The Padhue situation in France highlights the struggles of foreign-trained medical practitioners who face significant challenges, including low pay and precarious working conditions, despite their qualifications. A recent hunger strike by 300 practitioners emphasizes their fight for recognition and fair compensation. Many are forced to take knowledge verification tests to secure their positions, but stringent requirements and limited slots leave them vulnerable. The Ministry of Health is considering reforms to improve their situation, acknowledging their vital role in the healthcare system.
Understanding the Padhue Situation in France
If you’re new to the medical field, the term ‘Padhue’ might not ring a bell. This acronym stands for ‘practitioners with degrees outside the European Union in France,’ referring to doctors who have completed their training in countries outside of Europe. Recently, on March 5, a collective named ‘Ipadecc’ initiated a hunger strike involving 300 of these practitioners to advocate for their rights.
Challenges Faced by Foreign Medical Practitioners
Dr. Abdelhalim Bensaidi, who shared his experience on Sud Radio, exemplifies the plight of many foreign doctors. Hailing from Algeria, where he completed his medical education, he now practices diabetology in France. His monthly earnings amount to just ‘2,000 euros’, which is equivalent to a full-time salary. In contrast, his French counterparts earn over ‘5,000 euros’ for performing the same roles and responsibilities.
Dr. Bensaidi’s situation is not unique. Another practitioner revealed to the Dauphiné Libéré that he has conducted ‘2,000 urology consultations and 267 surgical procedures,’ yet he takes home only ‘1,600 euros net’ each month, excluding on-call shifts. A parliamentary report from last November shed light on the precarious circumstances faced by ‘Padhue’, indicating that there are at least 5,000 of these foreign-trained doctors in France, many working under insecure conditions and vague administrative statuses.
Despite their qualifications, these practitioners often find themselves functioning similarly to interns, managing entire departments while receiving minimal compensation. The report also noted that a significant number of these doctors hail from Algeria, Tunisia, and Syria.
Their precarious situation is intended to be temporary, as these foreign doctors are expected to take ‘knowledge verification tests’ (EVCs) to solidify their skills and eventually obtain hospital practitioner status. However, the process resembles competitive exams, with limited slots available each year and high standards for different specialties. Many candidates report failing the tests despite achieving scores above 13 or even 14.
While it is crucial to ensure that these health professionals possess the necessary skills to practice in France, candidates express concerns over the discrepancies in grading and the inequities that arise when positions remain unfilled due to strict requirements. Jean-François Cibien, the president of the inter-union Action Praticiens Hôpital (APH), described the situation as ‘incomprehensible.’
Emergency physicians have pointed out that many doctors are deeply integrated into their hospital teams, working over 60 hours a week yet earning barely above the minimum wage. This raises concerns about exploitation, particularly during a time when their contributions are vital for maintaining a fragile healthcare system, as highlighted during the Covid crisis. For these practitioners, failing to pass the EVCs means they may have to leave France or shift to other healthcare roles.
In February, the Ministry of Health announced plans to revise the EVCs to improve success rates. Discussions about creating an ‘internal’ pathway for these practitioners have also been held. It remains to be seen if these adjustments will resolve the ‘administrative precariousness’ noted by Emmanuel Macron in early 2024, who acknowledged the essential role of foreign doctors in the healthcare system.
As the situation stands, many Padhue are performing duties that far exceed the limits of their official roles, akin to interns who are supposed to operate under the guidance of licensed practitioners. However, in reality, they are often assigned responsibilities equal to their colleagues, showcasing a disconnect between policy and practice.