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You can apply for this pathway if you have passed the Australian Medical Council examinations and are registered with the Australian Health Practitioner Regulation Agency (AHPRA).
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This pathway is for New Zealand and Australian medical graduates wanting to register within the Provisional General scope of practice to complete their internship.
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This pathway is for New Zealand and Australian medical graduates who have successfully completed their internship in Australia and want to register within the General scope of practice.
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Some pathways to registration require doctors to have completed their internship in a particular country. If you are applying for registration and did your internship somewhere else, this policy outlines how we will assess your suitability for registration.
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The Council offers two clinical supervision courses for clinical supervisors and prevocational educational supervisors. The courses supplement training that supervisors receive from training providers and medical colleges. Courses are available to all supervisors through the ePort platform.
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The professional services a doctor can perform in New Zealand are defined by the scope of practice for which they are registered.
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Request for confirmation of internship, NZREX pass, or general registration.
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If you are registered and practising in a vocational scope only, you must participate in the recertification programme offered by the medical college or other approved recertification provider responsible for your vocational scope of practice.
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Pain medicine is the biopsychosocial assessment and management of persons with complex pain, especially when an underlying condition is not directly treatable. The scope of pain medicine supplements that of other medical disciplines, and utilises interdisciplinary skills to promote improved quality-of-life through improved physical, psychological and social function.
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All international medical graduates (IMGs) registered in a provisional general, provisional vocational and special purpose scope of practice must be supervised. This is to support their practice while they become familiar with the New Zealand health system and the expected standard of medical practice.
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Sexual health medicine is concerned with sexual relations, including freedom from sexually transmissible infections (STIs), unplanned pregnancy, coercion and physical and psychological sexual discomfort. Its practice encompasses a wide range of factors that contribute to STIs, sexual assault, sexual dysfunction and fertility.
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Council requires all doctors in PGY2, to satisfy the requirements of a programme ordered by Council under section 40 of the HPCAA.
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Internal medicine involves the diagnosis and management of patients with complex medical problems which may include internal medicine, cardiology, clinical immunology, clinical pharmacology, endocrinology, gastroenterology, geriatric medicine, haematology, infectious diseases, medical oncology, nephrology, neurology, nuclear medicine, palliative medicine, respiratory medicine and rheumatology.
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General surgery is a broad based specialty which includes the diagnosis and treatment (operative and non operative) of patients with disorders of the colon and rectum, upper gastro-intestinal organs, breasts, endocrine organs, skin and subcutaneous structures, blood vessels (including varicose veins) and the head and neck region. It also includes the early and ongoing management of trauma.
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Under the Health Practitioners Competence Assurance Act 2003, responsible authorities such as the Medical Council undergo regular independent reviews of how they are carrying out their statutory functions. The Act requires responsible authorities to publish their review report on their website.
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If you trained and qualified as a specialist outside of New Zealand and Australia and wish to work in New Zealand as a specialist you can apply based on overseas training and qualifications and we will assess your case on its merits.
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Intensive care medicine involves the diagnosis and treatment of patients with acute, severe and life-threatening disorders of vital systems that are medical, surgical or obstetric in origin, and whether adult or paediatric.
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We are reviewing our statement on a doctor’s duty to help in a medical emergency and would value your feedback. This statement discusses a number of factors doctors should consider when responding to a medical emergency.
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Neurosurgery is the diagnosis and treatment (operative and non operative) of patients with disorders of the central, peripheral and autonomic nervous system including their supportive structures and blood supply. This includes the skull, brain, meninges, spinal cord, spine and pituitary gland. It also includes the management of traumatic, neoplastic, infective, congenital and degenerative conditions of these structures and surgical pain management.
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List of schools of medicine in New Zealand
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This page sets out the recertification programme requirements for doctors registered and practising in the General scope of practice only. This is typically either participation in a medical college vocational training programme, or in the Inpractice recertification programme.
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This dashboard page contains information around registered doctors, those who are on the register and hold a current practising certificate. You can also view the same data for past quarters.
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Prevocational Training Requirements for Doctors in
New Zealand: a discussion paper on options for an enhanced training framework -
A Review of Prevocational Training Requirements for Doctors in New Zealand: Stage 2 - A second consultation paper on the proposed changes to prevocational training
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Medical Council Chair Dr Rachelle Love responds to the final report from the Abuse in State Care Royal Commission Inquiry.
