Under sections 11 and 12 of the Health Practitioners Competence Assurance Act 2003, Te Kaunihera Rata o Aotearoa | Medical Council of New Zealand (“Council”) gives notice of a notice titled “Scopes of Practice and Prescribed Qualifications for Physician Associate Practice in New Zealand Notice 2026”.

1. Title and Commencement

This notice may be cited as the Scopes of Practice and Prescribed Qualifications for Physician Associate Practice in New Zealand Notice 2026 and will come into force on 27 July 2026.

This notice has the status of secondary legislation for the purposes of the Legislation Act 2019.

This notice is published on the Council’s website www.mcnz.org.nz/about-us/publications/gazette-notices/.

2. Introduction

Under the Health Practitioners Competence Assurance Act 2003, the Council is required to define physician associate practice in New Zealand. The Council’s role is to identify physician associate practice as one or more “scopes of practice” (or “scopes”) and define the practice covered by each scope. Physician associates seeking to practise in New Zealand must first be registered with the Council in a relevant scope of practice.

The Council is also responsible for formally “prescribing” the specific qualifications that physician associates must have to be eligible to be registered in each of the scopes of practice. These prescribed qualifications will vary between the different scopes of practice. In some cases, a “prescribed” qualification will be an identified qualification but in some cases the Council will require a combination of a qualification, and additional training, or approved experience. In such cases, the physician associate will be required to meet all these requirements before they are recognised as having the “prescribed qualification”.

To be able to practise as a physician associate in New Zealand, a registered physician associate must hold a current practising certificate. A practising physician associate must also meet any ongoing recertification programme requirements set by the Council. Recertification programmes are scope-specific programmes, undertaken while in practice and designed to ensure that physician associates maintain the required standard of competence within their scopes of practice.

From December 2025 to February 2026, the Council consulted on a proposed framework for the regulation of physician associates. The framework comprises scopes of practice, prescribed qualifications and supervision requirements for physician associates seeking to register and work in New Zealand. Council considered the consultation feedback at its April and June 2026 meetings and made decisions about the final requirements as set out in this gazette notice.

3. Physician Associate Provisional Scope of Practice

A physician associate registered in the Physician Associate Provisional scope of practice may:

1. Offer health assessments, take detailed patient histories, perform physical examinations, and order relevant diagnostic tests.
2. Under supervision, contribute to diagnosis and the development and implementation of appropriate treatment and management plans.
3. Offer health promotion and disease prevention advice.
4. Undertake relevant non-patient contact activities.

Permitted Minor Surgical Procedures

In low-risk clinical situations, a physician associate registered in the Physician Associate Provisional scope of practice may perform any minor surgical procedures, including suturing, excision of skin lesions and sebaceous cysts, punch biopsies and any other procedure or class of procedures, that fall within the clinical responsibilities defined through the employer credentialling, and that the physician associate’s current primary supervisor has approved the physician associate to perform.

Core Requirements

1. A physician associate registered in the Physician Associate Provisional scope of practice must:
• Work in a Council-approved position under Council-approved supervision with a Council-approved supervision plan.
• Be credentialled by their employer to define their specific clinical responsibilities within the Physician Associate Provisional scope of practice and within each service environment in which they work, taking into account their qualifications, training and experience, and the resources and support available in that service.
• Practise only in a setting where onsite supervision is available.
2. A physician associate registered in the Physician Associate Provisional scope of practice must:
• Work in collaboration with patients, their whānau, communities, and the multi-disciplinary healthcare team to deliver equitable person/whānau-centred healthcare.
• Practise in a culturally-safe way – promoting equity, inclusion, diversity, and rights of Māori as tangata whenua, Pacific Peoples and all population groups to support the provision of quality services that are culturally safe, equitable and responsive.
• Recognise when to seek the assistance and input of a vocationally-registered doctor.
3. A physician associate registered in the Physician Associate Provisional scope of practice must ensure that their practice is:
• Consistent with their qualifications, training, and experience, individual competence, Council standards, and legislative requirements.
• Within the terms of the supervision requirements set by Council, their supervision agreement with their supervising doctor, and their employer-credentialled defined clinical responsibilities in each specific service environment.

Time Limitation

Registration in the Physician Associate Provisional scope of practice is time-limited to a maximum of 36 months from the date of registration in that scope of practice. If the registrant has not completed the requirements of the provisional scope of practice and successfully obtained registration in the Physician Associate General scope of practice within this time, their registration in the Physician Associate Provisional scope of practice will expire.

Prescribed Qualifications for Physician Associate Provisional Scope of Practice

Pathway 1 – United Kingdom Qualifications-based

Applicant must:

1. Hold a qualification approved by the General Medical Council for registration as a physician associate/assistant; and have successfully completed the Physician Associate Registration Assessment (PARA) or the Physician Associate National Examination (PANE).

