EVC France Guide 2026: The PADHUE Route for Non-EU Doctors

France does not automatically recognise medical degrees from outside the European Union. If you qualified in Egypt, Syria, Algeria, India, Lebanon, the Gulf or anywhere else outside the EU and EEA, the main route to full practice is the procédure d'autorisation d'exercice (PAE), often called the PADHUE procedure, after praticiens à diplôme hors Union européenne. Its entry point is a competitive written exam: the EVC, the épreuves de vérification des connaissances.

This guide explains what the EVC are, who runs them, how the internal and external routes differ since the 2025 reform, what happens after you pass, and how to plan your preparation.

Key facts

How the PADHUE procedure fits together

The procedure has four stages. Each one depends on the previous one, so it helps to see the whole chain before you register.

1. EVC. You sit the written tests in your chosen specialty. Ranking decides whether you are a laureate on the main list or the complementary list.
2. Assignment. The CNG assigns laureates to a hospital post according to their rank. You do not simply apply for jobs freely at this stage.
3. Parcours de consolidation des compétences (PCC). You work full time in your profession and specialty under supervision. For doctors the PCC lasts two years.
4. Commission and authorisation. At the end of the PCC your file goes to the national authorisation commission placed with the CNG. On a favourable opinion the minister grants full authorisation to practise (plein exercice). You then register with the departmental council of the Ordre des médecins.

If the commission gives an unfavourable opinion, it can propose an extension of the PCC rather than a straight refusal, and the CNG can assign you again for the extra period.

The EVC are a competition, not a pass/fail exam

This is the single most important point to understand. The ministry publishes a fixed number of posts for each profession and, for doctors, for each specialty. The jury then sets the admission threshold. A score that would comfortably pass a licensing exam elsewhere may not be enough in a crowded specialty, and a modest score may succeed in a specialty with many posts.

Practical consequences:

• Choose your specialty strategically. You register in one specialty. Compare the number of posts with your realistic level and your documented training.
• Aim to rank, not to scrape through. Preparation should target the top of the distribution, especially in popular specialties.
• Main and complementary lists. Laureates are ranked on a main list; a complementary list is used when posts remain. For the 2024 session, 4,000 posts were opened, with 3,235 filled from the main list and 638 from the complementary list.

External route and internal route

A reform adopted in 2025 split the EVC into two routes, first applied from the autumn 2025 session.

External route

This is the classic route for doctors who are not yet working in France. It has two written, anonymous tests:

• a test of fundamental knowledge;
• a test of practical knowledge, built around clinical situations.

Internal route

The internal route is designed for practitioners who already work in French hospitals. You are eligible if you fall into one of these groups:

• you have at least two years of full-time-equivalent practice in France, in the profession or specialty concerned, during the three years before the opening order;
• you hold a provisional authorisation to practise (AEP) and are working in France when you apply, for example under a temporary associate practitioner contract (PACT);
• you were authorised to practise in an overseas territory under a transitional scheme.

Instead of two tests, the internal route has a single written MCQ test of fundamental knowledge. You also submit an attestation of clinical and relational skills, signed by your head of department and co-signed by the president of the hospital medical committee. Refugees and stateless candidates with experience in France can also take the single test.

The internal route has many more posts for doctors (2,896 against 1,003 in 2026), which reflects how many non-EU doctors already work in French hospitals on temporary statuses.

The 2026 session

For the 2026 session, the opening order was published in mid-June 2026 and online registration on the CNG platform opened on 17 June. A later order extended registration, which finally closed on 21 July 2026. The written tests run from November 2026 by route and specialty, with the detailed calendar published by the CNG. The review of candidates, hearings where required, and assignment of main-list laureates are planned for the first quarter of 2027.

If you missed 2026, use the time before the next opening order to build your file and your exam preparation. Sessions are opened by ministerial order each year, so watch the CNG website from late spring.

What you need to register

The opening order sets the exact documents for each route. In general, expect to provide:

• your medical degree, and specialist diploma where relevant, with certified French translations;
• proof that your degree allows you to practise in the country where it was awarded;
• identity documents;
• for the internal route, proof of your French practice (contracts, AEP, PACT) and the signed eligibility form and attestation;
• your choice of profession and specialty.

