Archive for the ‘France’ Category

France – Self-employed VS fixed salary – What foreign doctors should know

Thursday, May 15th, 2014


As a healthcare recruiting company, here at EGV Recruiting, we have constantly dealt with medical specialists eager to obtain a well-paying job as a specialist doctor in France, but on the other hand reluctant about working as a SELF-EMPLOYED in a private practice.

We are not here to judge the priorities of certain candidates and we understand the need of stability and the fact that for many foreigners not used to the French healthcare system self-employment might not sound as stable as earning a fixed income, but in France over 51% of medical specialists are self-employed and earn a bigger gross annual income than their fixed salary counterparts.

We did not come up with this numbers, so in order to make things clear here you have the official report:


The Organization for Economic Co-operation and Development (OECD) has gathered a wide amount of data about OECD-countries on the topic of medical remuneration, thus shading light on the subject of income in different Western European countries.

The study is conducted only on medical specialists, defined as physicians who have specialised and work in a field other than General Practice.

The study excludes resident doctors and physicians still in training, and the study underlines the average gross annual income.

Out of the 6 countries mentioned in the survey. Germany and France have the highest number of self-employed medical specialists with their own private practice outside the hospital (41% and 51%).

Self-employed medical specialists are paid by fee of service. The service can be a Diagnosis Related Group or other procedures (ex. operations or a visit).

In some countries, there is no precise clear cut between self-employment and fixed salary. In England for example 50% of self-employed doctors also work in the hospital. In France on the other hand, self-employed doctors don’t usually work in the hospital as well but some also work a day/week in the hospital to keep in contact with their colleagues.

In France, the government does not regulate the fees that self-employed doctors charge for their services! As a self-employed medical specialist one can set his own fee of service!

So how much do doctors in France usually earn?

After crunching the numbers, medical specialists in France that work on a fixed salary basis, usually earn a average gross salary of about 131.716 Euros/year.

A self-employed medical specialist in France earns an average gross salary of about 176.042 Euros/year.

As you can see the difference is substantial. WOULD YOU LIKE TO EARN 45.000 EUROS EXTRA PER YEAR?!

If we peaked your interest about working in France as a specialist doctor, send us your resume at

We currently have vacant positions for specialist doctors in the field of:

-          Respiratory medicine

-          Cardiology

-          Oncology

-          Anesthesiology

-          Ophthalmology

-          Obstetrics and Gynecology

-          Urology

-          Clinical Radiology

-          Occupational Medicine

EGV Recruiting




Confidence rating: the French vote the generalist and specialist doctors

Tuesday, May 28th, 2013


93% of the French confide ˝absolutely˝ or ˝especially˝ in specialist doctors and 92% in generalist doctors, reveal the third poll of the Groupe Pasteur Mutualité. It is 2% and 4% respectively more than in 2011, when the last survey was made.

On the whole, the healthcare professionals get a good press from the French: it is the case of the nurses (93% of the polled persons entrust them), the pharmacists (92%), the hospital practitioners and dentist-surgeons (both of them 88%).

Listening, experience and availability

The main criteria justifying this credibility are the listening (59 %), the experience (54 %), the availability (37%) and the ability to make quick decisions (32%).

Concerning the listening, three French of four (75%) vote for the generalist doctors and a little less (63,7%) for the specialist doctors. The pharmacists are the best classified (94%), followed by the nurses (87%) and the masseur- physiotherapists (80%).

Concerning the experience, the polled persons confide in specialist doctors, hospital healthcare professionals (both 83%) and generalist doctors (70%) regarding ˝the adaptation to the evolutions in healthcare and information on the new medical techniques applied on patients˝.

Access to unequal healthcare

The poll reveals moreover that a majority of the questioned consider that dental care (87%) and consultation at a specialist doctor (78%) are ˝the most expensive˝. On the contrary, only four of ten persons (42%) have the feeling that hospital treatments are the most expensive. Finally, the study shows that the French are the most concerned with the unequal regional division of professional healthcare practitioners. Only 35% of them consider that specialist doctors are ˝well distributed˝ in the Hexagon. Four of ten think the same thing of the generalist doctors and one of two (48%) of the hospital practitioners.

› A. B.-I.

