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Orthoptist

1. Defining the activity

The orthoptist is a health professional specializing in visual rehabilitation.

As such, he is dedicated to detecting visual impairments and to ensure the rehabilitation and rehabilitation of the eyesight of his patients, at all ages, on medical prescription.

Working closely with ophthalmologists, the orthoptist puts in place organizational protocols to ensure patient care. This may include the preparation of the medical examination by the ophthalmologist or the follow-up by the orthoptist of a patient whose visual pathology is diagnosed.

In the absence of a doctor, he may also be able to perform the first necessary acts of care in orthoptia.

To go further Article L. 4342-1 of the Public Health Code; Decree No. 2016-1670 of December 5, 2016 on the definition of orthoptics and the practice of the profession of orthoptist.

Two degrees. Professional qualifications

a. National requirements

National legislation

The practice of orthoptist is reserved for holders of the certificate of orthoptist ability.

To go further Article L. 4342-3 of the Public Health Code.

Training

Training leading to the Orthopty Capacity Certificate is available to licensees:

  • Baccalaureate;
  • A degree in access to university education
  • qualifications or experience deemed sufficient.

Access to the training is after passing an admission competition (with numerus clausus) in one of the fourteen schools which provide orthoptia training in France, which lasts three years.

What to know

The student will have to take several internships during his training which he will record in a notebook.

At the end of each year, the student must pass written and oral exams, obtaining the overall average of points on all tests. In the final year, they will have to pass written and oral tests, a demonstration of an orthoptic examination or treatment device, and make a final dissertation.

To go further : Order of October 20, 2014 relating to studies for the orthoptist certificate of ability.

Costs associated with qualification

Training pays off. For more information, it is advisable to get closer to the dispensing establishments.

b. EU or EEA nationals: for temporary and occasional exercise (Free Service Delivery)

A national of an EU or EEA state legally practising orthoptist activity in one of these states may use his or her professional title in France on a temporary and casual basis.

He will have to apply for it, before his first performance, by declaration addressed to the prefect of the region in which he wishes to make the delivery (see infra "5o. a. Make a prior declaration of activity for the EU or EEA national engaged in temporary and occasional activity (LPS)").

Where neither the activity nor the training leading to this activity is regulated in the state in which it is legally established, the professional will have to justify having carried it out in one or more Member States for at least one year during the ten years preceding the performance.

To go further Article L. 4342-5 of the Public Health Code.

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

Any national of an EU or EEA state who is established and legally practises orthoptist activity in that state may carry out the same activity in France on a permanent basis if he:

  • holds a training certificate issued by a competent authority in another Member State, which regulates access to or exercise of the profession;
  • has worked full-time or part-time for one year in the last ten years in another Member State that does not regulate training or the practice of the profession;
  • holds a diploma, title or certificate acquired in a third state but recognised and admitted in equivalence by an EU or EEA state on the additional condition that the person has been an orthoptist for three years in the State which has admitted equivalence.

Once the national fulfils one of these conditions, he or she will be able to apply for an individual authorisation to practise from the prefect of the region in which he wishes to practice his profession (see infra "5o). b. Obtain individual authorisation for the EU or EEA national for permanent activity (LE) ").

To go further Article L. 4342-4 of the Public Health Code.

Three degrees. Conditions of honorability, ethical rules, ethics

Although not codified, rules of ethics are the responsibility of those who wish to practise as orthoptist, including:

  • To offer the best possible care to its patients;
  • maintain and develop their scientific knowledge of the field;
  • to behave with loyalty and respect towards the people they contact in their professional practice.

In addition, the orthoptist is obliged to respect the professional confidentiality associated with the practice of his activity. Failure to comply with this obligation is punishable by one year's imprisonment and a fine of 15,000 euros.

To go further Article L. 4344-2 of the Public Health Code.

It's a four-degree one. Social legislation and insurance

a. Obligation to take out professional liability insurance

As a health professional, a liberal orthoptist 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.

b. Obligation to join the self-sustaining pension and pension fund of medical assistants (CARPIMKO)

Any orthoptist practising in the liberal form, even as a substitute, must join CARPIMKO within a month of starting his activity.

The person concerned will have to pass on the Form completed, dated and signed, and attach to his application a photocopy of his training title as well as his registration number Adeli (see infra "5." v. Registration with the Adeli directory").

c. Health Insurance Reporting Obligation

The orthoptist practising in the liberal form must declare his activity with the Primary Health Insurance Fund (CPAM).

Registration can be made online on the official website Medicare.

The applicant will have to attach to his application:

  • A copy of a valid ID
  • A professional bank identity statement
  • if necessary, the supporting documentation or titles allowing access to Sector 2.

Five degrees. Qualification recognition procedures and formalities

a. Make a prior declaration of activity for the EU or EEA national engaged in temporary and occasional activity (LPS)

Competent authority

The regional prefect is responsible for deciding on the request for a prior declaration of activity.

