Opinion of Advocate General Richard de la Tour delivered on 16 April 2026

Provisional text

OPINION OF ADVOCATE GENERAL

RICHARD DE LA TOUR

delivered on 16 April 2026 ( 1 )

Case C ‑ 131/25

Axel Dris

v

Gouvernement de la Communauté française

(Request for a preliminary ruling lodged by the Conseil d’État (Council of State, Belgium))

( Reference for a preliminary ruling – Citizenship of the Union – Right to move and reside freely within the territory of the Member States – Articles 18 and 21 TFEU – Directive 2004/38/EC – Principle of non-discrimination – Access to higher education – Nationals of a Member State moving to another Member State in order to pursue studies there – Restriction on enrolment by non-resident students for undergraduate education courses after passing the entrance examination – Student residing in Luxembourg who completed his secondary education in Belgium )

I. Introduction

1. The University of the Grand Duchy of Luxembourg was founded in 2003. ( 2 ) Since 2020, the university has been offering a three-year bachelor’s degree in medicine with the possibility of taking the second year of the course at its partner universities ( 3 ) in Belgium, Germany and France. ( 4 )

2. Up to and including the 2019 to 2020 academic year, students could take only the first year of the medical sciences course at the University of Luxembourg and were obliged to continue the course at one of the partner universities. Many students who were Luxembourg residents preferred to start their medical sciences courses directly from the first year at universities in Belgium, in Germany, in France, in Italy, in Austria, in Portugal, in the United Kingdom and in Switzerland. For example, during the 2018 to 2019 academic year, 133 of the Luxembourg students who submitted an application to the Luxembourg State for financial aid for higher educational studies pursued courses in medical sciences in Belgium. ( 5 )

3. That is the context of the situation of Mr Axel Dris, a Luxembourg national resident in Luxembourg, who completed his secondary studies in an educational establishment in Arlon (Belgium) and sought to enrol at a university in Belgium in order to pursue a course in medical sciences. That situation gave rise to the request for a preliminary ruling submitted by the Conseil d’État (Council of State, Belgium) concerning the interpretation of the first subparagraph of Article 18 and of Article 21(1) TFEU.

4. The Communauté française de Belgique (French Community of Belgium) ( 6 ) refused to grant Mr Dris a certificate of achievement enabling him to enrol in a medical faculty in the French Community, in spite of the fact that he passed the entrance and access examination in medical and dental sciences, because of the system restricting enrolments of non-residential students in the undergraduate higher education course in medical sciences (‘the quota capping non-residential students’) in force. In challenging that decision, Mr Dris claimed, in particular, that he is in a similar situation to a student classified as a ‘resident’, within the meaning of Article 1 of the décret de la Communauté française régulant le nombre d’étudiants dans certains cursus de premier cycle de l’enseignement supérieur (French Community Decree regulating the number of students in certain undergraduate higher education courses), ( 7 ) of 16 June 2006, in the version applicable to the dispute in the main proceedings, ( 8 ) as he had completed his secondary education and obtained a diploma of completion of secondary education in that Member State.

5. The Belgian legislation at issue in the main proceedings, in particular that decree, was the subject, in 2006, of an action for annulment which had led the Cour constitutionnelle (Constitutional Court, Belgium) to submit a request for a preliminary ruling to the Court of Justice. That request gave rise to the judgment of 13 April 2010 in Bressol and Others , ( 9 ) following which the Constitutional Court, in its Judgment No 89/2011, of 31 May 2011, annulled part of Article 8 of that decree.

6. The present reference for a preliminary ruling therefore follows on from the judgment in Bressol and Others and asks the Court to assess, in the light of Articles 18 and 21 TFEU, the similarity between the situation of students residing in a cross-border area who have completed their secondary education in the neighbouring Member State and the situation of students residing in the latter Member State.

7. I shall propose that the Court give the same answer as in the judgment in Bressol and Others, while stating the factors which the referring court must take into account in analysing the situation of Mr Dris who, in my view, should be able to benefit from the same system as resident students.