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The Health Practitioners Competence Assurance Act 2003 requires us to define the areas of medicine and specialties (known as ‘scopes of practice’) that make up the practice of medicine in Aotearoa New Zealand. You'll find these scopes of practice listed here. For a more detailed explanation of each, please select the scope of practice that interests you.
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Disclosure of harm refers to instances where a patient has been adversely affected as a direct result of medical care. Open disclosure in this situation promotes transparency, can strengthen the doctor-patient relationship and is important for the health and safety of the public in general. This statement is intended to help doctors understand the purpose of open disclosure and why it matters to patients and their family/whānau. It also guides doctors on factors to consider when a situation requires that the harm is disclosed.
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Patients are entitled to information about their health and the care they are receiving. This statement outlines what we expect of doctors when helping patients to make an informed decision about their care and treatment.
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If you, as an international medical graduate (IMG), apply for vocational registration and your application is successful, you will have to complete a provisional vocational registration period. You'll work under supervision for this period, during which we make sure you're competent to practise independently in your chosen field of medicine.
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Currently, there is no requirement for applicants for this examination to have had any clinical practice experience. This consultation seeks views on the merits of introducing a requirement that individuals applying to sit the NZREX must have had clinical practice experience and if so, then what that should be.
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The Health Practitioners Competence Assurance Act 2003 (HPCAA) requires us to specify the scopes of practice within which doctors are permitted to practice, and to describe and define the boundaries of each.
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This document outlines the policy, process and guidelines for recognition of a new vocational scope of practice.
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Diagnostic and interventional radiology is the diagnosis and treatment of patients utilising imaging modalities, including general radiography, angiography, fluoroscopy, mammography, ultrasound, computed tomography, magnetic resonance imaging, nuclear medicine and bone densitometry.
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Our current scopes of practice and prescribed qualifications (as published in the New Zealand Gazette on 5 April 2023, Notice no. 2023-gs1359).
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Te Kaunihera Rata o Aotearoa | Medical Council of New Zealand is inviting feedback on proposals for how PAs should be regulated in Aotearoa New Zealand.
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The Standards for accreditation of specialist medical training programmes are jointly agreed and applied by the Australian Medical Council (AMC) and the Medical Council of New Zealand (MCNZ). Australasian colleges are required to apply the New Zealand specific criteria in addition to the AMC standards.
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If you're applying for registration in the vocational scope and did your postgraduate training outside of New Zealand and Australia, this policy outlines the rules that will apply when we consider your application.
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There are 36 areas of medicine, or 'scopes of practice', within which you can be registered and work as a specialist in New Zealand. This page defines each scope, and details the structure of the New Zealand or Australasian training programme.
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Form that needs to be completed in order to apply for a partial refund of your practising certificate fee if your income for the year was below the threshold.
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An amendment of this notice was published on 1 October 2024, Notice No. 2024-sl4980 and another amendment was published on 31 March 2025, Notice No. 2025-sl1765.
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Patients are entitled to information about their health and the care they are receiving. This statement outlines what we expect of doctors when helping patients to make an informed decision about their care and treatment.
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This document covers a number of NZREX-related policies including pass criteria, serious concerns and critical incidents, request for resits, feedback, and recount of results.
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Under sections 11 and 13 of the Health Practitioners Competence Assurance Act 2003, Te Kaunihera Rata o Aotearoa | Medical Council of New Zealand (“Council”) gives notice of an amendment to the notice titled “Scopes of Practice and Prescribed Qualifications for the Practice of Medicine in New Zealand Notice 2024.
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Under sections 11 and 13 of the Health Practitioners Competence Assurance Act 2003, Te Kaunihera Rata o Aotearoa | Medical Council of New Zealand (“Council”) gives notice of an amendment to the notice titled “Scopes of Practice and Prescribed Qualifications for the Practice of Medicine in New Zealand Notice 2024.
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This gazette notice lists the scopes of practice and prescribed qualifications for Physician Associates.
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This document provides general advice to employers (including Te Whatu Ora | Health New Zealand and some PHOs) about their responsibilities as an employer of a doctor.
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An audit of medical practice is a systematic, critical analysis of the quality of a doctor’s own practice, the results of which are used to improve clinical care and/or health outcomes, or to confirm that current management is consistent with the current available evidence or accepted consensus guidelines.
