Data:

• Number of inhabitants : 60 million

• Number of speech and language therapists (orthophonistes) : 14,500

• Average density per 100,000 inhabitants : 24

• Unbalanced geographical repartition: in certain areas, the average per 100 000 inhabitants is 45, in others 11…

• Big urban and university cities have more SLTs than rural or semi rural areas.

• Free-lance work is under governmental legal agreement (linking to NHS even though in private practice): 11 500 SLTs

• 3000 SLTs are employed by hospital units, specialised institutes, …

France needs more SLTs in relation to its medical needs.

 Diploma and initial training:

• The diploma is called: Certificat de Capacité d’Orthophoniste (CCO)

• The profession obtained legal status on July 10^th 1964

• The profession is regulated by the “Code de la Santé Publique”

• SLTs (orthophonistes) are health professionals (or paramedical professionals), and are considered as “auxiliaires médicaux”,

• 13 schools for SLT are at the moment offering initial training

• These Institutes or schools are attached to Medical universities (university level)

• There is a limit to the number of students (“numerus clausus”) : in 2004, only 650 students will be able to follow these studies

• You need to have succeeded in the advanced level type school exam (“baccalauréat”) before being considered

• A selective entering exam is used as a means to choose candidates before entering the SLT schools (10% success)

• Training lasts 4 university years:  1700 hours minimum of theoretical and specific tuition, and 1200 hours minimum of practical training periods (plus personal work and the writing of an end-of-study research work and dissertation)

• Diploma is granted after an oral public presentation of the end-of-study research paper at the end of the 4^th year.

• Initial training is considered by the government as equivalent to a 3-year university degree.

• Graduates may enter university afterwards at DEUG level (2 year university degree) in Sciences of Language, Sciences of Education, or Psychology…

In order to work in France as a SLT/orthophoniste

• If you are from the European Union (15 countries before 1^st may, but we do not yet know about people from countries newly joining the UE since 1^st May 2004), and from Switzerland (specific agreement with UE), you need to go through the procedure for mutual recognition of diplomas, at the moment according to the directive 89/48 EEC, used since 1^st January 1991 (see technical information about this), and obtain authorisation to work.

• If you come from another non-UE country, you need to hold a French diploma (CCO), even if your national diploma is of a higher level… In this case, you need to enter a training programme in a French school (exam), then try to negotiate recognition of competence with the school director, according to personal qualification… France has not signed any bilateral agreement with another country.

• COMPULSORY registration of diploma is needed with the Direction Départementale des Affaires Sanitaires et Sociales (DDASS) of the area you work (or live if you only work as a replacement SLT), and whatever your status will be (employed or free-lance).

• It is then advised, to help in following the current regulations,  to subscribe to the local professional union which will be able to provide useful and important information.

• Practise of SLT in a commercial location is forbidden

• Outside of any specific agreement between a school and a practitioner, in dealing with the integration of a child, or any screening or prevention activities, SLTs are not allowed to work on school premises.

• As a salaried SLT, a contract with the employer will establish work conditions, salary and career progression. It may be in civil service, or private medico-social sector; in this case, according to the institute, the professional will work according to the collective convention of the employer.

• As a free-lance SLT: the national health local bureau (CPAM) has to be officially informed of the practise opening. There is an agreement between the National health System and the profession (Fédération Nationale des Orthophonistes), which gives details on the rights and duties of each party, enables health insured patients to get financial support under certain conditions. Compulsory registration to the pension scheme for the medical auxiliaries (“auxiliaries médicaux”) is also needed.

• In all cases, the profession being regulated by the Code de la Santé (health regulations), the SLT must comply to any national regulations currently in force: laws, decrees, conventions, ethical codes…

• Advertising is forbidden in France for all health professionals.

• The SLT is recognised as a medical auxiliary (“auxiliaire médical”), depends on the medical authority, and practises without direct medical supervision: a doctor must prescribe the initial assessment, and be informed of the SLT diagnosis, and the therapy plans and any follow up being advised.

Continuing professional education

• It is possible and recommended, in order for the SLT to keep up-to-date on recent knowledge, scientific research and techniques in all areas in relation to SLT. It may soon become compulsory.

• Fees may be paid for in any case:

  • For the salaried SLT: the employer pays for any training fees, and the time spent training; however, it needs to be part of the training strategy, or have an agreement from the employer.

  • For the free-lance SLT:  there are three options; either the SLT finances any personal training programme he/she wishes to undertake, or may follow a training session agreed for by the free-lance professions organisation (FIF/PL). Finally he/she may subscribe to training sessions organised and paid for by the National Health system.

Training programmes are described in the professional journals and on the Internet site of the Fédération Nationale des Orthophonistes : www.orthophonistes.fr

Useful addresses:

- Fédération Nationale des Orthophonistes : 145, Bd Magenta,
F-75010 PARIS / Tél : 01.40.35.63.75. E-mail : fno@wanadoo.fr

- Ortho-Edition (editor of  FNO): 76, Rue Jean Jaurès F-62330 ISBERGUES

- UNADREO (Association for research in SLT): 2, Rue des Deux Gares
F-75010 PARIS. e-mail : unadreo@wanadoo.fr

- Ministère de la Santé – Direction de l’Hospitalisation et de l’Offre de Soins. 8, avenue de Ségur, F-75007 PARIS

- Orthophonistes du Monde (humanitarian association) : 145, Bd Magenta, F-75010 PARIS

- www.orthophonistes.fr