Working in healthcare: what level of French do France and Quebec require?

To practise a healthcare profession in France with a degree earned outside Europe, you must prove a B2 level in French, a threshold set by the decree of 27 October 2014. Quebec asks for no language diploma at all: an examination run by the Office québécois de la langue française, built around a professional case study, takes its place.

What level of French does France require in healthcare?

For a doctor, dentist, midwife or pharmacist who qualified outside the European Union, access to practice runs through the épreuves de vérification des connaissances, known as the EVC. The application is only admissible if the candidate proves a level of French at least equal to B2 of the Common European Framework. The Centre national de gestion, which runs the exams, lists the accepted evidence: a TCF or TEF result at B2 or above, a DELF B2, a French baccalauréat or an equivalent French qualification, or a certificate showing studies followed entirely in French. Nationals of France and of countries where French is an official language are exempt. The threshold comes from the decree of 27 October 2014, issued under article L. 4111-2 of the public health code.

The EVC themselves are not a language test: two anonymous written papers of two hours each, one on fundamental knowledge, the other on practical knowledge, marked out of 20. Nobody deducts a point there for a wrong agreement, but a misread question costs the whole answer. If B2 is your target, our complete method for the DELF B2 sets out the four papers.

Why does Quebec not ask for a language diploma?

In Quebec the requirement is not a certificate but a knowledge of French appropriate to the practice of the profession, under section 35 of the Charter of the French language. Three situations exempt you, as the Ordre des infirmières et infirmiers du Québec recalls: having studied full time in French for at least three years, at secondary or post-secondary level; having passed the French mother-tongue examinations of the fourth or fifth year of secondary school; or having obtained a Quebec secondary school certificate from the 1985-1986 school year onwards. Outside those cases, the Office examination is the normal route.

That examination looks like no standard language test. The Office québécois de la langue française builds it around a professional case study, in four activities: individual preparatory reading, a group discussion with the other candidates, a piece of writing, then an individual oral interview in which you explain the solutions you chose. Allow about three and a half hours, break included. Its information guide is clear about passing: every single part of the examination must be passed to obtain the pass mark. One failed part means retaking the whole thing, as often as needed. Meanwhile the Ordre can issue a temporary permit valid one year, renewable three times, that is four years to reach the level.

Is a general language diploma enough to work in care?

Specialist certifications do exist. Le français des affaires, at the Paris chamber of commerce, offers a professional French diploma in Health at B1, B2 and C1. It tests work situations: an anxious relative on the phone, an instruction to rephrase, a report to write.

Do not confuse the two uses, though. The evidence listed by the Centre national de gestion does not include these specialist diplomas: for the regulatory file, the TCF, the TEF and the DELF are what count. A healthcare French diploma helps you hold the post, not tick the box. Hence the order to follow: the general certificate first, because it opens the door, the language of the job second, because it decides your first week.

What French is actually spoken at a patient's bedside?

The same fact travels through three registers, and you have to move between them without thinking:

• the patient says « j'ai mal au ventre » or « ça me serre » ;
• the spoken handover to a colleague says « douleurs abdominales depuis ce matin » ;
• the written file says « douleur abdominale, apparition ce matin ».

Three habits are rarely taught. You use vous with patients, however elderly, while colleagues on the same ward often use tu: this double regime of tu and vous is hard to read from the outside. Instructions are softened: not « tournez-vous » but « vous allez vous tourner vers moi, doucement ». And the essentials are exchanged fast, at handover, in the kind of fast spoken French full of abbreviations that is exactly what you understand least at first.

English speakers carry two traps into care work. « Drug » is not « drogue », which means a narcotic: the patient is waiting for « médicament ». And « intoxication » in French means poisoning, not drunkenness, so « intoxication alimentaire » is food poisoning. A third one is not lexical at all: English asks directly, French softens with the future and with diminutives, so « vous allez sentir un petit froid » is the normal register where English would say « this will feel cold ».

What these requirements do not tell you

A B2 certificate attests a level on one given day, on general documents. It says nothing about your ability to hold a night shift, nor to understand a patient who is speaking while in pain. The Quebec examination, closer to the ground, measures professional interaction without checking medical terminology: neither of the two verifies that you can say « pansement occlusif ».

Two practical limits. Requirements differ by profession and by country, and they move: the 2014 decree has been amended since, including in 2025. Check the rule in force with the relevant professional body or regional health agency before paying for a test. And none of this concerns recognition of the qualification itself, a separate path, often longer than the language. To place your starting point, a level test takes a few minutes, and our article on the job interview in French covers the next step.

At Frenchee, classes are live, by video, with qualified native teachers holding a master's degree in teaching French, one to one or in a small group of three to five students. You work on the situations of your own job, practising how to rephrase and how to ask someone to repeat.

Sources

• Centre national de gestion, épreuves de vérification des connaissances
• Office québécois de la langue française, examination for professional orders
• Ordre des infirmières et infirmiers du Québec, knowledge of French
• Le français des affaires, professional French diplomas