Ultimate Guide to Practicing Medicine in France

Why France? Well, who doesn’t want to live in France, right? From the snow topped French Alps, to the turqouise waters of the French Riviera, the  patisseries, the boulangeries, and the idea that you work to live is certainly a welcome change.  Here Dr. Jill Arthur shares a guide to practicing medicine in France.

French Healthcare System

France has a system of socialised medicine funded primarily by the government. This means that everyone has coverage. But it is a two-tiered system. There are public hospitals, akin to the NHS in England, and private hospitals, which are called Cliniques. I have been in both as a patient, and they both provide excellent care in facilities that are more or less pretty depending on whether they are public or private, similar to facilities in the US.

Medical License/Registration

It turned out that France was a much harder nut to crack than I had anticipated. I arrogantly thought that my US education and training would be recognised here. Or at least that it would make getting a medical license in France easier. Wrong.  I outline the eight steps to obtaining a French Medical License in a separate post.

Finding a Job

People started to contact me on LinkedIn after the results of the anesthesiology exam were published. I was solicited multiple times on LinkedIn.

Salary

During my first two years of working under supervision,  I will be making about 1/5 what I was raking in as a locum in the US. After this probationary my salary will increase to reflect my 17 years of experience as an attending pediatric anesthesiologist and will be about 40% of what I could make in the US. If I choose to stay in a University Hospital after the probationary period,  I will make approximately 90,000€/year.  At the current moment, I am making about half that during this probationary period.

In general, one can earn more working in the Cliniques. A private practice anaesthesiologist (not available until after the 2-3 year probation period) makes about 20,000€/month net. For anesthesia, it’s the same eat-what-you-kill system we used to have in private practice in the US, but the hours are longer. 

A 2019 physician compensation survey indicated that the average salary for a French physician was 108,000 USD (converted from Euros). Notably, the average annual cost of medical school in France, whether private or public, was 800 USD. 

Work Culture

I started working in France in November 2021, so aside from being in orientation (which is a lot more gentle and kind than the way we do it in the US), I am still in the honeymoon period. I have been logging a lot of hours because I have so much to learn. One of the colleagues told me I had been there too much.

Everything is just slightly different. They don’t have the same medications available here that we have in the US and in the US we don’t use the medications they use in France. A physician always works with a CRNA, mostly one-on-one, plus residents when they are not in lecture. They don’t rely on residents to run their system and they cap the work hours for attendings at 42 hours for the week.  As an anesthesiologist, my hours are split between preop clinic, the OR, and the floor (anesthesia follows all postop surgical patients).

Immigration

You will need a visa to stay in France for the long term and you can use this tool to figure out the type of visa you need. If you are not married to a French citizen or don’t have children with French citizenship, you will need a visa de long séjour to stay in France longer than 3 months at a time, .

The visa de long séjour costs about 250€ per year. You can apply for the first one from the US. One way to qualify for this extended tourist visa is by having enough money in the bank, 12x their minimum monthly wage (which at the time of writing is 1,589.47€). They want to know you won’t wind up in their welfare system.

When I first got to France with my first visa de long séjour, I had to get a chest film within a certain amount of time and get another stamp in my passport to stay here. After the first year, to continue with this status, you will need to convert this to a titre de long séjour (also called carte de séjour), which is basically the same thing. Each French Department (sort of like a state) grants their own visa and you will need a French address to qualify. There are all sorts of long-term rentals you can find for foreigners without a lot of trouble, but if you want to get a normal lease on an apartment, it can be a challenge without a work contract. Another option is to use a friend’s address, though there are a bunch of forms/affidavits your friend will have to fill out (they have to swear that they are housing you), but it doesn’t cost anything.

Soon after you arrive, you will need a French bank account. This can also be a challenge since overseas banks have to file a bunch of paperwork with the IRS and there aren’t a lot of them willing to do this. I went with HSBC, since they do business on both continents. BNP Paribas also has some affiliations in North American. I recommend opening an account with the branch in the US and then  it will be easier to open a bank account in their French branch. You won’t be able to rent a place on your own until you open a French bank account.

Now that I am working in France, I provided my hospital my valid carte de séjour when I signed the contract and the hospital applied for a work visa on my behalf.

Bottom Line

I feel incredibly fortunate to live in France and incredibly lucky to be able to work here. The food is much higher quality than what we have. There is an emphasis on quality of life that I’m still trying to get used to (it took me the better part of 3 years to really begin to get over the burn out).

I would do it again in a heartbeat. But if I had the information I shared in this series, I think I could have shaved about 2 1⁄2 years off the process.

Jill F Arthur, MD FAAP is a pediatric anesthesiologist who has been in practice for 17 years, 15 of which have been exclusively pediatric. After fellowship at Boston Children’s, her wide-eyed plan was a career in academia. Attending positions that followed included some at big-name institutions with long-standing reputations in research and academics, but the exigencies of practicing in a system that increasingly stresses money over advancement of knowledge brought that dream quickly (and sadly) to an end. Hope sprang eternal anyway, for the next dozen years, believing she could actually change the system. But in the end, its’ abuse and the burn-out it caused just made the decision to leave her country and find a way to practice in France, easier. Learn more about Dr. Jil Arthur’s story here.