II. Legal framework

A. International law

8. Article 1 of the Special Agreement on university cooperation in medical training between the Government of the French Community of Belgium and the Government of the Grand Duchy of Luxembourg ( 10 ) states:

‘Hospital establishments in the Grand Duchy of Luxembourg shall contribute to the medical training provided in the universities of the French Community …, in particular by accepting, for training in their facilities, undergraduate and postgraduate medical students for unpaid traineeships …’

9. Article 2 of that agreement provides:

‘Each year, a maximum of 15 students from the University of Luxembourg, with a secondary education diploma awarded by a secondary school in the Grand Duchy of Luxembourg and meeting the requirements for admission based on academic record to the University of Luxembourg, are eligible to complete the remainder of the undergraduate programme in medical and dental sciences at a university in the French Community.

Those students shall be selected by the University of Luxembourg from among those who, in that year only, passed the first year in the grade of ‘Academic Bachelor in Life Sciences – Medicine stream’ and ranked in the qualifying position after the end-of-year examination in which places are awarded in order of merit according to the general average.

The operational arrangements for such cooperation shall be established in specific agreements concluded between the University of Luxembourg and the French Community universities concerned …’

B. Belgian law

10. Article 1 of the Decree of 16 June 2006 provides:

‘A resident student within the meaning of the present decree shall be understood as meaning a student who, at the time of his or her enrolment in an institution of higher education, provides proof that his or her main residence is in Belgium and that he or she fulfils one of the following conditions:

1° he or she has the right to remain permanently in Belgium;

2° he or she has had his or her principal residence in Belgium for at least 15 months prior to his or her enrolment in an institution of higher education, at the same time carrying on a remunerated or unremunerated professional activity or benefiting from a replacement income granted by a Belgian public service;

…

7° he or she has had his or her principal residence in Belgium for at least three years at the time of his or her enrolment in an institution of higher education;

[…]

The “right to remain permanently” within the meaning of paragraph 1, 1°, shall mean, for citizens of another Member State of the European Union, the right recognised by virtue of Articles 16 and 17 of [Directive 2004/38/EC ( 11 )] …’

11. Article 1(1) of the décret de la Communauté française relatif aux études de sciences médicales et dentaires (Decree of the French Community on studies in medical and dental sciences), ( 12 ) of 29 March 2017, in the version applicable to the dispute in the main proceedings, ( 13 ) provides:

‘Only students who meet the general conditions for access to the undergraduate studies referred to in Article 107 of the Decree [of the French Community] of 7 November 2013 defining the higher education landscape and the academic organisation of studies [( 14 )] and who hold a certificate of achievement issued following an entrance and access examination for undergraduate studies in medical and/or dental sciences, hereinafter referred to as “entrance and access examination”, shall have access to undergraduate studies in medical and dental sciences for the purpose of obtaining the relevant degree.’

12. Article 6 of the Decree of 29 March 2017 provides:

‘1. At the latest within 3 days of the deliberations, the Chairman of the selection board of the entrance and access examination shall inform the candidates of the results of the examination through the [Academy for Research and Higher Education, Belgium (ARES)] and shall send the list of the successful candidates to the university institutions authorised to organise and organising undergraduate studies in medical and/or dental sciences.

At the latest within 10 days of the organisation of the examination, the selection board of the entrance and access examination shall issue, via ARES, to successful candidates a certificate of achievement in the entrance and access examination. Without prejudice to the other conditions of access, students holding that certificate shall be enrolled at the university identified at the time of their registration for the examination in accordance with Article 1(3).

That certificate of achievement in the examination shall be valid for enrolment only for the following academic year. It shall be personal and non-transferable. In the event of force majeure, when duly assessed by the selection board of the entrance and access examination, that certificate may be validated for the following two academic years.

2. In its deliberations, the selection board for the entrance and access examination shall apply the following provision: per stream, there shall be established a number T equal to the total number of candidates who have passed the entrance and access examination referred to in Article 1 and a number NR per stream equal to the number of candidates who have passed the entrance and access examination and who are not considered to be resident students within the meaning of Article 1 of the Decree of 16 June 2006 …

Where the ratio between that number NR and the number T exceeds 30%, the selection board of the entrance and access examination shall rank the candidates who have passed the entrance examination who cannot be regarded as resident students in order to designate those to whom a certificate of achievement will be issued. The selection board shall rank those candidates in descending order of the overall marks obtained by each of the candidates in the entrance and access examination. It shall grant certificates of achievement to the candidates who have passed the entrance examination ranked in descending order until the proportion of candidates who cannot be regarded as resident students corresponds to 30% of the total number of successful candidates.

