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Geriatrics

1. Defining the activity

Geriatrics manages the physical, mental, functional and social conditions in acute, chronic, rehabilitation, prevention and end-of-life care of the elderly. This group of patients has significant fragility and multiple evolutionary pathologies requiring a comprehensive approach. The need for medical and social support is also necessary. The geriatrician's activity is clinical during consultations (interrogation, examination of the patie, etc.).

The geriatrician works within:

  • Hospital services;
  • Follow-up care or rehabilitation facilities (SSRs);
  • Accommodation facilities for the elderly dependent (EHPAD);

Two degrees. Professional qualifications

a. National requirements

National legislation

Under Article L. 4111-1 of the Public Health Code, in order to legally practise as a doctor in France, those concerned must meet cumulatively the following three conditions:

  • hold the French state diploma of doctor of medicine or a diploma, certificate or other title mentioned in Article L. 4131-1 of the Code of Public Health (see infra "Good to know: automatic recognition of diploma");
  • be of French nationality, Andorran citizenship or national of a Member State of the European Union (EU) or party to the agreement on the European Economic Area (EEA) or Morocco, subject to the application of the rules derived from the Health Code public or international commitments. However, this condition does not apply to a doctor with the French state diploma of doctor of medicine;
  • with exceptions, be listed on the board of one of the departmental councils of the College of Physicians (see infra "5o. a. Application for inclusion in the College of Physicians list").

However, persons who do not meet the qualifications of diploma or nationality may be allowed to practise as a doctor by individual order of the Minister responsible for health (see below: "5. c. If necessary, apply for an individual exercise permit").

To go further Articles L. 4111-1, L. 4112-6, L. 4112-7 and L. 4131-1 of the Public Health Code.

Note that

Failing to meet all of these conditions, the practice of the profession of doctor is illegal and punishable by two years' imprisonment and a fine of 30,000 euros.

To go further Articles L. 4161-1 and L. 4161-5 of the Public Health Code.

Good to know: automatic diploma recognition

Under Article L. 4131-1 of the Public Health Code, EU or EEA nationals may practise as a doctor if they hold one of the following titles:

  • doctor training documents issued by an EU or EEA state in accordance with EU obligations and listed in the annex of the 13 July 2009 decree setting out lists and conditions for the recognition of EU training of doctors and specialist doctors issued by EU Member States or party to the EEA agreement covered by Article L. 4131-1 of the Public Health Code;
  • medical training certificates issued by an EU or EEA state in accordance with EU obligations, not on the above list, if they are accompanied by a certificate from that state certifying that they are sanctioning training compliant with these obligations and are assimilated by him to the training titles on this list;
  • medical training certificates issued by an EU or EEA state sanctioning medical training started in that state prior to the dates in the above-mentioned decree and not in accordance with EU obligations, if accompanied a certificate from one of these states certifying that the holder of the training titles has devoted himself, in that State, effectively and lawfully, to the practice of the profession of doctor in the specialty concerned for at least three consecutive years in the Five years prior to the issuance of the certificate;
  • doctor training certificates issued by the former Czechoslovakia, the former Soviet Union or the former Yugoslavia or which sanction training begun before the independence date of the Czech Republic, Slovakia, Estonia, Latvia, Lithuania or Slovenia, if accompanied by a certificate from the competent authorities of one of these states certifying that they have the same legal validity as the training documents issued by that state. This certificate is accompanied by a certificate issued by the same authorities indicating that the holder has exercised in that State, effectively and lawfully, the profession of doctor in the specialty concerned for at least three consecutive years in the Five years prior to the issuance of the certificate;
  • medical training certificates issued by an EU or EEA state not on the above list if they are accompanied by a certificate issued by the competent authorities of that state certifying that the holder of the training certificate was established on its territory on the date set out in the aforementioned decree and that it has acquired the right to carry out the activities of a general practitioner under its national social security scheme;
  • medical training certificates issued by an EU or EEA state sanctioning medical training started in that state prior to the dates in the above-mentioned decree and not in line with EU obligations but allowing to legally practise the profession of doctor in the state that issued them, if the doctor justifies having performed in France in the previous five years three consecutive full-time years of hospital functions in the corresponding specialty training as associate attaché, associate practitioner, associate assistant or academic functions as associate clinic head of universities or associate assistant of universities, provided that he has been appointed hospital functions at the same time;
  • Italy's specialist medical training certificates on the aforementioned list sanctioning specialist medical training begun in that state after 31 December 1983 and before 1 January 1991, if accompanied by a certificate issued by the state authorities indicating that its holder has exercised in that state, effectively and lawfully, the profession of physician in the specialty concerned for at least seven consecutive years in the ten years preceding issuing the certificate.

