Conditions of practice, provisional authorization and the EVC pathway in France
What is the PACT status?
Praticien associé contractuel temporaire. PACT stands for “Praticien associé contractuel temporaire”, or Temporary Contract Associate Practitioner.
It is a French public-law hospital employment status created by Decree No. 2024-1190 of 19 December 2024. It enables eligible holders of non-EU medical, pharmacy or dental qualifications to work temporarily in a supervised framework after obtaining the required attestation permitting provisional practice.
A PACT is not a full and permanent authorization to practise independently in France. The practitioner performs authorised prevention, diagnostic, treatment and emergency-care activities by delegation and under the direct responsibility of an appropriately qualified practitioner within the host structure.
Who can be recruited as a PACT?
The PACT framework applies to doctors, pharmacists and dental surgeons holding a doctorate qualification that permits practice in the country where it was obtained or in the country of origin. PADHUE doctors are therefore among the professionals who may be concerned, subject to the statutory conditions and the individual assessment of their file.
Before recruitment, the candidate must in particular satisfy the following requirements:
- Hold the required foreign professional qualification.
- Hold a valid attestation permitting provisional practice (attestation permettant un exercice provisoire).
- Meet the good-character, physical-fitness and compulsory-immunisation requirements.
- For non-EU/EEA nationals, be in a regular situation regarding residence and work authorisation in France.
- Be recruited by an eligible establishment under a written PACT contract.
PACT, provisional practice and full authorization: what is the difference?
|
Status |
What it permits |
Main limitation |
|
Attestation permitting provisional practice |
Authorises provisional practice in the named establishment, profession and, where applicable, specialty. |
It is temporary, establishment-specific and supervised; it is not a permanent authorization to practise. |
|
PACT contract |
Creates the public-law employment relationship for an eligible practitioner working under the PACT framework. |
The practitioner acts by delegation and under direct responsibility; the contract depends on the validity of the provisional-practice attestation. |
|
Full authorization to practise |
Allows practice subject to the rules applicable to the profession, including any registration and administrative formalities. |
It does not by itself remove all other professional, ordinal, employment, immigration or establishment-specific requirements. |
What is the provisional-practice attestation?
attestation permettant un exercice provisoire. The official regulatory expression is
It is an administrative authorization, not an employment contract. The attestation identifies the professional, the profession and any specialty, the host establishment and the period during which provisional practice is authorised.
The application is submitted by the prospective employer to the competent regional health agency (ARS). The file includes, among other items, evidence of qualifications, professional experience, French-language competence, the candidate’s undertaking to sit the EVC before the attestation expires, and the employer’s undertaking to recruit and supervise the candidate if the attestation is granted.
For an initial application, the regulations require at least three years of full-time professional experience in the relevant profession or specialty, including at least one year of full-time practice during the three years preceding the submission date. The required French-language level is specified in the relevant opening notice.
Where and under what supervision can a PACT work?
A practitioner holding the provisional-practice attestation may work within an eligible public health establishment, a not-for-profit private health establishment, or a social or medico-social establishment or service, subject to the terms of the authorization and contract.
For doctors and dental surgeons, practice is carried out by delegation and under the responsibility of a fully licensed practitioner qualified in the same specialty, who must be available to the holder of the attestation. A PACT cannot perform replacement work.
How long can a PACT contract last?
The initial PACT contract cannot exceed the validity period of the provisional-practice attestation and is capped at 13 months. It may be renewed once, but the total period of practice may not exceed 26 months. Expiry of the provisional-practice attestation automatically terminates the PACT contract.
The standard weekly service obligation is ten half-days, subject to the applicable working-time rules. The contract must be in writing and specify, among other matters, the functions, assignment, duration, salary, social-protection regime, service obligations and notice arrangements.
Does a PACT allow legal practice in France before full authorization?
Yes, but only within the temporary, supervised and establishment-specific framework authorised by the attestation and the PACT contract. It does not grant unrestricted professional autonomy, a right to open a private practice, or authority to practise independently throughout France.
Foreign nationals must also maintain the residence and work authorization required for their personal situation. The employment contract and professional authorization do not replace immigration formalities.
PACT and the internal EVC pathway: what is the real link?
it does not automatically create eligibility for the internal EVC pathway. A PACT position may help a PADHUE acquire professional experience in France. However,
For the 2025 EVC session, the internal route was open to PADHUE professionals working in France who could demonstrate at least two years of full-time-equivalent professional experience in France in their profession or specialty during the three years preceding publication of the opening order. The exact eligibility conditions, specialties, documentary requirements, deadlines and examination format must always be checked against the opening notice for the relevant EVC session.
Accordingly, a PACT contract should be assessed as one possible component of an individual professional plan. It is not a waiver of the EVC criteria and does not guarantee admission to any EVC route.
Checklist before accepting or pursuing a PACT position
- Confirm that your degree permits professional practice in the country of issue or origin and matches the profession and specialty sought in France.
- Identify an eligible employer willing to support the provisional-practice application and provide appropriate supervision.
- Verify that you meet the experience threshold, language requirements and documentary requirements for the provisional-practice attestation.
- Ensure that the proposed PACT contract matches the establishment, specialty, duties and duration covered by the attestation.
- Verify your immigration, residence and work-authorisation position before the proposed start date.
- Review the current EVC opening notice and calculate whether your French professional experience meets the requirements for the route you intend to use.
- Keep certified evidence of all employment periods, working time, specialty, supervision and professional activities in France.
Frequently asked questions
Does PACT automatically give access to the internal EVC route?
No. The PACT may enable supervised work experience in France, but internal-route eligibility depends on the requirements set by the EVC opening notice, including the relevant duration and nature of professional experience.
Can a PACT doctor work independently or replace another doctor?
No. The PACT framework is supervised and delegation-based. Practitioners are not authorized to carry out replacement work.
Is the PACT contract the same as the provisional-practice attestation?
No. The attestation is the administrative authorization allowing provisional practice in a specified setting. The PACT is the employment contract. Both are needed for lawful practice under this route.
Can a PACT contract continue after the attestation expires?
No. The end of validity of the provisional-practice attestation automatically ends the PACT contract.
Can full authorization be obtained immediately after a PACT?
Not automatically. The route to full authorization depends on the applicable statutory procedure, including the EVC where required, the consolidation-of-competence pathway and the authorization process.
How legal counsel can help
A tailored review can help a PADHUE practitioner or prospective employer coordinate professional authorization, the employer-supported provisional-practice application, the PACT contract, residence and work authorization, and the EVC strategy. The assessment should be made early, before a contract is signed or an administrative filing deadline is missed.
Legal sources and verification
- Decree No. 2024-1190 of 19 December 2024, creating the PACT framework and codified provisions including Articles R. 6152-934 to R. 6152-963 of the French Public Health Code.
- Decree No. 2024-1191 of 19 December 2024, governing the attestation permitting provisional practice, including Articles R. 4111-13-8-1 et seq. of the French Public Health Code.
- Centre national de gestion (CNG), EVC session 2025 information and current EVC notices.
- Applicable ARS and CNG notices, which must be checked for current periods, specialties, language evidence and filing requirements.
Important notice. This page provides general information on the French PACT framework for internationally trained health professionals. Eligibility depends on the applicable legislation, the professional qualification, the specialty, the employer, immigration status and the opening notice for the relevant EVC session. It is not a substitute for an individual legal or administrative assessment.
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