Names and dates must match across every document. Inconsistencies are a common cause of delay or refusal.

After the EVC: assignment and the PCC

Assignment

Laureates do not choose freely where to work. The CNG assigns each laureate to a hospital post according to rank and the posts available. A higher rank gives more choice.

University enrolment

Since the 2025 reform, EVC laureates enrol at the university linked to the subdivision of their assigned hospital, in the third-cycle (specialty training) office of their discipline. The enrolment is mainly administrative, but it attaches you to the local specialty coordinator or educational referent, who follows your progress, can adapt your PCC to your profile and supports you towards the commission. The CNG assignment notice is enough to justify enrolment. If your hospital's faculty is not accredited for your specialty, you enrol at an accredited faculty in the same subdivision.

Length and content of the PCC

For doctors the PCC lasts two years full time, in the profession and, where applicable, the specialty. Doctors can ask for an early referral to the commission after at least six months, if an evaluation report co-signed by the president of the hospital medical committee receives a favourable opinion. In practice, plan for two years and treat any shortening as a bonus.

During the PCC you work as a practitioner under supervision. Your clinical performance, your relationships with the team and your progress in the specialty all feed into the final evaluation, so the PCC is as important as the written exam.

The commission and full authorisation

At the end of the PCC, the national authorisation commission reviews your file. A favourable opinion leads to full authorisation by the minister. An unfavourable opinion can lead to a proposed extension of the PCC.

Registering with the Ordre des médecins

Full authorisation is not the last step. To practise you must register on the roll (tableau) of the departmental council of the Ordre des médecins where you will work. The council checks your identity, diplomas and authorisation, your criminal record and professional standing, and your command of French. Non-EU nationals also need a French residence permit that allows them to practise. The council has up to three months from a complete file to decide.

Alternatives you should know about

The EVC is the main route but not the only one. Depending on your situation, check whether one of these fits better:

• Gulf cooperation agreements. The Ordre lists temporary ministerial authorisations, valid for one year, linked to agreements with Saudi Arabia, the UAE, Bahrain, Oman, Kuwait and Qatar.
• Temporary authorisation under a cooperation agreement. A host institution applies to the CNG at least six months ahead, for a maximum of two years.
• EU route via another member state. If an EU or EEA country has recognised your non-EU degree and you have at least three years of practice there, a separate procedure may apply.
• Quebec mutual recognition for certain specialists trained at Quebec universities.

These routes have their own conditions and do not all lead to permanent full practice. Read the details on the Ordre and CNG websites before choosing.

How to prepare for the EVC

The EVC test medical knowledge at the level expected of a specialist in France, in French. A realistic plan:

1. Fix your specialty early. Your preparation, documents and strategy all depend on it.
2. Master French medical language. Questions, clinical vignettes and answer options are in French. Practise reading long vignettes quickly and precisely.
3. Learn French practice. French guidelines, drug names, prescribing habits and organisation of care can differ from what you learned. Use French national guidelines and the national curriculum used for the EDN as your reference.
4. Train on MCQs under time pressure. Both routes use written tests; the internal route is a single MCQ paper. Timed blocks build speed and accuracy.
5. For the external route, practise clinical reasoning. The practical knowledge test rewards structured management of clinical cases, not just facts.
6. Review every explanation. Track weak topics and revisit them with spaced repetition.

The MediFlow Exam Prep app has French-language practice questions for the EVC in medicine, organised by topic, with explanations you can review on your phone between shifts.

Common mistakes

• Treating the EVC as a pass/fail exam. It is a ranking competition with a limited number of posts.
• Picking a specialty without checking the posts. Look at how many posts are opened before you register.
• Underestimating French. Strong medicine is not enough if you misread vignettes.
• Missing the registration window. The 2026 window was about five weeks. Prepare documents in advance.
• Ignoring the internal route. If you already work in France with an AEP or two years of practice, check whether you qualify for the single-test route.
• Forgetting the PCC and the Ordre. Passing the EVC is the beginning, not the end, of the procedure.

Next steps

1. Check your eligibility for the internal or external route.
2. Choose your specialty and gather certified translations of your diplomas.
3. Start timed French-language MCQ practice now, well before the next opening order.
4. Read the full country overview in Working as a doctor in France.
5. Compare with the French student pathway in the EDN guide.