To go further Article L. 4131-1 of the Public Health Code; 13 July 2009 decree setting out the lists and conditions for the recognition of the training documents of doctors and specialist doctors issued by the Member States of the European Union or parties to the agreement on the European Economic Area referred to in the 2nd Section L. 4131-1 of the Public Health Code.

Training

Medical studies consist of three cycles with a total duration of between nine and eleven years, depending on the course chosen.

The training, which takes place at the university, includes many internships and is punctuated by two competitions:

  • the first occurs at the end of the first year. This year of study, called the "first year of common health studies" (PACES) is common to students in medicine, pharmacy, odontology, physiotherapy and midwives. At the end of this first competition, students are ranked according to their results. Those in a useful rank under the numerus clausus are allowed to continue their studies and to choose, if necessary, to continue training leading to the practice of medicine;
  • the second occurs at the end of the second cycle (i.e. at the end of the sixth year of study): this competition is called national classification tests (ECNs) or formerly "boarding schools". At the end of this competition, students choose, based on their ranking, their specialty and/or their city of assignment. The duration of the studies that follow varies depending on the specialty chosen.

To obtain a state degree (DE) as a doctor of medicine, the student must validate all his internships, his diploma of specialized studies (DES) and support his thesis successfully.

To go further Article L. 632-1 of the Education Code.

Good to know

Medical students must carry out compulsory vaccinations. For more information, please refer to Section R. 3112-1 of the Public Health Code.

General education diploma in medical sciences

The first cycle is sanctioned by the general training diploma in medical sciences. It consists of six semesters and corresponds to the license level. The first two semesters correspond to THE PACES.

The aim of the training is to:

  • the acquisition of the basic scientific knowledge, essential for the subsequent mastery of the knowledge and know-how necessary for the practice of medical professions. This scientific base is broad and encompasses biology, certain aspects of the exact sciences and several disciplines of the humanities and social sciences;
  • the fundamental approach of the healthy man and the sick man, including all aspects of semiology. It includes theoretical, methodological, applied and practical teachings as well as the completion of internships including a four-week introductory care course in a hospital.

To go further : order of March 22, 2011 relating to the education scheme for the general training diploma in medical sciences.

In-depth training degree in medical sciences

This three-year course is available to the holder of the general medical science diploma and aims to enable the candidate to acquire the necessary knowledge to practice in a hospital or outpatient setting.

During this training the candidate must:

  • follow theoretical teachings about what is common or serious or a public health problem and what is clinically exemplary;
  • complete one or more practical internships in a care unit lasting a total of thirty-six months. During this internship, the candidate is subject to a continuous check of his knowledge and at the end, obtains a certificate of clinical competence.

The in-depth medical science degree is awarded to the candidate who has validated all the teaching units and who has obtained the certificate of clinical competence.

To go further : order of April 8, 2013 relating to the curriculum for the first and second cycle of studies.

Specialized Studies Diploma (DES) in Geriatrics

To practice as a geriatric physician, the health professional must obtain the GERiatric DES.

Note that

Students can only attend NCT twice.

This diploma allows the future specialist to acquire the knowledge and practice necessary to carry out his duties.

This course consists of eight semesters, of which at least:

  • three in an internship with university supervision;
  • two in an internship place without university supervision.

Note that

During his training, the future geriatrician can enrol in one of the following specialized cross-sectional training (TSF):

  • pain
  • Applied nutrition
  • Medical/therapeutic pharmacology;
  • Palliative care
  • Sleep.