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Doctors who hold overseas qualifications and who want to apply for registration in Aotearoa New Zealand must have key documents verified from their primary source. Since November 2017, Council has required primary source verification using the Educational Commission for Foreign Medical Graduates’ Electronic Portfolio of International Credentials (ECFMG’s EPIC) service, which is now accessed via the MyIntealth portal.
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The Medical Council of New Zealand has two new members. The Hon Matt Doocey, Associate Minister of Health, made the appointments, which are effective from 1 July 2024 for a three-year term. The Minister also reappointed two current members for further terms. These four appointments follow the election by the profession, earlier this year.
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This dashboard page contains information around international medical graduates, doctors who obtained their primary medical qualification outside of New Zealand.
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Under section 14 of the Health Practitioners Competence Assurance Act 2003 (“Act”), Te Kaunihera Rata o Aotearoa |
Medical Council of New Zealand (“Council”) gives notice of an amendment to the notice titled “Scopes of Practice and
Prescribed Qualifications for the Practice of Medicine in New Zealand Notice 2024” published in the New Zealand Gazette, 30 September 2024, Notice No. 2024-sl4580 -
Council is seeking feedback on a proposed change to its processes. Specifically, in relation to advice obtained from medical colleges regarding an international medical graduate’s (IMG) application for registration in a provisional vocational scope of practice.
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Prevocational medical training for interns incorporates aspects of the apprenticeship model of 'learning on the job’ as part of a team. Senior doctors supervise and assess the interns’ performance, providing them with ongoing feedback and gradually increasing their responsibilities.
Prevocational medical training for interns in PGY1 and PGY2 is overseen by prevocational educational supervisors and clinical supervisors.
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We are seeking your feedback on the draft Professional standards for PAs. These draft standards propose the principles and values of good PA practice and the professional standards expected of PAs working in Aotearoa New Zealand.
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An amendment to our current scopes of practice and prescribed qualifications correcting the commencement date (as published in the New Zealand Gazette on 1 October 2024).
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If you are registered and practising in the provisional general scope as either a New Zealand or Australian medical graduate, or a doctor who has passed the NZ Registration Examination, you are required to complete prevocational medical training.
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Evaluation of Council's RPR programme by Malatest International - end of year report for 2017
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Evaluation of Council's RPR programme by Malatest International - end of year report for 2016
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Evaluation of Council's RPR programme by Malatest International - end of year report for 2017
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In August 2021, Te Kaunihera Rata o Aotearoa |Medical Council of New Zealand, underwent a full performance review that showed compliance to our obligations under the Health Practitioners Competence Assurance Act 2003 (HPCAA).
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This fact sheet is intended to provide information to those people who meet with a Professional Conduct Committee (PCC) as part of its investigation.
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Evaluation of Council's RPR programme by Malatest International - mid year report for 2016
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Evaluation of Council's RPR programme by Malatest International - mid year report for 2018
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Evaluation of Council's RPR programme by Malatest International - mid year report for 2015
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Search the registers of doctors and physician associates registered in New Zealand.
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Search the registers of doctors and physician associates registered in New Zealand.
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Evaluation of Council's RPR programme by Malatest International - end of year report for 2015
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This policy gives an overview of the rules we apply in deciding whether to register as a doctor or physician associate in New Zealand. There will also be a specific policy that applies to the pathway you are registering under and the two policies should be read together.
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Certificates of professional status (COPS) are documents used by professional regulators to share information about whether a health practitioner is in good standing. Doctors or physician associates applying for registration, restoration or returning from practising outside New Zealand need to provide us with certificates of professional status.
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A community-based attachment is an educational experience in an accredited clinical attachment in a community-focused service in which the intern is engaged in caring for the patient and managing their illness in the context of their family and community.
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Evaluation of Council's RPR programme by Malatest International - Interim report to November 2014
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Most international medical graduates (IMGs) registered within a provisional general, provisional vocational, or special purpose scope of practice will need to submit a supervision plan with their application. The Council will consider the proposed supervision plan as part of the application process.
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You can download copies of your current and expired practising certificates by logging into your myMCNZ account.
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As part of ongoing work to ensure that registration policies are fit for purpose and enabling, Council is reviewing its orientation, induction and supervision guide. The current guide has been in place for several years. With the evolving nature of supervision, now is an appropriate time to review and revise it.
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Glossary of terms used in relation to prevocational medical training. Examples include clinical attachment, intern, multisource feedback (MSF), and prevocational educational supervisor
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This document aims to clarify matters relating to the amended start date and changes to dates for intern clinical attachments for the year commencing at the end of 2020.
