Comparing salaries across countries is rarely simple — pay systems differ, and a single figure rarely tells the full story. This guide explains how pay is actually calculated in the French public hospital system, so you can evaluate a job offer with reliable benchmarks rather than a rough comparison.
How pay is calculated in the public hospital system
Pay for a public hospital employee ("fonction publique hospitalière", FPH) rests on a precise mechanism: an index number ("indice majoré"), determined by your grade and your step (seniority), multiplied by the index point value — a value set nationally and identical for every public employee, regardless of profession.
This system is governed by regulatory decrees: for general care nurses, decrees No. 2010-1139 and No. 2010-1143 of 29 September 2010 (consolidated by decrees No. 2021-1256 and No. 2021-1262 of 29 September 2021) define the applicable grade and step structure.
⚠️ The figures below are indicative benchmarks as of the writing date. The index point value and the grids change through regulatory decisions — always check the exact amount with your future employer or an up-to-date official source before relying on it.
Indicative grid for nurses (benchmarks, to be verified)
| Grade | Step | Index number | Indicative gross monthly pay |
|---|---|---|---|
| Grade 1 — General care nurse | 1st step | 395 | ~€1,944 |
| Grade 1 — General care nurse | 11th step (final) | 678 | ~€3,338 |
| Grade 2 — Specialised nurse | 1st step | — | ~€2,102 |
These figures are gross amounts, before social contributions and before income tax (deducted at source). Net take-home pay is generally around 20 to 25% lower than the gross figure, depending on your situation.
The index-linked pay supplement (CTI, "Ségur")
Following the Ségur health agreements, a specific increase is added to base pay: the index-linked pay supplement (complément de traitement indiciaire, CTI), equivalent to 49 index points, roughly €241 gross per month (~€183 net) at the current index point value. This supplement is separate from the base salary shown in the grid — add it to get the full picture of your compensation.
Public sector, private sector, and self-employed practice
The salary grid described above applies to the public hospital sector. The private sector (private clinics, non-profit private institutions) follows different collective agreements, with grids specific to each institution or group. Self-employed practice (for professions where it's permitted) follows an entirely different pay logic, tied to activity and billed procedures — outside the scope of this article.
What the grid doesn't show: common bonuses
Beyond the base salary and the CTI, several bonuses and allowances are added depending on your position and institution: the service bonus ("prime de service", tied to performance and periodically reassessed), allowances for atypical hours (night shifts, Sundays, public holidays), and, depending on the region, a residence allowance. Their amounts vary significantly from one institution to another and aren't standardised nationally the way the index-linked base pay is — this is another point worth clarifying directly with HR rather than relying on a national average.
Questions to ask in your interview about pay
Rather than relying on an approximate figure found online, these concrete questions will get you a reliable estimate directly from your future employer:
- What step will I be placed at, given my recognised professional experience?
- Is the index-linked pay supplement (CTI) already included in the figure quoted, or does it come on top?
- Are there institution-specific bonuses (night shift premium, service premium, hardship allowances)?
- What's the estimated net amount, once social contributions are deducted?
These four questions help you avoid the most common disappointment: discovering after signing that the figure quoted verbally was only part of your actual pay.
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