I’ve been to Italy once, and if there’s one place I would like to return in future travels, it’s this land of wine, pasta, and picturesque landscapes. From exploring historical sites in Rome to soaking up rays of sunshine on the coast, Italy has an endless array of experiences to offer. As nurse practitioners, our careers are quite flexible and may even allow us to practice in international locations such as this. If you’re an NP certified in the United States, how can you take your career to Italy?

This week, we’re looking at how nurse practitioners can practice in European countries. We started with the United Kingdom and France. But, if Italy’s more your style, here’s a quick look at the process of becoming a nurse practitioner in Italy.

Scope of Practice 

In 2006 the Italian Parliament created a national regulation that set forth education requirements and established the advanced practice nursing role, which it titled as a Nurse Specialist. But as seen with many other European countries, progress and implementation of the profession have been slow.

In addition to an excess of physicians in the country, perhaps the biggest hindrance in progression is due in large part to the current role of nursing in Italy and its lack of separation between the scope of practice of a registered nurse and a nurse specialist. Apart from prescriptive authority and medical diagnosis, nurses in Italy are able to perform any kind of technique and task in accordance with his or her experience and education such as ET intubation, manual defibrillation and invasive procedures; scopes of practice that are typically limited to physicians in most other countries.

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Certification and Licensure

Nurses in Italy are overseen by and are required to register with The Federation of the Ipasvi Colleges. The Ipasvi represents the nursing profession on a national basis and coordinates the Provincial Colleges, which are non-profit bodies by public law. The Colleges aim to protect registered nurses in the county by ensuring their level of competence and provide support services that help nurses practice their profession; in addition to keeping the Registers of nurses. Since the Nurse Specialist role is still in development, there is not currently a separate process for registering as an advanced practice nurse.

As a NP certified and educated in the U.S., before registering with Ipasvi, you must first contact the Italian Ministry of Health to have your professional qualifications and education recognized. According to the Ministry of Health, you will likely be required to travel to Italy to take aptitude tests that relate to the recognition of your profession; of which includes written, oral and practical components.

Once your qualifications are deemed as acceptable, you will be given a decree of recognition from the Ministry of Health, allowing you to proceed in registering; but not without first passing an exam to test your knowledge of the Italian language and as well as exam on the special provisions that rule the nursing practice in Italy.

In the event that the Italian Ministry of Health decides that your professional qualifications are not up to par, you may be required to complete additional schooling in Italy. 

Other Considerations

As a U.S. citizen you may also be required to apply for a work permit and visa to live and maintain employment in Italy.

Landing a nurse practitioner job in Italy may be difficult given the vague scope of practice and early stages of development of the profession in the country. But, NPs willing to brave the Italy’s ill defined scope of practice will find the country an exciting place to live and work.


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11 thoughts on “Ciao! Becoming a Nurse Practitioner in Italy”

  1. Hi, I just read your article and I really enjoyed it especially because I am a NP living in Italy! Just speaking from my personal experience though, it is quite difficult to even get the recognition of nursing degree part done here… it’s taken me over a year to get all the paperwork and bureaucratic stuff organized and I am in the final process of the application. Since there seems to be no precedent for NP’s wanting to come here either, no one has yet been able to tell me what to expect (with regard to exams, clinical hours, etc.) in order to get final certification to practice. I’d love to hear from any NP that has successfully gotten recognition to work here (you can email me at c.cassano.rem@gmail.com). In the meantime I do consulting for medical companies and wait for my paperwork to get done…

    1. Hi Bianca, I apologize for being almost a year late with a response, but I have added a comment below. Hopefully it helps.

    1. Hi, so… I’m still the one who wrote the original comment and 3 years later my application is still a mess. For some background to help understand my situation (and hopefully help some of you), I did an accelerated bachelor and master’s degree and worked both as an RN and an NP in the US.
      The Ministry of Health received my complete application about 2 years ago and has since sent 2 notices of missing documentation that was of course sent. Just the back and forth to straighten out these issues took over a year. Recently though they definitively rejected my application stating that I did not meet the minimum credit requirement of about 4800 hours of both didactic and clinical nursing courses. Apparently I have obtained less than 2000 hours of nursing courses while in college, even though my application is for the equivalent of an italian three year university degree, whereas I did many more years than that. It is frustrating to say the least, but there’s no getting around it.
      If you are unlucky and rejected for some silly technicality like me, there is one option left: apply to a nursing program in italy by studying for and passing the entrance exam, and then if accepted, have your fate decided by a panel that will evaluate whether to recognize any/all of your college courses or not.
      So I am currently studying for the entrance exam for nursing (esame di ammissione per le Professioni Sanitarie) which is such a torture because it not only requires brushing up on high school biology, chemistry, math, and physics, but it also has a section of italian culture that there is no way for me to have studied unless I went to an Italian high school (Italian literature, art, civics, etc.). The exam is held once a year, usually in early september, and admission is limited to a predetermined amount of new students each year. From what I have read, about 1 in 4 or 5 applicants are admitted each year.

      I admit I forgot about writing a comment here in 2017, but now that I know some people are interested, I will be sure to follow up once I take and hopefully pass that entrance exam. My email is no longer the one listed above, but we could exchange comments here if anyone has other questions. I would be more than happy to help anyone trying to figure things out here- I know how hard and frustrating it can be 🙂

  2. Cristiana,
    If you are doing all of that, what does it take to become a physician in Italy instead? I am an NP in the US and love being one…my only regret is not being to practice internationally as in many countries, NPs do not exist. I would have relished a Doctors Without Borders stint. Just a thought for your consideration…

  3. Hi Cristiana,

    I’m also an NP working in the US, but I have also an Italian citizenship ( I was born and raised in Italy, I have a dual citizenship USA and Italy). I wonder if that would make it any less painful? Any idea, since yo have been through a lot with this.

    thank you for your insight


    Hi Cris,
    How is it going in Italy with working as an NP? I just came home from yet another vacation and would love to live and work there any input would be greatly appreciated.


  5. My apologies, I had included a way to contact me in the original post, but I see it was removed. I guess I will continue to check here more regularly. To answer some above questions though:
    – Anjana, to become a physician here I would have to start all over. This would include passing the entrance exam for med school, 6 years of study, then specialty, etc… not worth it for me unfortunately. I could sign up for doctors without borders as a nurse, but with a small child it is currently not an option.
    -Pastor Paulo, I would if I could 🙂
    -Eleonora, I am a dual citizen since birth and speak both perfectly. None of this helped…
    – Margarite, I don’t remember if I detailed much in the previous posts, but I am unable to work as an NP here, I went with studying to be a midwife for 3 years to get a degree that allows me to work. I am currently in my second year (of three)of school.

    Best to all,

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