Did you qualify as a physiotherapist, healthcare assistant or occupational therapist in a European Union country? To settle in France, you need an authorisation to practise, granted case by case by the prefect of the region where you want to settle, after the opinion of a committee. The DREETS for that region is your practical starting point for applying. Here is the procedure common to the three occupations, then what changes from one to the other.
Does this apply to you?
Physiotherapists, healthcare assistants (aides-soignants) and occupational therapists qualified in the EU have no automatic recognition: their training is examined case by case. With the authorisation, you then work under the same conditions as someone trained in France. You can apply in three cases:
- your qualification allows you to practise this occupation lawfully in an EU or EEA country that regulates access to it or its practice;
- your country regulates neither the training nor the occupation, and you have worked in it for at least one year full time (or the equivalent part time) during the last ten years;
- your qualification comes from a non-EU country, it has been recognised by an EU or EEA country, and you have worked there for three years full time (or the equivalent part time).
This procedure does not apply to doctors, midwives or nurses whose qualification complies. With a qualification recognised automatically, they register directly with their Ordre; a doctor or midwife whose qualification does not comply applies for an authorisation to the Centre national de gestion (CNG), not to the regional prefect. See our guides for doctors, midwives and nurses.
A nurse whose qualification does not comply? If your nursing qualification does not meet the conditions for automatic recognition but allows you to practise lawfully as a nurse responsible for general care in your country, or if you hold a qualification for one of the French specialities of infirmier anesthésiste, infirmier de bloc opératoire or puéricultrice, you follow the same procedure: authorisation from the regional prefect after the opinion of the nurses' committee, and a 4-month silence that amounts to a refusal. See our guide for nurses.
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DREETS or regional prefect: who does what?
It is not the DREETS that authorises you to practise: it is the prefect of the region where you want to settle, after the opinion of the committee for your occupation. The DREETS (regional directorate for the economy, employment, labour and solidarity, a State office in the region) is the practical starting point: several DREETS explain on their website how to apply.
The application step by step
Step 1 — Find the DREETS page for your future region
All the DREETS are listed on dreets.gouv.fr (in Île-de-France it is called the DRIEETS). Choose the region where you want to settle, then look on its website for the page about European qualifications or applications for authorisation to practise: its title varies from one region to another (in Occitanie, for example, “Diplômés européens : Demande d'autorisation d'exercer”). Where it exists, it tells you how to apply in that region. The pages are in French: your browser's translation tool is enough to find your way around them (but not to translate the documents in your file).
Step 2 — Prepare your file
The content of the file is set by an order: the order of 20 January 2010 for physiotherapists and occupational therapists (official form on Légifrance), and the order of 24 March 2010 for healthcare assistants (form published in the French Official Journal). The documents are almost the same:
- the application form;
- an identity document valid on the day you submit;
- a copy of your qualification, and of any additional qualifications;
- evidence of your continuing training and experience;
- a certificate from the authority in your country, less than a year old, stating that you have not been sanctioned;
- certificates from the authorities that issued your qualification: level of training, courses and number of hours year by year, content and length of placements.
These orders ask for no CV, no cover letter and no certificate of conformity. Documents other than the form and the identity document must be in French or translated by an approved or authorised translator: see our article on translations.
Step 3 — Submit your file
Two cases:
- The page offers an online application (on demarche.numerique.gouv.fr): use it. In the regions whose website we read, for example Bretagne, the DREETS points to an online application that mentions these occupations.
- No online application: send your file in two copies, by registered letter with acknowledgement of receipt, to the secretariat of the committee for your occupation in the region. If the address is not on the page, ask the DREETS for it.
Watch out for the “attestation de conformité”. The online form marks this certificate of conformity as “obligatoire” (mandatory), along with a proof of address and a summary table of placements. None of these three documents is in the orders that set the file; the certificate of conformity is mainly used for automatic recognition, for example that of nurses responsible for general care. The content and length of your placements still have to be proven by your training certificates. Don't hold up your file looking for a document your country may not issue for your occupation: ask the DREETS what to attach instead.
Step 4 — Watch for the acknowledgement of receipt (1 month)
Within a month of submitting your file, you receive an acknowledgement of receipt. If documents are missing, it tells you: complete your file as quickly as possible. Keep this document: the decision period only starts once your file is complete.
Step 5 — Keep an eye on the 4-month period
Once your file is complete, count 4 months. What silence means depends on your occupation: if you have had no answer after 4 months, your application is refused if you are a physiotherapist or a healthcare assistant, and accepted if you are an occupational therapist. Before the period ends, ask the department that received your file (the DREETS or the committee's secretariat) how it is progressing.
