Special purpose scope

Policy on registration within a special purpose scope of practic

Policy Statement

The Medical Council of New Zealand has set requirements for doctors wishing to enter New Zealand to:

teach

train

carry out research

work as a locum tenens as a specialist

assist in an emergency or other unpredictable, short-term purpose, or

work as a teleradiologist
This policy must be read with reference to Council’s Policy on registration in New Zealand, the definitions and guidelines for a Council approved postgraduate training programme with a structured supervision plan (see Appendix 1), and the requirements for working as a teleradiologist (Appendix 2) .

Purpose of special purpose

The special purpose scope of practice is a temporary form of registration in New Zealand, specific to a particular purpose.

Registration within a special purpose scope of practice under this policy is not a pathway to registration within a general scope or in a vocational scope of practice.

Requirements for all special purpose scopes

To qualify for registration within a special purpose scope of practice the applicant must:

hold an acceptable primary medical degree from a university medical school listed in the Avicenna directory (formerly WHO directory) of medical schools; and
satisfy all criteria for one of the following special purposes (outlined below);
be fit for registration; and
competent to practise in the special purpose scope.

Specific criteria for each special purpose scope

1. Teaching as a visiting expert

The applicant must have been invited by an institution approved by the Council, which has specified the nature of any patient contact.

2. Postgraduate training

English: Applicant must satisfy Council’s English language requirements.

Registration:

(1)            The trainee must have medical registration in his or her own country (or the country providing sponsorship), to which he or she will return on completion of the training.

(2)            The trainee must have held registration and been practicing in their home or sponsor country for a minimum of one year immediately prior to application for registration in New Zealand or be from a Pacific Island and enrolled in a formal postgraduate training programme in Fiji or Samoa.

The applicant either:

(1)            is sponsored by or on behalf of a country or organisation to which the trainee will return after the proposed period of training; or

(2)            has a postgraduate qualification accepted by Council as indicating competence in the branch to which the trainee will confine his or her practice while in New Zealand; or

(3)            is enrolled in a formal training programme in his or her own country; or

(4)            has worked for at least 12 months in an institution with which a New Zealand hospital or medical school has an exchange programme.

Guaranteed employment: The trainee must have a guarantee of continuing employment in his or her home / sponsor country at the completion of the period of training in New Zealand.

Period of registration: Registration within the special purpose (postgraduate training) scope of practice is limited to two years. No applications will be considered by Council to extend this form of registration beyond two years.

Other registration options: The purpose of this scope of practice is to provide up to two years registration for doctors wishing to train in New Zealand to obtain knowledge and skills to take back to their own / sponsor country. It is not a pathway to permanent registration, nor is it a pathway to undertake a vocational training programme. Time registered within a special purpose scope of practice will therefore not be counted towards gaining registration within any other scope of practice in New Zealand. Trainees wishing to continue practising in New Zealand may decide to apply for admission to NZREX Clinical, but admission to sit the exam will not be granted while they are still registered in the SP: Postgrad Training scope.

Employer approval: Within a District Health Board (DHB), the application must be approved by the Chief Medical Adviser or Chief Medical Officer of the DHB (or their delegate) confirming that the position is part of a training programme of that DHB and that the purpose of the role is primarily for the trainee to gain postgraduate experience.

Within an organisation other than a DHB, high level sign-off is required from an appropriate person or organisation at the discretion of the Registration Manager.

Responsibility: The proposed supervisor must provide details of the level of responsibility to be delegated to the trainee.

Induction and supervision: The proposed supervisor must provide an induction and supervision plan including details of orientation to the New Zealand health system.

Funding: Confirmation must be provided from the employer that the training will not be funded by the Investment Relationship and Purchasing arm of Health Workforce New Zealand.

Night cover: There will be some preliminary requirements the employer must satisfy before the doctor is permitted to provide night cover as defined in the Policy for doctors in New Zealand for postgraduate training in relation to working at nights.

Relief runs: The trainee will not be permitted to work in a relief run for the duration of their registration (excluding trainee doctors working in cardiothoracic surgical training units).

Limit of trainees at any one centre (Cardiothoracic Surgical Unit trainees)

Numbers of trainees at any one centre will be limited in line with the Protocol for postgraduate trainees working in cardiothoracic surgery.

Training: The trainee must provide evidence that they are entering into a training position in New Zealand with a structured supervision plan (see appendix 1) that includes explicit and agreed training objectives. Details must be provided on the training objectives and delivery, and on how the training will be monitored and outcomes measured.

Progress towards learning objectives (delivery and outcome) and comments about supervised practice are to be provided to Council for each three-month period on the approved Council report form.

Employers will be required to confirm that the trainee doctor will have at least 2 hours per week protected time for teaching and will be required to attend any relevant tutorials and grant rounds. Quarterly reports submitted to Council will need to confirm that this is occurring.

See Appendix 1 for further information.

