Foreign Doctors in France Face Financial Crisis as Hospitals Demand Bonus Repayments

This bonus was paid to foreign doctors serving in the four hospitals (Marne-la-Vallée, Meaux, Coulommiers, Jouarre) forming the Grand Hôpital de l’Est francilien (GHEF), which, like many others, are facing a shortage of skilled labor. "These bonuses are a common practice that allows them to attract them to medical deserts where, due to their precariousness, they are at the mercy of the authorities. Without them, the hospitals would close," explains Kahina Hireche Ziani, general secretary and spokesperson for the SOS Pahdue union.

At the end of 2024, the new management of the GHEF informs the foreign doctors of its decision to stop paying this bonus which, according to it, has "no legal basis". Then, on March 31, 2025, it demands the reimbursement of this bonus over the last two years. A cold shower for the foreign doctors for whom this bonus represented nearly half of their income. "We end up with doctors now paid €1,100 net, less than cleaning ladies, with a debt of €34,000 to repay. It’s absurd," fumes the CGT, which met with the Ministry of Health on Wednesday.

"Some are chaining twenty on-call shifts per month to be able to keep their heads above water and feed their families, it’s not sustainable," says Catherine Dos Santos, deputy secretary of the hospital union. For its part, the management claims that it is only complying with the law and responding to a request from the Public Treasury, which is demanding a total of €2.7 million from it. "It’s obviously easier to recover this amount on the backs of precarious workers who don’t know French laws and are afraid of losing their residence permit as well as their job," fumes the CGT.

Faced with this difficulty, the foreign doctors have hired lawyers. "It is unthinkable to make them bear the responsibility for a decision made by the management, which has become final and is written into their employment contract and their job offer," protests Me Delphine Kriszch, who denounces a poor application of the texts. She has referred the matter to the administrative court of Melun. "We have no choice! Even by spreading it over two years, it’s impossible. We already have to pay taxes based on our old salary, our lawyers, all that with a salary that has melted away... And we can’t leave the GHEF without having obtained the validation of our exam. Many feel trapped," complains a doctor.

"It’s unacceptable! After eight to ten years of study, I would never have come to France to earn €1,500 or €2,000, which is what I would have been paid if I had stayed in Morocco. Trust is broken, everyone dreams of leaving the GHEF," rages another who has to pay back €60,000. "The decrees are deliberately vague, which gives free rein to the directors of the establishments to do what they want, the ministry knows it, but it suits everyone: the Pahdue come last for the choice of holidays and on-call shifts, while being underpaid. The system relies on them while saving money at their expense," denounces Kahina Hireche Ziani of SOS Pahdue.