At the end of that procedure, a number L shall be established per stream equal to the number of students holding a certificate of achievement in the examination.’

13. According to Article 17a of that decree:

‘Articles 1 to 7 of the present decree shall not apply to students who, pursuant to the Agreement [between the French Community and Luxembourg], are eligible to complete the remainder of the undergraduate programme in medical sciences at a university.’

III. The facts in the main proceedings and the question referred for a preliminary ruling

14. Mr Dris, who is a Luxembourg national domiciled in a Grand Ducal border municipality of Belgium, completed his secondary studies in an educational establishment in Arlon.

15. On 5 July 2022, he sat the entrance and access examination in medical and dental sciences, which he passed. However, since he was not a resident within the meaning of Article 1 of the Decree of 16 June 2006, Mr Dris was subject to a quota capping non-resident students, and, in the light of his ranking according to the general average, did not obtain the certificate of achievement required to enrol in a medical school in the French Community in Belgium.

16. On 12 September 2022, Mr Dris brought an action before the Conseil d’État (Council of State) seeking, first, the suspension, as a matter of extreme urgency, of implementation of the decision refusing to grant him the certificate of achievement, which was notified to him on 14 July 2022, an application which was rejected by judgment of that court of 27 September 2022, and, second, the annulment of that decision.

17. Mr Dris claims, first of all, that, since he is a Luxembourg national and has a certificate of higher secondary education issued by a secondary education establishment situated in Belgium, he is the victim discrimination:

– (i) when compared with Luxembourg nationals holding a secondary education diploma awarded by a secondary education establishment in Luxembourg and who, as a result, can be admitted to the remainder of the undergraduate programme in medical sciences at a university in the French Community;

– (ii) when compared with students who hold a certificate of higher secondary education issued by a secondary education establishment situated in Belgium and who, being residents within the meaning of Article 1 of the Decree of 16 June 2006, had only to pass the entrance examination and were not therefore subject to the quota capping non-resident students; and

– (iii) when compared with students holding a certificate of higher secondary education issued by a secondary education establishment situated in the Grand Duchy of Luxembourg, and who, being residents within the meaning of Article 1 of the Decree of 16 June 2006, had only to pass the entrance and access examination and were not therefore subject to the quota capping non-resident students.

18. Second, Mr Dris submits that Article 1 of the Decree of 16 June 2006, Articles 1, 6 and 17a of the Decree of 29 March 2017 and the Agreement between the French Community and Luxembourg infringe the first paragraph of Article 18 and Article 21(1) TFEU, in that they do not take account of the situation of cross-border students when establishing the system for the entrance examination and the organisation of the exception laid down for Luxembourg students.

19. More specifically, as regards his cross-border student status, Mr Dris is of the view, in particular, that his situation is similar to that of a student classified as a ‘resident’ within the meaning of Article 1 of the Decree of 16 June 2006, since he has completed his entire school education in Belgium and his primary connections (namely, his extra-curricular activities and his friends) are in Belgium. He adds that an EU citizen may not suffer adverse treatment merely because he or she has exercised his or her freedom of movement. Thus, relying on the judgment in Bressol and Others, he claims that the quota applied to non-resident students can be justified only with regard to students who have not yet exercised their freedom of movement, but cannot be applied to a student who already has a connection with the French Community.

20. Mr Dris submits that the residence condition required constitutes direct discrimination based on nationality and adds that the judgment of 15 March 2005 in Bidar ( 15 ) t reats a student who pursues his or her studies in a Member State in the same way as a resident of that State. As a result, he or she cannot be treated differently from students of the Member State of destination, even if he or she does not have the legal status of resident.

21. Mr Dris also claims that Luxembourg pupils attending school in Belgium and Belgian pupils from the province of Luxembourg share the same extensive employment area and that trained carers will serve that extensive employment area and the wider region concerned. In his view, a large part of the care available to the inhabitants of the province of Luxembourg (Belgium) is provided by care providers from the Grand Duchy of Luxembourg. He adds that the Belgian cross-border area in question is badly affected by a shortage of doctors.