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We are pleased to announce that we are increasing capacity to sit the NZREX Clinical across 2025, and plan to be able to examine up to 180 candidates over the course of 2025.
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Malatest International's final evaluation report of our Regular Practice Review Programme
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We may sometimes use terms you won't be familiar with. Find out here what they mean.
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Vocational registration is a form of permanent, specialist registration which allows you to work independently in New Zealand.
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This information sheet provides guidance to chaperones approved by the Medical Council of New Zealand (Approved Chaperone) about their role and responsibilities when acting as a chaperone.
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Evaluation of changes to prevocational medical training by Malatest International - end of year report for 2018
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These standards will come into effect on 1 July 2022. The standards outline the standards vocational training providers need to meet in order to be accredited to provide vocational medical training and recertification programmes. We have made revisions to update recertification, cultural safety, health equity and specialist assessment of IMG content.
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If you are thinking about practising medicine in New Zealand, there are many things to consider. This page provides an introduction to medical registration, the healthcare system, getting a job and settling in the country.
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Internet, email, and other forms of electronic communication are ways in which doctors communicate with patients and other health professionals, find information, and participate in informed discussion. This statement guides doctors on the use of email and other forms of social media.
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Application for registration: Australian graduates (Interns/PGY1)
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You are eligible for a 50 percent refund of your practising certificate fee if your medical income (including any tax) in New Zealand or overseas is NZ$20,000 or less.
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You can apply for registration through this pathway if you hold a qualification accredited for licensure in the United States of America for registration as a physician associate.
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Special purpose registration is a temporary form of registration, for specific purposes. You should apply for this scope when you want to work in New Zealand for a specific purpose such as research, further training or to assist with a disaster.
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This guide outlines why doctors may have conditions on their practice, how to find out if a doctor has conditions, and what some of the different types of conditions mean for you as a patient.
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This policy, which comes into effect on 1 April 2020, sets out on when we might make public in some way, information about an order or direction made by us about a doctor.
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This policy outlines the requirements you must meet before you can be registered in the General scope of practice.This policy should be read alongside Council's Policy on registration in New Zealand.
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Medical practitioners registered within the General scope of practice (or the Provisional General scope of practice, which precedes it) are typically resident doctors, resident medical officers (RMO) and doctors undergoing vocational training.
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This guidance explains what doctors should consider when using artificial intelligence (AI) in patient care. Because AI is increasingly being used in medical practice, it is essential that doctors do so ethically and responsibly, to ensure patient safety and the privacy of health information.
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This form outlines the additional information that we will require as part of an application for provisional vocational registration in psychiatry.
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Australian general scope pathway - Part A: Checklist for registration in New Zealand
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There are two key scopes of practice for physician associates:
Physician Associate Provisional scope of practice (for first period of registration).
Physician Associate General scope of practice (for physician associates who have completed the provisional period) . -
This policy applies if you're applying for registration temporarily to teach, train, carry out research, work as a locum tenens specialist, assist in an emergency or work as a teleradiologist.
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This draft statement sets out legal and ethical considerations as a doctor when responding to a medical emergency. It also discusses a number of factors you should consider when you attend to a medical emergency, whether that emergency is within a healthcare facility, or in a non-clinical setting, such as in the community.
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This report outlines the findings of our evaluation of the ‘Welcome to practice in Aotearoa New Zealand’ workshops for international medical graduates.
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Te Kaunihera Rata o Aotearoa | the Medical Council of New Zealand (the Council) is considering making changes to the advanced life support (ACLS) requirement for interns in the Provisional General scope of practice (postgraduate year 1, or PGY1) interns.
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This document sets out Council’s policy in regards to accrediting training providers of prevocational medical training (training providers) and their clinical attachments. It outlines the components of the accreditation assessment.
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Te Kaunihera Rata o Aotearoa | The Medical Council of New Zealand (Council) recently held an election to select four medical practitioner nominees and can now announce the results of this election.
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Every doctor in New Zealand must be registered to practise medicine. If you are not eligible for registration under any other pathway, you must sit and pass the NZREX Clinical, our registration examination.
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The purpose of these principles is to provide a framework for good decision-making about notifications assessed and managed by the Council. The principles are not intended to cover every specific scenario but rather provide guidance in how notifications should be assessed and managed. The framework applies to the decisions of the Notifications Triage Team (NTT) and of Council.
