Otago Difficulties of getting X registrar position then becoming X

Discussion in 'NZ General Discussion' started by Bonesaw, Nov 13, 2017.

  1. Bonesaw

    Bonesaw Member

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    I'm a NZ citizen studying medicine overseas and I would like to come back to NZ. I know all about that process and the likely hood of getting a HO position, however i'm not here to discuss that. Assuming everything goes well and in my favour, how difficult is it to get certain registrar positions? What are the competition levels like? Also what steps would one have to take to highly increase the chances? (special courses etc) Also how does it work for the surgical sub-specialities?

    I'm very familiar with the U.S system of undergoing a residency and then you come through the other end as said specialist however how exactly does it work in NZ? I want to do Orthopedics, so is the process something like this? Get a surgical registrar position, then work through that to apply to Ortho?

    If it's incredibly difficult to get that initial surgical registrar position what can I do to improve those chances? Courses at Otago or Auckland? Any advice is welcome.

    Please don't harp on about the difficulty I will have to get a HO position, please assume i'm past that point for the sake of this discussion.

    Thank you.
     
  2. frootloop

    frootloop Not this time. Moderator

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    Your odds of waltzing on in and getting a training surgical registrar job are... slim.

    Like, your most likely path if you wanted to end up in surgery would be to find a job as a senior house officer or non-training surgical registrar (although even those jobs aren't necessarily that easy to get - and I have no idea to what extent not having come through our system would handicap you there) and do that for a few years while you try to get onto a program.

    Ortho is pretty popular, so I wouldn't rate your chances of getting a training reg job straight off the bat as an IMG.
     
  3. Bonesaw

    Bonesaw Member

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    Thanks for your fast reply. Yeah i'm aware it's highly competitive and extremely difficult. I just want information about the process and how to maximize my chances. Would IMG status still be relevant? I would've gone through the two house officer years just like everyone else so shouldn't I be on a level playing field? As i'm also going to apply for U.S residencies, I have research (mainly anatomy atm) and will likely have U.S letters of recommendation (i'll do my rotations in the U.S or even NZ which is possible) surely this will aid my application?

    What about things like postgraduate diplomas? e.g Surgical Anatomy etc

    Just trying to gather as much information as possible :)
     
  4. frootloop

    frootloop Not this time. Moderator

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    Well assuming you're fully registered etc in a country which NZ doesn't through IMG exams, and you're a citizen, then sure, you'd be able to apply for DHB jobs 'on equal footing' with NZ grads. The only downside for you being your lack of experience of our system, and any NZ-based references. Which would make getting even a non-training reg job a pretty tall order I'd imagine. Nothing to stop you trying to come in as a senior house officer (we have plenty of overseas trained SHOs, for the moment at least) and then working your way towards where you want to be.

    Just don't expect to waltz in and be on the ortho training program in a year or something.

    Oh, and those postgraduate diplomas and stuff are heinously competitive. Can't speak to how Otago would preference you for entry, but at a guess I'd say close to the bottom of the list as someone who's never worked here.
     
  5. Bonesaw

    Bonesaw Member

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    Oh sorry if I gave off the vibe i'm/i'll be registered elsewhere, I basically plan to graduate and then sit NZCREX (forgive me if I got the exam acronym wrong) and go straight through the NZ system. If I can do my rotations in NZ (my final MBBS year) would that possibly erase the IMG status (metaphorically speaking) as my clinical years will have been NZ based, thus i'll be familiar with the NZ system.

    Yeah I have no expectation of easily picking up a spot haha.

    Hmm my bachelors degree was from Otago but however I just want process information not actual chances of entry :)

    Thanks a lot.
     
  6. frootloop

    frootloop Not this time. Moderator

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    I hate to tell you that your plan of 'erasing' your IMG status by doing an elective here (there is zero chance of you managing to get close to all of your clinical years of medical school done here) is a bit of a fantasy.

    You've chosen to study overseas, so now you'll be swimming upstream as an IMG - whether you think you can weasel your way around it or not.
     
  7. Bonesaw

    Bonesaw Member

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    Not trying to weasel anything... I'm just trying maximize my chances like I've stated from the get go?

    Anyway thanks for your replies
     
  8. govpop

    govpop Regular Member

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    I'm not sure exactly how the overseas aspect works- all I know is that you have to be eligible for registration with the medical council of NZ. You can check the process for this on the MCNZ website.

    However there are several overseas trained docs who have come here and started in non-training surgical registrar positions and my impression is its not terribly difficult to do so. Getting into a training position however is difficult- you can boost your chances of success by playing sports at a national level. This isn't even a joke, you can see the CV marking template for yourself on nzoa.org.nz

    You are right in suggesting that the usual pathway is for registrars to spend a number of years in a non-training position before being accepted onto the training program. Some even seem to be perpetual non-training registrars. You wouldn't want to go straight into a training job anyway- there is an expectation that the training registrars have some level of independence when it comes to basic operations.
     
  9. Bonesaw

    Bonesaw Member

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    Yeah i'm fully eligible to register. Could you please just quickly clarify what exactly a non-training position is and what future hurdles it will present? Hmm I've never played sport at a national level but sport has been my life up until University, maybe i'll still get some brownie points from small talk in an interview fingers crossed haha.

