Prevocational training - PGY1/PGY2 & NZREX requirements
Prevocational medical training (the intern training programme) spans the two years following graduation from medical school and includes both postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2). Doctors undertaking this training are referred to as interns. Prevocational medical training is undertaken by all graduates of New Zealand and Australian accredited medical schools and doctors who have sat and passed the New Zealand Registration Examination (NZREX Clinical).
- Intern Guide
- Intern training programme
- Requirements for PGY1 and gaining a general scope
- Clinical attachments
- Professional development plan (PDP)
- Advisory panel to recommend registration in a general scope of practice
- Requirements for PGY2
- Community based experience
Download Intern guide (June 2017)
Council accredits training providers (DHBs) that have demonstrated they meet Council’s Standards for accreditation of training providers to deliver a 2 year intern training programme. For further details please go to the accreditation page.
The aim of the intern training programme is to ensure that interns further develop their clinical and professional skills gained at medical school. This is achieved through completing 13 week attachments that provide a range of clinical experience, under the close supervision of senior doctors and more senior trainees. This will allow interns to substantively attain the learning outcomes in the New Zealand Curriculum Framework for Prevocational Medical Training (NZCF). The intern training programme is based on adult learning principles and has at its core a personally developed professional development plan (PDP).
During PGY1 interns will record their learning in their ePort. This includes maintaining a PDP and recording the learning outcomes attained from the NZCF (including prior learning). Interns will meet with their prevocational educational supervisor at the beginning of the year and after each clinical attachment and will meet with their clinical supervisor on the clinical attachment at the beginning, mid-way through and at the end of each clinical attachment.
To apply for registration within a general scope of practice an intern must meet the following requirements:
- The (satisfactory) completion of four accredited clinical attachments.
- The substantive attainment of the learning outcomes outlined in the NZCF (prior learning will be taken into account).
- Completion of a minimum of 10 weeks full-time equivalent in each clinical attachment. Full time is equivalent to a minimum of 40 hours per week.
- Advanced cardiac life support (ACLS) certification at the level of the New Zealand Resuscitation Council’s CORE Advanced, less than 12 months old, ACLS CORE Level 7 less than 12 months old will also be accepted until 31 December 2017.
- A recommendation for registration in a general scope of practice by a Council approved advisory panel.
In addition, interns are required to establish an acceptable PDP for PGY2, to be completed during PGY2.
Clinical attachments must meet Council’s standards for accreditation of a clinical attachments. The standards ensure every clinical attachment provides a quality educational experience with appropriate supervision. A clinical attachment will span 13 weeks (or 14 weeks maximum) and have at least one (and up to four) named clinical supervisors registered in the relevant vocational scope of practice who will be responsible for meeting with the intern (beginning, mid and end of the attachment) to provide formal feedback on the intern’s progress and performance.
New Zealand Curriculum Framework for Prevocational Medical Training (NZCF)
The NZCF outlines the learning outcomes to be substantively completed in PGY1 and by the end of PGY2. These learning outcomes are to be achieved through clinical attachments, educational programmes and individual learning, in order to promote safe quality healthcare.
The learning outcomes in the NZCF are underpinned by two central concepts:
1. Patient safety
Patient safety must be at the centre of healthcare and depends on both individual practice and also effective multidisciplinary team work.
2. Personal development
Throughout their careers, doctors must strive to improve their performance to ensure their progression from competent through proficient to expert practitioner, with the aspiration always to provide the highest possible quality of healthcare.
At the beginning of PGY1 interns will be able to identify and take into account learning from their prior years and record this as prior learning in ePort.
For further information about the NZCF and the learning outcomes click here.
A PDP is a short planning document compiled by the intern, with input from their prevocational educational supervisor and the clinical supervisor on each attachment. The PDP will assist the intern to reflect on achievements to date and identify what they need to learn and need to consolidate in order to substantively attain the learning outcomes in the NZCF. It will help to structure and focus learning, strengthen existing skills, and develop new skills. The PDP can also help the intern to focus on their vocational aspirations. The PDP is regularly reviewed and updated throughout PGY1 and PGY2.
Development and endorsement of the PDP for PGY2
Towards the end of PGY1 interns need to consider what they need to learn, need to consolidate and want to learn in PGY2 in order to develop their PDP for PGY2. The prevocational educational supervisor and intern should meet to discuss the PDP for PGY2. The DHB advisory panel is responsible for endorsing the PDP for PGY2 as acceptable when they consider the intern’s overall performance and progress for PGY1 and assess whether the intern has met the requirements for registration in a general scope of practice.
