Policy Statement

The Medical Council of New Zealand has set requirements for doctors to meet before they may be registered to work in New Zealand within a general scope of practice.

Initially registration within a provisional general scope of practice will be granted to doctors who have the prescribed qualifications, and who are considered fit for registration and competent to practise. The doctor will work on a provisional general scope for up to two years, subject to conditions to satisfy the Council that all requirements for registration in a general scope are met.

The exception to this is for graduates from New Zealand or Australian university medical schools who have completed their internships in New Zealand or Australia , who will be granted registration in a general, and a vocational scope if appropriate.

If a doctor fails to satisfy the conditions on his or her practice as required by Council to ensure competence within a general scope of practice within two years, the Registrar will refer the doctor’s application for an Annual Practising Certificate (APC) to the Council under section 27(1)(b) of the Health Practitioners Competence Assurance Act (HPCAA).

This policy must be read with reference to Council’s Policy on registration in New Zealand .

Eligibility for registration in a provisional general scope

Eligibility for registration in a general scope

• work in a New Zealand hospital that has been accredited by the Council
• complete at least four three-month runs, including
• one category A medical run
• one category A surgical run
• two other runs, which may be category A or B runs
• have three consecutive runs immediately prior to applying for registration in a general scope where the doctor’s performance is assessed to be of a satisfactory standard; two of these three runs must be in different disciplines
• work for no less than 10 weeks (or 10 weeks’ full time equivalent) out of each run
• certify as competent in cardiac life support as required by Council’s policy
• be recommended for registration in a general scope by the Intern Supervisor.

To be eligible to apply for registration in a provisional general scope, the applicant must hold a primary medical degree from a university medical school accredited by a competent authority and have one year of general medical experience under the jurisdiction of the competent authority.

If the doctor did not complete the first postgraduate year in the UK or Ireland, and completed it elsewhere, then the application will be assessed individually based on the Policy on recognition of internships undertaken by New Zealand, Australian, UK and Irish medical school graduates in countries other than New Zealand, Australia, the UK or Ireland when applying for registration.  Please contact Council about the additional information required with the application.

To be eligible to apply for registration in a general scope, the applicant must have completed the following requirements while working within a provisional general scope:

• Completed six months working within a provisional general scope in a New Zealand hospital, general practice, educational institution or other organisation approved by the Council and under the supervision of a medical practitioner approved by the Council; and
• Received two consecutive satisfactory supervision reports for the six months of medical practice completed immediately prior to applying for registration within a general scope. Registration within a provisional scope will be extended for up to two years if the doctor receives any poor supervision reports during their first six months of registration, until the doctor has received two consecutive satisfactory reports.
• Been recommended for registration within a general scope by his or her supervisor.

To be eligible to apply for registration in a provisional general scope, the applicant must hold a primary medical degree from a university medical school listed in the Avicenna World Directory of Medical Schools, and have met the prerequisites for applying to sit NZREX, and, finally, passed NZREX.

To be eligible to apply for registration in a general scope, the applicant must have completed at least one year within a provisional general scope, satisfying the following:

• practice in a New Zealand hospital accredited by the Council, and
• satisfactory completion of four runs, of which one must be a category A medical and one a category A surgical run. (NB The practitioner may work in category A or B relieving or rotating runs during the first six months, but may not work in category C rotating or relieving runs until the second six months. The practitioner can only work in C runs if a rotating internship has been completed prior to registration in New Zealand), and
• satisfactory completion of three consecutive runs immediately prior to registration in the general scope, and
• certify as competent in cardiac life support as required by Council’s policy
• been recommended for registration with a general scope by the supervisor.

 OR

• practice in a primary care setting approved by the Council and under the supervision of a medical practitioner approved by the Council; and
• receive satisfactory reports for the three runs completed (or nine months worked) immediately prior to applying for registration within a general scope
• been recommended for registration within a general scope by the supervisor.
• To be eligible to complete the provisional general registration period in a primary care setting, the, the applicant must: have completed a general intern year, have passed NZREX at first attempt, have five years or more experience in primary care, and have similar primary care practice experience. The applicant’s nominated supervisor must not be his/her employer.