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To apply for registration within a special purpose (locum tenens) scope of practice, you must first hold an approved postgraduate qualification in the branch of medicine in which you want to work, and then meet remaining requirements outlined in the registration policy.
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List of overseas regulatory and educational bodies that we interact with regularly.
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The Medical Council has today launched Torohia – Medical Training Survey for New Zealand, a new survey designed with the profession, for the profession, to better understand doctors’ experience of postgraduate training.
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Council is proposing to extend the provisional vocational assessment period from 18 to 24 months. This will enable a specific cohort of specialist IMGs who may not otherwise meet the standard, to gain provisional vocational registration and complete discrete training to address identified
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Manatū Hauora | Ministry of Health is the agency responsible for the proposal and consultation on the regulation of physician associates under the Health Practitioners Competence Assurance Act 2003. The Medical Council made a submission during the Ministry’s consultation on the proposal in December 2023 (as did a number of other organisations) and is awaiting the Ministry’s release of the outcome. The Medical Council cannot advise on when this information will be released by the Ministry.
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All physician associates applying for registration in New Zealand must have key documents verified from their primary source. Council uses the Educational Commission for Foreign Medical Graduates’ (ECFMG) Credential Verification for Health Professionals (CVHP) service to do this.
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This guidance explains what doctors should consider when using artificial intelligence (AI) in patient care. Because AI is increasingly being used in medical practice, it is essential that doctors do so ethically and responsibly, to ensure patient safety and the privacy of health information.
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Te Kaunihera Rata o Aotearoa | Medical Council of New Zealand’s latest quarterly workforce data shows that women now make up slightly more than half of practising doctors in Aotearoa New Zealand.
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Graduates of Aotearoa New Zealand and Australian accredited medical schools and doctors who have sat and passed an approved medical registration examination, including the New Zealand Registration Examination (NZREX Clinical) complete prevocational medical training.
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From November 2014, Council reviewed and implemented significant changes to prevocational medical training requirements for doctors in Aotearoa New Zealand. The changes aim to improve patient safety and the performance of doctors through provision of high-quality learning.
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The Medical Council of New Zealand |Te Kaunihera Rata o Aotearoa today released the results of its 2025 Workforce Survey, showing continued growth, more diversity, and important shifts in the medical workforce.
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Council is proposing to change the current requirement that international medical graduates registered in the special purpose teleradiology scope of practice must be supervised by doctors based in Aotearoa New Zealand.
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If you hold an approved postgraduate medical qualification from the UK, Ireland or Australia and intend to work as a specialist in Aotearoa New Zealand in an approved area of medicine, you can apply via the VOC4 fast-track pathway.
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This policy explains the requirements you will have to meet if you are registered in the general scope, or in a vocational scope of general practice, and you wish to perform tumescent liposuction.
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Te Kōwhiringa o Te Kaunihera Rata o Aotearoa 2024 | The Medical Council of New Zealand election 2024
Council elections are about building a strong Council that the public, government and medical profession can have confidence in. The opportunity to cast your vote for the election of four medical members to join the governance of the Medical Council is available starting Tuesday, 20 February 2024. -
Graduates of Aotearoa New Zealand and Australian accredited medical schools and doctors who have sat and passed an approved medical registration examination, including the New Zealand Registration Examination (NZREX Clinical) complete prevocational medical training.
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It is the Council’s role to ensure that the quality of training and education programmes offered by medical colleges is of a high standard. Information on accredited medical colleges and the Council’s accreditation standards can be found here.
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If you are registered and practising in both the General and a vocational scope of practice, you need to meet recertification requirements in both scopes of practice.
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The International Association of Medical Regulatory Authorities (IAMRA) signed a historic Memorandum of Understanding (MoU) today with the World Health Organization in a ceremony in Geneva.
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There are two medical schools in Aotearoa New Zealand. Council recognises the primary medical training qualifications from both Aotearoa New Zealand and Australian medical schools.
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Our registration application forms include a range of 'fitness for registration' questions. This page will help guide you should you need to make a declaration about any issues that might affect your fitness for registration.
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This statement outlines the rights and responsibilities of health care workers and infected health care workers in relation to transmissible major viral infections.
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This policy outlines the requirements you must meet in order to be issued a general scope without limitations.
