The Swedish Parliament and Government has recently sanctioned a new 6 year undergraduate medical degree leading directly to license, followed by a 12 month introduction to work as a certified doctor. The undergraduate education is internationally harmonized and the 23 learning outcomes address competence needs in future Swedish and international health-care. Particular attention is given to professional competence, critical thinking, team-work and health promotion. All 23 learning outcomes must be documented before the University can issue a MD degree. After license, the doctor applies for a 12 month introduction to employment as doctor in the Swedish health-care system. This introduction is mandatory for all, regardless of the country where the license was issued. The introduction comprises clinical service in general medicine, emergency medicine and elective disciplines. Assessment of 10 learning outcomes is carried out in a formative wav by experienced and trained clinicians during the clinical service. After the introduction, the doctor is duly qualified to apply for specialist training.