Doctors' Salaries in France and Belgium: What Belgium Doesn't Tax
Dr. Thibault Mendes
Doctor & Founder of MyMedjob
Published on July 21, 2026 · 8-minute read
| Employment Income | Net France | Net Belgium (individual) | Net Belgium (company) |
|---|---|---|---|
| 150 000 € | €65,500 — 43.7% | €69,600 — 46.4% | €89,800 — 59.9% |
| 200 000 € | €88,500 — 44.2% | €92,900 — 46.4% | €120,700 — 60.4% |
| 250 000 € | €113,500 — 45.4% | €116,100 — 46.4% | €151,500 — 60.6% |
| 400 000 € | €183,300 — 45.8% | €185,900 — 46.5% | €243,700 — 60.9% |
What is the maximum amount of contributions in France and Belgium?
Belgium has a cap, while France does not. That is the fundamental difference between the two systems, and it is enshrined in law.
| Income bracket | Contribution Rates in Belgium |
|---|---|
| Up to €75,024.54 | 20,50 % |
| From €75,024.54 to €110,562.42 | 14,16 % |
| Over €110,562.42 | 0 % |
These three lines are taken directly from the schedule published byINASTI. On the French side, the 9.70% CSG-CRDS is applied to income plus mandatory contributions, and the 3.10% family allowance is applied to total income. Neither is subject to a cap. The CARMF and health insurance are capped, but the 13.1% base rate remains in effect indefinitely.
Direct consequence: Starting at approximately €110,000 in professional income, every additional euro is fully taxable and available as take-home pay in Belgium, whereas in France, 13.1% is withheld. The more lucrative the specialty, the wider the gap becomes.
Why is society changing so much in Belgium?
Because Belgian dividends are exempt from social security contributions, whereas their French counterparts are not. This is the second mechanism, and it is the one that accounts for most of the difference shown in the figures above.
In Belgium, a healthcare professional’s SRL pays corporate income tax at a reduced rate of 20% on the first 100,000 euros of profit, provided that the manager receives gross compensation of at least 50,000 euros. The remainder may be distributed as dividends under the VVPRbis regime, subject to an 18% withholding tax since 2026—and these dividends are exempt from social security contributions.
In France, the equivalent arrangement runs up against a specific rule: for a professional service firm, the portion of dividends that exceeds 10% of the share capital, share premiums, and the partner’s current account is added back to the TNS contribution base at the same rates as compensation. The option of non-reported dividends is therefore closed off. Two practitioners with the same revenue, two comparable legal structures, two very different net income figures.
What is the actual take-home pay when professional income is equal?
With professional income ranging from €150,000 to €400,000, a Belgian doctor practicing in a medical group retains 33 to 37 percent more in take-home pay than a French colleague—that is, €24,000 to €60,000 per year. For self-employed individuals, the gap narrows to 1 to 3 percentage points in take-home pay: at this level, Belgium does not offer a decisive advantage.
The explanation lies in the combination of these two mechanisms. The cap exempts the highest portion of income from any contributions; the dividend channel then allows this top portion to be withdrawn at a combined tax cost of approximately 34% (20% corporate income tax followed by 18% withholding tax), whereas the Belgian personal income tax rate reaches 50% starting at €49,840. Without a corporation, the Belgian physician bears the full brunt of this 50% marginal rate—and the advantage evaporates.
Do general practitioners really earn more in Belgium?
No, and let’s be clear: general practitioners do not exceed the €110,562 threshold, so they do not qualify for either of the two programs. The available data do not show any advantage for Belgium at this income level.
On the Belgian side, a national study commissioned by the Federal Planning Commission and conducted among 2,974 general practitioners puts the average net income at €4,707 per month. On the French side, the CARMF estimates the average net income from self-employment for the 57,227 private general practitioners at €97,099 for 2024, an 8.70% increase year-over-year. The two figures are not directly comparable—the second is before income tax—but neither supports the idea that Belgian general practitioners are significantly better off.
What Belgium offers general practitioners lies elsewhere: streamlined procedures for setting up a practice, better-paid locum positions, a common practice of combining private practice with hospital work, and a demand for medical care that far exceeds the supply. The medical job postings published in Belgium reflect this reality.
