In France, one makes an appointment “with the doctor” to see their primary care physician. The two words are used interchangeably in everyday conversation, to the point that the distinction seems purely rhetorical. It is not. One refers to an academic title, while the other refers to a regulated profession, and the boundary between the two has become even more complex with recent reforms in the French university system.
Academic title versus health profession: a confusion rooted in usage
The word “physician” refers to a profession. It designates a person authorized to diagnose pathologies, prescribe treatments, and follow patients. To practice this profession in France, one must have completed the full medical education curriculum and obtained the state diploma of doctor of medicine.
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The word “doctor,” on the other hand, is a title. It applies to anyone who has defended a thesis in an academic discipline. A doctor of law, a doctor of science, a doctor of history holds this title just like a doctor of medicine. Common usage has simply reduced “doctor” to the medical field, which fuels the confusion, as highlighted by the definition of doctor on 123 Docteur clearly distinguishing the two terms.
A physician is always a doctor of medicine, but a doctor is not necessarily a physician. A researcher in molecular biology with a doctorate can legitimately call themselves “doctor” without ever having examined a patient.
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State diploma and academic degree: the gap in the LMD system
Most articles addressing this topic stop at the opposition between title and profession. The current regulatory framework goes further and deserves attention.
The state diploma of doctor of medicine, which authorizes clinical practice, is classified at level 7 of the RNCP (National Directory of Professional Certifications). This level corresponds to a master’s degree in the License-Master-Doctorate system. Therefore, the state diploma does not confer the academic degree of doctor in the academic sense of the term.
The academic degree of doctor is reserved for holders of a research doctorate, equivalent to the Anglo-Saxon PhD. A clinical physician who has only defended their professional thesis is not recognized as a “doctor” by the university in the context of the LMD system, even if they hold this title in their daily practice.
Professional thesis and research thesis: two distinct paths
The professional thesis validates the ability to practice medicine. It is defended at the end of the curriculum and generally focuses on a clinical subject. The university doctoral thesis, on the other hand, involves several additional years of research and results in an original contribution in a scientific field.
The same person can hold both: being a doctor of medicine (professional title) and a doctor of neuroscience (academic degree). The available data does not allow for a precise quantification of the proportion of physicians who also hold a research doctorate, but it remains a minority compared to all practicing professionals.
Who can legally hold the title of doctor in France
The French legal framework distinguishes two categories of doctors:
- Holders of a professional thesis in health disciplines (medicine, dental surgery, pharmacy, veterinary medicine) hold the title of doctor. This title is directly linked to their right to practice.
- Holders of a research doctorate (sciences, law, literature, economics, etc.) hold the degree of doctor. This degree attests to academic competence, not professional qualification.
- University professors in medicine often combine the title and the degree: they practice in a hospital setting and conduct research. They are referred to as “professor” rather than “doctor,” which adds a layer of complexity to the usage.
In practice, in a medical office, no one asks to see the exact nature of the diploma. The title “doctor” functions as a social marker of trust between the patient and the practitioner, regardless of the legal subtleties that underlie it.
Physician without a research doctorate: the case of foreign practitioners
Since the 2023 reform, France has expanded the conditions for access to medical practice for practitioners graduated outside the European Union (PADHUE). These physicians, trained in foreign faculties, can practice in France after a verification procedure of their competencies.
Their foreign diploma does not automatically confer the French title of “doctor of medicine.” They do practice medicine, they are indeed physicians in the professional sense, but their academic title depends on the recognition of their diploma by French university authorities.
A PADHUE practitioner can therefore be a practicing physician without officially holding the title of doctor in the sense of French law, at least until the recognition procedure is finalized. This situation concerns a growing number of professionals, particularly in under-served healthcare areas.
Female form of the title and linguistic evolutions
The Académie française long maintained “doctor” as the unique form, with the feminine “doctoresse” considered outdated. Contemporary usage hesitates between “docteure” (preferred spelling in Quebec and increasingly common in France) and “doctrice,” modeled on the Latin doctrix.
In practice, most female physicians are called “doctor” without a gender marker, or accept “docteure” in writing. The feminine remains a topic without stable consensus in official French texts, unlike in Quebec where “docteure” has been standardized for several years.
The distinction between physician and doctor seems anecdotal as long as one stays in their general practitioner’s office. It takes on a whole new dimension when one looks at the functioning of the university system, the recognition of foreign diplomas, or hospital hierarchies. Two words, two logics, and a daily usage that continues to merge them without a second thought.