22. The Government of the French Community disputes those arguments, contending in particular that, first, the situation of cross-border residents is no different from that of non-resident students who have obtained a certificate of higher secondary education at a Belgian school. Second, the argument that a cross-border student is likely to offer his or her medical services in Belgium is not plausible, since that applies to any non-resident student who decides to settle in Belgium at the end of those studies and, moreover, it proceeds from the assumption that such a cross-border student will be a ‘cross-border’ doctor at the end of his or her academic course in medicine, which is merely an expectation.

23. Furthermore, the case-law of the Court of Justice relied on by Mr Dris, in so far as it concerns national legislation on financial assistance for students and social benefits, is not relevant, since the dispute in the main proceedings concerns restrictions based on public health requirements.

24. In those circumstances, the Conseil d’État (Council of State) decided to stay the proceedings and to refer the following question to the Court of Justice for a preliminary ruling:

‘Are the first paragraph of Article 18 and Article 21(1) [TFEU], read in isolation or in conjunction with Article 165(1) and the second indent of Article 165(2) thereof and with Article 14(1) of the Charter of Fundamental Rights of the European Union, to be interpreted as precluding a system of quotas for “non-resident” students, such as that established by Article 1 of the Decree [of 16 June 2006] and Articles 1, 6 and 17a of the Decree [of 29 March 2017], for access to university medical studies with the aim of maintaining a high-quality medical service and guaranteeing the objectives of quality supervision during training and the protection of public health based on the high proportion of non-resident students who leave the territory at the conclusion of their full medical training?’

25. Mr Dris, the Belgian Government and the European Commission filed written observations and participated in the hearing held on 14 January 2026, during which they answered the questions for an oral answer put by the Court.

IV. Analysis

26. Before addressing the question put by the referring court on whether, in essence, the first paragraph of Article 18 and Article 21(1) TFEU preclude legislation which provides, for access to studies in medical sciences, for a system of quotas for non-resident students in the Member State organising those studies, I think it important to clarify two points at the outset.

A. Preliminary observations

27. First, contrary to the Commission’s assertions in its written observations, reiterated at the hearing, Directive 2004/38 cannot, in my view, be applied in the present case as a basis for a right of residence for Mr Dris in Belgium. Article 6(1) of that directive states that ‘Union citizens shall have the right of residence on the territory of another Member State for a period of up to three months without any conditions or any formalities other than the requirement to hold a valid identity card or passport’. The mere fact of travelling in the daytime in another Member State without sleeping there is insufficient to characterise that right of temporary residence enabling such citizens to enjoy the equal treatment provided for in Article 24(1) of that directive. Moreover, paragraph 2 of that article provides for exceptions, inter alia that the host Member State is not ‘obliged, prior to acquisition of the right of permanent residence, to grant maintenance aid for studies, including vocational training, consisting in student grants or student loans to persons other than workers, self-employed persons, persons who retain such status and members of their families’.

28. I do not think that a different conclusion can be drawn from the judgment in Bressol and Others , ( 16 ) in which the Court confined itself to asking the referring court to verify whether some of the applicants resided in Belgium before deciding that they would like to enrol in one of the courses concerned. However, the status of Mr Dris as a citizen and resident of Luxembourg is not disputed.

29. I conclude from this that Directive 2004/38 is not applicable to the dispute in the main proceedings.

30. Second, the Agreement between the French Community and Luxembourg, to which Article 17a of the Decree of 29 March 2017 refers, provides, in essence, that a certain number of students of the University of Luxembourg holding a secondary education diploma obtained in Luxembourg may continue their medical science studies begun at the University of Luxembourg at a university in the French Community, since the University of Luxembourg does not have a complete programme in medical sciences.

31. In that regard, it should be noted that Mr Dris does not fulfil the conditions of access to that inter-university cooperation because he does not possess a secondary education diploma awarded by a secondary education establishment in the Grand-Duchy of Luxembourg and has not begun a course in medical sciences at the University of Luxembourg.

32. However, the subject of the dispute in the main proceedings is an action seeking annulment of the selection board’s decision not to issue the certificate of achievement to Mr Dris after applying to him the quota system for non-resident students. Therefore, the question for a preliminary ruling is, in my view, hypothetical in so far as it concerns Article 17a of the Decree of 29 March 2017.

