# US to New Zealand



## waaaemt

Hey all,  i have searched threads about Americans going to New Zealand but nothing recent. Everything is from 2 years ago or longer. Just seeing if anyone has updated info on that. Hopefully someone from there? 

What is the process of reciprocity of any? 

Would it be easier to maybe just go to EMT school there? They have much higher scope than America so it would be worth the experience to me. 

How valuable would said schooling be outside of NZ?  

And what are the coolest areas to live?


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## waaaemt

Oops this should be under international ems sorry...


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## TransportJockey

Its not just scope. Commonwealth paramedics are actually educated to a reasonable level, not just given an advanced first aid course


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## SpecialK

Hello.

International recruitment has dried up quite a bit here as of late; there is no longer the (relative) shortage of Ambulance Officers we once had five to eight years ago.  This is largely due to the tertiary programs providing sufficient numbers and even some of them are finding competition quite tough.  

The first thing you will need is a work visa.  If you meet certain requirements Immigration New Zealand should give you a visa as a skilled migrant.  Paramedic and Intensive Care Paramedic are no longer on the skill shortage lists (having been removed several years ago).  As long as you are under about 35 and have a university degree (your paramedic degree will do fine) you should be eligible.  

Understand ambulance personnel are not regulated health professionals in New Zealand, yet.  Just as Australia has recently agreed to nationally register Paramedics under AHPRA, New Zealand is moving towards registering Paramedic and ICP level officers under the Health Practitioners Competency Assurance Act which is broadly similar to the National Registration and Accreditation Scheme in Australia.

For now, to obtain Authority to Practice (ATP) at a specified level you must prove equivalent qualifications and practice.  For Emergency Medical Technician you would need to prove equivalence of the Diploma in Ambulance Practice.  This is at Level 5 on the New Zealand Qualification Framework which is equivalent to first-year university level (second year if you come from somewhere with a 4-year degree).  You also need to prove operational readiness (an operational appraisal) and undergo a one-hour clinical assessment which is essentially a large OSCE type interview where you must explain your clinical decision making, diagnostic (and differentially diagnostic) reasoning, treatment reasoning, explain pathophysiology and pharmacology (etc) for given scenarios.  

If you practice at the equivalent of Paramedic or Intensive Care Paramedic you will be required to enter and complete the internship program which is a six-month structured program consisting of mentoring, supervised practice and clinical assessments.  It is very challenging, for-example the recent ICP level assessments have had a pass rate of approximately 50%.

There is also a new skills matrix which outlines how many positions at each ATP level are required, and where they are required.  For example Auckland is 14 ICPs and one Paramedic over subscribed which means only a small number of vacancies are likely to occur in the near future. Other areas are under-subscribed.

It would be next to impossible to get a paid position at EMT level as an international, even as a Paramedic or ICP it would be quite hard. 

If you are successful in gaining a work visa, and a paid position (and ATP) there is a great amount of ability to truly use your brain and decide what is best for your patient.  Diagnose and refer on is the basic method of operating, no longer is it automatic just because somebody called an ambulance they get taken to hospital (indeed, I do not ever think we've been like that, but it was more prevalent even five years ago).  There is so much scope to use your brain and apply critical thiking it's very nice.  

If there is anything specific you'd like to know I will try and answer it for you.


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## Chimpie

waaaemt said:


> Oops this should be under international ems sorry..


It has been moved.


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## NUEMT

NZ.gov says its on the list.

http://skillshortages.immigration.govt.nz/intensive-care-ambulance-paramedic/


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## SpecialK

NUEMT said:


> NZ.gov says its on the list.
> 
> http://skillshortages.immigration.govt.nz/intensive-care-ambulance-paramedic/



No, it's on the "skilled occupations" list, not the "skills shortage list".  

The difference is quite important: a skilled occupation is one where you can apply for a skilled migrant visa using the occupation to get you additional points (provided you have the necessary qualifications and experience) but it justs "helps you along" so-to-speak whereas a "skills shortage" occupation is one where the Government actively assists you in getting a visa because we are short of that particular skill.

From 1 July 2016, all personnel (irrespective of their Paramedic degree being gained in New Zealand or internationally) will need to successfully apply for and complete the St John internship program  for ATP at Paramedic or ICP level to be issued.  I can foresee a situation where a number of places in a number of different locations are available and you nominate a preference but ultimately, may receive an offer to any available location.  This is similar to the process for new Nurses and House Officers as well as the Police and Fire Service. 

Registration is also being considered by Health Workforce New Zealand which in the future will shift assessment of qualifications and such to an external regulatory authority rather than the ambulance service itself.  Certainly this is a good thing, and there will remain some aspect of service-level involvement, however ATP (which will become an APC - annual practicing certificate) will be on a national basis.  

