Overseas Nurses Face Challenges in New Zealand Registration Process

Internationally qualified nurses looking to work in New Zealand face significant hurdles, as highlighted by the experience of Saanvi, an intensive care nurse with over 20 years of experience. After relocating from India in May 2023 to take the required examination, she has struggled to pass the Objective Structured Clinical Examination (OSCE) and has spent more than $30,000 in the process.

Saanvi initially felt confident about her chances of success. However, after failing the exam twice without clear explanations, she finds herself in a precarious situation. “In a couple of weeks, I’ll be retaking the exam for a third time. If I don’t pass it, I’ll need to go back to India as I have finished all my money,” she stated. Remarkably, after her first interview with The Press, Saanvi received an email stating that her failed result had been changed to a pass due to a “coding error,” allowing her to continue the registration process. Despite this change, her concerns about the overall exam process remain.

Concerns Over Examination Fairness

Saanvi’s experience is not an isolated case. Several internationally qualified nurses have expressed dissatisfaction with the OSCE, claiming it lacks transparency and fairness. Nurses holding qualifications from countries such as the United States, United Kingdom, and Singapore may be exempt from taking the OSCE, while those from Australia can apply under the Trans-Tasman Mutual Recognition Act.

In December 2023, the Nursing Council announced that the OSCE would replace the previous Competence Assessment Programme (CAP) for assessing the skills of overseas nurses. Candidates who pass an initial online assessment must travel to Christchurch for a two-day orientation followed by the OSCE, which comprises ten different clinical stations designed to assess various competencies.

Candidates receive immediate results after completing the exam, but those who fail do not receive detailed feedback regarding their performance. This lack of insight leaves candidates uncertain about what areas they need to improve.

The initial cost of taking the OSCE is $3,500, with an additional $3,000 for each retake. This does not include other expenses, such as application fees and travel costs. Candidates are permitted to retake the exam twice before having to restart the entire registration process.

Call for Transparency and Support

Felix Rexy, founder of New Zealand Skills Connect, an organization that assists internationally qualified nurses in preparing for the OSCE, has raised concerns about the high failure rates among candidates. He noted that many candidates endure significant financial hardships to take the OSCE, only to be disheartened by failing without clear reasons.

“My humble request to the Nursing Council is to restructure the process a little bit. It is a fantastic way of screening excellent-standard nurses, but we need a bit of transparency, we need a bit of encouragement,” Rexy emphasized. He suggested that candidates should receive more detailed feedback and clearer criteria regarding what the exam assesses.

Another nurse, who wished to remain anonymous, shared her story of working in Sri Lanka before moving to New Zealand. She and her husband have spent nearly $20,000 on the registration process, with no success in passing the OSCE. “We go in there having no clue, and we don’t know what they are looking for,” she expressed, comparing the lack of feedback unfavorably to the process in Australia.

Several letters have been sent to Prime Minister Christopher Luxon and the Nursing Council, highlighting the “lack of transparency” in the OSCE process. One letter stated, “Constructive feedback is not only reasonable but essential for professional growth. Without it, candidates are left uncertain, repeating the same mistakes and suffering repeated financial and emotional stress.”

Nursing Council’s Response

Catherine Byrne, Chief Executive and Registrar of the Nursing Council, defended the OSCE as a reliable method for assessing the competence of internationally qualified nurses. She acknowledged the concerns raised and mentioned that the council is exploring the possibility of publishing OSCE performance information to help candidates understand how they can improve.

Byrne noted that the council does not provide financial assistance for candidates and was unaware of any external funding options. She highlighted that previous competence assessment programmes were considerably more expensive and involved longer durations.

While the Nursing Council has registered 3,454 internationally qualified nurses this year, specific pass rate data for the OSCE remains confidential to protect the integrity of the examination.

A spokesperson from the Ministry of Health described competence testing for nurses as “a complex area,” emphasizing the need for balance between providing reasonable chances for candidates while ensuring that those practicing in New Zealand can deliver safe and competent care.

As the process currently stands, many internationally qualified nurses are left grappling with uncertainty and financial strain as they navigate the challenges of gaining registration in New Zealand.