State of play – Close to 220,000 doctors are currently practising medicine in France. They mainly work as general practitioners and as specialists in public or private hospitals. Lack of doctors and hence job opportunities are given in particular in smaller towns and the countryside, for example in the centre of France, and in certain specialties such as anaesthetics, obstetrics and emergency medicine. By contrast, competition for posts is still fairly tough in metropolitan areas such as Paris, Lyon or Bordeaux and in tourist regions such as South France.
However, due to the demographic changes the need for doctors replacing retiring ones is expected to increase in the coming years. This has led the French government recently to lower the barrier (“numerus clausus”) for admission to medical studies. Foreign doctors have been immigrating to work in France mainly from neighbouring countries (such as Belgium and Germany), North Africa and more recently from Romania.
How to become a doctor in France
The French central system of educating and training doctors (études de santé) at universities and hospitals is divided into three phases, adding up to 9 – 11 years depending on the specialty. The first phase « de formation générale » of 3 years includes an important exam (concours) after the first year. The second phase « de formation approfondie » of another 3 years includes theoretical studies and practical hospital internships in several specialties and is concluded by several tests (les épreuves classantes nationales).
The third phase « d’études spécialisées » is a paid specialty training at hospitals, lasting 3 years for general practitioners (médecin généraliste) and 4-5 years for other specialties (médecin spécialiste). There are 42 different medical specialties, but the choice of some specialties depends on the test results. At the end of the specialty training the residents receive their diploma of specialised studies (Diplôme d’Études Specialises – DES) and are required to defend a thesis (thèse d’exercice) before a jury in order to receive the diploma in medicine (diplôme d’État de docteur en medicine).
In order to practice medicine in France, doctors need to register with the competent Conseil Départemental of the French Medical Association (Ordre des Médecins).
Hurdles to take for foreign doctors
Fluent French language skills are normally indispensable for working as doctor in France. EEA/Swiss doctors with an EEA/Swiss qualification benefit from automatic recognition under EU Directive 2005/36/EC. Normally foreign EEA doctors are first employed at hospitals as “contractual practitioners” for a maximum of two years, before their status can be upgraded to “hospital practitioner” following successful completion of an examination.
Other foreign doctors wishing to practice medicine in France – known under the acronym “PADHUE” (Praticiens A Diplôme Hors Union Européenne) – face fairly high hurdles. They need to follow the “Procédure d’autorisation d’exercice” (PAE), which includes submission of academic and work records as well as examinations of medical competence and French language proficiency.
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