The French government promised on April 30, 2026 to re-examine the status of " Padhue"These doctors with foreign degrees, particularly Algerian ones, are forced to retake competitive exams to obtain permanent positions. He specifically means..." simplify "the procedure for granting permanent status to these doctors, after the President Emmanuel Macron lashed out on Monday at their plight. An overview of a complex system:
Who are they?
THE " Padhue" , an acronym for Practitioners with Diplomas from Outside the European Union, practice in France but do not benefit from the " full exercise", therefore the same working conditions and income as graduates in Europe. Emergency physicians, psychiatrists, gynecologists, general practitioners, geriatricians... For more than 20 years, the medical desertification has led many establishments to recruit them.
Theoretically, they work under the supervision of a senior physician. But in many hospitals, they keep busy in departments under pressure and perform duties similar to those of senior doctors, according to unions. According to the interns' union (ISNI), they work an average of 50-75 hours per week, under precarious contracts with salaries far lower than their colleagues.
Their numbers swelled during the Covid-19 epidemic, when the overwhelmed hospital was seeking reinforcements. Since then, they have been denouncing their precarious situation and administrative instability.
How many are there?
“ No reliable statistics "does not list their " exact number" , wrote the Medical Association in 2024 to LFI (radical left) MP Damien Maudet, author of a report on the subject. By compiling several sources, the MP estimated their number at more than 10,000 in 2024. In 2023, the French Hospital Federation (FHF) counted 7,000. When questioned, the Ministry of Health did not provide any figures.
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How are they appointed to permanent positions?
To have their diploma recognized, they must obtain a " full exercise authorization", via an annual competition followed by a lengthy procedure. These constraints aim, according to the Academy of Medicine and the Order, to guarantee quality and safety » care.
The competition, called the knowledge verification tests (EVC), long pitted doctors already practicing in France against those applying from abroad. It was reformed in 2025. Now, doctors already in practice take a competitive exam. internal and are given priority for most available positions. A external "A more selective process exists for those without experience in France."
This year, the jury selected 1,863 winners: 1,425 out of 1,935 participants in the competition. internal and 438 out of 4,040 candidates for the " external", according to the National Management Centre. Once awarded the prizes, the Padhue " begin a skills consolidation pathway » (PCC), a kind of two-year internship (which can be shortened by a maximum of 18 months, under certain conditions), before being authorized or not to practice by a dedicated commission.
The procedure is often criticized, accused of keeping them in indecent working conditions for a long time. Its detractors call for the exemption of the " Padhue "of competitions and to have their skills recognized by their peers. On Wednesday, the executive promised to simplify » the procedures with the idea of « to break free from this competition logic“.
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And what if it fails?
A special arrangement allowed them to be hired for several years under various employment statuses, with salaries ranging from €1,500 to €2,200 per month. Now required to pass the competitive exam, they can apply for temporary permits in the meantime. A 2023 law created the status of temporary contractual associate practitioner (PACT).under which experienced doctors can work for a maximum of 26 months, for €31,204.37 gross per year. Some hospitals still employ " Padhue "under other, more precarious statuses, according to unions and elected officials.
What becomes of the former Padhue?
As of January 1, 2026, the former " Padhue "Those who became fully qualified represented 9.21% of doctors in regular practice (approximately 19,000 practitioners), compared to 4.11% in 2010," it was indicated. to AFP, the Order of Physicians.
According to a 2025 studyThey are mostly graduates from Algeria (38.6% of the « Regular active Padhue », Tunisia (16%), Syria (8.3%), Morocco (6.8%) or Lebanon (4.2%). According to this study, the most represented specialties are general medicine (19.6% of the Padhue “ regular assets), psychiatry (8.8%) or anesthesia and resuscitation (7.9%).
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