Conditions for medical practice in Vietnam — what businesses, hospitals/clinics and individual practitioners must meet under the 2024-2026 framework

On 9 January 2023 the National Assembly passed Luật số 15/2023/QH15 — the new Law on Medical Examination and Treatment — which took effect on 1 January 2024 and replaced Luật 40/2009/QH12 together with its later amendments. On 30 December 2023 the Government issued Nghị định 96/2023/NĐ-CP (9 chapters, 149 articles, 7 appendices) detailing the law, and on 31 December 2023 the Minister of Health issued Thông tư 32/2023/TT-BYT, which fixes the scope-of-practice tables for each professional title. The framework was supplemented in 2025 by the entry into force of the three-tier system for medical facilities (Điều 104, effective 1 January 2025), and was further reshaped in 2026 by Nghị quyết 21/2026/NQ-CP (29 April 2026), which from 1 July 2026 delegates licensing authority to provincial People's Committees. Reading these instruments together, the conditions for medical practice in Vietnam now sit on three layers — the individual practitioner, the establishment (hospital/clinic), and the legal entity (the company or other organisation behind the establishment).

Two licences, not one — the architectural split

Vietnamese medical-practice law has always distinguished two distinct authorisations and Luật 15/2023 keeps that split, but renames and reframes both:

• Giấy phép hành nghề khám bệnh, chữa bệnh (GPHN) — issued to the individual person performing medical acts. It is title-based (chức danh chuyên môn) rather than degree-based, and from 1 January 2024 has a five-year validity (Điều 27), with renewal conditional on continuous medical education (CME) and, in the new regime, on the national competency assessment organised by Hội đồng Y khoa Quốc gia.

• Giấy phép hoạt động khám bệnh, chữa bệnh (GPHĐ) — issued to the establishment (cơ sở khám bệnh, chữa bệnh), whatever its legal form. It is form-based (one of the regulated organisational types in Điều 48 of the law and Điều 39 of Nghị định 96), and is conditional on premises, equipment, personnel and a designated person in charge of clinical practice (người chịu trách nhiệm chuyên môn kỹ thuật).

A company — whether a joint-stock company, a limited liability company, a household business, a public service unit, or a foreign-invested entity — does not itself "practice medicine". It owns or operates the establishment that holds the GPHĐ, and it must engage individuals who hold a GPHN. The law treats the legal entity as the upstream container, with conditions imposed by adjacent regimes (Luật Doanh nghiệp 2020, Luật Đầu tư 2020 for foreign-invested cases, and the relevant tax and social-insurance laws).

Layer 1 — conditions on the individual practitioner

Article 26 of Luật 15/2023 lists ten professional titles that require a GPHN: (a) bác sĩ, (b) y sĩ, (c) điều dưỡng, (d) hộ sinh, (đ) kỹ thuật y, (e) dinh dưỡng lâm sàng, (g) cấp cứu viên ngoại viện, (h) tâm lý lâm sàng, (i) lương y, (k) người có bài thuốc gia truyền or người có phương pháp chữa bệnh gia truyền. Note that y sĩ enrolment is restricted to forces of the People's Armed Forces under the new law; civilian y sĩ titles continue under the transition rules until expiry of the old chứng chỉ.

The core conditions on an applicant for an initial GPHN are:

• A diploma or qualification appropriate to the title — verified against the Ministry of Health's list of accepted training programmes.
• Completion of supervised practice (thực hành khám bệnh, chữa bệnh) at a recognised establishment, for a duration that depends on the title (typically 12 months for bác sĩ, 9 months for y sĩ, 9 months for điều dưỡng / hộ sinh / kỹ thuật y, shorter for nutrition and clinical psychology, with the detailed map in Nghị định 96 Chapter II).
• Health adequacy (giấy khám sức khỏe) and good moral standing — no current criminal sentence, no current administrative ban on practice.
• For foreign nationals, Vietnamese-language proficiency under Điều 21. The exceptions to the Vietnamese-language rule are narrow: same-mother-tongue patients, foreign patients, humanitarian medical missions, and short-form technology-transfer or expert-cooperation programmes between Vietnamese and foreign establishments. In all such non-Vietnamese cases, an interpreter must be engaged, and medical records must be kept in both the foreign language and Vietnamese.

