The Medical Council of New Zealand will assess the eligibility of doctors who have qualifications, training and experience as specialists overseas for registration within a vocational scope of practice.

To qualify for registration the doctor must:

• have passed, or been exempted from passing, the IELTS English test
• be fit for registration (HPCAA, s16), and
• be able to assure Council that he or she has qualifications, training and experience equivalent to, or as satisfactory as, that of a New Zealand trained doctor registered within the same vocational scope¹ (HPCAA, s 15(2)), and
• be capable of independent, unsupervised practice, and
• be competent to practise medicine within the vocational scope for which he or she has applied, and
• be intending to practise in New Zealand .

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

Rationale

1. The Council is responsible for protecting the health and safety of members of the public by providing for mechanisms to ensure that doctors are competent and fit to practise medicine in New Zealand (section 3).

2. International medical graduates registered within a vocational scope must demonstrate that their qualifications, training and experience are equivalent to, or as satisfactory as, that of a New Zealand trained doctor working and registered within that same scope of practice.

Procedures

3. The Council has two pathways to assess the eligibility of IMGs who have completed their vocational training and have appropriate qualifications, training and experience for registration within a vocational scope of practice (see flow diagram). 

4. Applications must be made in a recognised vocational scope, requirements for which are listed on the Council's website.

5. Council takes advice from the appropriate branch advisory body (BAB) responsible for advising Council about matters relevant to a particular vocational scope.

6. The BAB will carry out an initial paper assessment, which may be done while the applicant is overseas.  If the IMG is considered to be suitable to proceed, he or she will be required to attend an interview with the BAB.  The IMG may be allowed to start work pending the interview; but always under assessment in the first instance. 

7. The BAB will advise Council on whether or not the IMG’s training, qualifications and experience are equivalent to, or as satisfactory as, that of a New Zealand trained doctor registered within the same vocational scope.  The BAB will also advise whether the IMG is suitable for registration within a vocational scope via:

   (a) the supervision pathway; or
   (b) the assessment pathway. 

8. Council requires IMGs to satisfactorily complete a minimum of 12 months of supervised practice which allows the IMG to acculturalise to the New Zealand health environment.  The BAB will recommend what, if any, additional assessment is required.  This may include:

• supervision by doctor(s) who are registered within the same vocational scope (including one additional supervisor who is not working onsite with the IMG);
• a performance assessment;
• a 360 degree evaluation (colleagues, patients and self);
• a formal audit of any interventions performed in procedural based practice;
• sitting and passing the relevant BAB examination;
• other forms of assessment. 

9. Council will assess the application for registration within a vocational scope and the BAB advice.  Council has the discretion to determine whether the applicant’s qualifications, training and experience are appropriate for registration within the vocational scope applied for and what, if any, further assessment should be undertaken.
   
10. Once the IMG has suitable employment arranged, he or she will be registered within a provisional vocational scope of practice via one of the following two pathways:
    (1) provisional vocational scope (supervision)
    (2) provisional vocational scope (assessment)
    
    
11. Provisional vocational scope (supervision)
    
    If Council considers that the applicant has training, qualifications and experience equivalent to that of a New Zealand trained doctor registered within the same vocational scope and is capable of practising at the required standard, then Council will approve the applicant eligible to apply for registration within a provisional vocational scope of practice (supervision).   
    
    In order to qualify for registration within a vocational scope of practice the applicant is required to satisfactorily complete a minimum of 12 months of supervised practice.   
    
    (In this pathway, IMGs’ training and assessment programmes are well known and similar to those in Australasia.  For example, those IMGs holding a postgraduate qualification from the UK and the UK Certificate of Completion of Training (CCT) or equivalent.)
    
    
12. Provisional vocational scope (assessment)
    
    If Council considers that the applicant’s training, qualifications and experience are as satisfactory as a New Zealand trained doctor registered within the same vocational scope, then Council will approve the applicant eligible to apply for registration within a provisional vocational scope of practice (assessment). 
    
    The IMGs registered within a provisional vocational scope (assessment) will need to meet the following criteria:
    1. the BAB advice is that the IMG is suitable for registration within a vocational scope via the assessment pathway; and
    2. the BAB advice is that the IMG must work under supervised assessment for 12 to 18 months and undertake additional assessment, if any.

Supervision for provisional vocational scope (assessment)

The applicant is required to work under supervised assessment for 12 to 18 months.  Requirements for supervision are:

• one or more supervisor(s) who are registered within the same vocational scope applied for; and
• supervisor(s) to provide comprehensive supervision reports to Council and the relevant BAB at three monthly intervals.

Assessment

The applicant must satisfactorily complete further assessment as required within the 12 to 18 months of registration within a provisional vocational scope of practice to confirm his or her eligibility for registration within a vocational scope of practice. 

The assessment may include:

• performance assessment undertaken by two members of the relevant BAB +/- a layperson (which may include observing the doctor with patients, records review, case based oral, interview); and/or
• a 360 degree evaluation (by colleagues, patients and self); and/or
• a formal audit of interventions in procedural based practice (the IMG should maintain a log book including names, numbers and outcomes of procedures performed); and/or
• sitting and passing the relevant BAB examination; and/or
• other forms of assessment.

If the IMG does not meet the required standard as demonstrated through the assessment process, then the case will be reconsidered by Council.  Council may direct the IMG to either reskill in a particular area of deficiency or to satisfactorily complete other forms of assessment such as having to sit and pass the relevant BAB examination. (Refer to para 17, below.)

13. On satisfactory completion of this time, and when all assessment requirements have been satisfied, and the doctor has shown he or she is competent and suitable for independent, unsupervised practice, Council will authorise a change of scope from a provisional vocational scope of practice to a vocational scope of practice.
    
14. If the IMG fails to satisfy the conditions on his or her practice required by Council to ensure competence in a vocational scope within two years, the Registrar will refer the IMG's application for an APC to the Council under section 27(1)(b) of the Act. The Council may:

• extend registration within a provisional vocational 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.

15. This pathway is only for assessment of doctors who have completed their vocational training overseas. Registration will not be granted to enable a doctor to participate in a vocational training programme.
     
16. All IMGs applying for registration within a vocational scope of practice must be intending to practise in New Zealand . Registration will only be granted once the IMG has attended a registration interview and has suitable employment arranged.
     
17. If an applicant has not been assessed for general medical competence², then he or she will be authorised to practise only within a specified vocational scope, and will be subject to conditions imposed by the Council under section 22 of the HPCAA.