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456 results matching “what is the mass of clouds”
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You can apply to access the full medical register, but before you apply make sure you know what information the register holds. Whether your application is approved or not depends on what you want to do with the information.
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Collegial relationships are a component of recertification for general registrants, doctors working outside of their vocational scope of practice, and in select cases doctors limited to non-clinical practice.
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A Professional Conduct Committee (PCC) is an investigatory body appointed by the Council. Its purpose is to investigate matters and concerns referred to it by the Council about a registered doctor. Although a PCC is appointed by the Council, it is separate from the Council, and regulates its own procedures.
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To ensure that you are continuing to maintain your competence to practise medicine, you must meet recertification programme requirements set by Council, including any minimum continuing professional development (CPD) requirements.
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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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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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We serve Aotearoa New Zealand by protecting public health and safety. We do this by setting and promoting standards for the medical profession.
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This sheet provides information on how Professional Conduct Committees (PCCs) request information, what powers they must obtain information, what they do with information they receive, and answers some frequently asked questions.
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This pamphlet explains the role of a Professional Conduct Committee (PCC) and what to expect if your notification about a doctor is referred to a PCC.
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Established on 1 July 2022, Te Whatu Ora leads the day-to-day running of the health system across New Zealand, with functions delivered at local, district, regional and national levels.
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Under the HPCAA, doctors can have their competence or performance reviewed at any time, or in response to concerns about their practice. This guide outlines what you can expect if you are undergoing a performance assessment
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The Minister of Health has announced two new initiatives targeted at overseas doctors who have passed their New Zealand Registration Examination (NZREX) examination in the last five years, allowing them to apply for roles in New Zealand that will lead to full registration as a doctor.
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Council is reviewing the core ethical standards it sets for the profession, ensuring the standards reflect both patient expectations and the realities of clinical practice. As part of this work, we have sought feedback from patients and doctors and have now released two reports that reflect their views.
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Whether you're Māori or non-Māori, you are welcome to visit a Māori health provider. What makes their care different from a non-Māori health provider is the kaupapa (principle) and delivery framework, which is distinctively Māori.
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This pamphlet explains the role of a Professional Conduct Committee (PCC) and what to expect if you are referred to a PCC.
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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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A history of the Medical Council of New Zealand, compiled by Professor Richard Sainsbury.
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Our definition of the practice of medicine and clinical practice
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Torohia – Medical Training Survey for New Zealand – is here! Doctors in training voices matter. Let's make sure they're heard. Visit the Torohia website to find out more and download the promo kit to help spread the word! https://www.torohia.org.nz/
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Malatest Evaluation of the RPR Programme - end of year 2014
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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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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 - mid year report for 2016
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Malatest Evaluation of the RPR Programme: mid-year 2017
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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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This draft statement outlines what is expected of doctors when harm to patients occurs as a direct result of medical care. See the consultation section of our website to provide feedback on this draft statement.
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Summary of the Malatest evaluation of the regular practice review (RPR) programme for 2017.
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Evaluation of Council's RPR programme by Malatest International - Interim report to November 2014
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Evaluation of Council's RPR programme by Malatest International - end of year report for 2015
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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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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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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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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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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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Council has not issued standards specific to practice within the purpose of the End of Life Choice Act 2019 (EOLCA). Council considers that the provision of health services under the EOLCA falls within the wider practice of medicine, to which Council’s statements are directed. This document sets out existing Council statements alongside the relevant sections of the EOLCA.
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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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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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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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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. -
Search the list of doctors registered in New Zealand.
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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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This policy outlines the requirements you must meet in order to be issued a general scope without limitations.
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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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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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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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Manatū Hauora - The Ministry of Health (the Ministry) is proposing that the Physician Associate (PA) profession be regulated under the Health Practitioners Competence Assurance (HPCA) Act 2003. This document outlines the details of this proposal.
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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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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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Certificates of professional status (COPS) are documents used by medical professional regulators to share information about whether a doctor is in good standing. Doctors applying for registration, restoration or returning from practising outside New Zealand need to provide us with certificates of professional status.
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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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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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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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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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We recognise Taiwanese medical schools so that graduates from these schools have the opportunity to undertake NZREX Clinical. We must ensure we only register fully qualified doctors. However, the exclusion of Taiwanese medical schools from WDOMS is due to political factors and not the standard of those schools. The ECFMG has approved graduates of these schools to undertake the prerequisite examination - USMLE Steps 1 and 2.
