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Poor retention rates for overseas-trained doctors in NZ


For immediate use

28 February 2017

Research points to poor retention rates for overseas-trained doctors in New Zealand

New Zealand’s success in attracting overseas-trained doctors isn’t matched by our ability to hang onto them, says Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS).

“Hospital specialists come here for a lot of reasons but often these include perceptions that the quality of life will be better. In some cases, they’re turning their backs on much higher salaries in their home countries but they believe the trade-off will be worth it.

“What we’re finding, however, is that retention rates for international medical graduates (IMGs) are poor. Research suggests that the working conditions here play an important part in the decision by many to leave.”

An ASMS Research Brief summarises the main findings of research into IMGs in New Zealand, as well as key factors influencing international medical migration. The paper is available on the ASMS website at

The Research Brief reiterates New Zealand’s heavily reliance on IMGs and vulnerability to fluctuations in international medical migration.

The paper reports that about 240 New Zealand specialists leave the workforce each year, including an estimated 180 below the traditional retirement age. Many of these will be leaving to work overseas. Many will be senior doctors who have migrated to New Zealand but after some time on these shores have decided not to stay. Currently about a quarter of IMGs are lost within three years of gaining vocational registration, rising to almost a third by their fifth year post-registration.

The prospect of better working conditions, increased remuneration, and better career opportunities, appears to be key reasons for doctors leaving New Zealand. In addition, many IMGs are employed on only temporary contracts. Whether that is because the conditions here are not attractive enough for them to want a permanent position, or whether it’s because the district health boards (DHBs) can’t afford them on a permanent basis – despite across-the-board specialist shortage – remains unclear. Either way, they are vital questions the DHBs should be addressing.

Data from the Organisation for Economic Cooperation and Development (OECD) show that one in six New Zealand-trained doctors head overseas to work. At the same time the OECD says New Zealand has had one of the lowest numbers of medical graduates per head of population for many years (eg, 27th lowest out of 34 countries in 2014). In an effort to fill the gaps in our medical workforce, New Zealand has the second-highest proportion of IMGs among OECD countries (behind Israel).

An ASMS survey of members in August last year indicated IMGs in larger urban DHBs comprised approximately 37% of the senior medical workforce on average, compared with approximately 66% in the smaller provincial DHBs. According to the Medical Council of New Zealand, most IMGs here (78%) come from just six countries: the United Kingdom, South Africa, India, Australia, USA and Sri Lanka).

At the same, international competition for senior doctors is increasing, with significant shortages forecast for a number of countries.

Ian Powell says the Research Brief highlights the need for urgent action on medical workforce issues, including retention of IMGs.

“We need to have proper workforce planning in place to make sure we have enough doctors now and in the future. We can’t rely on our ability to attract doctors from overseas and we can’t assume that the ones who do come here are going to stay.

“This paper also drives home the need for adequate resourcing of the public health system if we are to convince doctors to stay in New Zealand.”


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