B. Substance

33. On the substance of the case, it should be noted that national legislation which places certain nationals at a disadvantage simply because they have exercised their freedom to move and to reside in another Member State constitutes a restriction on the freedoms conferred by Article 21(1) TFEU on every citizen of the Union, ( 17 ) particularly in the field of education. ( 18 )

34. In the judgment in Bressol and Others , the Court recalled that the principle of non-discrimination prohibits not only direct discrimination on grounds of nationality but also all indirect forms of discrimination which, by the application of other criteria of differentiation, lead in fact to the same result. ( 19 ) Therefore, unless objectively justified and proportionate to the aim pursued, a provision of national law must be regarded as indirectly discriminatory if it is intrinsically liable to affect nationals of other Member States more than nationals of the host State and there is a consequent risk that it will place the former at a particular disadvantage. ( 20 )

35. Moreover, in that judgment, the Court stated that the Member States may opt for an education system based on selection of students, provided that it is not discriminatory. ( 21 )

36. In the present case, the decrees at issue lay down different selection procedures depending on the students’ residence and define that concept by reference to a certain number of criteria. In the case of non-resident students, the fact of having passed the entrance examination may be insufficient for access to studies in medical sciences in Belgium. If those students represent more than 30% of the total number of students who have passed the entrance examination, they are ranked according to their results, and therefore the percentage of non-resident students who receive the certificate of achievement necessary for access to studies in medical sciences is limited to 30% of the total number of students who have passed the entrance examination. ( 22 ) Conversely, resident students who have passed the entrance examination obtain the certificate of achievement irrespective of their number.

37. Thus, the national legislation at issue in the main proceedings creates a difference in treatment between resident and non-resident students. A residence condition, such as the condition at issue in the main proceedings, is more easily satisfied by Belgian nationals, who more often than not reside in Belgium, than by nationals of other Member States, whose residence is generally in a Member State other than Belgium. ( 23 ) That difference in treatment constitutes a restriction on the right to move and reside freely within the territory of the Member States.

38. According to the settled case-law of the Court, a restriction on the right to freedom of movement and residence can be justified in the light of EU law only if it is based on objective considerations of public interest, independent of the nationality of the persons concerned, and if it is proportionate to the legitimate objective of the provisions of national law. ( 24 )

39. The judgment in Bressol and Others has given some guidance on how to answer the question for a preliminary ruling. Thus, the Court has accepted that the objective of ‘maintaining a balanced high-quality medical service open to all’ was justified in so far as that objective contributes to achieving a high level of protection of health, ( 25 ) in particular by safeguarding the quality of training of future health professionals. ( 26 ) In that regard, it stated that it was for the national court to determine to what extent the national legislation is appropriate for securing the attainment of that objective and whether it goes beyond what is necessary to attain it. ( 27 ) In order to provide answers of use to the national court, ( 28 ) the Court sets out its reasoning in three stages.

40. First, the referring court must establish that there are genuine risks to the protection of public health, ( 29 ) it being specified that the Member State may take protective measures without having to wait for the shortage of health professionals or the risks to the quality of education to materialise. ( 30 ) In addition, the competent authorities must prove that those risks exist by conducting a numerical analysis taking into account, firstly, the impact of the group of non-resident students who have obtained their Belgian diploma of completion of secondary education in a French Community establishment on the pursuit of the objective of ensuring the availability of professionals within the French Community. Second, account must be taken of the possibility that resident students may decide to exercise their profession in a State other than the Kingdom of Belgium at the end of their studies. Last, that analysis must take into consideration the possible establishment within the French Community of persons who have not studied there in order to exercise the profession of medical practitioner. ( 31 )

41. In that analysis, account may also have to be taken of the possibility of providing all or some of the unpaid traineeships in the hospital establishments of the Grand Duchy of Luxembourg in accordance with Article 1 of the Agreement between the French Community and Luxembourg.

42. In the second place, if the referring court considers that there are genuine risks to the protection of public health, that court must assess, in the light of the evidence provided by the national authorities, whether the legislation at issue in the main proceedings can be regarded as appropriate for attaining the objective of protecting public health. ( 32 )

43. In that context, the referring court must assess whether the quota based on the residence criterion applied to Mr Dris contributes to that objective.

