Perceptions of migrant doctors joining the New Zealand medical workforce.

New Zealand, like many first World countries, has become increasingly dependent on overseas-trained doctors (OTDs). This qualitative study identifies and explores issues of concern to OTDs when first integrating into the New Zealand medical system through the New Zealand Registration Examination (NZREX) pathway. The data were collected using semistructured interviews and focus groups involving 10 OTDs who were working in a New Zealand hospital. The study identified four key issues: work issues which included difficulty finding employment and difficulty integrating into their work role; a bridging programme which improved the ability of OTDs to gain knowledge and experience of the New Zealand medical working environment; financial difficulties which were a major impediment to attaining registration and a career pathway in New Zealand; and bureaucratic barriers (including examinations and information availability), which were seen as necessary but unsympathetic processes in gaining registration. Sociocultural educational theory provides a useful framework for understanding the difficulties faced by OTDs integrating into a New Zealand medical workforce.