The competency-assessment overlay — the timeline

Điều 120 of Luật 15/2023 assigns the running of the new national competency assessment to Hội đồng Y khoa Quốc gia. Điều 121 (transitional provisions) staggers the obligation to pass that assessment as a precondition for the GPHN:

• From 1 January 2027 — bác sĩ.
• From 1 January 2028 — y sĩ, điều dưỡng, hộ sinh.
• From 1 January 2029 — kỹ thuật y, dinh dưỡng lâm sàng, cấp cứu viên ngoại viện, tâm lý lâm sàng.

Applicants who apply for a GPHN before their title's switch-on date are exempt from the competency assessment for that initial cycle. The window matters: bác sĩ applying in 2026 are still under the certificate-based regime; those applying on or after 1/1/2027 must clear the national exam first. For lương y and persons holding bài thuốc / phương pháp gia truyền, no national exam applies; provincial or ministerial evaluation councils continue to assess.

Five-year cycle and CME

Once issued, a GPHN is valid for five years (Điều 27). Renewal requires:

• Demonstrated compliance with the CME requirements specified by the Minister of Health for the relevant title (cập nhật kiến thức y khoa liên tục).
• No outstanding administrative ban on practice.
• A short, document-based re-application — not a re-run of the competency exam, in the steady state — although the Ministry has flagged that this position may evolve once the first cohort comes up for renewal in 2029.

In effect, the five-year cycle replaces the previous lifetime certificate. Practitioners who hold a chứng chỉ hành nghề issued under Luật 40/2009 continue to be recognised until they next have to renew, at which point they convert into the new GPHN scheme.

Layer 2 — conditions on the establishment (cơ sở khám bệnh, chữa bệnh)

Article 48 of Luật 15/2023, expanded in Điều 39 of Nghị định 96/2023, enumerates the recognised organisational forms a medical-practice establishment may take. The principal forms are:

• Bệnh viện (general or specialty hospital).
• Bệnh xá thuộc lực lượng vũ trang nhân dân (armed forces clinic).
• Nhà hộ sinh (maternity home).
• Phòng khám đa khoa (multi-specialty clinic).
• Phòng khám chuyên khoa (single-specialty clinic), including phòng khám bác sĩ y khoa, phòng khám điều dưỡng, phòng khám hộ sinh, phòng khám kỹ thuật y, phòng khám dinh dưỡng, phòng khám tâm lý lâm sàng and so on.
• Phòng khám liên chuyên khoa and phòng khám bác sĩ y học gia đình.
• Phòng chẩn trị y học cổ truyền.
• Cơ sở dịch vụ cận lâm sàng (laboratory / imaging diagnostic service).
• Cơ sở dịch vụ kính thuốc có đo thị lực (optical shops that perform vision testing).
• Trạm y tế (commune health station).
• Cơ sở cấp cứu ngoại viện (out-of-hospital emergency service).
• Cơ sở khám bệnh, chữa bệnh y học gia đình.
• Other forms designated by the Minister of Health.

Each form has its own set of conditions on premises, equipment, personnel and minimum scale, codified in Chapters III–V of Nghị định 96. Representative thresholds:

• Bệnh viện đa khoa — minimum 30 inpatient beds, minimum 50 m² of constructed floor area per bed, separate departments for emergency, examination, inpatient treatment, pharmacy, infection control, medical records and so on.
• Phòng khám đa khoa — at least two single-specialty consultation rooms, of which the consultation rooms are at least 10 m² each; emergency room at least 12 m²; observation room at least 15 m² (≥ 5 m² per bed once the third bed is added).
• Phòng khám chuyên khoa — minimum 10 m² consultation room (plus separate technical / procedure rooms for the specialty).
• Cơ sở dịch vụ cận lâm sàng — minimum laboratory or imaging room per the technical service, with calibration and external quality control evidence on file.

