Working under supervision
Supervision is a registration requirement for all new doctors registered in a provisional general, provisional vocational and special purpose scope of practice.
Good supervision
Supervision provides guidance and feedback on personal, professional and educational development of doctors within the context of providing safe and appropriate patient care.
Good supervision should enable the doctor to review and develop their practice in a supportive environment, and enhance their knowledge, skills and professionalism. In addition, supervision encourages a culture of continuous learning and development. We support both formal (scheduled and planned) and informal supervision.
The purpose of supervision
Supervision supports a doctor's practice and enables a doctor’s performance to be assessed, over time, while they become familiar with:
- the New Zealand health system
- the required standard of medical practice.
It assures Council that a doctor is able to practise safely, with support and oversight, until the doctor is able to demonstrate that they are able to practise competently and safely, independently.
Who must be supervised?
Doctors who must work under supervision include:
- Interns (PGY1 and PGY2 doctors who have graduated from New Zealand/Australian accredited medical schools and doctors who have passed NZREX). Interns are supervised by Council appointed Prevocational Educational Supervisors.
- All international medical graduates (IMGs) registered on a provisional general, provisional vocational and special purpose scope of practice. IMGs are supervised by doctors who hold vocational registration in the area of medicine that the IMG is appointed to work in.
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All graduates of New Zealand and Australian accredited medical schools undertake prevocational medical training, also known as the intern training programme. It is also undertaken by doctors who have obtained registration based on a pass in the New Zealand Registration Examination (NZREX Clinical). Training for interns spans two years across postgraduate year 1 and postgraduate year 2.
Responsibilities - supervisor
The general responsibilities of a supervisor include:
- Ensuring that the IMG is participating in their orientation and induction programme.
- Providing clarity about how both parties will communicate during normal working hours and after hours (where applicable). This includes setting ground rules for communicating with other team members.
- Making sure that protected supervision time is scheduled regularly and kept free of interruptions.
- Being readily available and approachable.
- Where applicable, providing clear clinical notes and comprehensive management plans, which include parameters clarifying when specialist care is required for a particular patient.
- Monitoring and verifying what the IMG is doing, and that they are capable of carrying out their duties competently.
- Raising performance issues early. The sooner these are addressed, the more opportunity the IMG has to take corrective action.
- Identifying whether poor performance is caused by poor communication skills and making arrangements for communication skills tuition, when necessary.
- Reporting concerns to Council, if the supervisor believes that the IMG’s practice may put patient safety at risk.
- Arranging to regularly review the IMG’s understanding and knowledge of key clinical areas.
- Ensuring the IMG is working within their approved scope of practice and alerting the Council if this not the case.
- Understanding the requirements that the IMG must complete in order to gain full registration (for those on provisional scopes), and providing support, where appropriate, to help the IMG meet these requirements.
Responsibilities - supervisee
The general responsibilities of the supervisee include:
- Engaging fully in the supervision process.
- Ensuring an appropriate supervision schedule is in place, diarising these appointments and giving it priority.
- Working with the supervisor to set supervision and educational objectives.
- Keeping a supervision logbook, including participation in continuing medical education activities.
- Communicating clearly and responsibly with the supervisor.
- Being ready to accept constructive feedback, and being receptive to changing behaviour where necessary.
- Taking part in audit and peer review or group activities.
- Asking for advice appropriately.
- Asking for more support or mentoring, should this be necessary.
- Contacting the supervisor early on when concerns or issues arise, or when they feel out of their depth in any way.
- Recognising limits of professional competence.
- Obtaining approval from Council for any changes to supervision arrangements, registration conditions or requirements before they are implemented.
- Informing the Council if the conditions or requirements of supervision are not being met.
Responsibilities - employers
The general responsibilities of the employer include:
- Ensuring supervision is provided according to Council’s policies.
- Providing adequate 'protected time' for the IMG and supervisor.
- Ensuring the IMG is familiar with organisational policies and procedures.
- Advising Council of any concerns about the IMG if they form the opinion that there is a risk to the public that cannot adequately be addressed by implementing local measures.
- Understanding the requirements that the IMG must complete in order to gain full registration (for those on provisional scopes), and providing support, where appropriate, to help the IMG meet these requirements.
Reporting requirements
While an IMG holds a provisional scope of practice they must submit supervision reports to Council every three months. The reports should be completed and signed by the IMG and their supervisor. If required, the supervisor should be willing to discuss any concerns raised in the reports, and the measures put in place to manage issues of public health and safety, with Council staff. The IMG is responsible for ensuring reports are completed by their supervisor, signing them, and making sure they are sent to the Council on time.
Intern reports are completed electronically through eport. Other report forms can be downloaded from our website.
We also recommend you download and read the handbook Orientation, Induction and Supervision for International Medical Graduates.
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Supervision report form for doctors on provisional general (not interns), provisional vocational, and special purpose scopes of practice.
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Special purpose - postgraduate trainee report: progress towards learning objectives and comments about supervised practice.
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Supervision report for IMGs on a provisional vocational or special purpose scope doing telemedicine, pathology, diagnostic and interventional radiology, public health medicine and medical administration.
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These guidelines set out the roles and responsibilities for international medical graduates (IMGs) coming to work in New Zealand, and their employers and supervisors.