Notice from the French Academy of Medicine regarding the full practice right of PADHUEs
(Practitioners with Diplomas delivered from Outside the European Union)1
January 15, 2026
The shortage of doctors is restricting access to healthcare for a large proportion of the French population. This shortage requires, among other solutions, the recruitment of professionals trained abroad. If their diploma was obtained within the European Union, recognition has been automatic since 2005. If the training and diploma are obtained outside the European Union (PADHUE), candidates will have to pass a medical knowledge verification test (EVC), prove their mastery of the French language and follow a skills consolidation program before obtaining their right to practice. These skills will be validated by a national commission for each specialty. It is estimated that 8% of fully practicing doctors in France were trained outside Europe, although this proportion is higher in other European countries that also call on PADHUEs.
Despite having one of the highest medical workforces in Europe (around 240,000 practicing doctors) and training more than 12,000 new doctors by 2025, France is exploring other recruitment avenues to increase the number of doctors that are available. Increasing the number of PADHUEs to be recruited remains a priority, and more than 4,239 positions (440 external and 3,799 internal) have been opened up for competitive examination in 2025. Although, for these practitioners, the validation of knowledge procedure applied in France is similar to that applied in other European countries, the administrative and political authorities are tending to broaden the possibilities for validation both in mainland France and in certain overseas territories. To improve the precarious situation of many practitioners with non-European qualifications, recruited locally, sometimes a long time ago, to ensure the functioning or survival of many establishments, the Valletoux law of 2023 and its implementing decrees aim to speed up their integration.
1 Press release adopted by the Board of Directors
The French National Academy of Medicine considers that, to obtain the right to practice in positions where medical needs have been targeted by the territories, whether these are practitioners already in practice or new candidates holding a medical diploma obtained outside the European Union, they must justify their skills through a rigorous verification process, based on several criteria:
1- Validated medical knowledge
An anonymous written test, possibly supplemented by an oral, must assess the candidate’s scientific and clinical knowledge. This national test is based on programs drawn up by the National Professional Councils (CNP) for each specialty, guaranteeing consistency with French medical training.
2- Proficiency in the French language assessed
Candidates must demonstrate a minimum level of B2 in general French .For some specialties, a medical language test (written and spoken) at level C1 would be required, to ensure the ability to communicate effectively in a complex clinical context.
3- Quality of professional practice assessed
The assessment should include the assessments of the managers of the departments where the candidate has worked, or where he or she is doing a consolidation placement. Technical skills, particularly in surgery or interventional medicine, should in future be assessed using simulation tools.
4- Knowledge of the French healthcare system
Specific training should be provided during hospital placements to present: (a) how the healthcare and social protection system works; (b) the values of public service remit; (c) the role of health insurance and (d) the importance of interprofessional collaboration in the service of the patient.
5- A commitment to public service
Doctors already working in a healthcare establishment must undertake to work for at least five years in an establishment with a public service remit and within the geographical area in which they have been recruited.
Support in the event of failure
Doctors with qualifications from outside the European Union who have been practicing in France for several years, but who have not succeeded, despite several attempts, in passing the verification of skills test, should be helped to retrain for jobs requiring medical knowledge, such as: medical information for users, coding or hospital hygiene.
ACADÉMIE NATIONALE DE MÉDECINE
16 rue Bonaparte – 75006 Paris / Tél. : +33 (0)1 42 34 57 70
Site: www.academie-medecine.fr
Bull Acad Natl Med 2025;209:pp-pp. [En ligne] Disponible sur : URL
