What you need to check - Registration pathways

There are a number of ‘pathways’ by which medical practitioners can apply for registration via the Medical Council of New Zealand (MCNZ) to work in New Zealand which include:

• General scope
• Provisional general scope
• Special purpose scope
• Vocational scope
• Provisional vocational scope

Resident Medical Officers (RMOs) are recruited to work at Waikato District Health Board (DHB) using the general, provisional general and special purposes registration pathways. (Registration in a vocational scope recognises a doctor as a specialist in New Zealand).

Each scope requires the employer and the RMO to complete set paper work. As the ‘employer’, Waikato DHB (via the RMO Unit ONLY ) must complete all or part of the following [depending on MCNZ] requirements:

• Complete the employer’s checklist
• Attach:
• 1. job offer
  2. proposed supervision plan
  3. three references (on the MCNZ RP6/9 form or the nationally agreed ‘National RMO Reference’ form)
  4. induction and orientation plan
• Gather together all documentation (including those documents that the RMO has been requested to complete) and send the COMPLETE application to the MCNZ for processing

Associated documents

• Supervision Plan – Competent Authority
• Supervision Plan – Comparable Health Pathway
• Supervision Plan – Special Purpose Pathway
• 2015 Orientation Plan – Template
• National RMO Reference form

General scope

Doctors who have completed the requirements for registration within a general scope of practice, who must establish a collegial relationship so they do not work in professional isolation and to help with continuing professional development, and who are not required to work under supervision.

Required paperwork:

1. job offer
2. three referee reports (RP6_RP9 forms or ‘National RMO Reference’ form)forms)
3. CPD8 form
4. join the Bpacnzbpacnz Recertification Programme

Associated documents

• RP6/9 Form – referee form
• National RMO reference form
• CPD8 – Professional Development for doctors registered in the general scope
• Bpac FAQ sheet
• Inpractice – Bpac recertification programme
• Inpractice payment process

Provisional general scope

To satisfy the requirements for a general scope of practice, doctors must first work under supervision, work in an approved position, be registered within a provisional scope for 6 – 18 months and satisfy any other requirements set by the MCNZ.

New Zealand and Australian graduates (PGY1s)

These doctors must have graduated with a New Zealand or Australian university medical degree. Once these doctors have successfully completed four (13 week) clinical attachments signed off as ‘satisfactorily completed’ by their ward supervisors and their allocated ‘Prevocational Education Supervisor’ [PES] then they can apply for ‘endorsed’ general registration; after completing a second year, plus completing a ‘community-based’ clinical attachment and ‘substantively’ achieving the listed educational and learning objectives the Interns can then apply for (full) general registration.

Information on the New Zealand curriculum framework
PGY1s (or Interns as they are referred to by the Medical Council of New Zealand [MCNZ]) must work in accredited clinical attachments under the supervision of a prevocational educational supervisor (PES). Prevocational medical training requires the Waikato DHB to deliver a 2-year intern training programme with specific requirements for postgraduate year 1 (PGY1 house officers) and postgraduate year 2 (PGY2 house officers).
The MCNZ introduced the ‘New Zealand Curriculum Framework’ (NZCF) in 2015 – this requires that the year one house officers record their learning, have their progress tracked, create and update their ‘Professional Development Plan’ (PDP), record ‘continued professional development’ (CPD) activities plus complete their assessments through an e-portfolio system known as ‘ePort’.

The NZCF outlines the learning outcomes – underpinned by the concepts of patient safety and personal development - 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.

Additionally, every intern is required to complete one clinical attachment in a community based setting over the course of their  PGY1 and PGY2 intern years ; therefore a year one house officer may be rotated into a community placement and this may require daily travel or a relocation for the duration of the clinical attachment; in such situations,  reimbursements can be claimed as per the relevant clauses in the RDA MECA .

Year one house officers are expected to meet with their 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 the clinical attachment. It is important that the quarterly assessments are completed within two weeks of finishing a clinical attachment.

At the end of their first year of post graduate work, each year one house officer is expected to have successfully completed four clinical attachments; they must have all assessments, PDP and CPD documentation completed by the date stipulated by their PES, in readiness for the advisory panel performance assessment meeting 

The advisory panel will meet to discuss the overall performance of each year one house officer, assess whether they have met the required standard to be registered in a general scope of practise and are therefore ready to proceed to the next stage of training. The advisory panel will hold the responsibility for endorsing the PDP as acceptable for PGY2.