(1)  Telephone poll made between the 26th of February and the 6th of March 2013 by Viavoice, 1007 persons representing the French population, 18 years old and over respectively.


Source of the article here


Medical deserts: the explosive report of the Senate

Thursday, February 14th, 2013

INFO LE FIGARO – The elected representatives of the Upper House don´t believe in the incentives proposed by Marisol Touraine. On the contrary, they suggest to exclude from the Insurance those practitioners who want to move in overpopulated areas.

In order to repopulate the medical deserts, the senators have a radical measure: to obstruct the free choice of settling in of doctors and not encouraging them to open medical practices in overpopulated areas. This is at least what they are advocating in an explosive report published on Thursday and which Le Figaro have found out of. ˝Except from the doctors, all healthcare professional fields are controlled, justifies Herve Maurei (UDI), the author, together with the socialist Jean-Luc Fichet, of the report proved unanimously by the Town and Country Planning Commission.  We don´t propose to abolish the practitioners´  freedom of settling in, we just want to restrict the absolute liberalism leading to the desertification of certain areas.˝

In concrete terms, the  elected representatives of the Upper House propose to exclude from the Health insurance those doctors who would chose to settle in already overpopulated areas. As a consequence, as their patients wouldn´t be repayed by the Insurance, it would be impossible for young doctors to form his/her patient circle. A similar measure, applied to nurses in 2008, lead in 3 years to a leap of 33%   in settling in medical deserts. The specialist doctors (gynaecologists, cardiologists, etc.) would benefit from a more restricted regime, by the establishment of a compulsory two years medical service, at the end of their studies, in the small hospitals of the county towns which face a great difficulty in recruiting doctors.

Blocking of the hospitals

˝We have to inform the students right from the start that this system could be generalised if the medical deserts keep extending to the end of the legislature˝ guarantees Hervé Maurey, who has in sight the medical universities.  ˝We have to regionalize the numerus clausus according to the needs of the areas, as currently this mecanisme doesn´t define the actual number of the students in medicine but only at national level˝ insists the senator of the Eure.

So far, the doctors have had the tendency to settle in the towns where they studied. Only a few opt for the countryside in order to replace their fellow members who are more and more numerous and close to retire. ˝ Result, in my town Bernay (10.500 inhabitants), three doctors have closed their medical practice in just one year˝ testifies the center party elected representative. In order to fight this affliction, the senators don´t believe in these incentives, that they consider ˝unclear, complexe and inefficient˝. The Healthcare minister, Marisol Touraine, who presented at the end of 2012 a plan of fight against the deserts exclusively based on incentive, will appreciate.

To attack the freedom of settle in of the doctors is a dangerous political exercice. ˝All governments have stepped back in front of electoral difficulties of doctors and internal strikes˝ admits Hervé Maurey. Leading besides sometimes to the blocking of the hospitals over several weeks. Jean-Marc Ayrault, as his predecessors in Matignon. In 2011, when he was the leader of the socialist deputies, the prime minister wanted then, together with Marisol Touraine, to submit the doctors´ settling in to the authorization prior to administration. A chock measure named ˝rural shield˝ which have been mothballed since Francois Hollande was elected.


Source of the article here

France. The expert opinion on treatment for trauma victims

Thursday, December 13th, 2012

Management of trauma demands experienced and multidisciplinary team work in which radiologist should be involved in both diagnosis and treatment. On one hand scanning the entire body is key in identifying lesions and on the other hand endovascular treatment (stents and embolization), performed by interventional radiologists.

At the scene of the accident rescue teams identify and correct deficiencies and achieve the vital balance. Considerable progress has been made in the medicalization of rescue and transport of the wounded, reducing morbidity and mortality. Equally decisive progress has been made in the emergency department, benefiting from a coordinated multidisciplinary care generally guided by an anesthesiologist.

Everything must be perfectly organized because every minute counts. The highway trauma victims are often young subjects who were previously healthy. Everything must be done to save the patients in such a manner if possible to leave the minimum of scars so that may resume a normal social and professional life.

