France: The case of medical practitioners with diplomas from outside the European Union
Will the status of medical practitioners with diplomas from outside the European Union (PADHUE) survive the reform brought by the French government? In 2020, the government introduced a new status for PADHUE, to be effective on January 1 2021 (2021 decree). According to this decree, they would be able to practice if they pass the new version of the knowledge verification tests (EVC) and follow the skills consolidation program (PCC). The associate practitioner status was created to simplify the practice of PADHUE. On December 27 2023, the law aimed at improving access to healthcare through the territorial commitment of professionals, known as the "Valletoux law", named after Frédérique Valletoux, who had initiated the proposal, was passed. The law grants foreign doctors temporary authorization to practice for 13 months, renewable once, and requires them to pass the EVC. The derogation for PADHUE ended on December 31 2023.
The reform came as a new obstacle for foreign doctors who were already qualified and had been practicing in France for many years. Essential for hospitals and healthcare services that are chronically short of doctors, these foreign practitioners already had to meet the requirements of the Ministry of Health and the Medical Board. According to unions, between 4,000 and 5,000 Padhue doctors have been working in France. Although they do the same work as French doctors, their salaries do not match. Nor does the recognition of their qualifications. Some doctors say they were unable to take the EVC in their specialty. Others failed, although they had received appraisals from their superiors. They blame their workload and precarious situation, which prevents them from preparing optimally for the exams.
The future for doctors with non-EU qualifications
Unions, including the Unified Union of practitioners with degrees from outside the EU, have been calling on the government. How can doctors who already work 50 to 70 hours (or more) per week be compelled to take part in competitive examinations to practice a profession they already do and are already qualified for? Many doctors share their views and warned the government that without non-EU qualified practitioners, hospitals would be even more overwhelmed, which would have significant consequences for both doctors and patients.
Since January 1, between 2,000 and 3,000 doctors with qualifications from outside the EU have been at risk of not being able to practice anymore because they have not validated their EVCs. On January 3, several trade unions and associations launched a petition calling for the reinstatement of all PADHUE and the end of the obligation to leave French territory (OQTF) for all foreign doctors.
Fortunately, during his press conference on January 16, President Macron sent an initial positive signal, mentioning measures to "regularise many foreign doctors who sometimes support the healthcare services alone [...]" but are faced with "a completely ineffective administrative precariousness." On January 18, around a hundred foreign doctors protested in front of the Ministry of Health to denounce their precariousness, pointing out that France needed them during the health crisis and lamenting the new constraints. The message was heard by Health Minister Catherine Vautrin, who, backing up the President's statements, declared on January 22 that "the PADHUE would be able to continue working in the coming months" but without providing further details on the modalities of these authorizations. The unions remain mobilized.
Labor shortages around the world are expected to continue
While the health crisis justifies many of these shortages, tensions already existed before COVID-19. Other "crises" explain these global shortages: demographic crisis, vocational crisis, climate crisis, training crisis, labor crisis, etc. Jobs considered "dangerous, dirty and unrewarding" are not attracting young people. Working professionals and farmers are struggling to recruit.
In its annual report published on January 10, 2024, the International Labour Organisation (ILO) sounded the alarm. While global growth slightly exceeded expectations in 2023, economic recovery is slowing down. Labor shortages are exacerbating already significant imbalances between countries. According to the ILO, 77% of companies are facing recruitment difficulties. One of the reasons is that candidates' skills do not match their expectations. Sometimes, qualifications become an issue, not because they don't match, but because the host country doesn't recognize them or imposes restrictions, such as the obligation to take or retake an exam or test, to obtain diploma equivalence, etc.
In-demand professions: Key considerations for foreign professionals
Professionals wishing to engage in a particular profession in a foreign country should pay close attention to regulations. Some professions are regulated. Subject to the validation of a specific diploma, test, or professional examination, they are governed by legislative or administrative frameworks that may or may not allow their practice by a foreigner. These constraints have a direct impact on plans to move abroad. Regulated professions are classified by sector (healthcare, education, etc.) and job type.
The regulation of professions, the documents requested and the requirements to be met vary from country to country. In Canada, for example, it is estimated that around 20% of professions are regulated. However, keep in mind that each Canadian province has its own regulations.
First of all, it is important to verify that the host country recognizes the diploma. Diploma recognition and diploma equivalence are two different things. Equivalence is simply a question of level: it indicates the diploma's level in the foreign country but does not allow you to practice. In contrast, recognition of diplomas, as its name suggests, allows the diploma to be recognized abroad. However, it does not eliminate the other requirements that the host country may impose. Regulated professions are often under the authority of a professional body (e.g., the Medical Council) or association, which may require you to pass an additional examination, for which a fee is often charged. The professional body may also require foreign workers to undergo training to re-assess their skills. To stack the odds in your favour, it's best to start researching the country and its regulations for regulated professions as early as possible.
Useful links:
Diploma Recognition in France: centre Enic-Naric
Canada: regulated or accredited jobs
CICDI : Centre d'information canadien sur les diplômes internationaux
US Department of Education: recognition of foreign qualifications
Australian Department of Education: qualifications recognition
United Arab Emirates Ministry of Education: recognition of foreign vocational qualifications
South Africa: evaluate foreign qualifications