44. The criterion on which a quota for non-resident students for access to higher education may be based has been the subject of discussion. Thus, the mere criterion of the State in which the diploma of completion of secondary education had been obtained was accepted by the Commission which, in May 2017, ( 33 ) closed the infringement proceedings opened against the Republic of Austria on 24 January 2007. ( 34 ) However, at the hearing, the Commission stated that a new procedure in the form of an EU-Pilot had been opened against the Kingdom of Belgium relating to the quota system for non-resident students for access to studies in medical sciences based on a student’s residence and that the complaint of Mr Dris submitted in 2023 had been joined to it.

45. Although the existence of a residence criterion may be understood to limit access to studies in medical sciences and prevent university ‘tourism’ aimed at accessing studies in a Member State in which access to such studies is less strict than in other Member States in order to exercise a profession in another Member State, Mr Dris’ case shows that that sole criterion is, in itself, unsuited to certain situations.

46. Thus, Mr Dris, having completed the whole of his secondary education in Belgium, as certified by his diploma of completion of secondary education, spent most of his time in that Member State, which contributed to his development of friendships with other pupils and his involvement in extra-curricular activities in Arlon. As a child’s life is largely determined by his or her schooling and extra-curricular activities, it may be considered that he has a connection to Belgium equivalent to that of a resident within the meaning of the national legislation.

47. A similar discussion about the criterion to be used for the allocation of financial assistance to non-resident students has been addressed by the Court.

48. In that regard, ( 35 ) the Court has already held that a single condition concerning the place where the diploma of completion of secondary education was obtained is too general and exclusive in nature and that such a condition unduly favours an element which is not necessarily representative of the real and effective degree of connection between an applicant for the tideover allowance and the geographic employment market. ( 36 )

49. In that regard, the Court has held that the fact of having received a substantial part of his or her secondary education in a Member State has the consequence that the student concerned has established a genuine link with the society of that Member State. ( 37 ) In the case which gave rise to the judgment in Bidar , the guarantee of sufficient integration into the society of the host Member State followed from the conditions requiring previous residence in the territory of that State. ( 38 ) However, the Court found that the rules at issue in that case, which concerned assistance granted in the form of a subsidised loan only to students established in national territory, made it impossible for a national of another Member State to satisfy that condition, whatever his or her actual degree of integration into the society of the host Member State. Consequently, the Court held that such treatment could not be regarded as justified by the legitimate objective pursued by the rules at issue. ( 39 )

50. I consider that that concept of ‘connection’ may help to cover situations in which EU citizens who have exercised their freedom of movement in order to pursue secondary education, certified by a diploma of completion of secondary education, in another Member State, but who are not resident there, are treated differently from EU citizens who are resident in that Member State. That connection could be evidenced, in order to prevent a case-by-case analysis at the time of the access examination, in the requirement of a certain period of education in Belgium in the years immediately preceding the diploma certifying the completion of secondary education. Accordingly, the fear of university tourism would be dispelled in respect of young persons who are EU citizens who have been educated in Belgium at an age when their choice of vocation has not been determined.

51. Therefore, in my view, the quota system for non-resident students now laid down in respect of studies in medical sciences may be challenged as to its capacity to secure the attainment of the objective of public health, in particular as to whether a limitation on the number of students in the same situation as M Dris can really bring about an increase in the number of graduates ready to ensure the future availability of public health services within the French Community. ( 40 )

52. In the third place, in any event, it is for the referring court to assess whether the legislation at issue in the main proceedings, in so far as it does not treat ‘residents’, within the meaning of Article 1 of the Decree of 16 June 2006, in the same way as students who, like Mr Dris, have pursued a large part of their secondary education, certified by their success in obtaining the diploma of completion of secondary education, in Belgium, while being resident in Luxembourg, goes beyond what is necessary to attain the stated objective, that is, whether it could be attained by less restrictive measures. ( 41 )

53. Again within the area of financial assistance for higher education, the Court, when conducting the review of proportionality referred to in the previous point of this Opinion, has accepted that a condition of residence is not necessarily the sole representative element of the actual degree of attachment between the person concerned and the Member State, and is therefore too exclusive in nature. ( 42 ) In the judgment in Giersch and Others , the Court held that ‘the existence of a reasonable probability that the recipients of that aid will return to settle in Luxembourg and make themselves available to the labour market of that Member State, in order to contribute to its economic development, may be established on the basis of elements other than a prior residence requirement in relation to the student concerned’. ( 43 ) In that judgment, the Court accepted that account could be taken of the fact that the student resides alone or with his parents in a Member State which borders upon the State in which his parents have worked for a significant period of time. ( 44 )

54. It must be stated that the judgments in Bidar and in Giersch and Others , which do not concern access to higher educational studies, relate to financial assistance to students for such studies. However, that criterion for integration within the meaning of a genuine link or an actual degree of connection to the host society, as interpreted in those judgments, may be a way of giving effect to freedom of movement within the sphere of education where it is not accompanied by permanent residence in the Member State in which the secondary education was pursued and the diploma of completion of secondary education was obtained, which is the case in cross-border areas. In the case of boarding school pupils, the connection would be even stronger.