    My plan is to complete my Surgery rotation (12 weeks) in NZ or the US, wouldn't this gear me up enough to apply for a training position? (especially if I did the rotation in NZ) of course I will also try and get as many rotations in NZ/US as I can anyway. Just after your 2 cents on this.
     
  10. govpop

    govpop Regular Member

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    In a non-training position one works as a junior registrar but this does not count towards vocational training for the college of surgeons. These positions are a function of the fact that the demand for surgical registrars to carry the day to day workload far exceeds the number of vocational training spots. However it is expected that people accrue experience as non-training registrars prior to being accepted onto the vocational training programme- this may often be a number of years during which you will do audits, research projects, courses and other associated things to improve your chances of success, in addition to your day job.

    When you say your surgical rotation, do you mean in medical school? If you are coming here straight from graduating medical school overseas you would need to complete 2 years as an intern (house officer) in order to even be able to apply for a non-training position. A certain number of months of these 2 years would need to be spent in surgical specialties and also ED or HDU. Your medical school rotations would have no bearing on registrar job applications.
     
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  11. rustyedges

    rustyedges Moderator Moderator

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    A non-training position is when you are employed and working as a registrar, but have not yet been accepted onto a training programme, and I think most people have to work as a non-training registrar before they get onto training. The requirements for selection onto the programme are here Selection | Royal Australasian College of Surgeons

    Are you planning to complete a 12 week surgery rotation as a medical student? Unlike the US, you do not graduate into a specialty in NZ. You will have to do 2+ years as a house offer, then you can apply for registrar jobs.
     
  12. Bonesaw

    Bonesaw Member

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    Yes I mean my rotations during my final year of medical school. I see so basically it's common even for NZ medical graduates to pursue non-training positions then filter into training positions? So essentially once if I get a House Officer position i'll be on a level playing field with the other House Officers?

    Also out of curiosity is the process similar when applying for non-surgical jobs or are the surgical jobs heavily competed for in comparison? E.g Radiology

    Thanks for the replies.
     
  13. govpop

    govpop Regular Member

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    Not just common, essentially universal.
     
  14. Bonesaw

    Bonesaw Member

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    Ah gotcha, I see how it works then. Thanks a lot dude, you've been a big help.
     
  15. govpop

    govpop Regular Member

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    The process is the same for other specialties, but the phenomenon of non-training registrars is largely isolated to surgery.

    For example nearly everybody who gets a medical registrar job will have been accepted onto the basic physician training program. The reason for this is that in medicine the roadblock occurs further up the line, when you apply for advanced training.

    I don't really know how radiology works.

    No worries man.
     
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  16. chinaski

    chinaski Regular Member

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    Not for much longer; the RACP is introducing stricter entry criteria for entry into basic training which will essentially pull up the ladder.

    Selection into Training
     
  17. govpop

    govpop Regular Member

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    Seems unsuprising in a way. When you look at the volume of trainees sitting exams and compare with the number of consultant jobs at the top, I can't help but think that the math doesn't really add up.
     
  18. chinaski

    chinaski Regular Member

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    They've been openly planning this for years now - this is just the end product of a lot of committee work behind the scenes. There will now be three bottlenecks (entry to BPT, entry to advanced training, and acquisition of consultant positions); hopefully they are cautious about accrediting too many new jobs along the way.
     
  19. Benjamin

    Benjamin Intern (JCU MBBS) Administrator

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    I'm not sure how much it translates over to NZ but certainly in Australia Orthopaedics is suprisingly difficult to get onto just from looking at the MINIMUM requirements for a position. These requirements are listed in detail here: https://www.aoa.org.au/docs/default...e_set_selection_regulations_v0-4.pdf?sfvrsn=4

    A brief summary of them is as follows:
    1. 26 weeks of orthopaedic PHO work at PGY3 and up, terms prior to PGY3 do not count.
    2. Pass the GSSE.
    3. Have a good enough CV to get onto the program, points are as follows:
    - Upto 4 points for surgical terms >6 weeks, only Ortho, plastics, vascular, neuro & gen surg count. You can only get 2 points if they are all in the same hospital.
    - Upto 3 points for skills courses - ASSET / CCrISP / EMST. These are very expensive & have a long waiting list.
    - Upto 3 points for a higher degree, must be relevant to ortho.
    - Upto 2 points for research presentation.
    - Upto 4 points for research publication
    4. Have good referees. These must be from PGY3+ surgery terms & must be from EVERY department you have worked at in the last 2 years. They also include 'departmental' references which incorporate nurse unit manager & theatre nurse opinions.

    CV is worth 25%. Referees are 75%. You NEED to impress people to get an interview.

    In general people find that they can't apply for Ortho until at least PGY5 as the bare minimum. By the time you have completed the 26 weeks of PGY3+ surgery you've missed the cut-off for applying in PGY4 & so you are subsequently put into the PGY5 basket. In general people don't get on in their first year of applying - most of the registrars I know are PGY7+ & have been doing the house officer job for ~3-5 years. If one referee in a two year period decides to not give you 10/10 then you're essentially canned.

    There are ~35-50 registrars positions each year.
     
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  20. Bonesaw

    Bonesaw Member

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    Gotcha, yeah i've heard it's a long road I had an extended family member try get into it but he gave up and settled for radiology, I should have plenty of research so that's all well and good. Well i'm glad it's 75% referees because i'm hooked on surgery so my passion should shine through :)

    Thanks a lot, you've really summed it all up well for me!
     

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