Source: Radio New Zealand
When the small South Island town of Timaru and its cluster of US doctors hit the front page of the Wall Street Journal last week, it highlighted New Zealand’s dependence on overseas doctors, particularly in rural and regional parts of the country.
It is not just Americans – New Zealand has one of the highest proportions of internationally trained doctors among developed countries.
International Medical Graduates (IMGs) made up more than 40 percent of all New Zealand doctors last year, and about 70 percent of new registrations each year are overseas-trained doctors, according to Medical Council data.
But 60 percent of overseas doctors leave after two years compared to 6 percent of New Zealand-trained graduates, and a new report suggests retention could be improved by more help with adapting to New Zealand society, culture and medical system.
When Dr Brandon Williams, his wife and four children moved to Timaru in 2024, he was on the brink of burnout – juggling intense workloads with the knowledge his US patients could be crippled by the cost of treatment.
“The medical system in the States is horribly broken and frankly traumatic to practice in as a doctor.”
New Zealand stood out for its relative safety, lifestyle and public health system.
“There’s this medical system in New Zealand that provides care for everybody – while there’s certainly some needed growth in the system and needed adjustments, it functions way better than anything we have in the States.”
RNZ/LouisDunham
He said the more he looked into Aotearoa, the more attractive it became.
“Outside of the hospital, it’s a much better place to raise a kid, much better place to have a family – a lot safer – and a lot better set up to be outside, enjoy the countryside, enjoy going on holiday with my family.”
His family was on board – with one notable exception.
“My oldest daughter was very hesitant – she didn’t want to leave her friends group, but when she heard we might be able to have a pony in New Zealand, that’s all she needed to know – she was on board.”
The adjustment was aided by the warm welcome from locals, Williams said.
“The people here are wonderful – my wife jokes they’re aggressively friendly.”
His children adored their school, and the couple had enough American friends for well-attended Thanksgiving celebrations, and enough New Zealand friends to learn about the culture and feel they were integrating.
Association of Salaried Medical Specialists (ASMS) policy director Harriet Wild said New Zealand does a great job of attracting medical professionals, but was less successful at keeping them.
Harriet Wild. RNZ / Mark Papalii
A new report from the union, Recruited Globally, Neglected Locally, asked overseas trained members about their biggest challenges – many reported feeling unsupported, found pay and conditions lacking, and struggled with workload or logistics like dealing with immigration, banks or schools.
The survey also found only half reported having received a formal induction, less than a quarter had cultural training and just 3 percent were given an orientation to the New Zealand health system.
“The doctors we’re recruiting from overseas are not receiving any proper induction either into their jobs as a day-to-day thing about how to use the computer system or how electronic files stored, but also how the New Zealand health system works.”
The country’s dependence on foreign doctors stemmed from a longstanding training deficit, the inability to keep those trained here and the health needs of a growing population, Wild said.
Williams said he would have liked more information around cultural safety issues, and hoped more could be done to systematise and streamline support given to overseas doctors. But he was clear the family would be staying.
“We love it here – we’re here permanently, we’re not going anywhere.”
South Canterbury had 61 percent overseas-trained doctors last year, the highest proportion in the country. Whanganui followed closely behind with 60 percent, and the West Coast had 53 percent international medical graduates, according to Medical Council data.
The regions with the lowest proportions were Counties Manukau – 35 percent – and Auckland and Canterbury, both with 36 percent (though doctors can sometimes work across multiple regions but be allocated to one for reporting purposes, the council noted).
Timaru seemed to have a particular appeal to Americans, Williams said.
“I think it’s the right speed for us, getting away from the chaos of being in the States, getting something that’s a little bit of a slower pace, a more comfortable pace – we love it here.”
One of the reasons for the high ratio of international doctors in New Zealand was acute staffing shortages. ASMS figures put the vacancy rate for senior doctors nationwide at 15 percent – approximately 1731 full-time equivalent roles.
The union calculated unmet need – current shortages combined with what clinical leaders estimated would be needed for safe, sustainable staffing and appropriate care – at twice that (32 percent), leaving the country more than 3500 doctors short.
Williams acknowledged understaffing was a strain.
“It’s definitely been a challenge – we’re having a shortage of medical doctors at the hospital.”
The system was relatively well set up to fill gaps with locum doctors, though there was a need for aggressive hiring and more international recruits, he said.
The Wall Street Journal article garnered a great response from friends in the US, with many asking how they could get on board.
“There’s a lot of people in the States who are done there and would frankly like to move.”
When respiratory specialist Dr Kelly Sweerus moved to Timaru with her husband and six-year-old twins in 2021, the number of international colleagues was an added bonus that also offered improved quality of care.
“We’re able to come at a clinical problem from different perspectives, and I think patients gain when there’s a lot of different minds bringing their own perspectives – that goes not just for the specialists and the consultants, but the junior doctors, nursing, allied health, management, all coming from international places.”
Timaru Hospital. Supplied / Google Maps
The integration of Māori culture was important to her, and Timaru Hospital’s approach guided her decision to move south.
“Timaru made a point of including a mihi at the beginning of the interview, and it’s been one of the highlights here.
“There’s also good opportunities to be involved with our Pacifika communities, there’s a wonderful Tongan society that’s won awards and hosts community events we feel very welcome coming to.”
The initial response from her family and peers was mixed, she said.
“Some didn’t really understand it at the time, but I think the longer we’re here, they can see what our perspective might have been.”
“Many people have reached out to ask about our experience, and some have been interested in following in our footsteps.”
Health NZ was approached for comment.
Sign up for Ngā Pitopito Kōrero, a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
– Published by EveningReport.nz and AsiaPacificReport.nz, see: MIL OSI in partnership with Radio New Zealand
