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N. Pinsault1, J.-F. Dumas1, A. Guillaume1, P. Mathieu1
1French National Council of Physiotherapists, Demography Observatory, Paris, France
Background: Free movement of workers is a fundamental principle established by the Treaty on the Functioning of the European Union and developed by secondary legislation and the case law of the European Court of Justice. Limitations to this principle exist for reasons of public security, public order, public health and public sector employment. Thus, the sustainable practice of physiotherapy in France, for professionals who have graduated from another European Union country, requires authorization to practice and registration on the board of the Order. While a strong limitation on the number of diplomas awarded in France is imposed by the government in order to limit the supply of care and thus health expenditure, no regulation is proposed for the inflow of professionals with foreign diplomas. Moreover, it seems that the extent and characterization of this phenomenon remains unknown.
Purpose: To determine the prevalence of professionals graduating outside France, the dynamics of the incoming flow of professionals according to their characteristics and the origin of their diplomas.
Methods: Origin of the professional and of their diploma as well as modalities of practice were extracted on the first of January from 2015 to 2019 from the Order's database, listing all physiotherapists authorized to practice in France (i.e. the entire population).
Results: As of January 1, 2019, 25.1% of physiotherapists practicing in France hold a foreign diploma. 59% of these professionals are of French nationality.
The number of registered professionals holding a French diploma is increasing on average by 2.4% each year compared to 10.2% for professionals with foreign diplomas.
Belgium, Spain, Germany, Poland and Romania account for more than 90% of the origins of the diplomas of practicing physiotherapists with a diploma from outside France. For foreigners that graduated abroad, 4 nationalities represent more than 80% of this category: Spanish (36% of foreign professionals), Belgian (24.5%), Polish (12.5%) and Romanian (10%). It can be seen that the proportion of French nationals working in France who obtained their degree abroad varies greatly depending on the country in which it was obtained. Belgium is by far the country with the highest number of French nationals graduating, but the dynamic over the last 5 years shows an average annual growth in the number of French nationals graduating in Spain of 50% and in Romania of more than 30%.
The number of registered professionals holding a French diploma is increasing on average by 2.4% each year compared to 10.2% for professionals with foreign diplomas.
Belgium, Spain, Germany, Poland and Romania account for more than 90% of the origins of the diplomas of practicing physiotherapists with a diploma from outside France. For foreigners that graduated abroad, 4 nationalities represent more than 80% of this category: Spanish (36% of foreign professionals), Belgian (24.5%), Polish (12.5%) and Romanian (10%). It can be seen that the proportion of French nationals working in France who obtained their degree abroad varies greatly depending on the country in which it was obtained. Belgium is by far the country with the highest number of French nationals graduating, but the dynamic over the last 5 years shows an average annual growth in the number of French nationals graduating in Spain of 50% and in Romania of more than 30%.
Conclusion(s): Our results suggest that professionals use their rights to mobility to train and work within the European Union. However, the scale and dynamics of the number of French graduates abroad suggest that these are not chosen migrations but rather aimed at circumventing the numerus clausus imposed for training in France.
Implications: The definition of care supplies ratios according to health needs should integrate migration data to more clearly define a national training policy. The definition of a common framework for training in Europe should also be considered. With 129 physiotherapists per 100,000 inhabitants, French public health policy neglects the use of rehabilitation care for its population despite the recommendations of the World Health Organization to intensify it in developed countries.
Funding, acknowledgements: This study was carried out within the framework of the Observatory of Demography of the Conseil de l'Ordre des masseurs-kinésthérapeutes.
Keywords: European mobility, Demography, Education
Topic: Globalisation: health systems, policies & strategies
Did this work require ethics approval? No
Institution: N/A
Committee: N/A
Reason: Work on database
All authors, affiliations and abstracts have been published as submitted.
