Progress of successful New Zealand Registration Examination (NZREX Clinical) candidates during their first year of supervised clinical practice in New Zealand.

AIM: To determine the frequency and nature of clinical difficulties faced in the first year of supervised clinical practice by international medical graduates (IMGs) who have successfully passed NZREX Clinical in order to be able to practise in New Zealand. METHOD: All doctors who successfully passed NZREX Clinical and who registered with the Medical Council of New Zealand (the Council) from 2005 to 2013 were identified. Supervisor reports for each of the four runs in the first year of practice were obtained and reports where concerns were raised over clinical performance analysed. RESULTS: Of 353 IMGs successful in NZREX Clinical, 316 (89.6%) completed the subsequent clinical year with no adverse reports. Those requiring more than one attempt to pass NZREX Clinical had an incremental increase in number of unsatisfactory reports, where areas of the IMGs' performance were rated as 'below the expected standard'. Less than 2% of IMGs had more than one unsatisfactory report. The majority of unsatisfactory reports were generated in the first half of the clinical year. Areas of concerns found were Clinical Knowledge and Skills (28%), Clinical Judgment (35%), Patient Communication (28%) and Professional Attitudes and Behaviour (9%). CONCLUSION: Most IMGs who were successful in NZREX Clinical performed well in the subsequent year of clinical practice. NZREX Clinical would appear to have acceptable criterion validity.