The process of practicing medicine in France varies widely depending on whether a medical degree was earned within or outside the EU.

According to the latest data from the Organization for Economic Co-operation and Development, 18% of the doctors practicing in France are immigrants and 13% did not complete their studies in France. With its high standard of living, strong public healthcare system, and — no doubt — its culture and gastronomy, France continues to attract many foreign physicians, particularly from French-speaking countries. Yet the administrative steps required to obtain a license to practice there can be daunting.

To practice in France, doctors must apply for registration with the Departmental Council of the Order of Physicians (Conseil départemental de l’Ordre des Médecins [CDOM]) in the department where they plan to work (equivalent to a regional medical board). The next steps depend largely on where the applicant obtained their medical degree.

The National Council of the Order of Physician (Conseil national de l’Ordre des médecins [CNOM]) oversees the system and issues national guidance, but registration decisions are made at the departmental level.

Recognition for EU Doctors, Tougher Path for Others

Since a 2005 European directive, medical degrees benefit from automatic mutual recognition across the EU. A doctor who trained in any of the 26 other EU member states — or in Iceland, Norway, Liechtenstein, or Switzerland — and who is either a citizen of those countries or holds equivalent status (eg, the spouse of a citizen) will have their diploma automatically recognized in France. Doctors who earned their medical degree in the UK before Brexit took effect on December 31, 2020, also continue to benefit from this automatic recognition.

A European-trained doctor simply needs to apply for registration with the CDOM in the department where they intend to work. They must attend an interview assessing their moral character (which includes providing a certified translation of a foreign criminal record extract and, if available, a certificate from their local medical council), professional integrity, and proficiency in the French language.

The process is far more complex for doctors who hold qualifications from outside the EU — known in France as PADHUE (praticiens à diplôme hors Union Européenne or practitioners with non-EU diplomas). To obtain full authorization to practice, these doctors must complete the procédure d’autorisation d’exercice (authorization to practice procedure), overseen by the National Management Centre (Centre national de gestion [CNG]). The process includes three stages:

Knowledge exam. Candidates must pass a national examination, the Épreuves de Vérification des Connaissances (EVC), in their medical specialty. This exam is notoriously difficult, with a success rate of around 20%.

Skills consolidation. Those who pass must then complete a 2-year Parcours de Consolidation des Compétences, or competency consolidation program, involving supervised hospital training. Private practice is not permitted during this period.

Final review. The candidate’s full dossier — including EVC results, hospital evaluations, professional background, and French language proficiency — is then reviewed by the Commission d’Autorisation d’Exercice, a committee within the CNG that decides whether to grant full authorization to practice in France.

Residence Permit

In addition to meeting licensing requirements, foreign doctors must also comply with French immigration procedures. In January 2024, France introduced a new residence permit known as the “Talent - medical and pharmacy profession” card.

This multiyear residence card — valid for up to 4 years and renewable if the holder continues to reside in France or another EU country — allows doctors, pharmacists, midwives, and dentists to practice without needing a separate work permit. The permit also grants residency rights to the practitioner’s spouse and minor children upon arrival in France.

Rules in Flux

Non-EU doctors who have not yet received full authorization to practice may still work temporarily in French hospitals or clinics, which are frequently recruiting to fill staffing gaps. However, these contracts are generally less stable and offer lower pay than those held by physicians with full authorization.

The rules governing authorization for non-EU doctors have changed several times in recent years. A reform passed in May 2024 simplified parts of the process for foreign doctors already working in France, though additional changes may still come.

Two notable exceptions exist:

• Doctors trained in Quebec may, under certain conditions and in specific specialties, bypass the full authorization process by applying directly to the CNOM.
• Non-EU doctors already authorized to practice in another EU country (eg, an Argentinian physician licensed in Spain) may apply through a special route known as the “Hocsman procedure.” This process allows them to seek authorization from the CNG without completing the full authorization pathway.

Helping Fill France’s ‘Medical Deserts’

Foreign doctors can find job opportunities through the CNG and the Regional Health Agencies (Agences Régionales de Santé) — France’s regional public health authorities.

In many rural and underserved areas, known locally as déserts médicaux (medical deserts), non-EU physicians now play a vital role in maintaining access to care. A recent report by the CNOM highlighted the trend:

“A comparative reading of the departmental density maps of regular workers and the associated map of the proportion of former PADHUE recipients among all regular workers highlights the fact that the least densely populated departments are those where the proportion of former PADHUE recipients among regular workers is the highest.”

Alongside the CNG, healthcare professionals interested in working in France can seek guidance and advocacy from professional organizations representing foreign-trained doctors, including the National Union of Practitioners with Diplomas Outside the European Union and the Federation of Health Practitioners.

This story was translated from JIM, part of the Medscape Professional Network.