The DES is divided into three phases: the base phase, the deepening phase and the consolidation phase.

The base phase

Lasting two semesters, it allows the candidate to acquire the basic knowledge of the chosen specialty and to perform:

  • an internship in a senior geriatric location with a geriatric short-stay activity;
  • an internship in a licensed hospital in emergency medicine, internal medicine and clinical immunology, cardiovascular medicine, pneumology, neurology or rheumatology and as a complementary in geriatrics.

The deepening phase

Lasting four semesters, it allows the candidate to acquire the knowledge and skills necessary to practice the chosen specialty and to perform:

  • an internship in a senior geriatric location with a short-stay geriatric activity;
  • an internship in a senior geriatrics-certified location with an SSR activity;
  • two free internships in places approved as a complementary in geriatrics and principally in one of the specialties of the medical discipline and preferably in internal medicine and clinical immunology, cardiovascular medicine, pneumology, neurology, intensive medicine and resuscitation or rheumatology, oncology after agreement of the local coordinator.

The consolidation phase

Lasting one year, it allows the candidate to consolidate his knowledge and to complete an internship of one year or two internships of one semester either:

  • in a hospital location or with a senior specialist instructor at universities in geriatrics;
  • in the form of a joint internship in places and/or with a senior instructor at accredited universities in geriatrics.

To go further : 27 November 2017 amending the decree of 12 April 2017 relating to the organisation of the third cycle of medical studies and the decree of 21 April 2017 relating to the knowledge, skills and training models of specialised studies diplomas and setting out the list of these diplomas and specialized cross-sectional options and training from the postgraduate medical studies.

Costs associated with qualification

The training leading to obtaining the DOCTOR of medicine IS paid for. Its cost varies depending on the universities that provide the teachings. For more details, it is advisable to get closer to the university in question.

b. EU nationals: for temporary and casual exercise (LPS)

A doctor who is a member of an EU or EEA state who is established and legally practises in one of these states may perform acts of his profession in France on a temporary and occasional basis, provided that he has previously prior declaration to the National Council of the College of Physicians (see infra "5o. b. Make a pre-declaration for EU or EEA nationals engaged in temporary and occasional activity").

What to know

Registration on the College of Physicians' roster is not required for physicians in a free-supply of services (LPS) situation. As a result, they are not required to pay ordinal dues. The doctor is simply registered on a specific list maintained by the National Council of the College of Physicians.

The prior declaration must be accompanied by a statement regarding the language skills necessary to carry out the service. In this case, the control of language proficiency must be proportionate to the activity to be carried out and carried out once the professional qualification has been recognised.

When training titles do not receive automatic recognition (see supra "2.0). a. National legislation"), the provider's professional qualifications are checked before the first service is provided. In the event of substantial differences between the qualifications of the person concerned and the training required in France that could harm public health, the claimant is subjected to a test.

The doctor in LPS situation is obliged to respect the professional rules applicable in France, including all ethical rules (see infra "3." Conditions of honorability, ethical rules, ethics"). It is subject to the disciplinary jurisdiction of the College of Physicians.

Note that

The service is performed under the French professional title of doctor. However, where training qualifications are not recognised and qualifications have not been verified, the performance is carried out under the professional title of the State of Establishment, in order to avoid confusion With the French professional title.

To go further Article L. 4112-7 of the Public Health Code.

c. EU nationals: for a permanent exercise (Free Establishment)

The automatic recognition of diplomas obtained in an EU state

Article L. 4131-1 of the Public Health Code creates a regime for automatic recognition in France of certain diplomas or titles, if any, accompanied by certificates, obtained in an EU or EEA state (see above "2." a. National Legislation").

It is up to the departmental council of the college of doctors responsible to verify the regularity of diplomas, titles, certificates and certificates, to grant automatic recognition and then to decide on the application for registration on the Order's list. .

To go further Article L. 4131-1 of the Public Health Code; 13 July 2009 decree setting out the lists and conditions for the recognition of the training documents of doctors and specialist doctors issued by the Member States of the European Union or parties to the agreement on the European Economic Area referred to in the 2nd Section L. 4131-1 of the Public Health Code.

