France: the EDN ranking exam and the EVC for foreign-trained clinicians

Medical and health education in France

Medicine in France takes at least nine years: six years in two cycles, then three to five years of residency (internat) in the chosen specialty, which for general practice is now four years. Entry is through the PASS or LAS first-year options, which replaced the old PACES year. More than thirty health faculties teach in French, evaluated by HCERES and overseen by the ministries of higher education and health. Pharmacy and dentistry are six-year degrees, and nursing is a three-year degree.

The sixth year ends with the national EDN (Épreuves Dématérialisées Nationales), a ranking exam. Rank decides specialty and city, which makes France unusual: the exam allocates places rather than awarding a licence. A thesis defended at the end of residency gives the state diploma of doctor of medicine, and registration with the Ordre des médecins is required to practise. Doctors trained outside the EU must pass the EVC knowledge exam and complete supervised work. Confirm current rules with the CNG and the Ordre.

A ranking exam, not a pass mark

French medical education is organised around ranking. After the sixth year, students are not asked whether they are competent to practise. They are asked where they come in a national list, because that list allocates the specialty and the city of training. For that reason, the main exam in France behaves differently from the licensing exams of Germany or Switzerland. A high score is useful, a pass is not enough, and a candidate can do well and still miss a preferred post.

The same logic applies to foreign-trained doctors. The EVC does not just check knowledge. It allocates a limited number of posts by specialty, and those who succeed then complete a period of supervised consolidation before full registration.

Who needs a licensing exam in France

• Doctors, locally trained: EDN and ECOS, which are ranking tests that lead into the internat (residency).
• Doctors, trained outside the EU (PADHUE): the EVC, by specialty.
• Midwives, pharmacists and dentists, locally trained: no licensing exam. The state diploma is the qualification. Specialty entry runs through the internat competition.
• Midwives, pharmacists and dentists, trained outside the EU: EVC, by profession.
• Nurses and physiotherapists: no licensing exam. EU and EEA diplomas go through an autorisation d'exercice via the regional DREETS, sometimes with an aptitude test or adaptation period.

Doctors: EDN and ECOS

The EDN replaced the old ECNi as part of the R2C reform of the second cycle. The CNG (Centre National de Gestion) organises it, and its candidate handbook (the mémento du candidat) is the document to read first. The questions include isolated questions and progressive clinical cases, with single-answer (QRU), multiple-answer (QRM) and key-feature (KFP) formats, and the test includes critical reading of a scientific article (LCA). The written part is divided into several three-hour sessions.

ECOS are the clinical stations, an objective structured clinical exam (OSCE). The press reported about 10,700 students expected at ECOS in 2026. That number matters because it tells you the scale: this is one of the largest MCQ exam markets in Europe, and it is entirely in French.

Foreign-trained doctors: the EVC

The EVC is the route for doctors with a diploma from outside the EU, known in France as PADHUE (praticiens à diplôme hors Union européenne). It is organised by specialty. Two routes exist.

• Internal route: a multiple-choice paper of 40 questions.
• External route: two written papers, one on fundamental knowledge and one on practical knowledge of the specialty.

For 2026 the CNG announced 1,003 posts on the external route and 2,896 on the internal route for doctors. Successful candidates then do two years of consolidation in a French hospital before they can ask for full authorisation. French language proficiency is required, and the CNG pages set out the evidence it accepts.

1. Check eligibility and the route on the CNG EVC page for your specialty.
2. Register in the annual campaign. Dates move each year.
3. Sit the written papers. The format depends on whether you are on the internal or external route.
4. Be placed in a post. Your score determines whether you obtain a place in your chosen specialty.
5. Complete the consolidation period and apply for the final authorisation.

Midwives, pharmacists and dentists

Locally trained midwives, pharmacists and dentists qualify by state diploma. Those who want specialty training enter a separate competition: the internat in pharmacy, the internat in odontology. Those trained abroad follow the same EVC with profession-specific places, and the number is small.

One midwife post in a year shows how narrow the door is. Midwives considering France should read the CNG notice and think about whether retraining at a French school is a more realistic plan. Pharmacists with a foreign diploma can also look at the PHA-ET internat route for foreign titles, described on the CNG site.

Nurses and physiotherapists

Neither profession has a national licensing exam. A nurse holds the Diplôme d'État infirmier from an IFSI, and a physiotherapist the diplôme d'État de masseur-kinésithérapeute from an IFMK. For foreign professionals, the DREETS grants an autorisation d'exercice to holders of EU or EEA diplomas, sometimes after an aptitude test or an adaptation period. For holders of non-EU diplomas, the usual path is to enter the French school with partial exemptions and obtain the French diploma.

Exams at a glance

Language and recognition

All French exams are in French. A candidate from the Maghreb, the Middle East or sub-Saharan Africa will often have the clinical training but must put the vocabulary of French clinical practice in place, including drug names and the structure of the dossier clinique. For EU and EEA qualifications, recognition follows the EU directive and French language knowledge is checked at registration.

Using this page

If you are a French student, the CNG memento and the year's call notice are your primary documents. If you are a foreign-trained doctor, the CNG's EVC page and its latest results note are. The numbers on this page come from the CNG and may change in the next campaign. TriagePass is independent of the CNG and of any French authority.

Last reviewed October 2026