Pathway to specialist registration for IMGs

1
Pathway to specialist registration for IMGs

• Joan Crawford
• Registration Manager
• Medical Council of New Zealand

2
Assessment pathway for doctors who have

• Trained in a recognised scope of medicine or
  specialty.
• Postgraduate qualifications in that scope of
  medicine.
• Experience practising at specialist level.
• Ongoing involvement in continuing professional
  development.

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Why develop a new assessment pathway?

• Health Practitioners Competence Assurance Act
  2003
• Assessment differences
• no exit examination
• no clinical assessment
• no external assessment
• training providers not accredited by external
  agencies.
• More applicants from US Europe.

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Consultation with colleges on

• Interview process by colleges.
• Assessment tools
• practice visit assessments
• 360 degree evaluation
• audit of logbooks (procedural based)
• Examinations.
• Supervision requirements in New Zealand.

5
Responses to consultation paper

• Support to develop alternative assessment.
• Inconsistency in interview process
• standard questions
• training
• cross College observer.
• Subspecialisation.

6
Development of new pathways

• Possible criteria to define examination and
  performance assessment pathways
• time worked as a specialist in a comparable
  health system
• College advice
• formal external clinical exam.

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Proposed assessment pathway

• 12 months of supervised assessment.
• Standard assessment
• practice visit assessment (observing the doctor
  with patients, records review, case based oral,
  interview)
• 360 degree evaluation by peers and patients
• formal audit of interventions in procedural based
  practice.

8
Feedback from Colleges

• Concerns about resources in having two
  supervisors.
• Assessment process - resource intensive.
• Concerns about reliability and validity of
  proposed tools.
• Utility of layperson on assessment team.
• Little support for comparable health system as
  criteria.

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Review and reassurance

• Tools not used in isolation.
• Evidence gathered by range of tools, taken
  together are reliable.
• View to gain consistency across BABs with
  process.
• Each scope may recognise qualifications from a
  particular country differently.
• No room for comparable health system recognition.

10
Finalised policy

• Paper assessment and interview by College.
• College advises Council on
• IMGs training, qualifications and experience
• suitability for registration for supervision
  pathway or assessment pathway
• further assessment requirements.

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Finalised policy (contd)

• Council considers College advice and issues
  eligibility.
• Once IMG has proposed employment, registration
  via either pathway
• (1) provisional vocational scope (supervision)
• (2) provisional vocational scope (assessment).

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Assessment of qualification

• HPCAA, section 15.
• Prescribed qualifications.
• Supervision pathway IMGs training,
  qualifications and experience equivalent to that
  of a New Zealand trained doctor.
• Assessment pathway training, qualifications and
  experience are as satisfactory as a New Zealand
  trained doctor.

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Provisional vocational (supervision)

• At least 12 months supervision.
• Training and assessment programmes known eg, UK
  postgrad qualification CCT.

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Provisional vocational (assessment)

• Supervised assessment for 12 to 18 months - one
  or more supervisor(s) comprehensive reports
  3-monthly and
• Practice visit and assessment by two College
  members /- a layperson (observing the doctor
  with patients, records review, case based oral,
  interview) and/or

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Provisional vocational (assessment)

• 360 degree evaluation (by colleagues, patients
  and self) and/or
• Formal audit of interventions in procedural based
  practice (log book) and/or
• Sitting and passing the relevant College
  examination and/or
• Other forms of assessment.

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Implementation

• Standardisation and consistency of interview
  process.
• Training of assessors.
• Further training of supervisors.
• Communication plan.
• Funding issues.
• First practice visits and assessments scheduled
  for April 2007.