Every establishment must have:

• A người chịu trách nhiệm chuyên môn kỹ thuật — the named clinical lead — who must hold a GPHN with a scope matching the establishment's principal practice and have at least 36 months of relevant clinical experience (54 months for certain hospital-tier positions).
• Sufficient practitioners by number and ratio for the approved scope (the staffing ratios are pinned by Bộ Y tế in implementing instruments).
• Each practitioner who performs clinical work at the establishment must hold a valid GPHN registered for practice at that establishment (an individual may register at multiple sites, subject to the time-and-distance rules in Điều 36).
• A list of approved techniques (danh mục kỹ thuật) — the establishment can only perform what is on the approved list, and adding "special-category" techniques requires a separate approval procedure now delegated to provincial UBND under Thông tư 04/2026/TT-BYT.

The three-tier system (cấp chuyên môn kỹ thuật)

Điều 104 of Luật 15/2023, effective 1 January 2025, replaces the old four-tier scheme (central — provincial — district — commune) with three professional-competency tiers:

• Cấp khám bệnh, chữa bệnh ban đầu — outpatient care, primary health, community disease management, community rehabilitation.
• Cấp khám bệnh, chữa bệnh cơ bản — general outpatient and inpatient care; general practical training; organisation of continuous medical education.
• Cấp khám bệnh, chữa bệnh chuyên sâu — specialised outpatient and inpatient care; advanced practical training; research; continuous specialised training; technology transfer to other establishments.

An establishment is placed in exactly one tier. If it can carry out the duties of all three tiers it is placed in chuyên sâu; if it covers ban đầu and cơ bản it is placed in cơ bản. Placement is by four criteria: capacity of clinical services and scope, capacity to host practical medical training, capacity to provide technical support to other establishments, and capacity for medical scientific research. The tier is what determines a facility's role in the new BHYT (health insurance) referral and payment architecture — replacing the geographically-anchored tier reference that the 2009 law inherited.

Layer 3 — conditions on the legal entity (the "company")

Luật 15/2023 does not itself prescribe what corporate vehicle must hold the establishment; it speaks of "cơ sở khám bệnh, chữa bệnh" and reserves the practitioner relationship to the individual. The corporate-vehicle conditions therefore come from adjacent regimes:

• Vietnamese-domestic operators may use a công ty cổ phần (JSC), công ty TNHH (LLC), hộ kinh doanh (household business), hợp tác xã (cooperative), or, in the public sector, đơn vị sự nghiệp công lập. The legal entity's business-line registration must include the appropriate VSIC codes — typically 8610 (hospital services), 8620 (medical and dental practice), 8690 (other human health activities) — and the operating address registered for the business line must coincide with the establishment's premises.

• Foreign-invested operators must first hold an Investment Registration Certificate (Giấy chứng nhận đăng ký đầu tư) issued under Luật Đầu tư 2020, then a corporate registration under Luật Doanh nghiệp 2020, before applying for the GPHĐ. Hospital services and clinics are listed as conditional business lines for foreign investors; foreign-ownership ratios and the form of investment are constrained by Vietnam's WTO commitments and by Phụ lục about market access conditions in the implementing decrees of the investment law. The licensing authority for foreign-invested medical establishments has historically been the Ministry of Health — but with the 1 July 2026 delegation under Nghị quyết 21/2026/NQ-CP, provincial People's Committees are taking on most of these procedures.

• Public service units operating under the autonomy framework (Nghị định 60/2021/NĐ-CP) sit alongside private operators in the licensing system, but with separate rules on financial autonomy, asset management, and pricing of medical services under Điều 110 of the law.

The corporate vehicle must also satisfy:

• Tax registration under Luật Quản lý thuế.
• Social-insurance registration under Luật Bảo hiểm xã hội 2024 (Luật 41/2024/QH15, effective 1 July 2025) for employed practitioners.
• Fire-safety acceptance under Luật Phòng cháy, chữa cháy.
• Environmental clearance under Luật Bảo vệ môi trường 2020 — for hospital-scale operations, a full environmental impact assessment; for clinics, an environmental commitment.
• Medical-waste handling per Thông tư 20/2021/TT-BYT.