Once the vital functions are stabilized, a CT scan of the whole body is the ideal investigation method. In 3-4 minutes brain and abdomino-pelvic lesions can be reviled and thus prioritizing therapeutic strategies. The multidisciplinary team including radiologists, interventional radiologists, anesthesiologists, vascular surgeons, orthopedists, neurosurgeons, decide the therapeutic approach. This involves having a suitable technical platform and all of these specialists available round the clock.


The role of the CT and angiography in emergencies:

Traffic accidents may be responsible for damage of large arteries located in the chest or abdomen, including the aorta, iliac or sub-clavia arteries, causing massive bleeding sometimes. These lesions usually occur in the context of poly-trauma and are immediately lethal to 80% of patients.
Interventional radiologists can offer these patients a chance to fight! By being able to see the bleeding lesions, they can treat all arterial territories. To stop the bleeding radiologists use different techinques for hemostasis. Embolization can occlude the artery, either permanently or temporarily. The other procedure is to establish a covered stent to ensure the restoration of the continuity of the injured vessel, as it’s done in the context of cerebral aneurisms.

For the full trauma of abdominal organs (kidney, spleen, liver), the classification of the American Association for Surgery of Trauma refers to define treatment options. It distributes the visceral abdominal trauma in 5 stages of increasing severity. Embolization is indicated in patients with hemo-dynamically stable or controlled hemorrhagic shock in the presence of the active scanner leakage of contrast, false aneurysms, arteriovenous fistulas and depending on the severity.


Advances in materials

Regarding the renal trauma, depending on the type of injury, several interventional radiology techniques can be proposed: stents for truncal arterial rupture, embolization of acute hemostasis, secondary treatment of arterovenous fistula tracts.

For the spleen, ablation remains the rule for all patients in uncontrolled hemorrhagic shock. In other cases, embolization is indicated because it can retain a portion of parenchyma and therefore the function of the organ.

For the liver arterial embolization.

Pelvic fractures, they are markers of high velocity trauma. These may be accompanied by bleeding complications due to arterial bleeding, venous bleeding ore bone. Endovascular embolization should be preferred instead of the surgical approach.

All these procedures have benefited from advances in materials and devices. Depending on the type and location of lesions, the interventional radiologist chooses absorbable product that provides temporary occlusion and allows, after 3 to 4 weeks, the artery become permeable, or a non-resorbable. The range has also expanded stents and radiologists have devices of any diameter and any size.


Source of the article here 

Consider starting work as a doctor in France?

Tuesday, June 26th, 2012

Before starting the actual work, here are some general facts about France’s healthcare system!

The French healthcare system was considered in the year 2000 “the best overall health care provider” by the World Health Organization, and in 2005 France spent almost 12% of its GDP on healthcare.


The current system has undergone several changes since its foundation in 1945, though the basis of the system remains state planned and operated.

Jean de Kervasdoue, a health economist, believes that French medicine is of great quality and is “the only credible alternative to the Americanization of world medicine.” According to him, France’s surgeons, clinicians’ psychiatrists, and its emergency care system are an example for the world.

The health care system:

The entire population must pay health insurance. The insurers are non-profit agencies that annually participate in negotiations with the state regarding the overall funding of health care in France. There are three main funds, the largest of which covers 84% of the population and the other two a further 12%. A premium is deduced from all employees’ pay automatically. The 2001 Social Security Act, set the rates for health insurance covering the statutory health care plan at 5.25% on earned income, capital and winnings from gambling and at 3.95% on benefits (pensions and allowances).

After paying the doctor’s or dentist’s fee, a proportion is reimbursed. This is around 75-80%, but can be as much as 85% The balance is effectively a co-payment paid by the patient but it can also be recovered it the patient pays a regular premium to a voluntary health insurance scheme.

Under recent rules, general practitioners are required to act as “gate keepers” who refer patients to a specialist or a hospital when necessary.
About 65% of hospital beds in France are provided by public hospitals, around 15% by private non-profit organizations, and 20% by for-profit companies.



While French doctors only earn about 60% of what American doctors make, their expenses are reduced because they pay no tuition for medical school and malpractice insurance is less costly compared with the United States. The French National Insurance system also pays for a part of social security taxes owed by doctors that agree to charge the government-approved fees.
Médecin generaliste /General practitioner

The médecin généraliste (commonly called docteur) is responsible for patient long-term care. This implies prevention, education, care of diseases and traumas that do not require a specialist. They also follow severe diseases day-to-day (between acute crises that may require a specialist).

