Career bracket: category A
National recruitment by external (degree level) or internal competitive examination
Personnel are recruited externally from within government departments or local authorities


Initial training

Duration: 24 months

Since 2nd August 2005 and order n°2005-921 of 2 August 2005 the EHESP has been responsible for providing this training.

Initial training is based around work-based learning. It consists of a common curriculum of 21 months and 3 months on-the-job specialisation (hospital institution, company, European or non-European hospital): 14 classroom teaching units and 2 work placement teaching units.

There are 3 aspects to this training:

1. Cultural: acquiring new knowledge (public health, medical, legal, European) to support them in their professional role,
2. Human: development of inter-personnel management skills,
3. Technical: mastering the necessary leadership skills and methods needed to better manage human, financial, logistical, economic and technical resources.

Vocational training

Hospital work placement

  • February to April of the 1st year: observation and getting to know the hospital setting: activities, roles and organisation, institutional operation and strategic issues.
    The objectives can be adapted for those with prior hospital experience.
  • January to August of the 2nd year: vocational training in the same establishment: training is organised by the training supervisor under the auspices of a contract of agreed objectives which guarantees that the training will be professional and personal. This training is the subject of a professional thesis.

The location for the work placement is selected from a list approved by the school.

External work placement

  • Period: August/Octobre.
  • Location: either in a foreign health establishment – the school, will pay part of the cost of the work placement, or in France, in a private company.
  • Objectives: observation and analysis of management methods with regards to foreign hospital practices and public health policy.


2 possibilities available:

  • Professional thesis: based on the analysis and solving of problems or evaluation studies, within the context of the hospital work placement
  • University thesis related to third cycle university research


Certification, which is necessary for a permanent position as hospital director, is achieved in part through continuous assessment, which is based on the lessons provided at the school. This is combined with certification of the hospital work placement, the end-of-training thesis and various other work carried out by students. The final three months of training are devoted to specialisation. Postings are decided upon by the DHOS (Ministry of Health’s Hospitalisation and Healthcare Organisation) once course completion certificates have been issued.

Job adaptation training

Yearly training sessions geared towards:

  • Management personnel upon appointment to a new management role or first-time appointment as head of an institution.
  • Probationers recruited externally (12 weeks).

Professional development

The EHESP offers training programmes suited to directors of care services enabling them to keep pace with changes in both their own institutions and the health system in general.


EHESP Public service courses are reserved to people who have passed a national competitive entrance exam.
To find out more about the eligibility criteria for the competitive examinations, visit the website of the Centre national de gestion (CNG).


The hospital director is employed in public health establishments with more than 250 beds and in smaller establishments with surgery or psychiatric beds.

The role differs depending on whether the hospital director acts as head of the institution or simply as an assistant manager on the management team.

Health Care Institution Manager as head of the institution

As the institution’s legal representative, he or she implements the hospital strategic plan passed by the board of directors and manages the general business of the hospital.

Approximately one fifth of all hospital directors are employed as heads of institutions.

Health Care Institution Manager’ Assistant

He or she is responsible for functional management activities concerned with general, legal, medical and financial issues as well management analysis, human resources, economic, logistical and technical services, information systems, communications, quality etc.

They make up four fifths of all Health Care Institution Manager.

There are 2 aspects to the head of institution role:


  • Position the hospital as a provider of a holistic approach to patient care (physical, psychological and social)
  • Contribute to the preparation and implementation of the hospital’s strategic plan
  • Operate a policy of continuous improvement of the quality of care for the benefit of patients.


  • Develop management practices to direct change within the context of a continually evolving regulatory environment and an ever more restrictive budgetary framework,
  • Ensure efficient organisation of clinical, medical technical, technical and administrative services,
  • Manage human resources and provide financial, economic and logistical management in keeping with the institution’s local and historical background,
  • Administer the institution’s assets,
  • Develop effective communication processes and policies and an information system suited to the dynamics of the institution.

The career path of Health Care Institution Managers is determined by the hospitalisation and “Centre national de gestion”.

As management level employees within the hospital public service, Health Care Institution Managers are paid by the establishment that employs them.
Hospital directors may progress professionally starting out, for example, as an assistant director and progressing to head of an institution. They may also be seconded to another public service role within a local authority or a government ministry. Unpaid leave may also be granted to pursue a management role in a health establishment with a different status.


Office responsible for Health Care Institution Management Program
E-mail : – T. +33 (0) 2 99 02 26 62

Modified on 2 September 2019