Applying for House Officer Positions after NZREX

There is a centralised application for First year house officer positions in NZ. However, this is restricted to certain candidates only (NZ and Aus medical grads) and NZREX candidates are not eligible to apply.

That leaves you to apply to various DHBs by yourself.

There are two ways you could do this:
1. Apply to DHBs via email.
2. Apply to DHBs in person.

It may be easier to apply via email, but possibly more effective if you could personally hand in your CV. For most candidates, its probably easier to email as going to every DHB is not feasible (although, that's exactly what I did). Furthermore, looking at the number of NZREX passed candidates applying for a job, you could imagine how annoyed the RMO units would be if each of you showed up there with your CV. The least you could do is visit your local DHB and meet someone at the RMO office. Follow it up with an email expressing your interest.

So, after you've been to your local DHB to apply in person, the next step is to call all the other DHBs to express your interest and follow it up with an email too. Be prepared to get a rude reply from them or a simple "sorry we have no vacancies this year" or "we have a long waiting list". 

While I was applying for PGY1 positions, one of the DHBs always said "we have a waiting list for the next 2-3 years" and I pretty much stopped trying at this DHB after hearing that. A year and a half later, I was driving to every DHB in New Zealand as my last resort and drove to this DHB as well. Guess what - there was no such waiting list! I got the job a few days later. FYI - I got offers from 2 other DHBs a few days later as well. This was back in 2015. The situation was just as bad, if not worse, back then.

I would recommend sending through your CV every few weeks/months to show your continued interest. My email to every DHB had a snapshot of my achievements in the email body to highlight my strong points. You could do something similar too. Remember, you are not the only person reading this, be innovative.

If possible, know who you are meant to send emails to. Often there will be a general email id like recruitments@southerndhb.govt.nz, but if you can dig deeper or use your contacts, there may be an email id of the RMO coordinator lead or someone at a similar level. CC them into your application email to maximize your chances.

There is no right time to apply. The right time was 5 years ago, you've missed that boat, unfortunately. The worst time to get a job is probably in Nov/Dec as that is when the NZ grads start working and all available spots are usually taken up by them. Jobs come up throughout the year in different DHBs. The largers DHBs may have more vacancies, but the smaller DHBs tend to take more IMGs. So apply to all DHBs regardless. Once you get in, you can always change your DHB at a later time.

Your competition is not NZ or Aus grads, as you don't stand a chance against them. Its also not the European or American grads, as they often take up the PGY2 or above positions. Your competition is mainly other NZREX candidates and seems like there are a lot of them currently, often people with experience in their home countries. You need to be smart in your approach, don't just sit back and expect to get a call. Be active, go to various hospitals, apply for observerships, make contacts, get noticed.

I have compiled a list of all DHBs in New Zealand, hopefully making it easy for you to look up current vacancies or contact the RMO office of the respective DHBs.

District Health Boards in the North Island

·         Auckland DHB

·         Bay of Plenty DHB

·         Capital and Coast DHB

·         Counties Manukau DHB

·         HawkesBay DHB

·         Hutt Valley DHB

·         Lakes DHB

·         MidCentral DHB

·         Northland DHB

·         Tairawhiti DHB 

·         Taranaki DHB

·         Waikato DHB

·         Wairarapa DHB

·         Waitemata DHB

·         Whanganui DHB

District Health Boards in the South Island

·         Canterbury DHB

·         Nelson-Marlborough DHB

·         South Canterbury DHB

·         Southern DHB

·         West Coast DHB

Frequently asked questions about NZREX

I am from Country *** or have a post-graduate degree in *** or have a few years experience in *** specialty, do I need to take NZREX?

Please take the Medical Council self-assessment questionnaire and find out the answer yourself!

USMLE vs AMC vs PLAB, which exam should I take?

The answer to this question varies from person to person. Given that getting into the healthcare system in NZ is not that easy, it is a good idea to have a backup option. Which exam you take depends on what you want your backup to be. If you plan to apply to Aus as a backup plan, then take the AMC exams and so on. Remember that for those taking the USMLEs, you must take 2 exams Step 1 and Step 2CK, for the others its just the one exam.

Eligibility for applying for the NZREX?

English language requirements:

a.       IELTS with a minimum of 7.5 in speaking and listening; a minimum of 7 in writing and reading. Dated within 2 years.

b.       OET with a minimum of ‘A’ or ‘B’ in each of 4 components within one result. Dated within 2 years.

      NZREX Clinical candidates must have passed, within the last 5 years, one of the following prerequisite examinations:

a.       United States Medical Licensing Examination (USMLE) Steps 1 and 2 (Clinical Knowledge)

b.       PLAB Part 1

c.        Australian Medical Council MCQ

d.       Medical Council of Canada Qualifying Examination (MCCQE Part I)

Eligibility often changes, please visit the MCNZ website for the latest eligibility criteria.

NZREX Clinical Exam format?

The current NZREX Clinical is an Objective Structured Clinical Examination (OSCE) format of 16 stations.

NZREX passing rate?

Historically the pass rate for NZREX Clinical has averaged around 60%. Candidates will be scored for each of the 16 stations separately and the scores aggregated into a final mark.

There is no guarantee of employment for doctors who have sat and passed NZREX Clinical.

Do I need any documents after I pass the exam and get a job?

