Doctors are warning that giving GPs the task of doing more on-the-job training for new graduates and foreign-trained medics will load more pressure on primary care.
Health Minister Simeon Brown has set aside $47m dollars over four years for general practice to take on 50 medical graduates each year and up to 100 overseas doctors - a move he says will help ease the desperate workforce shortages.
"That has created a bit of impetus to taking on the New Zealand Registration Examination, which takes a lot of effort, in itself.
"People are preparing hard and supporting each other, you can see from the Facebook group of over 1000 doctors who are here and interested in sitting those exams."
Foreign doctors who have not trained or worked in one of 24 "comparable" health systems have to pass the Registration Exam and find a two-year, postgraduate house-officer job in a public hospital to complete their registration.
Twenty years after he first arrived in New Zealand, Dr Gotadki is finally realising his dream of working as a GP, in Feilding.
He did a post-grad degree in public health at Auckland University, and became a New Zealand citizen - but still found himself locked out of the system.
"I felt like I had reached a dead-end in New Zealand."
In 2019, he made the difficult decision to leave his family to train as a GP in Britain.
"The sacrifice that I had to go through was to leave my wife here, who is a dentist in Palmerston North, and I also left my daughter, who was five years old at the time.
"So a significant sacrifice to make, but I had reached an age, 35, when I thought, 'If I don't do something different, I will have to completely forget about being a GP here'."
It took four years - and for two of those (the Covid-19 years), he was unable to see his family due to New Zealand's strict border controls.
"It was hard, really hard, for me and my family. But when I came back with my qualification, some of my friends were still in the exact same position as they were four years previously, still trying to get into a GP programme."
Since returning in 2023, his British qualification has allowed him to practice in New Zealand - but he is still working under supervision towards full recognition as a fellow of the New Zealand College of General Practitioners.
The Primary Care Pathway to registration was an opportunity of "bypassing that bottleneck" for international medical graduates, who must compete with local graduates for those first and second year house office jobs (PGY1 and 2) in hospitals, he said.
The initiative is set to cost just $23.94m over four years, with rolling intakes throughout this year and next.
It builds on a pilot scheme in Waikato, involving 10 doctors.
The Medical Council has also tripled the registration exam spots for overseas doctors this year from 60 to 180.
However, Dr Gotadki warned overseas doctors - and GP clinics - would need extra help to ensure those placements were successful.
"A lot of international doctors end up leaving New Zealand because they may not have had the right support, or the right onboarding or the building up of their cultural capabilities."
Scheme 'potentially puts patients at risk' - doctors' union
A separate scheme involves up to 50 New Zealand medical graduates doing 18 months of their on-the-job training (PGY1 and 2) in primary care, after a six-month crash course in hospitals.
Resident Doctors Association national secretary Deborah Powell said the union - which works closely with Te Whatu Ora and the Medical Council on internships for first and second year doctors - was taken "completely by surprise" by the announcement.
The existing Community Based Attachment programme already gave junior doctors a taste of general practice - but only after they have had a chance to hone their skills in hospitals, she said.
"For instance, we don't put first years into general practice, they're too inexperienced, the amount of supervision they require is higher. So you're asking GPs to not only manage their own workloads, but to give more supervision than they would normally."
Overseas-trained doctors also needed a comprehensive grounding in the New Zealand health system, Powell said.
"We can give them that in the hospital system. General practice, not so much. That's setting everyone up to fail in my view - and putting patients potentially at risk."
The government has budgeted $23.275 million over four years for primary care to take on those new graduates.
Christchurch GP Angus Chambers, who chairs the General Practice Owners Association, said when it came to both schemes, "the devil will be in the detail".
"The practicalities are, there's not a lot of capacity. There's actually an issue around room space, because if you've got your practice running in all the rooms, where are you going to put a new graduate?"
It was "a good principle in theory" to give doctors more experience in primary care, in the hope they enjoyed it and decided to make it their life's work, he said.
However, both "green" graduates and overseas trained doctors would need intensive supervision and longer appointment times as well as space to work, which meant it was unlikely to result in shorter wait times for patients, "at least initially".
"That's the real key here, have we got the time and the room space to have these graduates, that have not got their full qualification? So I think it's going to prove difficult to get going in many ways, because of that capacity issue."
GPs were waiting for more detail on how both schemes will work, and how that funding would be distributed, Chambers said.
