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Foreign doctors strike over new French law

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7015.1248a (Published 11 November 1995) Cite this as: BMJ 1995;311:1248
  1. ALEXANDER DOROZYNSKI, medical journalist
  1. Paris

    Doctors who practise in France with a foreign diploma held two one day strikes recently in protest against their status of “assistant practitioner,” imposed by recent legislation. They claim that the new law also restricts their work to poorly paid and precarious jobs in public hospitals.

    These so called “foreign” doctors are also protesting against a recent ruling that requires them to take aptitude tests similar to those required of full time hospital doctors. Only those doctors who have practised for at least three years will be admitted for testing, and even if they pass the test they will not be integrated on a full time basis in the hospital system.

    “We accept a system of control of our knowledge, but only if it leads to a real status,” said Dr Mohamed Ettahiri, president of a committee of doctors with foreign diplomas (meaning degrees earned outside the European Union).

    Dr Ettahiri pointed out that the aptitude tests are of the same level as those in the competitive examination given to doctors who want to become hospital practitioners. But he said that foreign doctors can be only “assistant practitioners,” which he said was a “discriminatory subcategory of underpaid doctors listed separately with the Ordre des Medecins [the national medical association to which all practising doctors must belong].”

    Figure1

    'Foreign' doctors in France want to be integrated into the health system

    The committee of doctors with foreign diplomas is also concerned that the test can be taken only by those doctors who have practised for at least three years: “An aptitude test is a selection in itself and there is no need to preselect. Each doctor should have the possibility of proving he is competent,” said Dr Ettahiri.

    About 7500 doctors in France hold diplomas obtained outside the European Union, but about 5000 of them are in fact French citizens, either by birth or by naturalisation. Most have had specialty training in France, and they make up a quarter of hospital doctors. The law stipulates that, as of next January, hospitals will no longer be authorised to employ foreign doctors.

    The committee of foreign doctors had invited Elizabeth Hubert, minister of public health, to discuss their problems, but she did not attend the meeting. The committee then decided on two days of symbolic strikes and has also asked the Conseil d'Etat, which advises the government on legislative matters, to rule that the law constitutes an excessive use of power.

    In July the Paris public hospital system warned that less than 30% of the 1750 foreign doctors it employs would qualify to take the aptitude tests and that if the others were not allowed to continue working in hospitals “problems would unavoidably arise in certain specialties.”

    Professor Bernard Glorion, president of the French medical association, criticised the law as being too constraining and said that the aptitude tests were too selective. “We must remember that these foreign doctors have rendered many services,” he said.

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