As of January 1, 2025, 19,154 practitioners with diplomas from outside the European Union (Padhue) were registered with the French Medical Council. This figure represents a growth of 141% compared to the 7,963 recorded in 2010, according to a report from the National Assembly dated March 2026. This progression reflects a structural dependence of the French healthcare system on professionals trained abroad, in a context of ongoing tensions regarding medical demographics.
Procedure for the regularization of Padhue: what the reform announced in 2026 changes
At the end of April 2026, the Ministry of Health announced its intention to simplify the regularization process for foreign-trained doctors. The stated principle: to move from a competitive exam to an assessment linked to the employing institution. Consultations were launched as early as April 2026, with the aim of integrating this reform into any available legislative framework.
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Until now, Padhue had to undergo knowledge verification tests (EVC), a system often described as a bottleneck. The number of available spots remained limited, and waiting times could stretch over several years, during which these practitioners worked under temporary statuses.
To understand the growing number of foreign doctors in France, one must look beyond mere migratory flows and examine the administrative mechanisms that frame, hinder, or accelerate their integration into the hospital fabric.
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The announced reform does not have unanimous support. Some hospital unions see it as a risk of lowering standards, while associations of Padhue denounce a system that has kept them in precariousness for too long. Field feedback diverges on this point: the elimination of the competitive exam could streamline pathways or, conversely, create new forms of inequality depending on the institutions.
Precarious status of foreign doctors in public hospitals
The term Padhue encompasses very diverse realities. Some have been practicing in France for over ten years, while others arrive with limited experience. Their common point: temporary practice authorizations that place them in a state of permanent professional insecurity.
In concrete terms, a Padhue awaiting regularization receives a salary lower than that of a permanent hospital practitioner, for often identical on-call duties and responsibilities. This disparity fuels a well-documented sense of downgrading highlighted by recent parliamentary work.
Conditions that maintain precariousness
- Fixed-term contracts renewed year after year, with no visibility on regularization
- A salary lower than that of permanent practitioners in equivalent positions
- Limited access to continuing education and supervisory responsibilities within departments
- Administrative barriers related to residency permits, which sometimes condition job retention
This precariousness has cascading effects. Public hospitals, especially in underserved areas, depend on these practitioners to ensure continuity of care. Conversely, the proposed conditions discourage some candidates who prefer to practice in other European countries offering clearer integration pathways.
France and international medical recruitment: a lag compared to European neighbors
In Norway, Ireland, and Sweden, foreign-trained doctors represent a substantial share of the workforce, with proportions approaching 30 to 40%. In France, this share is only about 12%, placing the country in a unique position among comparable healthcare systems.
This gap is not due to a lack of candidates. The obstacles are primarily regulatory: the French diploma recognition process remains among the longest and most complex on the continent. While some Nordic countries offer integration programs combining language training, supervised internships, and regularization in less than two years, the French pathway can take much longer.
The issue goes beyond technical aspects. It touches on the very conception of the healthcare system. Recruiting doctors trained elsewhere without offering them stable prospects amounts to using qualified human resources as a budgetary adjustment variable, a finding articulated by several parliamentary and associative analyses.
Ethical dimension of recruiting doctors trained in Southern countries
A significant portion of Padhue practicing in France comes from North African and Sub-Saharan African countries. This transfer of skills raises a question rarely addressed in the French public debate: the impact on the healthcare systems of the countries of origin.
The World Health Organization has established recommendations on the international recruitment of health personnel, urging recruiting countries not to exacerbate shortages in low-resource countries. The available data do not allow for conclusions regarding France’s actual compliance with these recommendations, but the topic is receiving increasing attention in parliamentary work.
The debate took a political turn in early 2026 when presidential statements linked diplomacy with Algeria to the presence of Algerian doctors in French hospitals. This instrumentalization was criticized by practitioner associations, which remind us that medical migration primarily responds to individual professional and economic logics, not bilateral agreements.
The trajectory of Padhue in France concentrates several tensions within the healthcare system: a shortage of practitioners in underserved areas, administrative rigidity, statutory precariousness, and ethical questions related to international recruitment. The reform announced in April 2026 opens a window, but its concrete modalities remain to be defined. The sector is now awaiting a legislative timetable.