Step 6 — If the decision requires a compensation measure
The committee compares your training with the French training, taking your experience into account. If there are substantial differences, the prefect may let you choose between an aptitude test and an adaptation period, impose one of them, or both. The decision states its reasons; the aptitude test takes place within six months of its notification.
Step 7 — After the authorisation
What follows depends on your occupation (see the table below): registration and entry on the Ordre's register for physiotherapists, registration with the ARS (regional health agency) for occupational therapists. The French Public Health Code provides for no Ordre for healthcare assistants.
What the texts say. The authorisation is issued by the prefect of the region designated by order of the Minister of Health, after the opinion of the relevant committee: Articles R4321-27 (physiotherapists), R4391-2 (healthcare assistants) and R4331-9 (occupational therapists) of the French Public Health Code. That order designates the region in which you intend to settle. The orders of 20 January 2010 and 24 March 2010 provide for the file to be sent in two copies, by registered letter with acknowledgement of receipt, to the committee's secretariat. The online applications offered by some DREETS are an administrative practice: the texts we consulted do not say whether they replace this postal submission, or whether a file containing all the documents in the order, but not the extra documents requested online, counts as complete.
What changes from one occupation to another
| Occupation | 4-month silence | File | After the authorisation | European Professional Card |
|---|---|---|---|---|
| Physiotherapist | Refusal | Order of 20 January 2010 | Registration and entry on the register of the Ordre des masseurs-kinésithérapeutes | Possible; its place alongside the authorisation is not established (see our article) |
| Healthcare assistant | Refusal | Order of 24 March 2010 | The French Public Health Code provides for no Ordre | No |
| Occupational therapist | Acceptance | Order of 20 January 2010 | Free registration with the ARS; no Ordre | No |
| Nurse (non-compliant qualification) | Refusal | Order of 20 January 2010 | Registration and entry on the register of the Ordre des infirmiers | Possible; its place alongside the authorisation is not established |
The guide for your occupation details each step and the full list of documents: physiotherapist, healthcare assistant, occupational therapist.
French: what the texts say
For healthcare assistants and occupational therapists, the law requires the knowledge of French needed for the job, checked in a proportionate way after your qualification has been recognised; it sets no level. For physiotherapists, the authorities may check your command of French, and their decision can be challenged before the administrative court; the texts set no numerical level. In every case, ask the department handling your file whether and how your French will be checked.
Frequently asked questions
Does the DREETS decide on my authorisation?
No. The prefect of the region where you want to settle decides, after the opinion of the committee for your occupation. The DREETS is the practical starting point: several DREETS explain on their website how to apply.
Which region should I choose?
The one where you intend to settle: that is what the order designating the competent prefects provides for. Find the DREETS for that region on dreets.gouv.fr.
Do I really have to send my file by registered letter?
Not necessarily. Start with the page of the DREETS for the region where you want to settle: several DREETS, for example in Bretagne, point to an online application, and that is then the route they indicate. The texts themselves provide for the file to be sent in two copies, by registered letter with acknowledgement of receipt, to the committee's secretariat (orders of 20 January 2010 and 24 March 2010): that is the procedure to follow if your region offers no online application. The texts do not say whether the online application replaces this postal submission: if in doubt, ask the DREETS.
What does the authorities' silence mean?
Four months after your complete file, silence amounts to a refusal for physiotherapists, healthcare assistants and nurses whose qualification does not comply, and to acceptance for occupational therapists.
Do I need a CV, a cover letter or a certificate of conformity?
No: these documents are not in the orders of 20 January 2010 and 24 March 2010. If the online application asks for a certificate of conformity, ask the DREETS what to attach instead.
Can a physiotherapist use the European Professional Card?
The card is open to physiotherapists, but no text allows us to say it is faster, and the texts we consulted do not say whether it exempts you from the prefect's authorisation. Find out before choosing: see our article on the European Professional Card.
Are nurses, midwives and doctors concerned?
No, except a nurse whose qualification does not meet the conditions for automatic recognition but allows them to practise lawfully as a nurse responsible for general care in their country, and holders of a qualification for one of the French specialities of infirmier anesthésiste, infirmier de bloc opératoire or puéricultrice: they follow the same procedure. With a qualification recognised automatically, doctors, midwives and nurses register directly with their Ordre; a doctor or midwife whose qualification does not comply applies to the Centre national de gestion (CNG). See the guide for their occupation.
Official sources
- French Public Health Code, Article R4321-27 — authorisation for physiotherapists
- French Public Health Code, Article R4391-2 — authorisation for healthcare assistants
- French Public Health Code, Article R4331-9 — authorisation for occupational therapists
- Order of 20 January 2010 — file (physiotherapist, occupational therapist)
- Order of 24 March 2010 — file (healthcare assistant)
- DREETS portal — find the DREETS for your region