3. Teleradiology

The registration within the special purpose scope of practice teleradiology for consumers is for a maximum period of 12 months. Registration via this pathway will be reviewed following receipt of advice from the BAB and then each 12 months thereafter.

See Appendix 2 for further information.

4. Research

The research project must have the approval of a formally constituted ethics committee in New Zealand, and patients’ informed consent must be received if patient treatment is involved.

5. Locum tenens in a specialist post

English: Applicant must satisfy Council’s English language requirements.

Qualification: Have an acceptable postgraduate qualification in the branch of medicine in which the doctor wishes to work.

Experience: Have been in active clinical practice (20 hours per week) relevant to the branch of medicine registration is applied for, for at least 24 out of the past 36 months.

Position: Be appointed to a supervised post not able to be filled by a New Zealand resident doctor.

The applicant may work in a consultant post for a maximum period of six months. If the doctor intends to practise in New Zealand beyond six months he or she must apply for registration via the vocational scope of practice pathway.

6. Emergency or other unpredictable, short-term situation

The applicant must have qualifications appropriate to the requirements of the emergency or other unpredictable situation, and as determined by Council.

Conditions on registration within a special purpose scope of practice.

When working within a special purpose scope of practice the doctor must work:

in a New Zealand hospital, general practice, educational institution or other organisation approved by the Council
under the supervision of a registered doctor approved by the Council
for the duration of the teaching, training, research, emergency, or locum tenens
within a Council recognised scholarship or fellowship programme.

No clinical work may be undertaken other than that approved by Council.

Approved by Council: May 2004

Updated for HPC AA 2003: September 2004

Updated approved by Council: April 2005

Updated approved by Council: April 2006

Updated approved by Council: April 2007

Updated approved by Council: August 2007

Updated approved by Council: December 2007

Updated English language requirements: May 2009

Updated approved by Council: December 2009

Updated approved by Council: April 2011

Updated to include Teleradiology approved qualifications list: December 2011

Appendix 1

Special purpose (postgraduate training) scope of practice

Definition of a postgraduate training programme

This scope of practice is for the purpose of obtaining knowledge and skills that the doctor can take back to their home / sponsor country. Although the primary purpose of the programme is to learn, the time spent in New Zealand is intrinsic to and aligned with service delivery.

A postgraduate training programme will offer doctors a post:

-          to improve and advance the trainee’s medical education in their clinical specialty and targeted / identified sub specialties (if applicable);

-          to practise within a host institution able to provide training and education;

-          to learn and develop specific clinical expertise and procedures;

-          to acquire first hand training and broad exposure to a range of procedures and medical practice in a supervised environment;

-          to have the opportunity to work with mentors.

The outcome will be for the trainee to develop excellent clinical and research skills, experience in their field, and exposure to the various components of their scope of practice.

The prerequisite for acceptance will be fulfilling the criteria for registration by the Medical Council of New Zealand within a special purpose (postgraduate training) scope of practice.

NB: A postgraduate training programme for this scope is not a vocational training programme leading to fellowship of a specialist college. Doctors registered in this scope of practice will not be registered to participate in an Australasian vocational training programme.

Guidelines for a postgraduate training plan

A training plan is a personalised plan provided to the trainee doctor with suggested reading. It must include some or all of the following:

1. A programme of education and training that may include:

-       clinical observership

-       clinical responsibilities including patient care lectures

-       conferences/courses

-       journal club

-       case presentations

-       research

2. A training schedule detailing:

-       orientation

-       learning objectives

-       clinical competencies and their assessment

-       professional competencies, communication skills and their assessment

-       operative programme (if applicable)

-       reflective learning of clinical experience

-       critical appraisal of scientific evidence

-       formal teaching

3. The trainee doctor’s personal expectations

4. A log to record medical education and training undertaken recording:

-       surgical procedures (if applicable)

-       major non-surgical procedures (if applicable)

-       presentations made

-       clinical audit

-       continuing medical education e.g. journal club, seminars, tutorials,

-      conferences

-       reflective learning observations

-       critical incidents (if appropriate)

5. Learning outcomes

The trainee will agree to provide quarterly reports evaluating their training post and their progress towards meeting their training objectives. The reports will also confirm that the trainee has been participating in at least 2 hours per week of protected time to attend relevant tutorials, grand rounds, etc.

Appendix 2
Special purpose (teleradiology) scope of practice

Prescribed qualifications

A medical practitioner may be registered to provide teleradiology services to New Zealand consumers for up to 12 months. If the practitioner wishes to continue to practise after that time, he / she will need to apply for registration again.