Which specialties benefit the most from this gap?
Those whose incomes significantly exceed the contribution ceiling—that is, technical and medical-technical fields. The CARMF 2024 ranking of net incomes from self-employment in France provides an indication of the scale of the specialties involved.
| Specialty | Net Income from Self-Employment (France, 2024) |
|---|---|
| Oncology | 405 800 € |
| Nuclear Medicine | 241 700 € |
| Anesthesiology and Critical Care Medicine | 215 900 € |
| Ophthalmology | 210 700 € |
| Surgery | 195 300 € |
| Radiology and Imaging | 194 600 € |
| Pediatrics | 90 200 € |
| Geriatrics | 83 800 € |
| Endocrinology | 81 200 € |
All medical specialties with earnings above €110,000 are exempt from social security contributions in Belgium on their entire excess income. The clinical specialties at the lower end of the scale—pediatrics, geriatrics, and endocrinology—remain below the threshold and find themselves in the same situation as general practitioners.
This status amplifies the effect. France applies national salary scales in hospitals—published by the National Management Center—which narrow the pay gaps between specialties. In Belgium, many hospital specialists practice as independent contractors, a status that grants them access to the private sector and, consequently, to the two mechanisms described above.
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What should you check before taking the plunge?
Four factors determine whether this discrepancy actually exists and should be discussed with a Belgian accountant before any decision is made.
- Hospital rebates. The gross fees of a Belgian hospital specialist are subject to rebates to the hospital ranging from 40 to 70 percent. A Belgian gross figure cited without this clarification is meaningless.
- The actual cost of running a company. Expect €3,900 to €5,900 per year in fixed costs—accounting, filing with the BNB, and amortization of incorporation expenses—plus executive compensation of at least €50,000 to qualify for the reduced tax rate.
- The stability of the system. The VVPRbis withholding tax has just increased from 15% to 18% in 2026. The mechanism is real, but it is politically subject to change.
- Social benefits. A higher net salary in Belgium comes with lower pension benefits and less comprehensive disability coverage. This is part of the cost, and it doesn't appear in any comparison charts.
How do you decide whether to practice in France or Belgium?
The decision depends on income level and preference for the corporate structure. For those with professional income exceeding €110,000 and operating as a corporation, Belgium offers a substantial and well-documented net advantage. Below that threshold, or for individuals, the difference becomes marginal, and other criteria take precedence.
- If you are an independent technical or hospital specialist, this is the profile where the gap is most pronounced.
- If you practice general medicine: the financial argument doesn't hold up, but setting up a practice and finding substitutes are much more accessible.
- You reject the constraints of society: the Belgian advantage amounts to only a few points and does not, on its own, justify moving abroad.
- If you prefer comprehensive social protection and a regulated framework, France remains the most comfortable option.
- Whether you're hiring or managing a department, check out MyMedjob's solutions for employers in the healthcare industry.
In any case, have your specific situation assessed. The thresholds listed here are those for 2026, and the difference depends directly on your specialty, your volume of business, and your legal structure.
Key Takeaways
- In Belgium, professional income above €110,562.42 is exempt from social security contributions.
- In France, the CSG-CRDS (9.70%) and family allowances (3.10%) remain payable without any cap, amounting to 13.1% on each additional euro.
- Belgian dividends under the VVPRbis regime are taxed at 18% and are exempt from social security contributions; in France, SEL dividends exceeding 10% of the capital are included in the social security tax base.
- For professional income between €150,000 and €400,000, the difference in take-home pay in favor of Belgium ranges from 33% to 37%—but only for corporations.
- For individuals, the difference narrows to 1 to 3 points: the Belgian tax bracket reaches 50% starting at €49,840.
- For general practitioners, no Belgian benefits are specified: the average net income reported by the Federal Planning Commission is €4,707 per month.
The Belgian advantage isn’t a matter of lower tax burdens in general. It’s a matter of tax thresholds and structure. It applies to high corporate incomes, and you need to calculate it based on your own situation before making a decision.
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