Studying Medicine Abroad: A Guide for French Students

When a family reaches out to me because their child has just failed the French first health year, or because they dread the cut-off of PASS, one sentence comes up almost every time: “What if we went abroad to study medicine?”. Usually with the idea that it would be simpler, safer, a clean way out.

I understand the instinct, and I never brush it aside. For many families, especially expatriate families already used to living internationally, it is a genuine option, sometimes the right one. But it rests on a precise mechanism that few people know about, and on a stubborn misconception: no, it is not an easy path, and no, not every country is equal when it comes to returning to practise in France.

This article sets out how it really works. The principle of degree recognition, country by country, what changes everything between the European Union and the rest of the world, and the concrete criteria for deciding with open eyes. In our practice, that clarity is exactly what families lack at the moment they consider this move.

The principle that governs everything: degree recognition

Before we talk about any particular country, there is one rule to understand, because it governs the whole decision.

A medical degree earned in a European Union country (or in the European Economic Area) is automatically recognised in France, under EU Directive 2005/36/EC on the recognition of professional qualifications. In practice, the holder of a Romanian, Belgian or Italian degree can apply to register with the departmental board of the Ordre des médecins where they intend to settle. The board checks that the degree conforms and that the applicant has the required command of French (B2 level), and registration generally takes three to six months. The applicant must be a national of the EU, the EEA, Switzerland or Andorra.

This is the crucial point: the degree does not have to be retaken. A doctor trained in Cluj or Zagreb practises in France with the same title as one trained in Lyon.

Outside the European Union, everything changes. A degree obtained in Canada, the United States or Lebanon opens no automatic recognition. The doctor must sit the knowledge-verification exams (épreuves de vérification des connaissances, EVC), pass a capped competitive exam, then complete a multi-year consolidation period in a hospital before being cleared to practise. The pass rate is low and the process is long. Switzerland sits apart: it is not in the EU but benefits from a specific agreement, though its own numerus clausus makes it hard to enter in the first place.

Keep that dividing line in mind. It explains why a rational French family looks to Romania or Belgium rather than to a university outside Europe: it is not a question of prestige, it is a question of the way back.

Belgium: the closest, but capped

French-speaking Belgium is the reflex destination, for an obvious reason: same language, proximity, a degree recognised in France. It is also the most tightly regulated.

Historically, access to first-year medicine on the French-speaking side (Fédération Wallonie-Bruxelles) was decided by a lottery, a system that long caused outrage. It has been replaced by an annual entrance exam. For 2026, the exam takes place on 27 August 2026 in Brussels, with online registration from 18 May to 5 July 2026. To pass, candidates must score an average of 10/20 on each of the two parts and at least 8/20 on each sub-test.

The sensitive point for French families is the non-resident quota. To protect access for its own residents, the Fédération Wallonie-Bruxelles caps the share of non-resident students admitted to medicine and dentistry. That quota is set at 15% for the period 2023-2024 to 2029-2030: beyond it, non-residents are ranked by descending score and only the highest-ranked receive their certificate.

Be careful, the situation is in flux. In April 2026 the Court of Justice of the European Union (case C-131/25) called this quota into question for non-residents who completed their entire secondary schooling in Belgium, seeing it as a barrier to free movement. That is a strong signal, but the exact impact on the coming intakes was still being clarified as I write. If you are aiming for Belgium, check the current year’s rules carefully before committing. Our Belgium country guide sets out the general framework of the system.

The other European destinations

Beyond Belgium, several EU countries take in French students in medicine. More than 8,000 French students are currently following a medical course abroad. Here are the main options, each with its own logic.

Romania

This is often the first alternative mentioned, because some universities (Cluj, Iași) offer a French-taught course in the early years, which removes the language barrier. The cost is among the lowest in Europe: on the order of 10,000 to 11,500 euros a year depending on the university, with increases announced for 2026. The degree is recognised in France like any EU degree.

