Francophone Africa: how the Ordre des médecins model registers health professionals

One template, many national orders

Francophone Africa inherited the French model of professional regulation. A law creates an Ordre des médecins with public-law status. It keeps the tableau (the register), enforces the code of ethics and disciplines members. The state decides who holds a valid diploma. The Ordre decides who is enrolled. Neither tests clinical knowledge after graduation.

Senegal's Law 66-69 of 4 July 1966 shows the pattern clearly. To practise, a doctor needs a Senegalese state doctorate or a foreign diploma recognised as equivalent, Senegalese nationality or a treaty giving Senegalese doctors reciprocal establishment rights, and enrolment on the tableau. The tableau has a Section A for public servants and teaching staff and a Section B for everyone else. Foreign doctors who miss the nationality or diploma test can be authorised to work in hospitals and dispensaries, but not in private practice. Doctors funded by a scholarship under an agreement owe ten years of public service first.

The other twelve French-speaking countries below are listed in our data with the same structure. We have not read each national law, so treat Senegal as the best-documented example and not as proof about its neighbours.

The usual route from graduation to the register

1. Finish the state doctorate, which in most systems includes a thesis and a hospital internship.
2. Get the diploma recognised by the higher-education ministry if it was issued abroad. This is the equivalence commission.
3. Apply to the national Ordre with identity papers, diploma, criminal record extract and any ministry authorisation.
4. Be enrolled on the tableau in the section that matches your practice: public, private or teaching.
5. Take the oath and pay dues. In Senegal's law, practising without enrolment is an offence.

The fourteen systems side by side

Djibouti is French-speaking and follows the same Ordre logic, but its closest neighbours are in the Horn. It is covered with them on the Yemen and the Horn page. Burundi, also French-speaking, sits with its East African neighbours on the East and Southern Africa page. Cameroon and Rwanda have their own pages: Cameroon and Rwanda.

West Africa and the Sahel

Senegal

The best-documented system in the group. Law 66-69 sets the three conditions above and the Section A and B split. A press report cites about 5,675 registered doctors. Dakar and Saint-Louis are the main training sites. Foreign diplomas go to an equivalence commission before the Ordre will enrol the holder.

Mali

Doctors enrol with the Ordre National des Médecins after the state doctorate. The main faculty is in Bamako. Foreign graduates submit their diploma for equivalence, and a commission test is possible. Confirm current practice with the Ordre.

Burkina Faso

The same diploma-then-Ordre route, with health faculties in Ouagadougou and Bobo-Dioulasso. Foreign-trained doctors need equivalence first. Nurses and midwives register by qualification through the ministry.

Niger

Niamey is the main training site. The Ordre National des Médecins enrols graduates, and foreign diplomas follow the equivalence route. Our data lists no licensing exam and no separate exam for nursing, only school-level state examinations.

Guinea

The Ordre National des Médecins de Guinée enrols doctors by diploma. Foreign diplomas follow the equivalence route, and our data lists no licensing exam and no separate nursing exam.

Mauritania

Arabic and French both matter here. Registration is by diploma with the Ordre national des médecins, and specialist selection runs through a concours de l'internat. The closest comparable exams are on the Maghreb pages: Morocco, Tunisia, Algeria.

The Gulf of Guinea coast

Côte d'Ivoire

The Ordre National des Médecins handles enrolment. Foreign graduates face equivalence and, our data suggests, sometimes a national commission test. That test is the one point in this group where a knowledge check may apply to doctors, so ask whether it applies to your diploma.

Benin

Doctors enrol with the Ordre national des médecins du Bénin. The pattern matches Côte d'Ivoire: diploma, equivalence for foreign degrees, and a possible commission test.

Togo

Togo follows the same model through the Ordre National des Médecins du Togo. Lomé is the main training centre. As elsewhere on this coast, foreign diplomas go through equivalence and possibly a commission test.

Central Africa

DR Congo

DR Congo has a large medical-student base. The term to watch is "examen d'État". In DR Congo, "examen d'État" is the secondary-school leaving exam. It is not a licensing test for doctors, and it is easy to misread when searching in French. Doctors enrol with the Ordre des Médecins after graduation.

Republic of Congo

Brazzaville is the training centre. The Ordre des médecins du Congo enrols graduates, with equivalence for foreign diplomas and no licensing exam in our data.

Gabon

A small system, with registration through the Ordre National des Médecins du Gabon. A doctor returning with a foreign degree goes through the equivalence step before enrolment.

The Indian Ocean

Madagascar

Doctors register with the Ordre des Médecins de Madagascar. The competitive paper that matters is the concours d'internat qualifiant for specialist training. It selects for residency and does not license general practice. Malagasy and French are both used.

Mauritius

The outlier in this hub. English is the administrative language and French is widely spoken. The Medical Council of Mauritius, created by the Medical Council Act 1999, registers doctors. A council examination may apply to holders of qualifications outside its recognised list, though we could not verify it. Nurses and pharmacists register with their own councils.

Where graduates go next

For most doctors in this group the next exam is abroad. Three destinations dominate.

France. A doctor with a non-EU diploma applies through the PADHUE authorisation procedure. The first step is the EVC (épreuves de vérification des connaissances), a written knowledge test run by the Centre national de gestion. Candidates must show French at B2 with a TCF, TEF, DELF or DALF result. A candidate may apply for only one specialty per session. After authorisation, the CNG can require a consolidation pathway of up to two years in a hospital. The rules change by session, so read the current CNG notice.

The United Kingdom. French-speaking African doctors usually enter the UK register by passing PLAB, with an English test such as IELTS or OET. See the UK page.

Belgium, Switzerland, Quebec and the Gulf. Each has its own recognition process and a French-language option in some cases. Belgium and Switzerland are on their pages. Gulf licensing runs through Dataflow verification and a licensing exam such as the Saudi SMLE. Nurses can target the US NCLEX, covered on the US page.

Medical education in the region

Doctors train for about seven years in a state doctorate that ends with a defended thesis. The language of instruction is French, and the curriculum follows French models, with early clinical rotations in teaching hospitals and a final internship. The higher-education ministry recognises the degrees, and the health ministry and the Ordre handle practice rights. For the US, ECFMG asks whether your school's accrediting agency holds international recognition, so look up your school's status early.

Some students from the group train abroad, for example in France, Morocco, Tunisia, Algeria or Cuba. Their degrees go through the equivalence step on return. For nurses and midwives, training is in public and private institutes, with a state diploma at the end. This is why many nurses register by qualification only.