2. Hold current full registration as a physician associate/assistant with the General Medical Council, and/or with a state, provincial or territorial regulatory/licensing authority for physician associates/assistants in the United States of America or Canada.

3. Have practised clinically for at least 36 months (working at 0.5 FTE or more) during the 5 years immediately prior to application. This work must have been undertaken in the United Kingdom, and/or the United States of America or Canada, practising in the same or a similar area of clinical practice to the proposed position in New Zealand.

4. Provide evidence of satisfactory completion – within 12 months prior to applying for registration – of a Council-approved knowledge-based programme in cultural safety for health practice in New Zealand.

Pathway 2 – United States of America Qualifications-based

Applicant must:

1. Hold a qualification accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) for state licensure as a physician associate/assistant in the United States of America and have successfully completed the Physician Assistants National Certification Examination (PANCE) administered by the National Commission on Certification of Physician Assistants (NCCPA); and maintained current certification with the NCCPA.

2. Hold current full registration as a physician associate/assistant with the General Medical Council, and/or with a state, provincial or territorial regulatory/licensing authority for physician associates/assistants in the United States of America or Canada.

3. Have practised clinically for at least 36 months (working at 0.5 FTE or more) during the 5 years immediately prior to application. This work must have been undertaken in the United Kingdom, and/or the United States of America or Canada, practising in the same or a similar area of clinical practice to the proposed position in New Zealand.

4. Provide evidence of satisfactory completion – within 12 months prior to applying for registration – of a Council-approved knowledge-based programme in cultural safety for health practice in New Zealand.

Pathway 3 – Canada Qualifications-based

Applicant must:

1. Hold a physician assistant qualification accredited by Accreditation Canada and recognised by the Physician Assistant Certification Council of Canada (PACCC) and have successfully completed the Physician Assistant Entry to Practice Certification Examination administered by the PACCC, and maintained current certification with the PACCC.

2. Hold current full licensure as a physician associate/assistant with a state, provincial or territorial regulatory/licensing authority for physician associates/assistants in the United States of America or Canada, or with the General Medical Council in the United Kingdom.

3. Have practised clinically for at least 36 months (working at 0.5 FTE or more) during the 5 years immediately prior to application. This work must have been undertaken in the United Kingdom, United States of America or Canada, practising in the same or a similar area of clinical practice to the proposed position in New Zealand.

4. Provide evidence of satisfactory completion – within 12 months prior to applying for registration – of a Council-approved knowledge-based programme in cultural safety for health practice in New Zealand.

Pathway 4 – New Zealand Experiential

Applicant must:

1. Hold any of the following:

• a qualification approved by the General Medical Council for registration as a physician associate/assistant; and successfully completed the Physician Associate Registration Assessment (PARA) or the Physician Associate National Examination (PANE); and hold current full registration as a physician associate/assistant with the General Medical Council; or
• a qualification accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) for state licensure as a physician associate/physician assistant in the United States of America; and have successfully completed the Physician Assistants National Certification Examination (PANCE) administered by the National Commission on Certification of Physician Assistants (NCCPA); and maintained current certification with the NCCPA; or
• a physician assistant qualification accredited by Accreditation Canada and recognised by the Physician Assistant Certification Council of Canada (PACCC) and have successfully completed the Physician Assistant Entry to Practice Certification Examination administered by the PACCC, and maintained current certification with the PACCC.

2. Have practised clinically for at least 36 months (working at 0.5 FTE or more) during the last 5 years, in New Zealand, United Kingdom, and/or the United States of America or Canada, including at least 24 months’ practice in New Zealand immediately prior to application. This work must have been undertaken in the same or a similar area of clinical practice to the proposed position in New Zealand.

3. Provide evidence of satisfactory completion – within 12 months prior to applying for registration – of a Council-approved knowledge-based programme in cultural safety for health practice in New Zealand.

4. Physician Associate General Scope of Practice

A physician associate registered in the Physician Associate General scope of practice may:

1. Offer health assessments, take detailed patient histories, perform physical examinations, and order relevant diagnostic tests.
2. Under supervision, contribute to diagnosis and the development and implementation of appropriate treatment and management plans.
3. Offer health promotion and disease prevention advice.
4. Undertake relevant non-patient contact activities.
5. Use their expertise in areas and roles such as leadership, management, education, policy and research.

Permitted Minor Surgical Procedures

In low-risk clinical situations, a physician associate registered in the Physician Associate General scope of practice may perform any minor surgical procedures, including suturing, excision of skin lesions and sebaceous cysts, punch biopsies and any other procedure or class of procedures, that fall within the clinical responsibilities defined through the employer credentialling, and that the physician associate’s current primary supervisor has approved the physician associate to perform.