Hungary and Croatia

Both countries rely on English-taught programmes at well-regarded faculties (Semmelweis in Budapest, Zagreb, Rijeka). They require a strong level of English and, often, passing the university’s own entrance exam. Budget roughly 14,000 to 18,000 euros a year in Hungary and 8,000 to 12,000 euros a year in Croatia. Again, the degree is recognised in France.

Italy

Italy selects through a national test, the IMAT (International Medical Admissions Test), taken in English for English-taught programmes. The course lasts six years. Fees vary widely by university, from a few thousand euros to close to 18,000 euros a year, as they often depend on the family’s income.

Spain

Spain is appealing, but with a budget trap. Public universities are cheap yet almost inaccessible to foreigners (selection on the very high nota de corte, via the Credencial UNED and the PCE exams). French families therefore usually go through the private route, where fees can reach 20,000 euros a year. The language of instruction is Spanish.

Switzerland

I mention it for completeness, but Switzerland remains almost closed to foreigners in medicine: a strict numerus clausus, priority to residents, and outside the EU’s automatic-recognition framework. It is not a realistic path for most families. Our Switzerland country guide explains why.

Returning to France for residency

This is the question families forget most often, and yet it is decisive. Doing your six years of medicine in Romania or Hungary does not exempt you from going through the French system if you want to specialise and do your residency in France.

A student trained at an EU faculty can register for the national computerised exams (EDN, formerly ECN), then the ECOS clinical exams, provided they do not already hold a specialty diploma. These are exactly the same exams that French students sit in their sixth year. The final ranking combines the EDN (60%), the ECOS (30%) and portfolio points (10%), and it determines the specialty and the city of residency.

In other words: studying medicine abroad bypasses the bottleneck of the French first year, but not the residency exam. A student who prepares poorly for the EDN will end up in the same national competition, with a foreign course that will not always have trained them for the very specific French format of these exams. That is a real preparation issue, to be anticipated from the fifth year onward.

Five criteria for deciding with a clear head

When a family lays out its plan to me, I always bring the discussion back to five concrete criteria. None of them is trivial.

1. Degree recognition. EU or non-EU? This is the first filter, the one that determines any return to France. A non-EU degree is a heavy bet.
2. The language of instruction. French (partly in Romania, Belgium), English (Hungary, Croatia, some Italian faculties) or the local language (Spain). Following six years of medicine in a poorly mastered language is a real cause of failure.
3. The total cost over six years. Tuition, but also housing, living costs and travel. An honest budget often runs from 40,000 to more than 100,000 euros. That figure is set at the start, not along the way.
4. The return for residency. Anticipate the EDN, plan for suitable preparation, understand that the national ranking makes no allowance for a foreign course.
5. The reality of the difficulty. This is not an easy route. It is a move abroad, an adjustment, a long course. The families who succeed are those who treat it as a genuine project, not an improvised plan B.

If your child is still hesitating between the French health year and going abroad, weigh the option coldly rather than as a rescue. Our Studying abroad section sets the wider context for building an international study project.

Key takeaways

• The dividing line is the EU. A medical degree earned in a European Union country is automatically recognised in France; outside the EU, you must sit the long and selective knowledge-verification exams.
• Belgium is the closest but the most capped, with an entrance exam (27 August 2026) and a 15% non-resident quota whose legality is now being challenged before the EU courts.
• Romania offers the best access-to-cost ratio with courses partly in French; Hungary and Croatia teach in English; Italy selects through the IMAT; Spain usually runs through the expensive private route.
• The return for residency comes down to the same national exams (EDN then ECOS) as for students trained in France: studying abroad bypasses the first year, not the residency competition.
• It is not a shortcut. High cost, a language to master, a six-year course: it is a real project, to be decided on concrete criteria, not on a miracle-solution myth.

Going further

• Studying abroad section: the wider framework for building an international study project.
• Belgium country guide and Switzerland country guide: the detailed picture of our two neighbours.
• Your Europe: recognition of professional qualifications: the official EU source on how professional qualifications, including medicine, are recognised across member states.

Article written by Constantin Mardoukhaev, co-founder of Axiom Academic.