Specialised regimes inside the law

Luật 15/2023 codifies several practice regimes that previously sat in scattered instruments:

• Khám bệnh, chữa bệnh từ xa (telemedicine) — recognised as a regulated practice form, performed between licensed establishments and between an establishment and a registered practitioner; the establishment's GPHĐ scope must include the relevant remote-care techniques.
• Khám bệnh, chữa bệnh lưu động (mobile / outreach medicine) — permitted under conditions on equipment, hygiene and supervision.
• Cấp cứu ngoại viện (out-of-hospital emergency) — newly codified as a recognised cơ sở form, distinct from a hospital.
• Khám bệnh, chữa bệnh nhân đạo (humanitarian / charitable medicine) — special expedited procedures for foreign teams and short-term missions, with Vietnamese-language relaxation under Điều 21.
• Khám bệnh, chữa bệnh y học gia đình (family medicine) — codified as a separate establishment form and as a recognised practitioner specialisation.

What changes on 1 July 2026 — Nghị quyết 21/2026/NQ-CP

Nghị quyết 21/2026/NQ-CP, issued on 29 April 2026, is the most consequential procedural change since the law took effect. From 1 July 2026:

• Bộ Y tế stops issuing GPHN to individual practitioners. The full lifecycle — initial issue, re-issue, renewal, adjustment, suspension, revocation — moves to Chủ tịch UBND cấp tỉnh, who in practice will delegate the operational work to Sở Y tế.
• The delegation applies retroactively to chứng chỉ hành nghề already issued under Luật 40/2009 — those licences are now managed at provincial level.
• Statutory timelines tighten. New GPHN applications must be assessed within 40 days of receipt, and the licence issued within 10 working days of the assessment report.
• The decentralisation runs in parallel with Thông tư 04/2026/TT-BYT (16 March 2026), which delegates the procedure for adding "special-category" techniques (danh mục kỹ thuật loại đặc biệt) to provincial UBND for establishments outside Bộ Y tế / Bộ Quốc phòng / Bộ Công an perimeter, and Thông tư 02/2026/TT-BYT, which amends the 2024 circular on the broader delegation of administrative procedures in the KCB field.
• The resolution itself is transitional — effective 29 April 2026 through 1 January 2028 — and contemplates a follow-on instrument that may codify the new allocation more permanently.

Transition rules from Luật 40/2009 to Luật 15/2023

The bridge from the old regime to the new is structured around the validity of pre-existing documents:

• A chứng chỉ hành nghề issued under Luật 40/2009 remains valid until its holder applies for renewal or until the practitioner is required to convert under the staged competency-assessment timeline above. On first renewal, the document is reissued as a five-year GPHN.
• A GPHĐ issued under Luật 40/2009 / Nghị định 109/2016/NĐ-CP remains valid; the establishment must apply for adjustment if its scope, address, principal premises or person-in-charge changes, and at that point it migrates onto the Nghị định 96 forms.
• Establishments must complete the placement procedure into one of the three tiers (Điều 104) — guidance and acceleration instructions have been issued through 2025-2026 (see kcb.vn and the Ministry's directional notices).
• Foreign practitioners holding a chứng chỉ under Luật 40/2009 keep that authorisation pending renewal, but at the next renewal they fall under the Vietnamese-language conditions of Điều 21.

Practical checklist — what businesses, hospitals/clinics and individuals should do now

For individual practitioners

• Audit your CME hours and your re-application date against the five-year cycle. If your old chứng chỉ does not have an expiry date, your effective expiry is the first event that triggers renewal (change of practice scope, change of registered establishment, voluntary renewal).
• If you are a bác sĩ planning to take the national competency assessment, work to the 1 January 2027 switch-on. Hội đồng Y khoa Quốc gia's preparatory materials are circulated through ump.edu.vn and the major medical universities.
• If you practise at more than one site, re-check the multi-site registration in Điều 36 — distance, time, conflict-of-interest and informed-consent rules.
• If you are a foreign practitioner, treat the Vietnamese-language Phụ lục of Nghị định 96 (Phụ lục V) as the practical reference for your renewal; the exception list is not as broad as the marketing language sometimes suggests.