They survey epidemics, fulfill a legal role (consultation of traumas that can bring compensation, certificates for the practice of a sport, death certificates, certificates for hospitalization without consent in case of mental incapacity), and a role in emergency care (they can be called by the SAMU, the emergency medical service). They often go to a patient’s home if the patient cannot come to the consulting room (especially in case of children or old people) and they must also perform night and week-end duty.


Emergency medicine

Ambulatory care includes care by general practitioners who are largely self employed and mostly work alone, although about a third of all GPs work in a group practice. GPs do not exercise gatekeeper functions in the French medical system and people can see any registered medical practitioner of choice including specialists. Thus ambulatory care can take place in many settings.



A government body, ANAES, Agence Nationale d’Accréditation et d’Evaluation en Santé (The National Agency for Accreditation and Health Care Evaluation) is responsible for issuing recommendations and practice guidelines. There are recommendations on clinical practice (RPC), relating to the diagnosis, treatment and supervision of certain conditions, and in some cases, to the evaluation of reimbursement arrangements. ANAES also publishes practice guidelines which are recommendations on good practice that doctors are required to follow according to the terms of agreements signed between their professional representatives and the health insurance funds. There are also recommendations regarding drug prescriptions, and to a lesser extent, the prescription or provision of medical examination. By law, doctors must maintain their professional knowledge with ongoing professional education.


If you would want to become part of the French health care system, feel free to read more about France on our website see our current job vacancies and apply!

EGV Recruiting


Wednesday, November 30th, 2011

Given the fact that you considered our previous comparison study: “The cost of living comparison between Germany and Romania, Hungary, Bulgaria, Slovakia, Lithuania” useful, here, we present you the sequel.

Continuing on the same idea, you are a specialist doctor (because France only recruits specialists), you like the French lifestyle, culture, language and everything France has to offer and consider continuing your medical career in France!

So we, the EGV Recruiting Team, present to you the cost of living comparison between France and Romania, Hungary, Bulgaria, Slovakia, and Lithuania:

Restaurant prices:

A meal at an inexpensive restaurant would cost you about:
– 4.07€ in Romania
– 4.87€ in Hungary
– 4.17€ in Bulgaria
– 4.42€ in Slovakia
– 5.27€ in Lithuania
– 12.04€ in France

A three-course meal for two, at a mid-ranged restaurant costs you:
– 16.84€ in Romania
– 25.58€ in Hungary
– 16.85€ in Bulgaria
– 19.89€ in Slovakia
– 21.98€ in Lithuania
– 46.59€ in France

Market prices:

1 Liter of milk costs about:
– 0.83€ in Romania
– 0.76€ in Hungary
– 0.92€ in Bulgaria
– 0.68€ in Slovakia
– 0.73€ in Lithuania
– 1.04€ in France

Fresh white Bread costs about:
– 0.50€ in Romania
– 0.73€ in Hungary
– 0.47€ in Bulgaria
– 0.89€ in Slovakia
– 0.86€ in Lithuania
– in France the price is about 1.23€

1 kilogram of chicken breasts costs about:
– 3.99€ in Romania
– 4.90€ in Hungary
– 4.75€ in Bulgaria
– 5.28€ in Slovakia
– 6.30€ in Lithuania
– in France the price is 8.69€

1 kilogram of oranges costs about:
– 1.02€ in Romania
– 1.21€ in Hungary
– 1.32€ in Bulgaria
– 1.21€ in Slovakia
– 1.16€ in Lithuania
– in France the price is 1.57€

1 kilogram of potatoes costs about:
– 0.46€ in Romania
– 0.45€ in Hungary
– 0.48€ in Bulgaria
– 0.37€ in Slovakia
– 0.41€ in Lithuania
– in France the price is 1.25€
A monthly pass for the local transport system costs:
– 13.35€ in Romania
– 32.68€ in Hungary
– 19.17€ in Bulgaria
– 22.46€ in Slovakia
– 30.25€ in Lithuania
– in France it costs about 47.47€