The derogatory regime: prior authorisation

If the EU or EEA national does not qualify for the automatic recognition of his or her credentials, he or she falls under an authorisation scheme (see below "5o). c. If necessary, request for individual authorization to exercise").

Individuals who do not receive automatic recognition but who hold a training designation to legally practise as a doctor may be individually allowed to practice in the specialty concerned by Minister for Health, after advice from a commission made up of professionals.

If the examination of the professional qualifications attested by the training credentials and the professional experience shows substantial differences with the qualifications required for access to the profession in the specialty concerned and its exercise in France, the person concerned must submit to a compensation measure.

Depending on the level of qualification required in France and that held by the person concerned, the competent authority can either:

  • Offer the applicant a choice between an adjustment course or an aptitude test;
  • impose an adjustment course or aptitude test
  • impose an adjustment course and an ordeal.

To go further Article L. 4131-1-1 of the Public Health Code.

Three degrees. Conditions of honorability, ethical rules, ethics

a. Compliance with the Physicians' Code of Ethics

The provisions of the Code of Medical Ethics are required of all doctors practising in France, whether they are on the Order's board or exempt from this obligation (see above: "5. a. Application for inclusion in the College of Physicians list").

What to know

All provisions of the Code of Ethics are codified in sections R. 4127-1 to R. 4127-112 of the Public Health Code.

As such, the physician must respect the principles of morality, probity and dedication essential to the practice of medicine. He is also subject to medical secrecy and must exercise independently.

To go further Articles R. 4127-1 to R. 4127-112 of the Public Health Code.

b. Cumulative activities

The physician may only engage in any other activity if such a combination is compatible with the principles of professional independence and dignity imposed on him. The accumulation of activities should not allow him to take advantage of his prescriptions or his medical advice.

Thus, the doctor cannot combine the medical exercise with another activity close to the health field. In particular, he is prohibited from practising as an optician, paramedic or manager of an ambulance company, manufacturer or seller of medical devices, owner or manager of a hotel for curators, a gym, a spa, a massage practice.

Similarly, a physician who fulfils an elective or administrative mandate is prohibited from using it to increase his or her clientele.

To go further Articles R. 4127-26 and R. 4127-27 of the Public Health Code.

c. Conditions of honorability

In order to practice, the physician must certify that no proceedings that could give rise to a conviction or a sanction that could affect his inclusion on the board are against him.

To go further Article R. 4112-1 of the Public Health Code.

d. Obligation for continuous professional development

Physicians must participate in a multi-year continuous professional development program. The program focuses on assessing professional practices, improving skills, improving the quality and safety of care, maintaining and updating knowledge and skills.

All the actions carried out by doctors under their obligation to develop professionally are traced in a specific document attesting to compliance with this obligation.

To go further Articles L. 4021-1 and subsequent articles R. 4021-4 and the following of the Public Health Code.

e. Physical aptitude

Physicians must not present with infirmity or pathology incompatible with the practice of the profession (see infra "5.0). a. Application for inclusion in the College of Physicians list").

To go further Article R. 4112-2 of the Public Health Code.

It's a four-degree one. Insurance

a. Obligation to take out professional liability insurance

As a health professional, a physician practising in a liberal capacity must take out professional liability insurance.

On the other hand, if he practises as an employee, this insurance is only optional. In this case, it is up to the employer to take out such insurance for its employees for the acts carried out during their professional activity.

To go further Article L. 1142-2 of the Public Health Code.

b. Obligation to join the Autonomous Pension Fund of Doctors of France (CARMF)

Any doctor registered on the Order's board and practising in the liberal form (even part-time and even if he is also employed) has an obligation to join the CARMF.

Time

The person concerned must register with the CARMF within one month of the start of his Liberal activity.

Terms

The person concerned must return the declaration form, completed, dated and countersigned by the departmental council of the College of Physicians. This form can be downloaded from the CARMF website.