To apply for registration within a general scope of practice the year one house officer must meet the following requirements:

• The (satisfactory) completion of four accredited clinical attachments.
• The substantive attainment of the learning outcomes outlined in the NZCF
• 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 standard of New Zealand Resuscitation Council CORE level 7 less than 12 months old.

When an intern is approved registration in a general scope of practice an endorsement related to completing a PDP will be included on their practising certificate for the PGY2 year, under the competence provision of the HPCAA.

At the end of PGY2, interns must demonstrate through the information in their ePort that they have met the prevocational training requirements and achieved their PDP goals. The prevocational educational supervisor will then recommend the intern’s endorsement be removed from their practising certificate as part of the practising certificate renewal process.

When applying for general registration they need to submit a COS3 form, a CPD8 form, verification (a copy of the certificate) that the doctor has ACLS certification and join the ‘Bpac’ recertification programme (if they are not on a vocational training pathway)

Required paperwork:

• job offer
• current CV
• referee reports (RP6_RP9 forms) if have them but not mandatory
• completed all application details and paperwork as required to have their application processed through the ACE ‘matching’ process

Medical Council of New Zealand: Policy for New Zealand and Australian graduates

Associated documents

• RP2 Form - Interns report: clinical attachment evaluation
• CHECKLIST 1 – NZ / Australian graduates
• REG1 Form – Application for registration
• REG2 Form – NZ PGY1 application for registration
• REG2B Form – Australian PGY1 application for registration
• RP6/9 Form – Referee form

NZREX

These doctors must have passed the NZREX exam within the last five years

Required paperwork:

1. Job offer
2. Current CV
3. Referee reports (RP6_RP9 forms) if have them but not mandatory
4. Checklist 03 Passed NZREX Clinical
5. REG1
6. REG3 – one form for year with all runs listed on it and signed by Intern Supervisor
7. Copy of IELTS results
8. Certificates of Good Standing (if required)
9. Certified copies of passport identity pages
10. Certified copies of work permit or residency visa
11. Immigration forms – INZ1113
12. These doctors are also eligible to apply for year one house officer position through the ‘ACE’ matching process if that coincides with their passing the NZREX exam – they must complete all ACE application forms and paperwork

 Medical Council of New Zealand: Policy for NZREX clinical

Associated documents

• REG1 Form – Application for registration
• RP6/9 Form – Referee form
• REG3 Form - Application for approval of position and supervisor
• INZ1113 Form – Immigration paperwork
• CHECKLIST 3 – Passed NZREX clinical
• NZREX Paperwork checklist

UK/Irish doctors

These doctors must have graduated with a UK or Irish university medical degree and   must have completed their internship

Required paperwork:

1. Job offer
2. Current CV
3. Three verified referee reports (RP6_RP9s)
4. Checklist 02
5. REG1
6. REG3 – one for each supervised run the RMO will work in
7. Supervision Plan
8. Orientation Plan
9. Certified copies of passport identity pages
10. Certified copies of work permit or residency visa
11. Verified copies of Medical Qualifications
12. Immigration forms – INZ1113
13. Evidence of:
    1. Completion of their intern year OR
    2. Completion of their Foundation year one year (FY1) OR
    3. Full registration with the GMC or IMC

Medical Council of New Zealand: Policy for UK and Irish graduates

Associated documents

• REG1 Form – Application for registration
• RP6/9 Form – Referee form
• REG3 Form - Application for approval of position and supervisor
• INZ1113 Form – Immigration paperwork
• Supervision plan – Competent authority
• 2015 Orientation Plan – Template
• CHECKLIST2 – United Kingdom/Irish graduates
• UK and Irish graduates paperwork checklist

Comparable health

Applicants registering under this category must:

• Satisfy the MCNZ’s English policy (pass an IELTS exam)
• Hold an acceptable primary medical degree from a university medical school listed on the MCNZ’s website
• Have either full or general registration in the comparable health system(s)
• Have worked for a minimum of 30 hours per week
• Have worked for 33 of the last 48 months in a country with a health system comparable to New Zealand’s. The MCNZ lists these as:
  
  

  Australia	Italy
  Austria	Norway
  Belgium	Portugal
  Canada	Republic of Ireland
  Czech Republic	Singapore
  Denmark	Spain
  Finland	Sweden
  France	Switzerland
  Germany	The Netherlands
  Greece	United Kingdom
  Iceland	United States of America
  Israel