Core Requirements

1. A physician associate registered in the Physician Associate General scope of practice must:
• Work under employer-approved supervision of a doctor registered in a vocational scope of practice that is relevant to the practice setting and the physician associate’s role.
• Be credentialled by their employer to identify the specific clinical responsibilities they may perform within the Physician Associate General scope of practice and within each service environment in which they work, taking into account their qualifications, training and experience, and the resources and support available in that service.
• Practise only in a setting where onsite supervision is available.
2. A physician associate registered in the Physician Associate General scope of practice must:
• Work in collaboration with patients, their whānau, communities, and the multi-disciplinary healthcare team to deliver equitable person/whānau-centred healthcare.
• Practise in a culturally safe way – promoting equity, inclusion, diversity, and rights of Māori as tangata whenua, Pacific Peoples and all population groups to support the provision of quality services that are culturally safe, equitable and responsive.
• Recognise when to seek the assistance and input of a vocationally registered doctor.
3. A physician associate registered in the Physician Associate General scope of practice must ensure that all health care they provide is:
• Consistent with their education, individual competence, Council standards, and legislative requirements.
• Within the terms of the supervision requirements set by Council, their supervision agreement with their employer and supervising doctor, and their employer-credentialled clinical responsibilities.

Prescribed Qualifications for Physician Associate General Scope of Practice

Pathway 1 – United Kingdom Qualifications-based

Applicant must be registered in the Physician Associate Provisional scope of practice and satisfy the following requirements:

1. Complete 12 months (full-time equivalent) working within the Physician Associate Provisional scope of practice.

2. Receive satisfactory supervision reports for the 9 months of practice completed immediately prior to applying for registration within the Physician Associate General scope of practice.

3. Hold current advanced cardiac life support (ACLS) certification less than 12 months old at the standard of New Zealand Resuscitation Council CORE Advanced for physician associates working in hospital-based practice; or CORE Immediate for physician associates working in general practice (or an alternative certificate approved by Council).

4. Been recommended for registration within the Physician Associate General scope of practice by their supervisor, who has been the physician associate’s supervisor for at least 3 months immediately prior to the application.

Pathway 2 – United States of America Qualifications-based

Applicant must be registered in the Physician Associate Provisional scope of practice and satisfy the following requirements:

1. Complete 12 months (full-time equivalent) working within the Physician Associate Provisional scope of practice.

2. Receive satisfactory supervision reports for the 9 months of practice completed immediately prior to applying for registration within the Physician Associate General scope of practice.

3. Hold current advanced cardiac life support (ACLS) certification less than 12 months old at the standard of New Zealand Resuscitation Council CORE Advanced for Physician Associates working in hospital-based practice; or CORE Immediate for Physician Associates working in general practice (or an alternative certificate approved by Council).

4. Been recommended for registration within the Physician Associate General scope of practice by their supervisor, who has been the physician associate’s supervisor for at least 3 months immediately prior to the application.

Pathway 3 – Canada Qualifications-based

Applicant must be registered in the Physician Associate Provisional scope of practice and satisfy the following requirements:

1. Complete 12 months (full-time equivalent) working within the Physician Associate Provisional scope of practice.

2. Receive satisfactory supervision reports for the 9 months of practice completed immediately prior to applying for registration within the Physician Associate General scope of practice.

3. Hold current advanced cardiac life support (ACLS) certification less than 12 months old at the standard of New Zealand Resuscitation Council CORE Advanced for Physician Associates working in hospital-based practice; or CORE Immediate for Physician Associates working in general practice (or an alternative certificate approved by Council).

4. Been recommended for registration within the Physician Associate General scope of practice by their supervisor, who has been the physician associate’s supervisor for at least 3 months immediately prior to the application.

Pathway 4 – New Zealand Experiential

Applicant must be registered in the Physician Associate Provisional scope of practice and satisfy the following requirements:

1. Complete 6 months (full-time equivalent) working within the Physician Associate Provisional scope of practice.

2. Receive satisfactory supervision reports for the 6 months of practice completed immediately prior to applying for registration within the Physician Associate General scope of practice.

3. Hold current advanced cardiac life support (ACLS) certification less than 12 months old at the standard of New Zealand Resuscitation Council CORE Advanced for Physician Associates working in hospital-based practice; or CORE Immediate for Physician Associates working in general practice (or an alternative certificate approved by Council).

4. Been recommended for registration within the Physician Associate General scope of practice by their supervisor, who has been the physician associate’s supervisor for at least 3 months immediately prior to the application.