To be eligible to apply for registration in a provisional general scope, the applicant must:

• hold a primary medical degree from a university medical school listed in the Avicenna World Directory of Medical Schools
• have a minimum of 36 months’ work (for at least 30 hours per week) during the 48 months prior to application, in a health system comparable to New Zealand as prescribed by Council
• either full or general registration in the comparable health system(s) in which the applicant met Council’s active clinical practice requirement at the time of registration or the applicant is satisfactorily participating in a training programme recognised by the American specialty boards, Canadian colleges, or Irish Medical Council. 
• proposed employment in New Zealand in the same or a similar area of medicine, and at a similar level of responsibility as what the applicant has been doing for the previous 36 out of 48 months.

To be eligible to apply for registration in a general scope, the applicant must have completed the following requirements while working within a provisional general scope:

• Completed 12 months working within a provisional general scope in a New Zealand hospital, general practice, educational institution or other organisation approved by the Council, in a position for which the medical practitioner has appropriate experience, and under the supervision of a medical practitioner approved by the Council; and
• Received satisfactory supervision reports for the nine months of medical practice completed immediately prior to applying for registration within a general scope. Registration within a provisional scope will be extended for up to two years if the doctor receives any poor supervision reports during their first year of registration, until the doctor has received three consecutive satisfactory reports.
• Been recommended for registration within a general scope by his or her supervisor. OR;
• Satisfactorily completed 12 months on a provisional general scope, of which at least 6 months was spent practising in a Council-approved general practice position. The doctor is only able to work in general practice if there has been sufficient previous general practice experience in the comparable health system on which the doctor's application for a provisional general scope was based.

Conditions limiting the doctor’s practice may be imposed on the doctor’s registration in a general scope of practice if the doctor does not complete a minimum of six months of medicine and six months surgery during the provisional period. To avoid limitations on a doctor’s general scope of practice, the following step may be taken:

• After Council has received two positive supervision reports, the doctor may be permitted to work in an area of medicine for which the doctor does not have recent experience in a comparable health system. For this to be approved by Council, the doctor must have a job offer:
• as a house officer or senior house officer (ie PGY1 or PGY2 level)
• in a hospital accredited by Council for the purposes of intern training to ensure the hospital is able to provide adequate support, training and education opportunities (ie tutorials). The doctor does not need to work in accredited runs.
• that has received sign off by the Chief Medical Advisor at the hospital to ensure the role has adequate supervision and assessment.
• More information is available in the Policy on changing the scope of practice for doctors registered within a provisional general scope to registration within a general scope of practice without limitations.

Doctors who have worked in any area of medicine in a hospital environment for at least 6 months of their 12 months under supervision, will be limited to "hospital -based practice". Conditions limiting the doctor to one area of medicine will apply in all cases where the doctor has not worked in general practice for a minimum of 6 months. For example, doctors who have worked only in accident and medical practice, will remain limited to accident and medical practice.

Note

Failure to meet conditions on practice while registered within a provisional general scope of practice

If a doctor fails to satisfy the conditions on his or her practice as required by Council to ensure competent practice within a general scope of practice within two years, the Registrar will refer the doctor’s application for an APC to the Council under section 27(1)(b) of the (HPCAA).

The Council may:

• extend registration within a provisional general scope for a further period, or
• propose to either place restrictions on, or decline to issue the doctor’s APC under section 28, and give the doctor an opportunity to make written submissions and be heard by Council, and
• then make a decision whether to issue the APC.

Recertification requirements

Once registered to practise within a general scope of practice the doctor is no longer required to work under supervision, but instead must establish a collegial relationship and meet requirements for recertification in order for an annual practising certificate to be issued. Full details of these requirements are available on the Council’s website, or from the Council office.