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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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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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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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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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There are two key scopes of practice for PAs:
Physician Associate Provisional Scope of Practice (for first period of registration).
Physician Associate General Scope of Practice (for PAs who have completed the provisional period) . -
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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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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In some circumstances you can be restored to the medical register if your registration has been cancelled. This page outlines how to apply to be restored to the register.
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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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This page outlines how the process of renewing your practising certificate works and what to do if your certificate is about to expire and you haven't heard from us.
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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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This guide will help you when you complete the workforce survey as part of your application to renew your practising certificate.
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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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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 -
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 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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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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Approved list of postgraduate medical qualifications recognised for registration via the VOC4 pathway
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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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Physician associates are trained health professionals who work under the supervision of a medical doctor to provide healthcare to patients.
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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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Prescribing medicines and treatment is an essential part of medical practice. This statement outlines what good prescribing practice involves and the legal requirements doctors must comply with.
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This document outlines the standards that an applicant will be assessed against.
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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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Te Kaunihera Rata o Aotearoa | Medical Council of New Zealand is committed to meeting Aotearoa New Zealand's healthcare demands by enabling highly qualified international and locally trained doctors to join the workforce through flexible and efficient registration pathways.
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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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You can use this document to provide feedback on the updated version of our statement Disclosure of harm following an adverse event
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One of our most important roles is ensuring doctors are fit to practise medicine. We have a set of standards which outline what we expect of doctors, and procedures to follow if there are concerns about a doctor's conduct, competence or health.
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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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This gazette notice lists the fees payable from 1 July 2026.
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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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Kiwi Health Jobs is owned and supported by Te Whatu Ora | Health New Zealand and the New Zealand Blood Service and provides a one-stop-shop if you are looking for a job in New Zealand's public health sector.
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This gazette notice lists the fees payable from 1 July 2025.
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This document is a guide for interns and includes information on what MSF is about and step-by-step instructions to complete the process.
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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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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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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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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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Maintaining clinical records is part of good medical practice. Clinical notes are an important tool for managing the patient's care, and communicating with other doctors and health professionals. This statement guides doctors on what information they should record, and for how long they should retain patients' records.
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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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The main purpose of the collegial relationship is to ensure that a doctor's PDP and CPD are appropriate for the work they are doing. This guide is intended to outline what you need to do as part of this relationship including prompts for guiding discussion in collegial relationship meetings.
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The Performance Assessment Committee (PAC) is made up of two medical members and a lay member. The PAC can assess a doctor’s performance at any time.
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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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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 guide is for accredited training providers who are preparing for a Council accreditation assessment. This guide provides training providers with detailed information as to what the Council expects you to provide in your self-assessment.
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If a doctor has an issue with their own health, wherever possible we try to help them to remain in practice while it is being resolved. That said, our primary objective is to protect the health and safety of the public - which may mean that the doctor will be unable to practise safely, or will be limited in what they can do, until they are well enough to fully resume practice.
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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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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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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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Urgent care medicine (formerly known as accident and medical practice) is the primary care of patients on an after-hours or non-appointment basis, where continuing medical care is not provided.
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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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These standards have been superseded by the 2022 standards above.
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This gazette notice lists the scopes of practice and prescribed qualifications for Physician Associates.
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Regardless of your scope of practice, the basic process for registration as a medical practitioner in New Zealand is as outlined here.
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Our consultation regarding the strengthening of the accreditation framework for prevocational medical training is now open. We invite your feedback.
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Family planning and reproductive health is the treatment of and provision of health services for patients in relation to contraception, reproductive health and associated primary sexual health issues.
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Our principal function is to protect you by ensuring that doctors are competent and fit to practise. We do this by setting standards of clinical and cultural competence and ethical conduct for doctors.
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This statement outlines what cultural safety means and why it is important. The document reflects the evolution of thinking away from the cultural competence of doctors – that is acquiring skills and knowledge of other cultures – towards self-reflection of a doctor’s own attitudes and biases that may affect the cultural safety of patients. Council requires doctors to meet these cultural safety standards.
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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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The principal function of the Medical Council of New Zealand is to protect the health and safety of the public by ensuring that doctors are competent and fit to practise. We do this by setting standards of clinical and cultural competence and ethical conduct for doctors.
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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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A notification around concerns about your health is different from one about conduct, and our approach to dealing with it it is non-judgmental and focuses on your rehabilitation and the safety of patients and people you come into contact with.
