Introduction
Before accepting a position or preparing to relocate, always compare the actual disposable income, working hours, and associated benefits rather than looking only at the gross salary. For a general practitioner, France generally offers higher remuneration than Spain, particularly in private practice and in certain positions in the private sector. However, the difference depends heavily on employment status, the Spanish autonomous community, the French region, the number of on-call shifts, taxation, and housing costs.
Doctors’ mobility in Europe reflects growing needs for medical recruitment in both France and Spain. Public hospitals, health centers, private clinics, and post-acute care facilities are seeking professionals capable of ensuring continuity of care. To place this comparison in a broader context, also see our analysis: Which European countries pay doctors the best?.
The amounts presented below are indicative estimates, particularly for 2024. They should be verified against the applicable collective agreement, salary scale, proposed contract, and the doctor’s tax situation.
1. General Practitioner’s Salary in France and Spain
The first step is to compare equivalent situations: salaried employment with salaried employment, private practice with private practice, and even the same number of on-call shifts. Compensation levels cannot be directly compared if one contract includes on-call duties or additional private activity.
France: Salaried Employment and Private Practice
In France, a general practitioner employed by a public hospital, a municipal center, or a nonprofit health center can generally earn around €55,000 to €80,000 gross per year. This range varies depending on experience, contractual status, working hours, and assigned responsibilities. On-call shifts, standby duties, regional bonuses, and allowances can bring monthly net pay to between €2,800 and €3,800, or even higher for certain positions in high-demand areas.
Public hospitals notably recruit general practitioners for general medicine departments, emergency services, unscheduled care units, psychiatric facilities, and affiliated care centers. Offers may include relocation assistance, administrative support, a settling-in bonus, or temporary accommodation.
In private clinics, compensation depends on the applicable agreement and the physician’s role. An employed position may offer a fixed salary supplemented by bonuses, while self-employed or mixed practice may be paid according to the number of consultations, sessions worked, or procedures performed. Secretarial support, access to technical facilities, and the organization of consultations should be factored into the overall assessment.
In private practice, annual income after professional expenses and social security contributions, but before income tax, frequently ranges from €85,000 to €120,000 for an established general practitioner. This estimate covers very different situations. A solo practice, a multidisciplinary health center, work in an underserved area, or a schedule that includes lengthy consultations will not produce the same result.
Spain: Public Sector and Mixed Practice
In Spain, a general practitioner working as a médico de familia within the Sistema Nacional de Salud generally receives a basic salary of between €40,000 and €60,000 gross per year. The amount depends on the autonomous community, seniority, level of responsibility, and administrative status.
With guardias, productivity bonuses, and certain allowances, total remuneration can reach approximately €50,000 to €70,000 gross per year. Monthly net income is often around €2,200 to €3,000, with significant differences between Madrid, Catalonia, the Basque Country, Andalusia, Galicia, and other regions.
Additional private practice can increase income by 10% to 25%, depending on local demand, the number of sessions worked, and the possibility of working in several facilities. However, this option entails additional constraints: travel, administrative management, specific contributions, and longer working hours. The financial gain must therefore be weighed against the time actually devoted to the activity.
Overall, France offers a higher average salary for general practitioners. This advantage is particularly noticeable in private practice, but it should not obscure differences in the cost of living or social protection.
2. Gross, net and taxation: the factors that change the comparison
Comparing €70,000 gross in France with €60,000 gross in Spain is not enough. At least four levels must be distinguished: gross salary, net salary before tax, net salary after tax, and disposable income after professional and personal expenses.
In France, salaried doctors pay substantial social security contributions, but they benefit from structured coverage for healthcare, retirement and social protection. On-call duties, bonuses and allowances are generally taxable. Withholding at source makes it possible to adjust the tax, but the amount actually available varies depending on the family situation and the household’s other income.
For a self-employed doctor, it is necessary to take into account URSSAF contributions, pension contributions to CARMF, CSG-CRDS contributions, professional liability insurance, rent, secretarial services, computer equipment, medical software and any practice employees. An income from professional activity of €100,000 therefore does not correspond to a net salary of €100,000.
In Spain, public-sector employees are subject to social security contributions and progressive taxation, the rules for which may vary depending on the autonomous community. Guardias can significantly increase annual earnings, but they also affect taxation and rest time. For private work carried out as a self-employed person (autónomo), contributions and deductible expenses should be reviewed with a local adviser.
For guidance purposes, a salaried doctor in France earning €70,000 gross per year including on-call duties may receive approximately €2,600 to €3,100 per month after tax, depending on their circumstances. In Spain, a total gross income of €60,000 including additional payments may result in approximately €2,200 to €2,700 net per month. These estimates do not constitute a personalized tax simulation.
The OECD’s international data on general practitioners’ remuneration make it possible to compare trends between countries. For France, DREES series and professional data provide additional insight into the income of self-employed doctors.
3. Purchasing power, working hours, and working conditions
The highest salary does not always mean the best standard of living. Housing, transportation, childcare, tuition fees, and commuting time can significantly affect the attractiveness of an offer.
In France, housing costs are high in major metropolitan areas, but medium-sized cities and less densely populated areas may offer a better balance. Some local authorities provide relocation assistance, temporary housing, an equipped practice, or an established patient base. These schemes are particularly relevant for healthcare jobs in France located in areas where access to care is limited.
In Spain, the cost of living may be more moderate outside Madrid, Barcelona, and highly sought-after coastal areas. However, pay is also lower for many public-sector positions. Schedules involving guardias and travel between multiple sites must be factored into the calculation of hourly income.
