By and large, they're substantially stricter. Using Germany as an example[1]: they require potential drivers to take a multi-segment first aid, submit to a recent optical exam, and perform at least 37 hours of officially overseen driving practice. I believe there are additional training segments that German drivers are required to pass as well, but I'll let an actual German (or other European) speak about those.
For contrast: in New York (a somewhat strict state, by US standards), there is no hours of practice requirement once you're over 18. I don't believe there's a medical knowledge requirement either, and the DMV accepts whatever optical record you give them.
Germany's car fatality rate is roughly a quarter of the US's[2].
[1]: https://en.wikipedia.org/wiki/Driving_licence_in_Germany
[2]: https://en.wikipedia.org/wiki/List_of_countries_by_traffic-r...