How to become an ambulance worker in France
Patient transport has a fast way in and a long one, and the one you pick sets what you are allowed to do on the job.
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French rules recognise two ambulance jobs, both set out in the ministerial order of 11 April 2022. An auxiliaire ambulancier (ambulance assistant) completes a 70-hour course and may then drive a VSL (véhicule sanitaire léger, a light car used for seated patient transport) or an ambulance, and work as the qualified ambulancier’s crewmate (article 2). A holder of the DEA (diplôme d’État d’ambulancier, the State diploma) is described as a health and patient-transport professional who cares for and transports patients on medical prescription (annex I); that diploma takes 801 hours plus a selection process. Both routes require a driving licence past its probationary period, a prefecture certificate of fitness to drive an ambulance, a medical certificate, up-to-date vaccinations and the AFGSU 2 emergency care certificate. Most jobs are in private patient-transport companies, where pay follows the road transport collective agreement (convention collective, the sector-wide contract negotiated by unions and employers) and its 16 February 2004 pay agreement.
Assistant or State diploma: how many weeks before you can work
State ambulance diploma (DEA)
22.9 weeks
| Ambulance assistant | 2.0 weeks |
| DEA hours | 801 h |
| Assistant course hours | 70 h |
The DEA includes 7 weeks of 35-hour placements; selection beforehand on file and interview.
Two routes into the same vehicle
In France, “ambulancier” is not just a driving job. The 2022 order splits the work between two people with different rights, and you choose which one you want to be.
| Ambulance assistant | Qualified ambulancier (DEA) | |
|---|---|---|
| Training | 70 h, assessed | 801 h, after selection |
| What the rules let you do | drive the VSL and the ambulance, crew alongside the ambulancier | care for and transport patients on medical prescription |
| Entry selection | none in the order | scored file, then interview |
| Legal basis | order of 11 April 2022, art. 2 | same order, art. 1 and annex I |
Use the calculator above to see how many weeks each route takes at the pace you can manage.
The assistant route
The 70-hour course teaches hygiene, professional conduct, how to deal with patients and colleagues, safe lifting, stretcher work and patient-transport rules. You come out able to drive and assist, not to lead patient care. It suits anyone who wants to earn quickly or see the job from the inside before committing to a long course.
The diploma route
The DEA makes you a health professional in your own right. Its content runs from clinical observation and emergency care to vehicle checks and teamwork. Selection, course hours and credit for previous health qualifications are explained in ambulance training (DEA), so we do not repeat them here.
What both routes ask of you
Articles 2 and 7 of the order set the same entry checks for assistants and diploma candidates:
- a valid driving licence that has left its probationary period. If you hold a foreign licence, find out first whether it must be exchanged for a French one;
- the prefecture’s certificate of fitness to drive an ambulance, given after a medical examination (the préfecture is the State’s local office in each département);
- a certificate from a doctor stating that nothing prevents you from doing the job;
- proof that your vaccinations meet the rules.
You will also need the AFGSU 2, the level 2 certificate in emergency gestures and care: assistants before they start (article 2), diploma students before the jury can pass them (article 27). If you passed your test recently, check your probation end date before anything else, because neither course will take you until it is over.
From assistant to diploma
The two routes are linked, which is good news if you are not sure yet. 1 month of assistant work in the past 3 years removes the observation placement (article 6). A full year of continuous work for patient-transport firms in that window reduces selection to a single admission file (article 9).
Ambulance, VSL or medical taxi
Three kinds of vehicle carry patients in France, and they belong to different worlds.
- Ambulance: crewed vehicle; the assistant may drive it or be the second crew member, the qualified ambulancier provides the care.
- VSL: a patient-transport car that the assistant is also allowed to drive (article 2). We do not cover its own rules on this page.
- Taxi conventionné: not a health vehicle at all, but a taxi whose operator has an agreement with the health insurance fund to carry seated patients at fares set by the 13 February 2025 decision. Service-public adds that such taxis have until 1 January 2027 to fit certified geolocation and the SEFI electronic billing system.
A medical taxi driver follows the taxi route: the chamber of trades exam, a taxi driver card and a taxi licence. That path, including the health insurance agreement, is set out in how to become a taxi driver.
Getting hired
Most ambulance staff are employees of private patient-transport firms, the same firms that host training placements. Their contracts fall under the national collective agreement for road transport of 21 December 1950. Pay floors come from the 16 February 2004 agreement on ambulance staff pay, last updated by amendment no. 8 of 6 May 2025, which sets three ambulance levels and an allowance for Sunday and bank holiday work.
Read the offer closely. At 2 of the three levels, the hiring rate in the scale is below the 2026 Smic (France’s statutory minimum wage), so the Smic is what you are actually owed. The amendment does not say which job sits at which level, so ask the employer to put your level in writing. Hourly rates and a monthly calculation are on ambulance worker pay.
The order also names hospital patient-transport units as places for the observation placement. Hospital recruitment follows other rules, outside the scope of this guide.
A first-week checklist
- Find the end date of your licence probation.
- Ask your préfecture how to book the medical examination for the ambulance driving certificate.
- Check your vaccination record with a GP.
- Decide on a route, or plan both in sequence.
- Price it all in the start-up cost calculator using a real institute quote.