What to know

In the event of a practice in a liberal practice company (SEL), membership in the CARMF is also mandatory for all professional partners practising there.

c. Health Insurance Reporting Obligation

Once on the Order's roster, the doctor practising in liberal form must declare his activity with the Primary Health Insurance Fund (CPAM).

Terms

Registration with the CPAM can be made online on the official website of Medicare.

Supporting documents

The registrant must provide a complete file including:

  • Copying a valid piece of identification
  • a professional bank identity statement (RIB)
  • if necessary, the title (s) to allow access to Sector 2.

For more information, please refer to the section on the installation of doctors on the Health Insurance website.

Five degrees. Qualification recognition procedures and formalities

a. Application for inclusion on the College of Physicians' Table

Registration on the Order's board is mandatory to legally carry out the activity of a doctor in France.

The inscription on the Order's board does not apply:

  • EU or EEA nationals who are established and who are legally practising as a doctor in a Member State or party, when they perform acts of their profession on a temporary and occasional basis in France (see supra "2o. b. EU and EEA nationals: for temporary and occasional exercise);
  • doctors belonging to the active executives of the Armed Forces Health Service;
  • physicians who, having the status of a public servant or a holding agent of a local authority, are not called upon, in the course of their duties, to practice medicine.

To go further Articles L. 4112-5 to L. 4112-7 of the Public Health Code.

Note that

Registration on the Order's board allows for the automatic and free issuance of the Health Professional Card (CPS). The CPS is an electronic business identity card. It is protected by a confidential code and contains, among other things, the doctor's identification data (identity, occupation, specialty). For more information, it is recommended to refer to the government's website French Digital Health Agency .

Competent authority

The application for registration is addressed to the Chairman of the Board of the College of Physicians of the Department in which the person concerned wishes to establish his professional residence.

The application can be submitted directly to the departmental council of the Order concerned or sent to it by registered mail with request for notice of receipt.

To go further Article R. 4112-1 of the Public Health Code.

What to know

In the event of a transfer of his professional residence outside the department, the practitioner is required to request his removal from the order of the department where he was practising and his registration on the order of his new professional residence.

To go further Article R. 4112-3 of the Public Health Code.

Procedure

Upon receipt of the application, the county council appoints a rapporteur who conducts the application and makes a written report.

The board verifies the candidate's titles and requests disclosure of bulletin 2 of the applicant's criminal record. In particular, it verifies that the candidate:

  • fulfils the necessary conditions of morality and independence (see supra "3.3. c. Conditions of honorability");
  • meets the necessary competency requirements;
  • does not present a disability or pathological condition incompatible with the practice of the profession (see supra "3." e. Physical aptitude").

In case of serious doubt about the applicant's professional competence or the existence of a disability or pathological condition incompatible with the practice of the profession, the county council refers the matter to the regional or inter-regional council expertise. If, in the opinion of the expert report, there is a professional inadequacy that makes the practice of the profession dangerous, the departmental council refuses registration and specifies the training obligations of the practitioner.

No decision to refuse registration can be made without the person being invited at least a fortnight in advance by a recommended letter requesting notice of receipt to appear before the Board to explain.

The decision of the College Council is notified within a week to the individual, the National Council of the College of Physicians and the Director General of the Regional Health Agency (ARS). The notification is by recommended letter with request for notice of receipt.

The notification mentions remedies against the decision. The decision to refuse must be justified.

To go further Articles R. 4112-2 and R. 4112-4 of the Public Health Code.

Time

The Chair acknowledges receipt of the full file within one month of its registration.

The College's departmental council must decide on the application for registration within three months of receipt of the full application file. If a response is not answered within this time frame, the application for registration is deemed rejected.

This period is increased to six months for nationals of third countries when an investigation is to be carried out outside metropolitan France. The person concerned is then notified.

It may also be extended for a period of no more than two months by the departmental council when an expert opinion has been ordered.

To go further Articles L. 4112-3 and R. 4112-1 of the Public Health Code.