For hospitals and clinics

• Confirm your tier placement under Điều 104. Until placement is complete, the BHYT referral path and reimbursement coefficients remain on the legacy mapping.
• Re-check the danh mục kỹ thuật approved at your establishment against the current scope and against what your practitioners are actually doing. Discrepancies are now the most common DAV/Sở Y tế inspection finding, and the Thông tư 04/2026 special-technique addition path is the procedural fix.
• Re-paper the người chịu trách nhiệm chuyên môn kỹ thuật: the new law fixes the minimum experience requirement and the named-person-in-the-licence rule more strictly than the 2009 instruments.
• Map your GPHN portfolio against the 1 July 2026 delegation date. Documents already in flight to Bộ Y tế before 1 July 2026 will be handled under transitional rules; new submissions from that date go to UBND cấp tỉnh.
• Run a gap analysis against Nghị định 96 Chapter III–V on premises and equipment. Findings here are the cheapest to remediate before a scheduled inspection.

For companies and corporate operators

• Confirm that your business-line registration covers the establishment's actual scope — VSIC 8610 / 8620 / 8690 is the usual map, and missing codes are a common reason GPHĐ adjustment dossiers are returned.
• If you are a foreign-invested operator, refresh your Investment Registration Certificate scope to match the establishment's practice scope; market-access conditions and ownership ratios can be re-tested by the licensing authority on any material change.
• Reconcile your public-pricing structure with Điều 110 of Luật 15/2023 and the implementing pricing guidance — the autonomy regime tightens the disclosure requirements.
• Check downstream compliance: Luật BHXH 2024 (effective 1 July 2025) and the upcoming Luật Bảo hiểm y tế (sửa đổi) 51/2024/QH15 sequence affect employment, contributions and referral payments for practitioners working under your establishment.

Direction of travel — from licence-as-permission to licence-as-quality-loop

Read together, Luật 15/2023, Nghị định 96, Thông tư 32, the tier-system entry into force on 1 January 2025 and the 1 July 2026 delegation under Nghị quyết 21/2026 move Vietnam's medical-practice regime from a static "permission to operate" model towards a quality-loop model — five-year practitioner licence, national competency assessment, formalised CME, tier-based facility placement, decentralised administrative oversight, and a more explicit corporate-side compliance perimeter (investment, tax, environment, fire safety). For multi-site operators and foreign-invested entities, the practical answer is to treat 2026 as the year to refresh the entire licence stack, because the delegation to provincial People's Committees changes both the counterparty and the cadence of every interaction with the regulator.

Sources

• Quốc hội — Luật Khám bệnh, chữa bệnh số 15/2023/QH15 (9 January 2023; effective 1 January 2024), full text via Cổng thông tin Chính phủ (xaydungchinhsach.chinhphu.vn) and ThuVienPhapLuat.
• Chính phủ — Nghị định 96/2023/NĐ-CP (30 December 2023) on the detailing of several articles of the Law on Medical Examination and Treatment.
• Bộ Y tế — Thông tư 32/2023/TT-BYT (31 December 2023) detailing several articles of the Law, including scope-of-practice tables (Phụ lục I–XII).
• Chính phủ — Nghị quyết 21/2026/NQ-CP (29 April 2026) on cutting and decentralising administrative procedures in the health sector.
• Bộ Y tế — Thông tư 04/2026/TT-BYT (16 March 2026) on delegation of special-technique addition procedures.
• Bộ Y tế — Thông tư 02/2026/TT-BYT and Văn bản hợp nhất 10/VBHN-BYT (2026) on delegation of administrative procedures in the KCB field.
• Bộ Y tế — Quyết định 658/QĐ-BYT and Quyết định 966/QĐ-BYT (2026) publishing the updated administrative-procedure list.
• Cục Quản lý Khám, chữa bệnh (kcb.vn) — guidance on tier placement and on the Nghị định 96 implementing path.
• Luật 40/2009/QH12 and Nghị định 109/2016/NĐ-CP — superseded but referenced in transition.
• Luật Đầu tư 2020 (Luật 61/2020/QH14), Luật Doanh nghiệp 2020 (Luật 59/2020/QH14), Luật BHXH 2024 (Luật 41/2024/QH15), Luật Bảo vệ môi trường 2020 — adjacent regimes shaping the corporate layer.
• LuatVietnam, ThuVienPhapLuat, baochinhphu.vn, suckhoedoisong.vn, kcb.vn — analytical coverage of the new framework and the 2026 delegation.