A new investigation has exposed a deep and dangerous flaw at the heart of Europe’s system for regulating doctors: national health authorities across the continent are routinely ignoring official warnings about physicians who have been banned elsewhere. The result is a fragmented oversight regime that allows doctors disciplined for serious misconduct – including actions that directly harm patients – to quietly cross borders and continue practicing.

At the center of the problem is the European Union’s Internal Market Information System (IMI), a digital platform designed to facilitate cooperation between authorities in the EU’s single market, as well as associated countries like Norway and Iceland. Under EU rules, when a doctor loses their license for “substantial reasons” – such as misconduct, criminal convictions, or serious breaches of patient safety – the relevant authority must issue an alert through IMI so counterparts in other countries are informed. In theory, this system should prevent banned doctors from simply relocating and resuming work under a different regulator.

In practice, newly obtained data suggests the system is failing on a systemic level.

An analysis of more than 500 IMI alerts issued about doctors in 2024 and 2025 reveals a striking pattern: only about one-third of the jurisdictions that receive these warnings actually open them. Even fewer go a step further and access the personal data attached to the alert – including the identity of the disciplined physician. In many cases, the warnings are effectively ignored, rendering the entire mechanism little more than a bureaucratic formality.

One case illustrates the stakes. Swedish health authorities revoked a doctor’s license in 2021 after investigating more than a dozen incidents involving inappropriate administration of medication. One patient suffered a double lung collapse. Citing inadequate medical knowledge and serious risks to patient safety, Sweden immediately filed an IMI alert to notify the other 29 jurisdictions in the European single market. Norway followed with its own alert months later after revoking the same doctor’s license.

By that time, however, the doctor was already practicing in Cyprus.

Despite receiving two alerts flagging a physician whose actions had caused severe harm, Cypriot........

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