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One of the ways the Council helps doctors to stay competent is by requiring them to participate in recertification programmes. Regular practice review (RPR) is one part of this continuing professional development.
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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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This page contains all of Council's publications and can be filtered by publication type to help you find what you're looking for.
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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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Dermatology is the study, research and diagnosis of disorders, diseases, cancers, cosmetic, ageing and physiological conditions of the skin, fat, hair, nails and oral and genital membranes.
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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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Training providers that offer vocational medical training and recertification programmes must gain accreditation with the Council by meeting the Accreditation standards for Aotearoa New Zealand training providers of vocational medical training and recertification programmes (2022).
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It is the Council’s role to ensure that the quality of training programmes offered by providers of prevocational medical training is of a high standard. Information on accredited prevocational training providers and the Council’s accreditation standards can be found here.
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This document highlights the revisions we're making around recertification, cultural safety, and health equity to the accreditation standards for NZ training providers of vocational medical training and recertification programmes
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We have three main types of registration (what we call scopes) - vocational, general and special purpose. 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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Anaesthesia is the provision of anaesthetics, peri-operative care, intensive care and pain management to patients and can include the provision of resuscitation, retrieval/transportation (inter and intra hospital) and hyperbaric medicine to patients.
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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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Orthopaedic surgery is the diagnosis and treatment (operative and non operative) of patients with disorders of the musculoskeletal system (bones, joints, ligaments, tendon and peripheral nerves). It includes the management of trauma to the musculoskeletal system and the management of congenital and acquired disorders.
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Public health medicine is the epidemiological analysis of medicine concerned with the health and care of populations and population groups. It involves the assessment of health and health care needs, the development of policy and strategy, the promotion of health, the control and prevention of disease, and the organisation of services.
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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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Rehabilitation medicine is the medical care of patients in relation to the prevention and reduction of disability and handicap arising from impairments, and the management of patients with disabilities from a physical, psychosocial and vocational viewpoint.
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Our current standards set out the principles and values that define good medical practice, and outline what we expect from doctors in all aspects of their professional behaviour.
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Our current standards set out the principles and values that define good medical practice, and outline what we expect from doctors in all aspects of their professional behaviour.
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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 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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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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Obstetrics and gynaecology involves the diagnosis and management of patients in the area of reproductive health and diseases, including but not limited to women’s health issues, maternal foetal medicine, gynaecological oncology, reproductive endocrinology and infertility, and urogynaecology, male sexual disorders, post and perinatal issues.
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Earlier this year we sought feedback on the draft statement on Treating yourself and those close to you. A wide range of submissions was received from key stakeholders across the profession and some common themes emerged. Council has revised this statement taking into account your feedback.
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When applying for registration at the end of your medical training you will have to answer questions relating to your fitness to practise. This guide will help you to figure out what you may need to declare to Council.
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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. -
It is Council’s role to accredit and monitor specialist training providers and to promote medical education training in Aotearoa New Zealand. Council assesses Aotearoa New Zealand-based vocational medical training and recertification providers against these standards.
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Paediatric surgery is the diagnosis and treatment (operative and non operative) of children (usually up to 15 years of age) who may require surgery. It includes non-cardiac thoracic surgery, general paediatric surgery, oncological surgery, urology in children and the management of congenital abnormalities both ante-natally and in the neonatal period. Also included is the management of major trauma in children.
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Plastic and reconstructive surgery is the diagnosis and treatment (operative and non operative) of patients requiring the restoration, correction or improvement in the shape and appearance of the body structures that are defective or damaged at birth or by injury, disease, growth or development. It includes all aspects of cosmetic surgery.
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Cardiothoracic surgery is the diagnosis and treatment (operative and non operative) of patients with disorders of structures within the chest including: the heart and vascular system, the lungs and trachea, the oesophagus, the diaphragm and chest wall. It includes the management of trauma and congenital and acquired disorders of these structures.
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Once a doctor successfully completes prevocational medical training and has received registration within a general scope of practice, a doctor is then eligible to enrol in a vocational medical training programme. Doctors undertaking this training are referred to as trainee doctors, and are usually employed as registrars.
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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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This statement outlines the doctor's responsibility to maintain sexual boundaries with patients, includes advice on what to do if boundaries are threatened, and offers guidance on sexual relationships with former patients and with family members of patients.