From the EU to the US... eventually

Qualifications and training in one EU country should be recognised throughout the EU, however there may be additional requirements if you are not also an EU citizen. Only EU citizenship AND an EU qualification together give you total freedom of movement within the EU.

I am not an expert on the US system but my understanding is that in order to practice there as an overseas trained doctor you must sit the USMLE exams and complete 3 years of residency, regardless of your level of previous training.

 

Upon graduating from a Spanish (or other European) medical school your options will be:

A) Go back to the US, take the USMLE and apply for a Residency.
+ No or little school debt.
- Longer duration (most Europ. med schools are 5-7 yrs, I -think- Spain is 6)
- You'd be an IMG, so it WILL be more difficult to get into competitive residencies.
- You'll probably have to arrange clinical US rotations yourself (which you'd need for Letters of Recommendation).

B) Stay in Spain after med school.
+ Will compete for Residency spots on equal terms with Spanish peers.
+ You'll stay in Spain (presumably, you like the country).
- To get Residency, you'll need work permit. I've heard it's as difficult, if not more so, than getting US work visa.
- Generally, Residencies in Europe are longer (but less intense)
- You'll NOT be able automatically to work in other EU countries, as you're not an EU-citizen.
- Pay after Residency will be considerably lower than in the US.

MOST IMPORTANT:
Note, that these two options are basically mutually exclusive. If you do Residency in Spain, or other place outside North America, you will NOT be able to work as a physician in the US, unless you redo your entire Residency in the US (with a few, very narrow and specific exceptions).
Likewise, if you train in the US, but decide to go back to Europe, it's basically strictly on a case-by-case basis if they'll recognize your US training. Some get it fairly easily, others must redo everything, like in the US.

Generally, I think that people should think really, really carefully, before entering a medical school in a different country from the one they intend to work in.