The two-yearly review of the Clinical Practice Guidelines has also begun again as well, it will be interesting to see what changes are madje.  

The ambulance sector nationally has committed to ending single crewing by 2018 through a number of measures, including a large increase in the number of Emergency Medical Assistants, so certainly they are interesting times ahead for our sector.  

I would be interested in knowing how the person who asked about this is getting on.  I haven't seen many new internationals around in ages.


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## Tigger

I was under the impression that American qualifications weren't being recognized anymore, or at least a different user had posted that at some point.

I would do a lot to return to NZ as a paramedic, though it sounds like immigration would likely be difficult. Perhaps I need to follow in my Grandfather's footsteps and marry a Kiwi.


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## SpecialK

We don't have a lot of international paramedics; i would say maybe 5% or less.  Most come from Australia, South Africa and the UK.  There are one or two Canadians and one or two Americans as well.

At the moment, because paramedics are not registered, qualifications and experience are considered by the ambulance service to determine where they fit equivalent to our practice levels.  This will become the responsibility of the regulatory authority once one is established.  I would expect this to be at least a year, if not two, away.

As long as you can prove equivalent knowledge and practice to our levels you should be fine.  You might not have something specific for example ceftriaxone or loratadine but that is not important, proving equivalent knowledge and practice is what's important.  For example, one of my colleagues is a Paramedic from the UK (ICP equivalent) but he doesn't practice at ICP level here.  While he couldn't do as much as he can here back home in the UK, that is not really important, his methods and level of clinical decision making was about the same.  

For Paramedic and ICP level you must now complete the St John internship program.  This is a structured six month program of precepting and supervision prior to undertaking a clinical assessment day.  The assessment days are very tough, I haven't personally sat one of the new ones and I wouldn't really want to, the pass rate has been something like 50%.

If you want to come over here as a Paramedic hmm ....... I guess you can but try, it'll probably be expensive and time consuming but see how you go.


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## waaaemt

SpecialK said:


> No, it's on the "skilled occupations" list, not the "skills shortage list".
> 
> The difference is quite important: a skilled occupation is one where you can apply for a skilled migrant visa using the occupation to get you additional points (provided you have the necessary qualifications and experience) but it justs "helps you along" so-to-speak whereas a "skills shortage" occupation is one where the Government actively assists you in getting a visa because we are short of that particular skill.
> 
> From 1 July 2016, all personnel (irrespective of their Paramedic degree being gained in New Zealand or internationally) will need to successfully apply for and complete the St John internship program  for ATP at Paramedic or ICP level to be issued.  I can foresee a situation where a number of places in a number of different locations are available and you nominate a preference but ultimately, may receive an offer to any available location.  This is similar to the process for new Nurses and House Officers as well as the Police and Fire Service.
> 
> Registration is also being considered by Health Workforce New Zealand which in the future will shift assessment of qualifications and such to an external regulatory authority rather than the ambulance service itself.  Certainly this is a good thing, and there will remain some aspect of service-level involvement, however ATP (which will become an APC - annual practicing certificate) will be on a national basis.
> 
> The two-yearly review of the Clinical Practice Guidelines has also begun again as well, it will be interesting to see what changes are madje.
> 
> The ambulance sector nationally has committed to ending single crewing by 2018 through a number of measures, including a large increase in the number of Emergency Medical Assistants, so certainly they are interesting times ahead for our sector.
> 
> I would be interested in knowing how the person who asked about this is getting on.  I haven't seen many new internationals around in ages.



Thanks for all the info! Very helpful. I am considering doing the 1 year working holiday visa just to have an adventure. Do you have recommendations for work for someone doing that? Not necessarily as a medic or anything. Would be interested to volunteer while there too.


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## SpecialK

The London Ambulance Service are actively recruiting internationals, will assist with a work visa, obtaining a UK license with category C1 and all you have to do is essentially prove equivalence to the HCPC.  

I'd look at London first.


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## waaaemt

SpecialK said:


> The London Ambulance Service are actively recruiting internationals, will assist with a work visa, obtaining a UK license with category C1 and all you have to do is essentially prove equivalence to the HCPC.
> 
> I'd look at London first.



Really?? Do you work in the UK? I'd  love more info. Are they recruiting paramedics only or willing to train EMTs?


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## SpecialK

waaaemt said:


> Really?? Do you work in the UK? I'd  love more info. Are they recruiting paramedics only or willing to train EMTs?



I seriously investigated the LAS as they are actively recruiting Australasian personnel given the level of education and clinical practice are the most similar.

You can find out more information here http://jobs.londonambulance.nhs.uk/...NHS_Trust/Paramedic/Paramedic-v597374?_ts=772


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