The goals in the PDP should be targeted around the following:
- Outstanding learning outcomes from the NZCF that have not been completed in PGY1.
- Learning outcomes from the NZCF that are stipulated for PGY2.
- Areas for improvement identified on previous clinical attachments.
- Multisource feedback results (if completed).
- Community based experience.
- Vocational aspirations.
ePort is the e-portfolio system used by interns to record learning and track progress. Every intern will have their own ePort account that allows them to record the learning outcomes from the NZCF that have been attained, create and update their PDP, record CPD activities and view their assessments. Prevocational educational supervisors can access the ePort of the interns they supervise to record feedback and provide educational support. Clinical supervisors can access the ePort of the interns they supervise, for the duration of supervision, to provide feedback on performance and progress and complete assessments.
Assessment will be on the job and multi-facetted and will be based on a high level of trust that assumes that nearly all interns will exceed the minimum levels of competence.
Please refer to the Policy on prevocational medical training for further information.
Each intern is assigned to a prevocational educational supervisor at their training provider. A prevocational educational supervisor is a Council appointed vocationally registered doctor who has oversight of the overall educational experience of a group of PGY1 and/or PGY2 doctors as part of the intern training programme.
On each 13-week clinical attachment the intern will be under the supervision of one or more clinical supervisors named as part of the accreditation of that particular clinical attachment. Clinical supervisors must be vocationally registered senior medical officers in the vocational scope relevant to the clinical attachment and be in good standing with the Council.
The clinical supervisor is responsible for meeting with the intern at the beginning, mid-way and at the end of the clinical attachment to provide formal feedback on progress and performance and review the intern’s ePort, specifically the PDP. The clinical supervisor must also complete the End of clinical attachment assessment.
Download Guide for prevocational educational supervisors (June 2015, PDF, 812 KB)
Download Guide for clinical supervisors (June 2015, PDF, 562 KB)
For further information on supervision please go to the supervision section.
At the end of PGY1 when an intern has satisfactorily completed four clinical attachments, an approved advisory panel (within each training provider) will meet to discuss the overall performance of each PGY1, assessing whether they have met the required standard to be registered in a general scope of practise and proceed to the next stage of training. The advisory panel will hold the responsibility for endorsing the PDP as acceptable for PGY2.
The advisory panel will make a recommendation to Council, who as regulator is the decision maker.
Each training provider will establish an advisory panel comprising of the following four members:
- a CMO or delegate
- 2 x prevocational educational supervisor (one must be the intern’s own)
- a lay person.
The use of an advisory panel adds further robustness to the assessment of interns and will ensure that prevocational educational supervisors are better supported, and not placed in the role of advocate and judge.
- The advisory panel will review the information stored in the intern’s ePort to inform their recommendation.
The recommendation of the advisory panel will take account of the following factors:
- The intern is actively engaged in ongoing learning and is responding to feedback.
- The intern has addressed sufficiently all issues arising from the ‘requires development’ sections of the End of Clinical Attachment Assessment, particularly those that have any implications on safety to practice.
- The intern has met a substantive proportion of the learning outcomes in the NZCF.
- The intern is making progress to meet all the learning outcomes in the NZCF.
Download Guide For The Advisory Panel (July 2015, PDF, 479 KB)
For further information about PGY2 please refer to:
An endorsement is placed on the practising certificates of PGY2 interns, reflecting the imposition of programme requirements under section 40 of the HPCAA. These requirements are that:
- Interns must complete four Council-accredited clinical attachments. All accredited clinical attachments will span for 13-weeks.
- Interns must continue to set goals in the PDP and work towards achieving these goals.
During PGY2, interns must continue to record and show progress in attaining the remaining learning outcomes in the NZCF. To be considered sufficient, interns should record the attainment of at least 95% (354) of the learning outcomes by the end of PGY2.
At the end of PGY2, interns must demonstrate through the information in their ePort that they have met the prevocational training requirements for PGY2 in order to have the endorsement on their practising certificate removed. The prevocational educational supervisor may make this decision. However, if the prevocational educational supervisor has concerns about whether the intern has met the programme requirements the decision must be escalated to the CMO or delegate. If the intern has not met the PGY2 requirements then the endorsement will remain.