Supporting documents

The application is made by filing a file that includes the following documents:

  • A copy of a valid ID
  • A copy of the training title allowing the profession to be practised in the state of obtainment;
  • a certificate less than three months old from the competent authority of the EU State or the EEA certifying that the person is legally established in that state and that, when the certificate is issued, there is no prohibition, even temporary, Exercise
  • any evidence justifying that the national has practised the profession in an EU or EEA state for one year in the last ten years, where that state does not regulate training or access to the requested profession or its exercise;
  • where the training certificate has been issued by a third state and recognised in an EU or EEA state other than France:- recognition of the training title established by the state authorities that have recognised this title,
    • any evidence justifying that the national has practiced the profession in that state for three years;
  • If so, a copy of the previous statement as well as the first statement made;
  • a certificate of professional civil liability.

What to know

If necessary, the pieces must be translated into French by a certified translator.

Time

Upon receipt of the file, the regional prefect will have one month to decide on the application and will inform the national:

  • that he can start the performance. From then on, the prefect will register the applicant in the Adeli directory;
  • that he will be subject to a compensation measure if there are substantial differences between the training or professional experience of the national and those required in France;
  • he will not be able to start the performance;
  • any difficulty that could delay its decision. In the latter case, the prefect will be able to make his decision within two months of the resolution of this difficulty, and no later than three months of notification to the national.

The prefect's silence within these deadlines will be worth accepting the request for declaration.

Note that

The return is renewable every year or at each change in the applicant's situation.

To go further Articles R. 4342-13, and R. 4331-12 to R. 4331-15 of the Public Health Code; December 8, 2017 order on the prior declaration of service provision for genetic counsellors, medical physicists and pharmacy and hospital pharmacy preparers, as well as for occupations in Book III of Part IV of the Public Health Code.

b. Obtain individual authorisation for the EU or EEA national for permanent activity (LE)

Competent authority

The authorisation to exercise is issued by the prefect of the region, after advice from the committee of orthoptists.

Supporting documents

The application for authorization is made by filing a file containing all of the following documents:

  • The Form Application for an exercise permit;
  • A copy of a valid ID
  • A copy of the training title
  • If necessary, a copy of the additional diplomas;
  • any evidence justifying ongoing training, experience and skills acquired in the EU or EEA State;
  • a statement from the competent authority of the EU State or the EEA justifying the absence of sanctions against the national;
  • A copy of the authorities' certificates specifying the level of training, the detail and the hourly volume of the courses followed, as well as the content and duration of the validated internships;
  • any document justifying that the national has been an orthoptist for one year in the last ten years in an EU or EEA state where neither access nor exercise is regulated in that state.

What to know

If necessary, the pieces must be translated into French by a certified translator.

Procedure

The prefect acknowledges receipt of the file within one month and will decide after having the opinion of the committee of orthoptists. The latter is responsible for examining the knowledge and skills of the national acquired during his training or during his professional experience. It may subject the national to a compensation measure.

The silence kept by the prefect of the region within four months is a decision to reject the application for authorisation.

To go further Articles R. 4342-10 to R. 4342-12 of the Public Health Code; decree of 25 February 2010 setting out the composition of the file to be provided to the relevant authorisation commissions for the examination of applications submitted for the practice in France of the professions of psychomotrician, speech therapist, orthoptist, audioprosthetist and optician-lunetier.

Good to know: compensation measures

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 of orthoptist and its exercise In France, the person concerned will have to submit to a compensation measure which may be an adjustment course or an aptitude test.

The aptitude test takes the form of a written or oral exam scored out of 20. Its validation is pronounced when the national has obtained an average score of ten out of twenty or more, without a score of less than eight out of twenty. If successful in the test, the national will be allowed to use the title of orthoptist.

The internship is done in a public or private health facility, or at a professional level, and must not last more than three years. It also includes theoretical training that will be validated by the internship manager.

To go further : decree of 30 March 2010 setting out the organisation of the aptitude test and the adaptation course for the practice in France of the professions of psychomotrician, speech therapist, orthoptist, audioprosthetist, optician-lunetier by European Union Member States or parties to the European Economic Area Agreement.

c. Registration with the Adeli directory

A national wishing to practise as an orthoptist in France is required to register his authorisation to practice on the Adeli directory ("Automation of Lists").

Competent authority

Registration in the Adeli directory is done with the regional health agency (ARS) of the place of practice.

Time

The application for registration is submitted within one month of taking office of the national, regardless of the mode of practice (liberal, salaried, mixed).

Supporting documents

In support of his application for registration, the orthoptist must provide a file containing:

  • the original diploma or title attesting to the training of orthoptist issued by the EU state or the EEA (translated into French by a certified translator, if applicable);
  • ID
  • Deer 10906-06 form completed, dated and signed.

Outcome of the procedure

The national's Adeli number will be directly mentioned on the receipt of the file, issued by the ARS.

Cost

Free.

To go further Article L. 4342-2 of the Public Health Code.

d. 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 a 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 ).