• Provide practice profiles showing they have relevant and comparable experience to the position applied for in New Zealand
• Have proposed employment in New Zealand in the same or a similar area of medicine, and at the similar level of responsibility as what the applicant has been doing for the preceding 33 out of 48 months
• Have proposed and supervised employment in a recognised scope of practice in New Zealand

Required paperwork:

• Job offer
• Current CV
• Three verified referee reports (RP6_RP9s)
• Checklist 04
• Practice profiles
• • Checklist 05 = General Practice Profile
  • Checklist 06 = Hospital Practice Profile
• IELTS results
• Certified copies of passport identity pages
• Certified copies of work permit or residency visa
• Official translations of documents NOT in English
• Verified copies of Medical Qualifications
• Registration Certificate / Licensure to Practice
• Supervision Plan
• Orientation Plan
• Immigration forms – INZ1113

Medical Council of New Zealand: Comparable health system

Associated documents

• REG1 Form – Application for registration
• RP6/9 Form – Referee form
• REG3 Form - Application for approval of position and supervisor
• INZ1113 Form – Immigration paperwork
• Supervision Plan – Comparable health pathway
• 2015 Orientation Plan – Template
• CHECKLIST 4 – Comparable health system
• CHECKLIST 5 – Practice profile: general practice
• CHECLIST 6 – Practice profile: hospital practice
• Comparable health system paperwork checklist

Special purpose scope

All doctors applying for registration must hold an acceptable primary medical degree as described on the MCNZ’s website. These doctors must:

• Satisfy the MCNZ’s English policy (pass an IELTS exam)
• Be registered in their own country to which they will return after this training (which cannot exceed 24 months in duration)
• Be sponsored by an organisation to which the doctor will return after the proposed period of training, OR have a formal postgraduate qualification accepted by MCNZ as indicating competence in the branch the doctor will train in while in New Zealand, OR be enrolled in a formal training programme in their own country OR have worked at least 12 months in an institution with which this DHB has an exchange programme
• Provide evidence that they are entering into a formal recognised scholarship or fellowship programme with a structured supervision plan
• Include details of the training objectives, delivery, and how the training will be monitored and outcomes measured
• Include from the supervisor, a clear indication of the level of responsibility that will be delegated the trainee
• Be approved by the CMA

(Please note that there is a 1:3 ratio per department for employing ‘special purpose scope’ RMOs, eg.  if there are six registrars in a department, no more than two of these can be postgraduate trainees registered in this pathway)

• The following changes took effect from May 5, 2011 :
• • Trainees may not undertake relief runs (excluding postgraduate trainees approved to work in cardiothoracic surgery).
  • Trainees must have at least 2 hours per week protected time for teaching and will be required to attend any relevant tutorials and grand rounds.
  • Trainees must have been registered and practising in their home / sponsor country for a minimum of 1 year immediately prior to their application (excluding Pacific Island graduates, if they had been training in a different Pacific Island health system at the time of their application because recognised primary medical training programmes are not available in their home / sponsor country).
  • Doctors may not apply to sit NZREX if they hold registration within the special purpose scope of practice (postgraduate training).

(The purpose of the postgraduate training scope is to provide registration for doctors wishing to train in New Zealand to obtain knowledge and skills to take back to their home country. It is not a pathway to permanent registration in New Zealand (or Australia), or intended to meet service delivery requirements, nor is it a pathway to undertake a vocational training programme)

Medical Council of New Zealand: Special purpose scope policy

Required paperwork:

• Job offer
• Current CV
• Three verified referee reports (RP6_RP9s)
• REG1
• IELTS exam results
• Verified Certificate of Registration
• Verified copy of primary medical qualification
• Letter stating the applicant will return home upon completing their period of training
• REG3
• letter stating the doctor is a ‘sponsored postgraduate trainee’
• Educational Objectives
• Supervision Plan
• Orientation Plan
• Letter explaining any gaps of employment
• Checklist 11
• REG10
• Immigration forms – INZ1113

Associated documents

• REG1 Form – Application for registration
• REG10 – Declaration: Special purpose scope of practice - postgraduate training
• RP6/9 Form – Referee form
• REG3 Form - Application for approval of position and supervisor
• INZ1113 Form – Immigration paperwork
• Supervision plan – Special purpose pathway
• 2015 Orientation Plan – Template
• CHECKLIST 11 – Post-graduate training or experience
• COS7 - Application to amend practising certificate - Special purpose scope
• Special purpose pathway paperwork checklist