Are pre-employment and periodic medical examinations required for workers in France?

Yes. In France every worker has health follow-up by the occupational health and prevention service (SPST), but its form depends on the risks. Most workers have an information and prevention visit (visite d'information et de prévention, VIP) within three months of starting, which is not a fitness test. Workers in posts with particular risks have reinforced follow-up (suivi individuel renforcé, SIR), which starts with a medical fitness examination by the occupational physician before they take up the post.

Short answer

• Standard follow-up: VIP within 3 months of actually starting work (R. 4624-10), by the occupational physician or, under the physician's authority, a collaborating physician, a resident or a nurse (L. 4624-1). Renewal at an interval set by the physician, at most 5 years (R. 4624-16).
• Adapted follow-up: disabled workers, workers receiving an invalidity pension, night workers and others whose health, age or risks require it: renewal at most every 3 years (R. 4624-17). Night workers and workers under 18 have the VIP before being assigned (R. 4624-18).
• Reinforced follow-up (SIR): fitness examination before assignment, giving an opinion of fitness or unfitness (R. 4624-24 and R. 4624-25); renewal at most every 4 years, with an intermediate visit at most 2 years after the physician's visit (R. 4624-28).
• Other visits: return-to-work examination, optional pre-return visit, mid-career visit and end-of-exposure visit (details below).
• Cost: borne by the employer through its SPST membership.

Which posts need reinforced follow-up

Article R. 4624-23 lists the posts with particular risks: exposure to asbestos, lead, carcinogenic, mutagenic or reprotoxic agents, biological agents of groups 3 and 4, ionising radiation, hyperbaric conditions, and the risk of falling during scaffold erection and dismantling. Any post that requires a specific fitness examination under the Code is also included. The employer may add other posts, giving written reasons, after the opinion of the occupational physician and the CSE, in line with its risk assessment; the list is sent to the SPST and updated every year.

Since 1 October 2025, driving equipment that requires a driving authorisation and electrical work near bare live parts no longer place a worker in SIR for that reason alone. Instead, the occupational physician issues an attestation of no medical contraindication, valid for five years (R. 4323-56 and R. 4544-10, Decree 2025-355 of 18 April 2025).

Visits during and at the end of the career

A new VIP is not needed when a worker had one within the previous five years (three for adapted follow-up), takes an identical job with equivalent risks, the health professional holds the last certificate and no restriction or unfitness was issued in that period (R. 4624-15).

Common mistakes

• Letting a high-risk worker start before the fitness opinion. Under SIR, the examination must take place before assignment to the post.
• Treating the VIP as a fitness certificate. The VIP leads to an attestation of follow-up; the fitness opinion before assignment is a feature of reinforced follow-up.
• Forgetting the return-to-work visit. The employer must contact the SPST as soon as it knows the date the sick leave ends.

Related on excodex

• Occupational safety and health in France: law, authorities and employer duties
• Must an employer in France appoint a safety professional or an occupational physician?
• What OSH training must employers provide to workers in France?

Standards and further reading

• Code du travail, articles L. 4624-1, L. 4624-2, L. 4624-2-1, L. 4624-2-2, R. 4624-10 to R. 4624-31: Code du travail numérique
• Décret n° 2025-355 du 18 avril 2025 (medical attestations for driving and electrical authorisations)
• Décret n° 2026-503 du 12 juin 2026 (return-to-work examination: exemption after a recent pre-return visit, R. 4624-31)

This article is general occupational safety and health information prepared by the excodex editorial team. It does not replace the applicable legislation, standards, manufacturers' instructions or the assessment of a competent OSH professional or occupational physician.