Before you can be registered and begin work, you will need to provide a certificate of professional status (good standing) from the regulatory authority(ies) of each jurisdiction in which you have worked for 5 years prior to your application for registration. It can take some time to obtain certificates of professional status (good standing). If you want to start work in New Zealand immediately after passing NZREX Clinical, you may want to request certificates of professional status (good standing) from the applicable authority(ies) prior to passing NZREX Clinical. Be cautious about obtaining a certificate of professional status (good standing) too soon – they must have been issued within 3 months of the date you intend to start work for Council to accept the certificate of professional status (good standing).

What books to read?

There are no official books for NZREX. Because it is an OSCE format exam, any OSCE preparation book would suffice. Some known ones are ‘Katrina Hurley’ and ‘AMC clinical assessment’.

General Practice by Murtagh is a good reference book to read prior to the exam.

BookDepository.com is our recommended BookStore to buy books.

What happens after the exam?

You must work as a House officer with Provisional Registration for 2 years before you can apply for a Post Graduate position (specialty) and before you can get General registration. The most difficult step is securing a First Year House officer job in NZ. There is no centralized application process for foreign graduates, you are left to apply on your own and must contact hospitals (DHBs) individually. As expected, DHBs get numerous application from overseas graduates and the process can, therefore, can be unpleasant at times.

What is a House officer?

In NZ, your first job after you graduate is that of a House officer. It is interchangeably called RMO, or house surgeon, PGY1.

After 2 years as a house officer, you can continue to stay as a house officer – you would then be called a SHO (Senior House Officer)

Alternatively, you can get a registrar job or apply for residency (also called training/post graduation).

How is the job situation in New Zealand after passing the NZREX?

A one-word answer to this question is ‘difficult’.

Only a handful of candidates get a 1st-year house officer position in NZ after NZREX each year. This is mainly due to a limited number of PGY1 positions in NZ and most of them are taken up by the NZ graduates (who are given first priority). Often NZ graduates do not get a position due to a lack of vacancies and they are then given first priority in case a vacancy comes up in the future. This image will give you a better idea of the situation.

What kind of Visa do I need for the exam?

You can come to NZ on a visitor visa to take the exam.

What is the average waiting period to get a job after the exam?

A few days to years. Who knows!

Some get in straight away, others wait for years, there seems to be no pattern.

I am an NZ resident or citizen, do I have better chances of getting a job after NZREX?

Potentially, your biggest advantage compared to a non-resident is that you can stay in NZ for a longer period and hence can keep applying even if you end up pursuing a different pathway. You would also have relatives (assuming that’s the reason you have a resident visa) to help support you during this process as it can get very pricey.

You may be given preference over a non-resident, but there are no rules as such. Your resident visa can let you start work immediately compared to someone who needs a work visa.

Are there any study groups?

Yes and no.

You are meant to either create your own or join an existing one.

There are a few facebook groups to start – just search NZREX on Facebook.

Do I need a study group?

Yes!

The exam is in OSCE format, which means you need to practice on patients. A fellow NZREX candidate would be a good practice patient and you can take turns to practice and criticize and learn from each other. Just reading from the book will not be sufficient.

Are communication skills important?

Yes, they are, a pretty important aspect of the exam.

These could include breaking bad news to a patient, obtaining informed consent, explaining how to use asthma inhalers, communication with children, communication with family members, communication regarding medication etc.

Examiners will be looking for a demonstration of good listening skills. These would include active listening, reflecting, clarification, choosing an appropriate level of medical terminology, body language etc. Incorporating the patient’s or family’s own values and beliefs is considered an integral part of good communication skills. Understanding the presenting problem from the patient’s perspective (the illness) should be sought in conjunction with information that allows an accurate medical assessment (the disease). An often overlooked part of communication skills is the generation of a mutually agreed management plan with the patient. This would include a discussion on what treatment options are available with the advantages and disadvantages of each. Candidates are expected to demonstrate good communication skills across a wide variety of social situations irrespective of the patient’s gender, race, religion or sexual orientation.

You will also be marked on professionalism which may include honesty, integrity, respect for patients, good moral reasoning and ethical practice.

Read our page on Communication Skills.

What can I do to get a job quicker?

Keep trying. You won't get it if you give up.

Be proactive and email/call/visit hospitals to stay in the loop.

Hand in your CV and ask them to keep it on file for any future vacancies.

Don’t just try one or two hospitals, try every hospital in the country that accepts 1^st years.

Do I need work experience to get a House Officer job?

No, you don’t. You can get a job without any experience. Having experience may improve your chances though.

Can I do other jobs while I apply for House officer positions?

Yes, you can as long as you have the right visa to do so. Be aware that often with HO positions, you may be required to start straight away, your temporary job may need a notice period before leaving, so be careful there or you may miss out when an opportunity comes knocking to your door!

What salary do I get as a house officer?

A pretty darn good salary and opportunities to earn more if you do additional shifts.

As per the national contract, your salary starts at just over $80,000 per year.

Additional shifts can get you an extra $150/hour and may vary between hospitals.

Cross-covering for an absent RMO can get you an extra $150 per day.

Your salary goes up by around $3000 every year.

You earn more in non-urban hospitals compared to urban hospitals.

What can I do while I wait for HO positions?

You may apply for an observership while you wait, These are getting increasingly hard to secure as you can imagine everyone trying to get one. They are unpaid and often free. You are usually not allowed to touch patients.

How can I improve my Communication Skills?

'Connect Communications' hold a communication skills course every now and then.

A good one to attend to help improve your communication skills and to practice as well. They also run difficult scenarios stations to help you learn and practice.

These guys seriously need to start paying me for all the advertising and recommending the course to numerous people who ask me about it ;)