Supporting documents

The applicant must submit a complete application file including:

  • two copies of the standardized questionnaire completed, dated and signed, accompanied by a photo ID? This questionnaire is available in the College's departmental councils or can be downloaded directly from the official website National Council of the College of Physicians;
  • A photocopy of a valid ID or, if necessary, a certificate of nationality issued by a competent authority;
  • If applicable, a photocopy of a valid EU citizen's family residence card, the valid long-term resident-EC card or the resident card with valid refugee status;
  • If so, a photocopy of the valid European credit card;
  • a copy, accompanied if necessary by a translation by a certified translator, of the training courses to which are attached:- where the applicant is an EU or EEA national, the certificate or certificates provided (see above "2. a. National requirements"),
    • applicant is granted an individual exercise permit (see supra "2. v. EU and EEA nationals: for a permanent exercise"), a copy of this authorisation,
    • When the applicant presents a diploma issued in a foreign state whose validity is recognized on French territory, the copy of the titles to which that recognition may be subordinated;
  • for nationals of a foreign state, a criminal record extract or an equivalent document less than three months old issued by a competent authority of the State of origin. This part can be replaced, for NATIONALs of EU or EEA states who require proof of morality or honourability for access to the medical activity, by a certificate dating back less than three months from the competent authority of the State certifying that these moral or honourability conditions are met;
  • a statement on the applicant's honour certifying that no proceedings that could give rise to a conviction or sanction that could affect the listing on the board are against him;
  • a certificate of delisting, registration or registration issued by the authority with which the applicant was previously registered or registered or, failing that, a declaration of honour from the applicant certifying that he or she was never registered or registered or, failing that, a certificate of registration or registration in an EU or EEA state;
  • all the evidence that the applicant has the language skills necessary to practice the profession;
  • A resume
  • contracts and endorsements for the practice of the profession as well as those relating to the use of the equipment and the premises in which the applicant practises;
  • If the activity is carried out in the form of SEL or a professional civil society (SCP), the statutes of that company and their possible endorsements;
  • If the applicant is a public servant or public official, the order of appointment;
  • if the applicant is a professor of universities - hospital practitioner (PU-PH), university lecturer - hospital practitioner (MCU-PH) or hospital practitioner (PH), the order of appointment as a hospital practitioner and, if necessary, the decree or order of appointment as a university professor or lecturer at universities.

For more information, please visit the official website of the National Council of the College of Physicians.

To go further Articles L. 4113-9 and R. 4112-1 of the Public Health Code.

Remedies

The applicant or the National Council of the College of Physicians may challenge the decision to register or refuse registration within 30 days of notification of the decision or the implied decision to reject it. The appeal is brought before the territorially competent regional council.

The regional council must decide within two months of receiving the application. In the absence of a decision within this period, the appeal is deemed dismissed.

The decision of the regional council is also subject to appeal, within 30 days, to the National Council of the College of Physicians. The decision itself can be appealed to the Council of State.

To go further Articles L. 4112-4 and R. 4112-5 of the Public Health Code.

Cost

Registration on the College's board is free, but it creates an obligation to pay the mandatory ordinal dues, the amount of which is set annually and which must be paid in the first quarter of the current calendar year. Payment can be made online on the official website of the National Council of the College of Physicians. As an indication, in 2017, the amount of this contribution was 333 euros.

To go further Article L. 4122-2 of the Public Health Code.

b. Make a pre-declaration of activity for EU or EEA nationals engaged in temporary and occasional activity (LPS)

Any EU or EEA national who is established and legally practises as a doctor in one of these states may exercise in France on a temporary and occasional basis if he makes the prior declaration (see supra "2o. b. EU and EEA nationals: for temporary and occasional exercise").

The advance declaration must be renewed every year.

Note that

Any change in the applicant's situation must be notified under the same conditions.

To go further Articles L. 4112-7 and R. 4112-9-2 of the Public Health Code.

Competent authority

The declaration must be addressed before the first service is provided to the National Council of the College of Physicians.

To go further Article R. 4112-9 of the Public Health Code.

Terms of reporting and receipt

The declaration can be sent by mail or directly made online on the official website of the College of Physicians.

When the National Council of the College of Physicians receives the declaration and all the necessary supporting documents, it sends the claimant a receipt specifying its registration number and discipline.

