especially because I knew nothing about the Italian healthcare system. They offered me the chance to learn something new while getting my bearings in this new country. But let’s be honest, if you chose to become a nurse it is because you love working with people, and that is something I missed dearly.

At one point however, a few coinciding situations encouraged me to take a leap: the final rejection from the Ministry of Health, the COVID pandemic, and maternity leave for my newborn son. All these happened at around the same time, and I thought what better moment than that to change course and do what I have always wanted to do: become a midwife. There are a few reasons I chose this path:

  • I have always loved women’s health. In fact that is how I started in NP school, but then I changed to family health because of the versatility. I now had the opportunity to pursue it.
  • The midwifery and nursing programs in Italy are very similar, in fact they are both considered 3 year “Professioni Sanitarie” programs that have the same entrance exam. This exam definitely requires some studying, especially if you haven’t brushed up on your basic sciences in a while.  The Professioni Sanitarie are all the programs that include: nursing, pediatric nursing, midwifery, dietitian, physical therapy, and a few others. The good thing is that since the exam is the same, you can often apply to up to 3 programs in your order of preference so that if you don’t get into your first choice you have back-ups available.
  • One of my biggest concerns about becoming a nurse in Italy is the fact that it is not a highly valued profession as it is in the US, and as a nurse practitioner, I personally struggle with the absence of professional autonomy. Midwives are considered and autonomous profession in Italy, and there is much more flexibility with the job prospects, so this was also a big incentive

So in the end, I took advantage of my maternity leave to study for the entrance exam a few months and fortunately I got into a program here in Milan.  Once I was in, I started classes and submitted documents from my previous education to get recognition. The school did in fact recognize a huge majority of courses for my first year as well as some for the second and third year. As I said before, no matter how much gets recognized, you still have to put in the time to graduate with the class you started out with, so I am now finishing up my first year and expect to graduate in 2023. 

I am surprised that there isn’t much practical information out there on this topic, so I am more than happy to update and integrate this post with any feedback.

If you have any experience with getting your nursing degree recognized in Italy, please feel free to share your experience and observations here, I am sure there are many people who would like to hear from you too!

 

20 Comments

  • Marjo

    Thank you for this post. Google lead me straight to you. I’m a Nigerian nurse doing another program here in Italy. Not looking to enter the italian health system but I was wondering if you had any suggestions on a short course i could do while i’m here especially on reproductive health.

    • naturallyinitaly

      HI Marjo, I’m glad you found it useful. Unfortunately I don’t know of any short term courses on the subject.. though I see a long time has passed since you wrote this (my apologies), so maybe in the meantime you have found something interesting? I would be very interested to know if you now have any suggestions, especially because someone reading this post may find it useful.

  • Angela

    Am a Ghanaian nurse currently in Italy for almost 4 years now. Am trying to do my recognition process, now gathering the necessary documents. What advice would you give me,is that going to be possible or you think I should find another way?

    • naturallyinitaly

      Hi Angela, my opinion would be to give the recognition process a try. I honestly think that since there is no real recognition standard, every person applying may have a different experience. What are the other options you are considering?

      • Atinuke Olowoyo

        Hi
        Please I will be starting my nursing accelerated degree in September (2yrs) in the UK and hopefully moving to Italian after the degree to practice as a nurse , was just wondering if the 2years nursing Degree is recognised or I should just do the 3years to avoid rejection . I am an Italian citizen by marriage

        • naturallyinitaly

          Hi Atinuke, I am not sure what the situation is now that UK is no longer in the EU. However, if I were you I would look into whether the Italian Ministry of Health (you can probably check on their website) still recognizes UK degrees as equivalent tu EU degrees. In this case obtaining a degree in 2 years as opposed to 3 years most likely irrelevant, and thus to your advantage.
          Your situation is very interesting though and I would be curious to know what you choose to do! Please keep me updated 🙂

  • Anonymous

    @Naturally in Italy, thank you for sharing your experience & for giving those in a similar situation an insight into the dynamics of nursing in Italy.. I’m a RN from the UK specialized in cardiac nursing, recently moved to Italy with my husband (an Italian) and I am yet to start my process. It does not seem like an easy task to accomplish, however I’m determined to give it a try, who knows what the ends results would be.

    Thanks again for sharing!

    • naturallyinitaly

      Even though the UK is no longer EU, I would imagine the recognition process is somewhat easier since it is a relatively similar education system. I would be interested to hear your updates throughout the process! Good luck 🙂

  • Denis

    Hello,

    I am an American nurse currently practicing in the states. I am interested in moving to italy and becomming a nurse but see that the clinical requirements may be a lot. You put that ” from what I gather recognition of non-EU degrees is dependent on the completion of about 400-500 hours of practical internship in a hospital and an Italian language proficiency exam”, you also stated that “I received a final letter stating that I didn’t complete the 4600 hours of mandatory didactic and practical university credit hours sufficient for having a nursing degree recognized” I believe I have about 1,000 hours of clinical from nursing school. Do you know where I can find the specific number of clinical hours needed for recognition? I have EU citizenship and am working on getting my passport now.

    • naturallyinitaly

      Hi Denis,
      I have yet to find an official document stating the exact requirements and number of clinical/didactic hours necessary for recognition; these are just numbers I gathered while going through the process. I presented my documents with over 1,400 hours of clinicals, but in my case they decided thta wasn’t enough… Like I have been suggesting in general to anyone, if you have the time and patience to attempt the recognition process, the vague requirements could maybe work in your favor, so its worth giving it a try!

