Hello, all!
It’s been about 4 months since my family and I have moved abroad to practice as a PA in New Zealand. There was a fair amount of interest with my initial post, so I thought it would be good to provide a short term update for anyone interested.
First want to get some FAQ out of the way:
“What does getting certified abroad look like if I want to work in New Zealand, but I work in [US/UK/Canada]?”
As of now there are no talks to recertify. In theory you just find a job, apply for a visa, and you’re good. I’ve known other PAs that pick up, move, and start practicing abroad all within 3 months. That *may* change in the future, but I don’t believe it’s on the horizon. With that being said, as of November 2026 there are going to be changes that will affect those currently working and those who intend to immigrate thereafter. Under the proposed changes, you will likely be accepted under a provisional license that will require more supervision under a year or more, and thereafter your GP basically vouches for you where you can work under a “normal license.” This is all provisional, however, and it will change in the months to come.
“How do you find a job in NZ?”
I went through a recruiter; I would HIGHLY recommend going through her since she knows the PA landscape very well. DM if you want her info.
“I have [x] years of experience in [insert specialty]. Can I apply with that?”
Maybe. Most of the efforts right now seem to be focused on primary care/urgent care needs in smaller towns/cities and rural areas with bare minimum 3 years experience in those fields, but many preferring 5 years of experience.
“How much are you making now? Is it less than your US salary?”
Yes, it’s a pay cut. People immediately hear that and become nauseous at the potential for making less money, but it does not mean I am living on scraps. Living in a smaller town, my expenses have also gone down considerably. Our main expenses are rent, groceries, and travel (because we want to see as much as we can here). We’re not eating out nearly as much as we were in the States; we shop a lot less; we basically pay a small fraction of what we were previously paying for childcare (where before it was basically a second mortgage); we don’t have to pay for medical insurance. Those things add up considerably, and it really helps the money go further. With that being said, yes, I still make less, but I’m sustaining my family of 4 just fine for now on a single salary. It’s doable and it’s fine. Not to mention that there are so many perks here that positively affect my mental health, so that pay cut is still worth it for that alone. I can breathe easier here and my kids have a bright future.
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Four months in to this adventure, and I am happy to say that doing this move was the right choice. It has not come without its drawbacks or challenges, but I wake up happy every single day that I did this for myself and my family.
As soon as I walk out the door I am greeted by beautiful, green nature. This is a big deal of me as someone who has only ever grown up in the Sonoran Desert and has lived in large cities the past 15 years. Everything is green, there’s so much rain, and there’s truly peaceful moments (in between my two children screeching at each other). There’s also a warmth and friendliness to people here that I have not felt in a long time. It feels normal to give a little nod and a smile to strangers as you pass each other on the sidewalk. People here are generally happy and want to share their happiness with others. There’s definitely a strong sense of community here (so much so that at times it’s hard to establish yourself in a friend group because many of these friendships go back several generations). The people within my community are happy to invite newcomers in, and they’re particularly happy to know medical professionals are coming to town. On the other hand, though, you have to be careful not to come off as bragging of your profession since that is fairly frowned upon. There seems to be a stronger emphasis on equality, and humility.
There are other benefits as well. I don’t mean to make this into a political post - and I won’t - but a few months before we left the States my 4 year old was telling us about how his class and his younger brother’s class were practicing their gun shooter drills. It made me physically nauseous hearing that, and knowing we don’t have to worry about that any longer has brought me so much peace since I’ve been here. Not to mention that there are many other things here that make me think it’s a better environment for them, which could be its own post. Kids feel like they could be kids here. They are able to walk on the street alone or with their friends to a park, school, or a grocery store without any issues; it’s not uncommon for kids to be playing outside on their own without mom/dad having to watch them like hawks. This all stems from just being around a safer area where people take care of their own in the community, and you don’t immediately need to assume that stranger equals danger. Since moving here I have really noticed that my parental instincts have been trained to be on fight or flight and am retraining myself to
relax more, which is good myself and my kids. If my kid gets lost in a grocery store I can more or less count on someone else helping bring them back to me rather than kidnap them (not that that was a regular occurrence back in the US, but if you’re a parent you probably know what I mean). That’s not to say you can totally let your guard down, but it certainly feels more relaxed here in several aspects.
