Rural hospital medicine

Rural hospital medicine is determined by its social context, the rural environment, the demands of which include professional and geographic isolation, limited resources and special cultural and sociological factors. It is invariably practised at a distance from comprehensive specialist medical and surgical services and investigations.

A broad generalist set of skills, knowledge and attitudes are needed to deliver optimum patient outcomes in rural hospitals. Unlike rural general practice, rural hospital medicine is orientated to secondary care and is responsive rather than anticipatory and does not continue over time.

Vocational training in New Zealand

Vocational training in rural hospital medicine is undertaken through the Division of Rural Hospital Medicine of New Zealand (DRHMNZ), which is a sub-faculty of the Royal New Zealand College of General Practitioners (RNZCGP). Once DRHMZ training is completed, the doctor is awarded the Fellowship of the DRHMNZ (FDRHMNZ).

  • Division of Rural Hospital Medicine of New Zealand (DRHMNZ)

    The Division of Rural Hospital Medicine of New Zealand (DRHMNZ) is a sub-faculty of the Royal New Zealand College of General Practitioners (RNZCGP). The Division of Rural Hospital Medicine grew as a new branch in 2008 to tackle growing vocational issues within small rural hospitals.

  • Royal New Zealand College of General Practitioners (RNZCGP)

    The Royal New Zealand College of General Practitioners (the College) is the professional body and postgraduate educational institute for general practitioners (GPs). The College strives to ensure a high standard of care in general practices across New Zealand by setting the standard for quality systems.

Am I able to apply to work as a recognised specialist in New Zealand?

To apply for vocational registration in rural hospital medicine, you need either:

  • the FDRHMNZ qualification; or
  • an international postgraduate medical qualification in rural hospital medicine, where your combination of qualifications, training and experience is assessed against the standard of the FDRHMNZ.

What standard will my training, qualifications and experience be compared against?

Recognised specialists in New Zealand must complete 6 years of training and meet the requirements below:

  • 2 years of general medical experience, which must include at least six of the following:
    • cardiology, dermatology, ENT, emergency medicine, general medicine, general practice, geriatrics, musculoskeletal, obstetrics and gynaecology, orthopaedics, paediatrics, palliative care, psychiatry, rehabilitation, respiratory medicine, rheumatology, rural hospital, rural general practice
  • 4 years of advanced medical training, including:
    • the rural hospital context, including cultural competency and Maori health
    • communication
    • clinical experience, covering: basic clinical skills, adult internal medicine, emergency medicine, aged care, child and adolescent, surgery, musculoskeletal (including orthopaedics), radiology, anaesthetics, obstetrics and women’s health, palliative medicine, rehabilitation, ophthalmology, dermatology, psychiatry and mental health, oral health, population health
    • professionalism and ethical practice
    • scholarship, including research and evidence based practice
  • complete the Early Management of Severe Trauma (EMST), Advanced Paediatric Life Support (APLS) and Advanced Cardiac Life Support (ACLS) courses before the end of their advanced training
  • participate in the DRHM continuing professional development programme.

Once a trainee has successfully completed all the examination and training requirements they will be awarded the FDRHM.

Note: completion of papers from the Postgraduate Diploma in Rural and Provincial Hospital Medicine (University of Otago) and the Postgraduate Diploma in Community Emergency Medicine (University of Auckland) form important parts of the training programme. A trainee may apply to have prior learning recognised in order to shorten their training programme.

I want to make a vocational registration application

To make a vocational registration application, please refer to the Vocational Registration Homepage and select the option appropriate for you.

Am I able to apply for other types of registration?

You may be able to apply for more than one type of registration. To find out which is the best fit for you, please use our self assessment tool.

  • Registration self assessment tool

    3 May 2023

    Use our registration self assessment tool to determine which pathway to registration (as a medical practitioner in Aotearoa New Zealand) you might be eligible for. Note: we do not cover student electives.