Working hours are an essential consideration. A position in France offering €3,200 net per month for 45 hours per week and several on-call duties may be less attractive than a position in Spain paying €2,700 net for fewer hours. Conversely, a well-organized private practice in France can offer a better hourly income thanks to efficient administrative support, a medical assistant, a multidisciplinary health center, and teleconsultation tools.
Purchasing power parity comparisons can reduce the apparent gap between the two countries. Nevertheless, the available trends generally indicate an advantage for France in the case of general practitioners, often estimated at between 10% and 20% for net hourly earnings in comparable situations. This difference may be more pronounced in private practice, provided that the French practice has a sufficient patient base and is well organized.
4. Careers, Recruitment and Physician Mobility
The choice between France and Spain also depends on the professional plans involved. In France, there are many career paths: public hospitals, private clinics, health centers, multidisciplinary healthcare centers, rehabilitation facilities or private practice. Rehabilitation centers in particular recruit general practitioners to monitor patients, coordinate care and work with physiotherapists and other healthcare professionals.
Private clinics may offer rapid integration, a more evenly distributed administrative workload and attractive working conditions. Public hospitals generally provide a multidisciplinary medical environment, access to specialized equipment and training opportunities. The choice therefore depends on the level of autonomy sought, the interest in coordination and the willingness to participate in on-call duties.
In Spain, the public system offers a more structured pathway in primary care, with a strong territorial organization. Private opportunities vary depending on the region and local demand. A doctor wishing to combine several activities must check the compatibility of the contracts, the rules governing multiple employment, and the tax implications.
To work in another European Union country, a medical degree may benefit from European recognition, but in practice the process is not automatic. Registration with the relevant professional body or competent authority, language proficiency, verification of the right to practise, and preparation of the administrative file are essential. The contract must also specify working hours, on-call duties, leave, professional liability, and social security coverage.
This logic also applies to other healthcare professionals in Europe, particularly physiotherapists in Europe, nurses, and pharmacists. However, needs, remuneration levels, and recognition requirements differ for each profession.
5. Method for comparing two specific offers
To make a reliable decision, use the same comparison framework for each country:
- Identify the exact status. Distinguish between salaried employment, self-employed practice, locum work, sessional work or mixed practice. Check the number of FTEs and the contractual duration.
- Calculate the actual expected income. Add on-call duties, standby shifts, bonuses, profit-sharing and benefits, then deduct professional expenses and estimated contributions.
- Measure the total time commitment. Include consultations, meetings, record-keeping, travel and remote on-call time.
- Compare hourly income. A high annual salary may be less advantageous if the working hours, commuting or on-call duties are particularly demanding.
- Assess the local cost of living. Analyse housing, transport, schooling, supplementary insurance and the cost of any potential relocation.
- Examine integration benefits. Housing, secretarial support, administrative assistance, language training, family support and relocation bonuses may amount to several thousand euros.
- Look ahead two or three years. Ask how compensation, patient numbers, responsibilities and opportunities for additional work are expected to develop.
For a comparison with other European markets, you can consult our article on doctors’ salaries in France and Germany, as well as our analysis of the highest-paying European countries for specialist doctors.
FAQ
What is the average salary of a general practitioner in Spain?
In the Spanish public sector, the basic salary is often between €40,000 and €60,000 gross per year. With on-call shifts, bonuses, and additional allowances, total compensation can reach €50,000 to €70,000 gross annually. Monthly net income generally ranges from €2,200 to €3,000, depending on the autonomous community, seniority, and tax situation.
Does a general practitioner earn more in France than in Spain?
On average, yes, especially in private practice and at certain private clinics. However, the difference depends on the number of on-call shifts, housing costs, taxation, and working hours. Comparing net hourly income is often more relevant than comparing annual gross salary.
In France, is it better to work in private practice or as an employee?
Private practice generally offers greater earning potential, but it involves higher expenses, economic risk, and administrative responsibilities. Employment provides greater stability, regulated leave, and structured social protection. The best choice depends on the individual’s plans, the region, and the organization offered.
Do on-call shifts significantly increase medical income?
Yes. In France and Spain alike, on-call shifts and standby duties can account for a significant share of annual remuneration. However, they should be weighed against rest time, the frequency of night shifts, and their impact on quality of life.
Can a Spanish doctor work in France?
A doctor trained in Spain can begin the process of having their qualifications recognized under the European framework. In particular, they will need to check the registration requirements with the relevant authorities, demonstrate their level of French, and provide the requested documents. Specialized support can facilitate the preparation of the application and integration into the institution.
Which institutions recruit general practitioners in France?
There is demand in public hospitals, private clinics, health centers, multidisciplinary health centers, psychiatric institutions, and functional rehabilitation centers. Positions may be salaried, self-employed, or mixed, with widely varying levels of compensation and benefits.
How can you receive support with a medical mobility project?
A healthcare recruitment agency can help identify opportunities, compare contracts, prepare administrative procedures, and organize integration. Euromotion Medical supports doctors and healthcare institutions with their medical recruitment projects in France and Europe, taking into account status, specialty, region, and professional expectations.
Conclusion
For a general practitioner, France generally offers the best earning potential, particularly in private practice and in positions that include on-call duties, bonuses, or private-sector work. Spain may nevertheless offer an attractive quality of life, sometimes lower day-to-day costs, and structured public-sector career paths. The right decision therefore does not depend solely on the advertised salary: it must take into account net income, working hours, expenses, benefits, housing, and career prospects.
Do you manage a hospital, clinic, or rehabilitation center and want to strengthen your teams? Or are you a doctor looking for a job in France with personalized support? Contact Euromotion Medical to explore the opportunities available and develop a professional project tailored to your goals.
