In this article the conditions and regulatory systems for access to medical practice in seven countries of the European Union are described with a view to the health protection of patients/consumers. In Belgium and France the legislator has chosen a monopolistic approach to the licensing of medical doctors: only the practice of medicine by legally qualified doctors is lawful. In Germany, Ireland and the United Kingdom a more tolerant system is in force: only medical practitioners with a university degree in medicine are recognized, but also persons who practice 'alternative medicine' without a medical degree are tolerated by law. In Denmark and the Netherlands the system is a mixture of the monopolistic and tolerant system. In principle everyone is allowed to practice medicine, with the exclusion of certain procedures that are reserved to qualified medical doctors. Violation of this limited monopoly can be prosecuted. The restrictions to and preconditions for access to medical practice are compared as well as the maintenance of the respective systems. The role of the legislator is described. From the perspective of the protection of patient's health and safety it seems that a mixed system offers the patient optimal protection.