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When a physician associate first applies for registration in New Zealand, they will be registered in the Physician Associate Provisional scope of practice. There are multiple pathways to registration in the Physician Associate Provisional scope. Each of these has specific requirements you will need to satisfy to be eligible for registration. This section outlines the different pathways for each scope.
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If you wish to apply for the NZREX Clinical, you must meet the requirements outlined in this Policy. You will also need to submit a recent photo in order to apply for the NZREX Clinical, this policy also outlines the requirements for the photo we need.
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We have three main types of registration (what we call scopes) for doctors - vocational, general and special purpose. Physician associates will apply for registration in the Physician Associate Provisional scope of practice. . Within each scope there are multiple application pathways. Each of these has specific requirements you need to meet in order to be registered. This section outlines the different pathways for each scope.
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Clinical genetics is the investigation, diagnosis of and provision of medical advice, assessment and management of patients in relation to inherited genetic and chromosomal disorders and predispositions.
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Doctors accompanying individuals or groups of people visiting New Zealand who will provide medical diagnosis, treatment or advice only to those individuals or groups, and who are not registered with the Medical Council will not be required to obtain registration and a practising certificate, so long as they restrict their practice to those individuals or groups for the duration of their visit.
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Te Kaunihera Rata o Aotearoa | Medical Council of New Zealand has today released the results of the first Torohia — Medical Training Survey for New Zealand , giving new insights into the experiences of doctors in training across the motu.
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Urology is the diagnosis and treatment (operative and non operative) of patients with disorders of the urinary tracts in males and females, and male genital organs. It also includes the management of trauma to these organs and the management of male sterilisation, infertility and sexual dysfunction.
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We are consulting with stakeholders on the proposed introduction of a fee for the accreditation of New Zealand-based vocational training and recertification providers.
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The Council and the Australian Medical Council (AMC) work together on accrediting the vocational medical training programmes offered by Australasian (joint Australian and New Zealand) vocational providers. If the applicant provider is seeking recognition in Australia (as an Australasian training provider), or if the scope is already recognised in Australia, stage 3 will be led by the AMC, with Council making a decision based on the AMC’s assessment.
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Council is pleased to announce that from 1 November 2024, international medical graduates (IMGs) with an approved postgraduate medical qualification, intending to practise in Aotearoa New Zealand in an approved area of medicine, can apply for specialist registration via a new fast-track registration pathway.
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Occupational medicine involves the study and practice of medicine related to the effects of work on health and health on work. It has clinical, preventive and population based aspects.
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If you are registered and practising in the provisional general scope via the UK/Irish graduates, comparable health system or the Australian general registrant pathway, you must practice in a Council-approved position, under Council-approved supervision.
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Psychiatry involves the assessment, diagnosis and treatment of patients with psychological, emotional, or cognitive problems resulting from psychiatric disorders, physical disorders or any other cause.
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This page contains a full list of our forms including application, report and referee forms, as well as checklists and the current fees payable.
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Musculoskeletal medicine involves the diagnosis and treatment (or referral) of patients with neuro-musculoskeletal dysfunction, disorders and diseases, most of whom present with acute or chronic pain problems.
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VOC1 (specialist) registration is for doctors who hold an approved New Zealand / Australasian postgraduate qualification and already hold registration in the General scope of practice.
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Emergency medicine is a field of practice based on knowledge and skills required for the prevention, diagnosis and management of acute and urgent aspects of illness and injury affecting patients of all age groups with a full spectrum of undifferentiated physical and behavioural disorders.
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Supervision is a registration requirement for all doctors registered in a provisional general, provisional vocational or special purpose scope of practice. Supervision supports a doctor’s practice and enables their performance to be assessed while they become familiar with the New Zealand health system and the expected standard of medical practice.
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Medical administration is administration or management utilising the medical and clinical knowledge, skill and judgement of a registered medical practitioner, and capable of affecting the health and safety of the public or any person.
This may include administering or managing a hospital or other health service, developing health operational policy, or planning or purchasing health services. Medical administration does not involve diagnosing or treating patients. -
Palliative medicine is the medical care that improves the quality of life of patients and their families and whanau facing the problems associated with life-threatening illness. The focus of palliative medicine is the anticipation and relief of suffering of patients by means of early identification, assessment and management of their pain and other physical, psychosocial and spiritual concerns. In particular, it affirms life, regards dying as a normal process and intends to neither hasten nor postpone death.