55. Moreover, in situations like that of Mr Dris, the geographical proximity associated with the cross-border situation does not prevent professional establishment in the employment area of the region concerned which, even if situated on the Luxembourg side of the border, may benefit Luxembourgish and Belgian patients. There is a directive regulating cross-border healthcare ( 45 ) which gave rise to the case-law on reimbursement of cross-border healthcare. ( 46 ) Furthermore, the French Community, in view of the shortage of health professionals, has introduced employment subsidies for the purpose of attracting young professionals in order to reinforce staffing in that region. ( 47 )

56. Consequently, I propose that the answer to the referring court should be that Articles 18 and 21 TFEU should be interpreted as precluding national legislation which does not treat residents in Belgium in the same way as students who have completed all or most their secondary education, certified by a diploma of completion of secondary education in Belgium, while being resident in another Member State, in order to limit the number of non-resident students who may enrol for the first time in courses in medical sciences of higher education establishments.

V. Conclusion

57. In the light of all the foregoing considerations, I propose that the Court of Justice should answer the question for a preliminary ruling referred by the Conseil d’État (Council of State, Belgium) as follows:

Articles 18 and 21 TFEU should be interpreted as precluding national legislation which does not treat in the same way as residents in Belgium students who have completed all or most their secondary education, certified by a diploma of completion of secondary education in Belgium, while being resident in another Member State, in order to limit the number of non-resident students who may enrol for the first time in courses in medical sciences of higher education establishments.

1 Original language: French.

2 See loi portant création de l’Université du Luxembourg, du 12 août 2003 (Law establishing the University of Luxembourg, of 12 August 2003 ( Mémorial A 149, p. 2990)), which entered into force on 10 October 2003. The University of Luxembourg took over the courses which, until then, had been delivered by the Centre Universitaire de Luxembourg, the Institut Supérieur de Technologie, the Institut Supérieur d’Études et de Recherches Pédagogiques and the Institut d’Études Éducatives et Sociales (see Articles 54 to 57 of that law).

3 See criteria for admission to that bachelor’s degree course on the University of Luxembourg’s website: https://www.uni.lu/fstm-fr/study-programs/bachelor-en-medecine/.

4 See information on the number of students admitted in each of those States on the University of Luxembourg’s website: https://www.uni.lu/fstm-fr/study-programs/bachelor-en-medecine/universites-partenaires/.

5 See explanatory memorandum to the draft law which gave rise to the loi portant organisation d’études spécialisées en médecine à l’Université du Luxembourg (Law on the organisation of specialised studies in medicine at the University of Luxembourg), of 31 July 2020 (Mémorial A 662), available at the following internet address: https://wdocs-pub.chd.lu/docs/Dossiers_parlementaires/7531/20250515_Dep%C3%B4t.pdf (p. 3).

6 ‘The French Community’.

7 Moniteur belge of 6 July 2006, p. 34055.

8 ‘The decree of 16 June 2006’.

9 C‑73/08, ‘the judgment in Bressol and Others ’, EU:C:2010:181.

10 Signed in Brussels on 17 July 2017 (‘the Agreement between the French Community and Luxembourg’). That agreement was annulled and replaced by the Special Agreement on university cooperation in medical training between the Government of the Grand Duchy of Luxembourg and the Government of the French Community of Belgium, done in Luxembourg on 4 January 2022, which was not yet in force at the time of the facts in the main proceedings.

11 Directive of the European Parliament and of the Council of 29 April 2004 on the right of citizens of the Union and their family members to move and reside freely within the territory of the Member States amending Regulation (EEC) No 1612/68 and repealing Directives 64/221/EEC, 68/360/EEC, 72/194/EEC, 73/148/EEC, 75/34/EEC, 75/35/EEC, 90/364/EEC, 90/365/EEC and 93/96/EEC (OJ 2004 L 158, p. 77, and corrigenda OJ 2004 L 229, p. 35, and OJ 2005 L 197, p. 34).