1 km with a taxi with normal tariff costs about:
– 0.36€ in Romania
– 0.76€ in Hungary
– 0.41€ in Bulgaria
– 0.81€ in Slovakia
– 0.51€ in Lithuania
– in France it costs about 0.81€

1 liter of gasoline costs about:
– 1.21€ in Romania
– 1.32€ in Hungary
– 1.21€ in Bulgaria
– 1.43€ in Slovakia
– 1.27€ in Lithuania
– in France it costs about 1.43€

Monthly utilities:

Basic electricity, water, gas and garbage costs about:
– 58.59€ in Romania
– 126.93€ in Hungary
– 70.24€ in Bulgaria
– 94.00€ in Slovakia
– 121.93€ in Lithuania
– in France it costs about 95.45€

1 minute of pre-paid mobile tariff costs about:
– 0.13€ in Romania
– 0.12€ in Hungary
– 0.17€ in Bulgaria
– 0.13€ in Slovakia
– 0.11€ in Lithuania
– in France it costs about 0.36€

Internet access (6Mbps, Flat Rate, Cable/ADSL) costs:
– 6.75€ in Romania
– 17.20€ in Hungary
– 10.42€ in Bulgaria
– 17.07€ in Slovakia
– 12.29€ in Lithuania
– in France it costs about 29.72€


Sports and leisure:

The monthly fee for an adult at a fitness center is:
– 24.34€ in Romania
– 32.46€ in Hungary
– 33.87€ in Bulgaria
– 35.71€ in Slovakia
– 41.51€ in Lithuania
– in France the monthly fee is 57.56€

1 hour tennis court rent in the weekend costs about:
– 10.02€ in Romania
– 8.61€ in Hungary
– 8.00€ in Bulgaria
– 7.33€ in Slovakia
– 15.21€ in Lithuania
– in France the fee is 17.15€

1 seat in the cinema for an international release costs about:
– 4.35€ in Romania
– 4.97€ in Hungary
– 4.37€ in Bulgaria
– 5.98€ in Slovakia
– 5.38€ in Lithuania
– in France the price is 9.21€


Clothing and shoes:

1 pair of Levis 501 costs:
– 67.62€ in Romania
– 73.55€ in Hungary
– 76.68€ in Bulgaria
– 69.71€ in Slovakia
– 70.34€ in Lithuania
– in France they cost about 79.57€

1 summer dress from a chain store (Zara H&M) costs:
– 37.63€ in Romania
– 45.58€ in Hungary
– 35.97€ in Bulgaria
– 49.50€ in Slovakia
– 48.91€ in Lithuania
– in France it costs about 32.14€

1 Pair of men leather shoes cost:
– 55.15€ in Romania
– 62.53€ in Hungary
– 47.65€ in Bulgaria
– 74.00€ in Slovakia
– 83.02€ in Lithuania
– in France they cost 98.46€


Rent per month:
The rent for a 1 bedroom apartment costs about:
– 172.97€ in Romania
– 158.22€ in Hungary
– 164.15€ in Bulgaria
– 318.57€ in Slovakia
– 170.29€ in Lithuania
– in France the rent price is about 486.60€

The rent for a 3 bedroom apartment costs about:
– 283.39€ in Romania
– 331.66€ in Hungary
– 305.80€ in Bulgaria
– 508.11€ in Slovakia
– 375.42€ in Lithuania
– in France the rent price is about 938.51€


This does not mean you can’t find cheaper alternatives!!!


Salaries and financing:

The median monthly disposable salary after tax is:
– 334.11€ in Romania
– 444.53€ in Hungary
– 352.32€ in Bulgaria
– 632.53€ in Slovakia
– 426.11€ in Lithuania
– in France 1938.11€

The yearly mortgage interest rate is:
– 8.61% in Romania
– 7.50% in Hungary
– 8.75% in Bulgaria
– 5.33% in Slovakia
– 9.75% in Lithuania
– in France it is 4.10%
In conclusion, although most living expenses are higher in France, the salaries are also much higher, making the local purchasing power in France 165.46% higher than in Romania, 148.36% higher than in Hungary, 176.79% higher than in Bulgaria, 83.28% higher than in Slovakia and 171.38% higher than in Lithuania.

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