NZREX FAQ

Frequently Asked Questions about the NZREX

 How many times is the exam held in year?

The exam is held 5 times a year starting 2013. It used to be 4 times a year until 2012.

 How many batches of students on the exam day?

There is a morning batch and an afternoon batch. The morning batch waits in the exam center until the afternoon batch starts their exam.

 Do we need to bring our instruments for the exam?

All you need to bring for the exam is your Stethoscope and Passport. Everything else (otoscope, ophthalmoscope, tuning fork, etc.) will be provided to you. You will not be permitted to use your own instruments.

 What is the Exam format?

Each student is assigned a station. Once the time starts, you have 2 minutes to read the question. You may not enter the exam room before the 2 minutes end. A bell rings and you enter the room. You have 10 minutes in the room to finish your task. The bell rings and you move to the next station and read the next question for 2 minutes. The time you take to move from one station to another counts towards the 2 minutes. There is a 6 minute break after 8 stations.

 Is there a break between individual stations?

No there is no such break except after your 8th station when you have a 6 minute break for water/rest room.

 What are the different types of stations?

The exam is usually consists of 4 static, 4 history taking, 4 physical examination, 4 counselling stations. Sometimes there could be a mixture eg. take a brief history and discuss management options.

 Do we get mannequins to perform maneuvers on the exam?

Yes, be prepared to be tested for skills like IV cannulation, Foley's catheter, Speculum exam, Bimanual exam, Suturing, etc. Make sure you use proper sterile techniques and know how to get consent for each of these. To get some practice on mannequins, read this post on "Must-Do's during your Observership"

 Is there an examiner for static stations?

No, there is no examiner in the room for static stations.

 Do you get to see the question once inside the exam station?

Yes a question sheet will be provided inside the exam room, similar to the one provided outside the station.

 How are the examiners?

They are generally very nice and wont disturb you at all. They may ask you the Differential Diagnosis or any further questions if required at the end of the station. They don't ask difficult questions. They usually do not stop you during your session, but if you finish early, expect some easy questions coming your way e.g. What do you think the patient is suffering from, what are your DDs, is there anything else you'd like to ask the patient, what investigations would you like to do, etc.

 What if the patient cries during the exam?

Tissues and water are kept in each room. Be very empathetic towards patients. There is a specific way of handling 'difficult stations'. A nice write up on how to handle difficult patients coming soon :)

 What if i get a depressed patient who doesn't talk?

Make sure the patient is comfortable. Build rapport. Ask a few basic/general questions before you dive into specific depression related questions. Know how to convince a depressed patient to talk!

 Do we have to give running commentary during the physical exam station?

Yes, ideally you must. A summary at the end would also suffice but you may not have time for that in the end. So a basic, short, running commentary is recommended.

 Do we get anything to write on during History taking or Counselling stations?

Yes, a paper and pen will be provided inside the room. It will be placed right in front of you on your desk. However, I would prefer looking at the patient and make eye contact, than write notes while they talk.

 What to expect in static stations?

Each static station has MCQ's. Usually between 4-8 questions. Each static station has a theme around which all the questions are based. So a 'Acute MI theme' may have questions related to MI management and they might put in an ECG as one of the questions.

 Are normal values provided for lab studies?

Yes, normal lab values are provided.

 How do I introduce myself to the patient?

When the bell rings and your time starts, knock on the door and open it. Greet the examiner and shake hands. The examiner may then say "here is your patient, you may proceed". That's when you introduce yourself. Sample introduction: "Hi my name is Dr. AAAA BBBB (full name) but you may call me Dr. AA (shorter and easier version of your name). I am the intern in the emergency department. May i know your name please." There are a variety of ways you can introduce yourself, this is just an example. Make sure you smile, shake hands (if possible) and that you are bold and confident when you introduce yourself and make eye contact. Your first impression must be good! For more info, please read: How to introduce yourself - for NZREX

 How can I apply for an observership?

Its best to call hospitals and ask if Observerships are available. Email is a good alternative. Most hospitals easily offer observerships as long as you apply well in advance. The NZREX acceptance letter may be required. For more detailed info, please read: How to get an observership in NZ and Must-Do's during your observership.

If you have any questions related to "the exam" please ask us in the comments below. 

OPD Rooms in NZ

The OPD rooms in New Zealand my look very different from those in your home country. Here we have a few pics of some OPD rooms in one of the hospitals in New Zealand.

If you are doing or plan to do an observership in New Zealand, I would highly recommend going personally and taking a look at the OPD rooms at your hospital. Yet another reason why doing an observership in NZ is important. This is also a "Must-Do" during your observership.

1. Bedside - the head rest can be elevated. The sphygmomanometer can either be mobile or fixed to the wall. Either ways, it has a mark on the cuff that says 'artery here' (or something like that). You must line it up with the brachial artery while putting the cuff on the patients arms.