The medical practitioner must:

                 have a postgraduate qualification in diagnostic radiology, approved by Council and published on the Council’s website (see list below):

United Kingdom
Fellow of the Royal College of Radiologists

AND if Fellowship obtained after following dates, must be accompanied by:

        After 12 January 1996

         CCST from Specialist Training Authority of the Medical Royal Colleges

        After 30 September 2005

         CCT from Postgraduate Medical Training Board

New Zealand
Fellow of the Royal Australian and New Zealand College of Radiologists

Canada
Fellow of the Royal College of Physicians and Surgeons of Canada; and
Specialist Certificate inn diagnostic radiology

South Africa
Fellow of the Faculty of Radiology (Diagnosis) of the College of Medicine of South Africa Fellow of the College of Radiologists of South Africa (Diagnostic Radiology)

United States of America
Certificate of the American Board of Radiology in diagnostic radiology

                 be registered in the jurisdiction where they are able to gain a postgraduate qualification approved by the Council; and

                 be providing radiology services under contract to a health provider located in New Zealand and be fully credentialed by the health provider.

o   The medical practitioner must have a contract with a health provider located in New Zealand who has undertaken a comprehensive credentialing process for the medical practitioner prior to applying for registration.

o   The NZ based health provider must have a dispute resolution process to facilitate the fair, simple, speedy and efficient resolution of complaints. This process must include automatic notification of the relevant authorities in NZ and the doctor’s home country should a complaint be received and must also permit and facilitate external review and investigation by those authorities.

o   The overseas facility the doctor works for must be accredited by a suitable national or international accreditation body. (IANZ accreditation is required, where this is available.)

o   Supervision of the doctor is to be provided by the clinical director of the NZ health facility.

o   The NZ based healthcare provider must have appropriate systems in place to provide supervision and induction, and to deal with complaints. This must include an agreement to fund the doctor to come to NZ if an investigation is necessary; and

                 have been in active clinical practice (at least 20 hours per week) in the scope of diagnostic radiology for at least 24 out of the last 36 months.

Further requirements

Registration

Applicants who meet the requirements within this scope of practice, may be approved immediately for registration up to a maximum period of 12 months.

English proficiency
The applicant must satisfy Council’s English language requirements.

Employment / position
The applicant must be employed by an overseas facility that has a contract with a health provider located in New Zealand. This NZ based health provider must carry out a comprehensive credentialing process for the doctor prior to applying for registration. This means that the health provider will be assured that the doctor has the qualifications, training and experience to carry out the specific procedures that the health provider requires within their specific clinical setting. The health provider must credential CPD throughout the period of registration.

Supervision

                Supervision is to be provided by the clinical director of the facility.

                The supervisor must provide details of the level of responsibility to be delegated to the doctor.

                The supervisor must provide an induction / orientation and supervision plan including:

- details of induction and orientation

             -   details of how supervision will occur, including the frequency of meetings

             -   availability by telephone and email of the supervisor.

                An audit must be carried out by the supervisor of 30 consecutive cases for each reporting radiologist to coincide with the first three month period supervision report. Clarification is to be obtained from the RANZCR about appropriate ongoing audit requirements.

                Supervision reports are to be provided to Council for each three-month period. Reports must include details of audits undertaken and reviewed by the supervisor.

Reapplying for registration

1.       Within 24 months since the applicant was last registered in this scope of practice

If an applicant wishes to continue practice immediately following expiry of the current registration, then they will need to provide:

-       An updated job offer / evidence of continued employment for a further 12 month period (or less, whichever is applicable)

-       An updated supervision plan

-       A logbook (Awaiting confirmation from the RANZCR of what type of logbook); and

-       Any other audit requirements that the RANZCR might indicate (to be checked with them)

Council will need to have received from the NZ-based supervisor satisfactory quarterly supervision reports for the period(s) that the applicant has previously been registered.

2.       More than 24 months since applicant was last registered in this scope of practice

If an applicant applies more than 24 months since they were last registered within this scope of practice, they will need to submit a completely new application.

Policy on registration within a special purpose scope of practic

Policy Statement

Purpose of special purpose

Purpose of special purpose

Requirements for all special purpose scopes

Specific criteria for each special purpose scope

Conditions on registration within a special purpose scope of practice.

Appendix 1

Special purpose (postgraduate training) scope of practice

Definition of a postgraduate training programme

Guidelines for a postgraduate training plan

Appendix 2
Special purpose (teleradiology) scope of practice

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Policy on registration within a special purpose scope of practic

Policy Statement

Purpose of special purpose

Purpose of special purpose

Requirements for all special purpose scopes

Specific criteria for each special purpose scope

Conditions on registration within a special purpose scope of practice.

Appendix 1

Special purpose (postgraduate training) scope of practice

Definition of a postgraduate training programme

Guidelines for a postgraduate training plan

Appendix 2 Special purpose (teleradiology) scope of practice

This site is best viewed with a resolution of 800x600 (or higher) and supports Microsoft Internet Explorer 6.0+, Netscape 7.0+ and Firefox 1.0+. We also recommend that you enable pop-ups for this site in your browser's settings.

Some of the content on www.mcnz.org.nz is presented in the Adobe Acrobat portable document format (PDF). You will need the free Adobe Acrobat Reader version 4.0 or later to read these documents. You can download and install the latest version of the reader here.

Appendix 2
Special purpose (teleradiology) scope of practice