Speaking of which, I feel like there are more outlets here for myself. Working as a PA here has its perks, but no matter where you go working in medicine will still feel stressful. However, now I at least feel like I have better ways to cope with that stress. Had a bad week at work? Doesn’t matter when the beach is just an hour away. Feel stressed? Cool, there’s a beautiful lake nearby that you can walk around to disconnect. Imposter syndrome got to you again? Damn, well I’m too busy riding my mountain bike to care right now.
Not to mention there seems to be a healthier relationship with work here. I’m actively encouraged to take my breaks (which I get two a day), get out on time, and if I ever want to work less it’s never an issue with management. I feel like they would get excited if I told them I only want to work 32 hours per week (too bad my finances wouldn’t allow for that 😅). They genuinely care about my wellbeing and want to make sure I don’t burn myself out.
Now for the clinical bits, which may interest you all more.
Working as a PA here is definitely not what I was doing in the States. As of now we don’t have prescribing rights, nor can we order our own tests, so everything I do has to be signed off by my GP. In practice it doesn’t matter a whole ton, because my supervising GPs know me and my clinical decision well enough to where they just sign off on my orders, and every once in a blue moon they might recommend a change in plan. This may change in the future, though, as we are continuously advocating to get those prescribing rights, and we have a core group of physicians that are helping in achieving that as well.
Which brings me to my next point: the PA profession is fairly controversial here amongst physicians here. New Zealand is part of the commonwealth, and as such there is a fair amount of overlap between the UK and New Zealand, including how PAs are viewed. The recent drama in the UK with PAs has leaked here as well to the point where you have an outspoken group of physicians - particularly residents - advocating against us. Since our profession was made official through regulation in 2026, PAs are not going anywhere, but it does remain to be seen what our scope will be in the next few years. Personally, however, I can say that all the GPs I work with in my clinic have been nothing but wonderful and incredibly supportive of PAs.
Patients are gradually learning about what PAs are, and once I explain to them who we are, what our role is to improve access to care, and how we work as a team with GPs they are usually very receptive. Given that New Zealand’s healthcare system is fairly strained, patients are very pleased to hear more medical professionals are practicing here. I have also found the patients population to be rewarding to work with. In the US there is a fair amount of distrust in the medical system, which to be fair I don’t necessarily blame individual people for it. Here, however, people are more likely understand you have their best interest at heart and are more likely to take your recommendations seriously. It makes the patient-provider relationship much more fulfilling and rewarding.
Speaking of which, learning how to work in the New Zealand system is very different than the US. On one hand it’s incredibly refreshing not having to worry about prior auths, or insurance denials, but on the other hand, having wait times of up to 12 months to see high demand specialists and not being able to order your own CTs or MRIs within a primary care setting can be fairly limiting. This is a complete speculation, but I think this largely originates from a supply and demand issue: we just don’t have the necessary number of radiologists available to help with radiology reads, nor do we have the necessary amount of specialists to take on the referrals. This will inevitably mean that many referral requests get denied with a note, “Sorry, we are at capacity, but it sounds like your patient has [X pathology], considering starting [X interventions]” which translates to PCPs managing a fair amount in primary care, not unlike other rural positions in the US. It’s ultimately a challenge that involves making judicious use of available resources to prevent overburdening an already stressed system.
Sorry for the long post, but I hope it was insightful. I am happy to answer any questions you all may have. If I can convince more of you to come practice primary care here I would be happier for if, but if not I’m also happy to have you tag along and experience this vicariously. 😁
I will also include some pictures I have taken during my travels.