2. The wash basin: Pretty straight forward.

3. Doctors Desk:

4. Wash basin, closer look.

5. Ophthalmoscope, otoscope, reflex hammer and tuning fork: The ophthalmoscope and otoscope may be dismantled. You must try it out and know how to fix it back in place. Make sure you use a new ear piece for your patient and dispose the used one when using the otoscope :)

I sincerely hope this helps candidates who do not get an opportunity to Observe at a hospital in NZ.
Good luck!

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NZREX Observerships - Must Do's

That is a question we keep asking ourselves, or at least I kept asking myself during my observership. What must I do to make the most of this opportunity.

This  is generally what people do during an observership:

• Shadow Consultants
• Ask a lot of questions (relevant questions, ofcourse)
• Present cases
• Attend ward rounds daily
• Go to the weekly Grand Rounds (a good place to meet some more docs )
• Be disciplined, well dressed, well informed, etc.

It is important not to forget why you are doing this Observership. Most of us think that doing the Observership will help us prepare for the NZREX. Thats so not true! Not if all you are going to do is follow the points mentioned above.

To exploit your Observership to the fullest extent here is what you've got to do:

Try to get an Observership at North Shore Hospital, Auckland. This is where the exam is going to be held! Also, some of your examiners are going to be consultants at North Shore. Not that you can get exam questions out of them, but these are the best people to tell you what is expected from a candidate. If you're in good terms with one of them, you can ask them to evaluate you while you take a history or do a physical examination. There are a whole bunch of reason why you should Observe at North Shore, some of them are mentioned below.

Catch hold of a Medicine Registrar (or a House Officer). They can be very good critics! Speak to one of them and team up with another NZREX candidate to simulate exam conditions. You can do a physical exam on a friend while the Registrar watches or plays the 'Examiner'. The ideal examiner would be an ex-NZREX candidate. So keep an eye out for IMG house officers. This is by far the most important thing you must do during your observership. Note: Please respect the fact that they will be sparing time for you from their busy schedule, so don't push it too far. This can severely hamper chances of candidates doing an observership after you and then there will be a time when they would learn to say NO! Please know your stuff before you ask someone to test you.

Look for mannequins at the hospital. Some stations on the exam could test skills like suturing, IV line insertion, indwelling foley's catheter, etc. Most Hospitals, especially the teaching ones, have a academic department that conducts courses to train their staff. These departments have mannequins :) You may have done these procedures on real patients, but performing these on mannequins could be a different ball game altogether. Talk to a Registrar and get them to take you to one of these room and practice on mannequins. While i did this, i realized that the IV catheters used in the hospital are very different from what we used back in my home country. This is not something i would like to learn at the time of the exam! P.S. The North Shore Hospital academic department has reserved their mannequins on mondays for NZREX candidates, please take advantage of this opportunity and get some practice before the exam. You don't have to be an observer to take advantage of this opportunity.

Check out the Outpatients Department Rooms (OPD rooms). The exam will be held in OPD rooms and it would be a good idea to go take a look at them and get a feel of it. See where the instruments are placed and get a hang of it. Use the sphygmomanometer, ophthalmoloscope, otoscope kept in the room and please, please, try to adjust the bed up and down. That is not something you want to waste time figuring out during the exam!

Follow these steps and I'am sure that you will be very happy at the end of your observersip and feel very prepared for the exam. In that case please don't forget to say thanks in the comments below :)

Welcome to Auckland

This post may be helpful for people arriving at the city of Auckland for their NZREX exam

At Auckland International Airport:

- You will find GSM Sim Cards for '2 degrees, Vodafone, Telecom' at the duty free section

- As you go out towards the receiving area, you will see a 'Vodafone Shop' that sells Sim cards, it is right opposite Mcdonalds. International Credit Cards are accepted here. Below is an example of what plans you could expect.

Note that new plans come up every now and then and the plan shown below may not be valid anymore.

Note: Sim card costs an extra $10 in addition to these prices mentioned below.

- There is 30 minutes of free WiFi at Auckland Airport. You can also get paid access to WiFi. There is a Boingo hotspot which you can use if you're a member. There is also free WiFi at McDonalds on the 1st floor!

- NZ$2 coins provides 10 minutes of internet access at internet kiosks and major credit cards accepted.

- Map of the airport can be found on the Auckland Airport website.

Going to Auckland City Center from the Airport

- Most of us would want to go to the City Center from the airport. You can obviously take a taxi from the Airport to the City Center. But why spend for a cab when we have a direct bus going to the City Center.

- The AirBus costs $16 from Airport to Ferry Terminal/Britomart (City Center). Tickets can be purchased at the Airbus Kiosk just outside the Airport terminal, next to the Airbus Stop. Tickets can also be purchased online.

- A more detailed map can be found on the Airbus Website.

- For those who want to go to the North Shore Hospital area, the Northern flyer ticket ($19) would be a better option. This ticket can be purchased at the same Airbus Kiosk mentioned above. It includes the Airbus from Airport to Britomart/Ferry Terminal and the Northern Express Bus (NEX) from Britomart to Smales Farm Bus Station (close to North Shore Hospital).

- You can carry your luggage in the Bus. There are no extra fees for your luggage.

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