On satisfying the requirements, as evidenced by the removal of the endorsement, the doctor will be required to, either:
- enrol and participate in the Council approved recertification programme for doctors registered in a general scope of practice, administered by bpacnz, OR
- enrol and participate in an accredited vocational training programme.
Interns will continue to be supervised by a prevocational educational supervisor and will be under the supervision of the named clinical supervisor on the particular clinical attachment, who will be responsible for providing formal feedback to the intern and meeting with the intern at the beginning, middle and end of the clinical attachment. It is recognised that the level of day to day supervision required for PGY2 will decrease, as the intern moves to more independent practice. Accredited clinical attachments will ensure an ongoing quality learning environment and an appropriate level of support.
Flexibility in meeting the PGY2 requirements
The intention is for PGY2 to provide a greater degree of flexibility in terms of an intern’s ability to take leave, have flexible working arrangements, enter vocational training or practise overseas. While the prevocational training framework outlines the competencies that need to be attained, also it is time-based with Council being clear that experience over time is necessary to further develop and consolidate the identified NZCF learning outcomes.
Taking leave or having flexible working arrangements
When an intern takes time out during PGY2, this effectively pauses their training and on return to practice they will need to continue working towards the prevocational training requirements for PGY2. Therefore, if an intern takes leave for a full clinical attachment they will need to complete an additional clinical attachment in order for their prevocational educational supervisor to consider recommending the endorsement on their practising certificate be removed.
Vocational training in PGY2
Interns may join a vocational training programme in PGY2. From 27 November 2017, interns participating in a vocational training programme will need to undertake their training in prevocational medical training accredited clinical attachments, maintain their PDP and continue to record attainment of the remaining learning outcomes from the NZCF in ePort.
Working overseas in PGY2
It may be possible for an intern who wishes to practise overseas during PGY2 to have the time practised overseas counted towards their PGY2 requirements. Interns wishing to do so must create a goal outlining their intentions, with information about the position overseas and a proposed PDP. This information is considered either by:
- the Advisory Panel when they are reviewing their PGY1 progress OR
- their prevocational educational supervisor if applying part way through their PGY2 year.
The Advisory Panel at the end of PGY1, or prevocational educational supervisor during PGY2, may approve all or part of PGY2 requirements to be completed in Australia, the UK or Ireland subject to one of the following:
- Within Australia – a prevocational training position under the supervision of a vocationally (specialist) registered doctor in a position approved for prevocational training.
- Within the UK – a position in an approved practice setting that has been recognised by the General Medical Council (GMC) for prevocational training in the UK.
- Within Ireland – a supervised position approved by Irish Medical Council (IMC) for prevocational training.
Any PGY2 who wishes to practise overseas outside of the above specified criteria must submit an individual application for approval to Council prior to going overseas, which will be considered on a case by case basis. Refer to Application for pre-approval of all or part of the PGY2 year to be completed overseas.
Interns will need to continue to maintain their record of learning in their ePort and work towards their goals in their PDP while practising overseas. This will include uploading completed supervision reports for time pactised overseas. This is similar to UK graduates completing Foundation Year 2 while practising in New Zealand.
On their return, a review of the completed supervision reports from the time spent overseas and the intern’s overall progress as demonstrated in their ePort is required, before a recommendation can be made to remove the endorsement on their practising certificate.
Download Application for pre-approval of all or part of the PGY2 year to be completed overseas for NZ, Australian or NZREX graduates who, following successful completion of PGY1 in New Zealand, is applying for pre-approval to undertake all or part of PGY2 overseas where the DHB Advisory Panel is unable to approve the proposed work.
Download Application for consideration of endorsement removal on practising certificate for a NZ, Australian or NZREX graduate who has completed all or part of their second postgraduate year (PGY2) overseas.
Every intern is required to complete one clinical attachment in a community based setting over the course of the two intern years (PGY1 and PGY2). Completing a clinical attachment in a community setting will familiarise interns with the delivery of health care outside the hospital setting. This will assist interns to understand the interface between primary and secondary care.
Council approved a staged transition, with a goal of 10% of interns completing a community based clinical attachment in the year commencing November 2015 and working towards 100% compliance by November 2020. Training providers will need to demonstrate progress over this period.
The definition of a community based attachment can be found here