  • Hilary Kaye

    Hi there! I’m a nurse in the US and I’m gathering all of my documents for this harrowing process… I was wondering if I could ask you some questions about the application process. I have my transcript and diploma apostilled. I did an MSN and the got an FNP certificate. But I’m just submitting my MSN paperwork. I’ve contacted the BRN in California for my license information and good standing. I wanted to get a letter from my employer with hours worked and need to update my resume. Then I’ll get it translated. Anyways reading your post was kinda demoralizing. Did you include anything else? Did you have work experience? I don’t understand why they wouldn’t give you the degree. How do you like midwifery school? Sorry, I have so many questions! I am moving to near Lake Garda, I’d love a nearby contact! Thanks 🙏 Hilary

    • naturallyinitaly

      Hi Hilary! Ok so, I too have an MSN and am an FNP-BC, and have worked as an RN, all in the USA. According to the Italian Ministry of Health application guidelines that you find online (and my experience confirms this), proof of previous work experience is not necessary, they are strictly interested in academics for their evaluation. They ultimately rejected my application because apparently the total amount of didactic and practicum experience hours I accumulated between my BSN and MSN were not sufficient to meet their requirements. That is, I had less than the 4,600 hours of didactic/clinical hours supposedly done here in a 3 year undergrad program…. This number seems incredibly exaggerated to me, but that’s the rule.
      I went through the recognition process a few years ago at this point so my memory isn’t great on the requirements, so please take a look at the link of the guidelines I posted, but I remember submitting: Identification documents, a US background check (though they didn’t accept mine because it didn’t have a stamp or hand written signature on it, so they couldn’t “certify” the validity of it), BSN and MSN diplomas with apostilles, high school certificate, resume, lists of all the classes taken/academic plan, transcripts, and most importantly, class descriptions of ALL classes taken with the singular/total numbers of didactic and practicum. All of this has to then be translated by a certified Italian translator.
      I found the process to be quite overqhelming, and maybe you do too, but if you are for sure moving here anyway it’s definitely worth a shot. My advice is to just plug away at getting all the documents listed on the guidelines. All the rest they really kind of ignore.

      Regarding your other question about midwifery school, I like it and I admit I am still learning a TON, which I enjoy. I would have much preferred working as an NP or at least being able to work as a nurse with the degrees I already have, but I guess 3 more years aren’t much in the long run. Of all the health professions in Italy, midwifery is the only one that would allow me to get back to working independently in the least amount of time, so I am still happy with the decision.

      You probably still have lots of questions and I would be very happy to give feedback on anything else. Though I have this website, I am terrible at managing it and I am working on figuring out how to set up an email account so that we can chat more easily. I’ll write back again soon with the info.

      Hope this all helps and definitely keep the questions coming!

  • Juliana

    Thanks for sharing. Just received my rejection letter this evening for the same reason of not having 4600 hours of didactics and so while trying to get some more info, I chanced on your post. It’s been very helpful…

    • naturallyinitaly

      Juliana, I am so sorry you got this rejection as well. I honestly don’t understand how there is such a huge difference in how didactic/clinical hours are counted…
      Have you decided to attempt another path or found some other solution? I would be very interested to read your updates!

  • Julie

    Thank you so much for posting all this information. Since I did an accelerated BSN program, I bet I am not even close to anywhere near their requirement of hours. 🙂 Such great info! Thanks again.

    • naturallyinitaly

      Julie, I will be honest in saying- probably not. But, since you did an accelerated program, and if you are determined to be a nurse in Italy, there is the option of applying to a nursing program here, and if accepted they will most likely allow you to skip the first year of the 3 thanks to recognition of many credits. Maybe that could be an option? Let me know how it goes 🙂

  • Giovanna

    My husband – a RN with MBA and hospital administrator and I have dreamed of moving to Italy. I have a DNP, am dual certified PMHNP/AGACNP and have been a nurse in the US for 27 years. I doubt I have 4600 didactic hours even with all of my education (I started as an ADN and obtained my BSN, MSN and post masters cert and finally DNP – I haven’t added up hours but can’t imagine they add up to that number) . That being said I have an aesthetics practice and am curious if you know where I might find info – or if you know any info – about licensing requirements for aesthetics (ie injections, skin care, etc) in Italy. I found an Italian organization but unfortunately there was no info about licensing.
    I really appreciate everything you’ve shared.

    • naturallyinitaly

      Hi Giovanna, you and your husband both have a very impressive resume!
      Unfortunately I think that all that further specialization will not be recognized here in italy since there is no similar educational/licensing equivalence.
      As for the aesthetics, I am somewhat a bit pessimistic about it as well. In Italy, as a nurse, there are strict rules on what you may or may not do as an independent health professional (not employed by a hospital), and the permission to injecting or applying medications may not be a given. For example, I used to work for a private pediatric clinic run by only doctors and by law they were not allowed to administer (or keep on hand) any form of medications, even for emergencies.
      Another random fact that may give you an idea, is that for example the only professionals legally allowed to do acupuncture are licensed physicians.
      So what Im trying to say is that you would have to do some research on what kind of licenses professionals need to do the kind of work you would like, and if legally it is something that can be done in a private practice…
      I apologize if this message got to you so late but I would be very interested in hearing if you have any new insight on the issue. Take care!

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