Note that

The service provider informs the relevant national health insurance agency of its provision of services by sending a copy of the receipt or by any other means.

To go further Articles R. 4112-9-2 and R. 4112-11 of the Public Health Code.

Supporting documents

The statement should include:

  • The declaration form Completed and signed;
  • Copying a valid piece of identification or any document attesting to the applicant's nationality;
  • Copying the training title and the specialist training designation allowing the applicant to carry out his activity;
  • a certificate of less than three months justifying that the professional is legally established and is not subject to any prohibition on practising, even on a temporary basis, his profession;
  • where the professional has acquired his training in a third state and recognised in an EU or EEA state:- Recognition of these basic and specialist training credentials,
    • any documentation justifying that he has been practising for three years full-time or part-time;
  • if so, a copy of the aforementioned statement.

To go further Articles R. 4112-9 and the following of the Public Health Code; December 4, 2017 on the prior declaration of service delivery for the medical professions and pharmacists.

Time

Within one month of receiving the declaration, the National Council of the Order informs the applicant:

  • Whether or not he can start delivering services;
  • when the verification of professional qualifications shows a substantial difference with the training required in France, he must prove to have acquired the missing knowledge and skills by submitting to an ordeal aptitude. If he meets this check, he is informed within one month that he can begin the provision of services;
  • when the file review highlights a difficulty requiring further information, the reasons for the delay in reviewing the file. He then has one month to obtain the requested additional information. In this case, before the end of the second month from the receipt of this information, the National Council informs the claimant, after reviewing his file:- whether or not it can begin service delivery,
    • when the verification of the claimant's professional qualifications shows a substantial difference with the training required in France, he must demonstrate that he has acquired the missing knowledge and skills, including subjecting to an aptitude test.

In the latter case, if he meets this control, he is informed within one month that he can begin the provision of services. Otherwise, he is informed that he cannot begin the delivery of services.

In the absence of a response from the National Council of the Order within these timeframes, service delivery may begin.

To go further Article R. 4112-9-1 of the Public Health Code.

c. If necessary, request for individual authorisation to exercise

For EU or EEA nationals

EU or EEA nationals with a training licence may apply for individual authorisation:

  • issued by one of these states that does not benefit from automatic recognition (see supra "2.0). c. EU and EEA nationals: for a permanent exercise);
  • issued by a third state but recognised by an EU or EEA Member State, provided they justify practising as a doctor in the specialty for a period equivalent to three years full-time in that Member State.

An Authorization Board (CAE) reviews the applicant's training and work experience.

It may propose a compensation measure:

  • where the training is at least one year less than that of the French ED, when it covers substantially different subjects, or when one or more components of the professional activity whose exercise is subject to the aforementioned diploma do not exist in the corresponding profession in the Member State of origin or have not been taught in that state;
  • training and experience of the applicant are not likely to cover these differences.

Depending on the level of qualification required in France and that held by the person concerned, the competent authority can either:

  • Offer the applicant a choice between an adjustment course or an aptitude test;
  • require an adjustment course or an aptitude test.

Theaptitude test is intended to verify, through written or oral tests or practical exercises, the applicant's fitness to practise as a physician in the relevant specialty. It deals with subjects that are not covered by the applicant's training or experience.

Theadaptation course is intended to enable interested parties to acquire the skills necessary to practice the profession of physician. It is carried out under the responsibility of a doctor and can be accompanied by optional additional theoretical training. The duration of the internship does not exceed three years. It can be done part-time.

To go further Articles L. 4111-2 II, L. 4131-1-1, R. 4111-17 to R. 4111-20 and R. 4131-29 of the Public Health Code.

For nationals of a third state

Individual authorization to practice may apply, provided they warrant a sufficient level of proficiency in the French language, people with a training degree:

  • issued by an EU or EEA state whose experience is attested by any means;
  • issued by a third state allowing the practice of the profession of doctor in the country of graduation:- whether they meet anonymous tests to verify basic and practical knowledge. For more information on these events, please visit the official website of the National Management Centre (NMC),
    • if they warrant three years of duties in an accredited department or organization for the training of interns.

