New Zealand, like other countries of the Anglosphere, recognises Emergency Medicine as a distinct medical speciality and shares a postgraduate training program and college with Australia, the Australasian College for Emergency Medicine (ACEM). The ACEM is responsible for specialist training programs and standards.

Upon completing specialist training, physicians take examinations to become Fellows of the ACEM (FACEM). Specialist emergency medicine physicians are often referred to as "FACEMs". The FACEM is recognised as an equivalent qualification to comparable ones from the UK, Ireland, USA and Canada and is recognised by medical regulatory authorities throughout the world.

The speciality of emergency medicine, despite its popularity and dynamic image, is listed in Tier 1 of Immigration New Zealand's Green list indicating that it is a recognised field of skills shortages. This creates job opportunities for international specialist physicians who are eligible for vocational or provisional vocational registration with the Medical Council of New Zealand (MCNZ) with the added bonus of visas granting permanent residency in New Zealand to the physician and family.

Obtaining a job as a specialist emergency physician in New Zealand is relatively easy for those with the right credentials and opens the door to diverse career opportunities in clinical medicine, medical education and medical leadership positions.

The Scope of Practice of Specialist Emergency Medicine Physicians

The MCNZ defines emergency medicine as "a field of medical practice based on knowledge and skills required for the prevention, diagnosis and management of acute and urgent aspects of illness and injury affecting patients of all age groups with a full spectrum of undifferentiated physical, psychiatric and behavioural disorders. It further encompasses an understanding of the development of pre-hospital and in-hospital emergency medical systems, and the skills necessary for this development."

Most specialist emergency physicians are employed by Health New Zealand, the public healthcare provider which runs all the public hospitals across North and South Islands. Health New Zealand's emergency departments are operational 24/7 and provide medical care free of charge to all citizens and residents of New Zealand who are eligible for free healthcare. They vary by size and staffing levels as follows:

• tertiary hospitals in Auckland, Wellington, Hamilton, Christchurch and Dunedin staffed by FACEMs, senior medical officers, and resident medical officers (RMOs), a mixture of FACEM trainees and non trainees. These departments manage all levels of emergencies and are approved by the ACEM for basic and advanced FACEM training.
• secondary hospitals in the smaller cities and towns staffed by FACEMs and resident medical officers. Most are Level 2 EDs and are accredited for ACEM training at the basic and / or advanced level.
• rural hospitals with 20-100 beds staffed by senior medical officers and sometimes by FACEMs and RMOs. These emergency departments provide basic emergency patient management and resuscitation and can admit patients for observation or transfer them to secondary or tertiary hospitals. Some are accredited for the rural component of FACEM training.

New Zealand emergency departments (EDs) use the Australasian triage scale to assess patients and determine how urgent their treatment needs are. The scale has five triage categories, with category 1 being the most urgent and category 5 being the least urgent. 

The role of the specialist emergency medicine physician requires a broad range of skills to perform a diverse set of duties including clinical practice, administration, and participation in the structured medical education of both medical students and RMOs. There are usually opportunities for clinical research, audit and service development and for the development of clinical leadership skills on the path to assume clinical director roles.

Employment Terms for Specialist Emergency Medicine Physicians

The employment terms of specialists are paid in accordance with the Collective Agreements which are negotiated by the Association of Salaried Medical Specialists (ASMS) with Health New Zealand and are uniform across all specialities. Basic salaries are determined by years of experience since eligibility for vocational registration and are supplemented by various allowances which are detailed in our article about medical salaries and remuneration packages in New Zealand.

Employment contracts are:

• permanent - no termination date and can be transferred between hospitals in the public sector
• fixed term - of limited term, usually 6-12 months to cover the leave of an incumbent physician
• locums - short term positions with the option of salaried or contractor status.

Ultimately salaries depend upon level of experience, work hours and additional responsibilities or allowances but a range of NZD 220K - 400K is usual.

International physicians are required to complete an initial supervision period of 6-18 months at the discretion of the professional regulator, the Medical Council of New Zealand (MCNZ), under provisional vocational registration before being granted full vocational registration.

The 4 Step Process for Finding Emergency Medicine Physician Jobs in New Zealand

The job search process is simple and straightforward for physicians who are well prepared and consists of 4 sequential steps:

1. Job Application: CV, Cover Letter and References (the three documents needed for a job search)
2. Interview: remote interviews using zoom and teams
3. Job Offer: negotiations over contractual terms and relocation packages
4. Onboarding: MCNZ registration and Annual Practising Certificate, Medical Indemnity Insurance, Relocation

However before making job applications, there are 4 vital considerations to address, the most obvious being eligibility for MCNZ registration, without which no job is possible, followed by the eligibility for a visa which permits work, and finally the personal preferences of scope of practice and location.