12 Moniteur belge of 14 April 2017, p. 51063.

13 ‘The Decree of 29 March 2017’.

14 Moniteur belge of 18 December 2013, p. 99347.

15 C‑209/03, ‘the judgment in Bidar ’, EU:C:2005:169.

16 See the judgment in Bressol and Others ( paragraphs 34, 37 and 39).

17 See judgment of 16 January 2025, Ministarstvo financija (Erasmus+ Grant) (C‑277/23, EU:C:2025:18, paragraph 38 and the case-law cited).

18 See judgment of 16 January 2025, Ministarstvo financija (Erasmus+ Grant) (C‑277/23, EU:C:2025:18, paragraph 40 and the case-law cited).

19 See the judgment in Bressol and Others , (paragraph 40 and the case-law cited).

20 See the judgment in Bressol and Others , (paragraph 41 and the case-law cited).

21 See the judgment in Bressol and Others , (paragraph 29).

22 See Article 6(2) of the Decree of 29 March 2017.

23 See the judgment in Bressol and Others (paragraph 45 and the case-law cited).

24 See judgment of 16 January 2025, Ministarstvo financija (Erasmus+ Grant) (C‑277/23, EU:C:2025:18, paragraph 53 and the case-law cited).

25 See the judgment in Bressol and Others (paragraph 62 and the case-law cited).

26 See the judgment in Bressol and Others (paragraphs 54 and 67).

27 See the judgment in Bressol and Others (paragraphs 63 and 64).

28 See the judgment in Bressol and Others (paragraph 65).

29 See the judgment in Bressol and Others (paragraphs 66 to 74).

30 See the judgment in Bressol and Others (paragraph 70).

31 See, by analogy, the judgment in Bressol and Others (paragraph 73). Constitutional Court judgment No 89/2011 of 31 May 2011 drew the consequences of the judgment in Bressol and Others by analysing each of the branches of medicine concerned by the legislation in question at the time in the light of the criteria laid down by the Court. Thus, the quota for non-resident students was justified in the case of physiotherapy and veterinary science courses, but was not regarded as justified in the case of the other seven courses which, following an analysis by the national court in the light of the guidance provided by the Court, were not affected by a shortage of their diploma holders to the point of it causing a genuine risk to public health. Consequently, the Kingdom of Belgium ceased to apply that quota system for non-resident students in seven of the nine branches where there was no genuine risk to health.

32 See the judgment in Bressol and Others (paragraph 75).

33 See Commission press release available at the following internet address: https://ec.europa.eu/commission/presscorner/detail/en/ip_17_1282.

34 See infringement procedure INFR(1998)2308 and Commission press release entitled ‘Free movement of students: the Commission sends letters of formal notice to Austria and Belgium’ of 24 January 2007, available at the following internet address: ec.europa.eu/commission/presscorner/detail/en/ip_07_76.

35 Unlike the position adopted by the Commission with regard to the Republic of Austria in respect of quotas for non-resident students (see point 44 of this Opinion).

36 See judgment of 11 July 2002 , D’Hoop (C‑224/98, EU:C:2002:432, paragraph 39).

37 See the judgment in Bidar (paragraph 62).

38 See the judgment in Bidar (paragraph 60).

39 See the judgment in Bidar (paragraph 61).

40 See the judgment in Bressol and Others (paragraph 76).

41 See the judgment in Bressol and Others (paragraph 77).

42 See judgment of 20 June 2013, Giersch and Others (C‑20/12, ‘the judgment in Giersch and Others’ , EU:C:2013:411, paragraph 73).

43 See the judgment in Giersch and Others .(paragraph 77).

44 See the judgment in Giersch and Others (paragraph 78).

45 Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients’ rights in cross-border healthcare (OJ 2011 L 88, p. 45).

46 See, for example, judgment of 4 September 2025, Casa Judeţeană de Asigurări de Sănătate Mureș and Others (C‑489/23, EU:C:2025:651).

47 See, in that regard, concerning nurses in the province of Luxembourg: https://www.province.luxembourg.be/actualites/subvention-infirmier.