Note that

Physicians with a specialized degree obtained as part of the foreign internship are deemed to have met the knowledge-verification tests.

To go further Articles L. 4111-2 (I and I bis), D. 4111-1, D. 4111-6 and R. 4111-16-2 of the Public Health Code.

Competent authority

The request is addressed in two copies per recommended letter with a request for notice of receipt to the NMC's Exercise Authorization Commission (CAE) unit.

The authorization to exercise is issued by the Minister responsible for health after notification from the EAC.

To go further Articles R. 4111-14 and R. 4131-29 of the Public Health Code; decree of 25 February 2010 setting out the composition of the file to be provided to the competent CAEs for the examination of applications submitted for the exercise in France of the professions of doctor, dental surgeon, midwife and pharmacist.

Time

The NMC acknowledges receipt of the request within one month of receipt.

The silence kept for a certain period of time from the receipt of the full file is worth the decision to dismiss the application. This deadline is:

  • four months for applications from EU or EEA nationals with a degree from one of these states;
  • six months for applications from third-party nationals with a diploma from an EU or EEA state;
  • one year for other applications. This period may be extended by two months, by decision of the ministerial authority notified no later than one month before the expiry of the latter, in the event of a serious difficulty in assessing the candidate's professional experience.

To go further Articles R. 4111-2, R. 4111-14 and R. 4131-29 of the Public Health Code.

Supporting documents

The application file must contain:

  • an application form for authorisation to practice the profession, modelled on Schedule 1 of the Order of February 25, 2010, completed, dated and signed, showing, if any, the specialty in which the applicant files;
  • A photocopy of a valid ID
  • A copy of the training title allowing the practice of the profession in the state of obtaining as well as, if necessary, a copy of the specialist training title;
  • If necessary, a copy of the additional diplomas;
  • any useful evidence justifying continuous training, experience and skills acquired during the professional exercise in an EU or EEA state, or in a third state (certificates of functions, activity report, operational assessment, etc. ) ;
  • in the context of functions performed in a state other than France, a declaration by the competent authority of that State, less than one year old, attesting to the absence of sanctions against the applicant.

Depending on the applicant's situation, additional supporting documentation is required. For more information, please visit the NMC's official website.

What to know

Supporting documents must be written in French or translated by a certified translator.

To go further : decree of 25 February 2010 setting out the composition of the file to be provided to the competent authorisation commissions for the examination of applications submitted for the practice in France of the professions of doctor, dental surgeon, midwife and pharmacist; 17 November 2014 no. DGOS/RH1/RH2/RH4/2014/318.

c. Remedies

French assistance centre

The ENIC-NARIC Centre is the French centre for information on academic and professional recognition of diplomas.

Solvit

SOLVIT is a service provided by the National Administration of each EU member state or party to the EEA agreement. Its aim is to find a solution to a dispute between an EU national and the administration of another of these states. SOLVIT intervenes in particular in the recognition of professional qualifications.

Conditions

The person concerned can only use SOLVIT if he establishes:

  • that the public administration of one EU state has not respected its rights under EU law as a citizen or business of another EU state;
  • that it has not already initiated legal action (administrative action is not considered as such).

Procedure

The national must complete an online complaint form. Once his file has been submitted, SOLVIT contacts him within a week to request, if necessary, additional information and to verify that the problem is within his competence.

Supporting documents

To enter SOLVIT, the national must communicate:

  • Full contact details
  • Detailed description of his problem
  • all the evidence in the file (for example, correspondence and decisions received from the relevant administrative authority).

Time

SOLVIT is committed to finding a solution within ten weeks of the day the case was taken over by the SOLVIT centre in the country in which the problem occurred.

Cost

Free.

Outcome of the procedure

At the end of the 10-week period, SOLVIT presents a solution:

  • If this solution resolves the dispute over the application of European law, the solution is accepted and the case is closed;
  • if there is no solution, the case is closed as unresolved and referred to the European Commission.

More information

SOLVIT in France: General Secretariat for European Affairs, 68 rue de Bellechasse, 75700, Paris ( official website ).