# Medical Council of New Zealand

The Medical Council of New Zealand (Māori: Te Kaunihera Rata o Aotearoa) is the peak national standards and assessment body for medical education and training. It is responsible for the registration of doctors and has the power to suspend or remove the right to practise medicine in New Zealand. Its responsibilities are defined by the Health Practitioners Competence Assurance Act 2003 and it is funded by practitioner fees paid by all practising doctors in New Zealand.

## History

Medical registration in New Zealand traces its origins to the mid-19th century, with initial attempts made on a provincial level. The New Munster Province, encompassing parts of New South Wales and New Zealand, led the way in 1850. Subsequently, the establishment of medical boards in provinces like Wellington in 1854 marked significant progress in regulating the medical profession. The pivotal moment arrived with the passage of the 1864 Act in Otago, which mandated registration for medical practitioners. This legislation empowered authorities to strike off any practitioner found guilty of misconduct or disreputable behavior. Despite early efforts, progress was not without its challenges. The Medical Practitioners Bill of 1860 faced substantial opposition, notably from proponents of homeopathy. This highlights a longstanding debate surrounding complementary and alternative medicine vis-à-vis conventional medical practices. The historical context underscores the enduring discourse on medical regulation and the integration of diverse medical approaches within New Zealand's healthcare landscape.

### Finance

The Medical Council relies heavily on revenue from practicing certificate fees, which encompass disciplinary charges. This financial aspect is of interest to both individual doctors and their employers, often being repaid as part of employment packages. Over time, the complexity of the Council's activities has led to an increase in the practicing certificate fee, reflecting its expanding operations. When Georgina Jones assumed the role of CEO, financial procedures were notably simpler. In 1987, the yearly practicing certificate cost only $63, which included a $21 disciplinary fee. In 1987, financial records indicate that income and expenditures totaled approximately $450,000. Within this, a surplus of $7,000 was noted in the general fund, while the discipline fund showed a deficit of $126,000 due to expenses exceeding income by roughly $300,000 versus $178,000, respectively. Consequently, by the end of the fiscal year, the disciplinary reserve account reflected a deficit as of March 31, 1987. Fast forward to 1996, significant growth and operational expansions led to the acquisition of new leased premises and a considerable increase in staff numbers. This expansion was reflected in the increase of fixed assets' net book value, which rose to $271,590, alongside investments exceeding $5,000,000, equivalent to a year's turnover. Income saw substantial growth, reaching nearly $1,900,000 in the general fund and over $3,200,000 in the discipline fund. Furthermore, the establishment of an examinations fund, generating approximately $350,000 in income, further underscored the organizational evolution. By the turn of the millennium, financial reporting had evolved, demonstrating a more sophisticated approach. Notably, output categories and their associated costs were meticulously outlined in the annual report for the year ending March 31, 2000. annual report. • Education – $609,512 • Health – $498,252 • Professional standards – $825,106 • Registration – $1,326,968 • Workforce – $170,212.

## Purpose

The primary objective of this council is to uphold the wellbeing and safety of the public within the healthcare sector and is aimed to ensure healthcare practitioners are proficient and competent in their respective professions. The Objectives are:
* Establishing mechanisms to ensure healthcare practitioners' proficiency and competence
* Introducing a uniform accountability framework for all healthcare professions
* Defining the scope of practice for each healthcare practitioner based on their competency
* Implementing systems to prevent healthcare professionals from practicing beyond their authorized scope
* Granting authority to restrict certain activities to specific categories of healthcare practitioners to mitigate public risk

## Qualification
### Domestic graduates
#### Fitness

Domestic graduates that are looking for registration with the Medical Council of New Zealand (MCNZ) are required to attend a fitness assessment to pass necessary standards of health, conduct, and competence required for practice in the country. Cooperation and transparency throughout this process facilitate MCNZ in making informed determinations regarding eligibility to practice medicine in New Zealand.

#### Proficiency in English

Applicants are required to attend an interview conducted by an MCNZ representative in major cities such as Auckland, Wellington, Christchurch, or Dunedin. During this interview, identity verification, discussion of practice intentions, and presentation of original documents are required. The interviewer elucidates the supervision requirements relevant to registration.

#### Registration interview

Proficiency in English language communication is important for registration. Non-native English speakers may need to pass a language assessment, unless exempted due to substantial work experience in English-speaking environments. Passing either the IELTS English test (with scores of 7.5 for Speaking and Listening, and 7.0 for Writing and Reading) or the OET Medical Module (achieving a minimum grade of 'B').

### International medical graduates

To be eligible, for registration ,individuals must have a recognized degree and show proficiency in English. This can be proven by passing either the English, Professional and Linguistics Assessment Board exam, the Australian Medical Councils multiple choice question assessment or the written test of the United States Medical Licensing Examination within the five years. After passing the New Zealand Registration Examination international medical graduates are advised to secure a position as a first year house officer in an internship role. Following a period of practice they can then apply for full general registration. For graduates from countries that have healthcare systems similar to New Zealand as recognized by the Council there are streamlined registration pathways available without having to take the registration examination. However those from countries that do not meet this criterion can still obtain registration by completing the New Zealand Registration Examination.

## Registration pathways

For specialist doctors in In New Zealand, specialist doctors have several registration pathways available. These pathways are designed to streamline the registration process based on the doctor's qualifications, experience, and intended scope of practice.

### Vocational Pathway
#### Option 1

This pathway is for specialist doctors who intend to practice medicine in New Zealand for a long time. It involves an assessment and registration process specific to the doctor's specialty.

#### Option 2

Another pathway for specialist doctors intending to practice in New Zealand long-term, with a different assessment and registration process.

#### Option 3

A pathway for specialist doctors intending to practice in New Zealand for a short term.

### General Pathway
#### NZ AUS Grad Pathway

For doctors who have graduated from a New Zealand or Australian university medical school and completed their internship in either country.

#### Competent Authority Pathway

Available for doctors who have graduated from UK and Ireland and have completed their internship there.

#### Comparable Health Pathway

For doctors with unrestricted registration in other countries and relevant experience and offered a job from a New Zealand hospital.

#### NZ REX Pathway

For doctors holding a primary medical degree from a New Zealand or Australian university medical school or have passed the NZREX Clinical exam.

#### Australian General Registrants

A pathway for doctors who have passed the Australian Medical Council exams and have full registration with the Australian Health Practitioner Regulation Agency.

### Special Purpose Pathway

This pathway includes options for specialist doctors intending to work in New Zealand for specific purposes such as emergency situations, pandemic response.
Each pathway has specific requirements related to qualifications, experience, English language proficiency, and job offers from New Zealand hospitals. The Medical Council of New Zealand