Doctoral student Johanna Thomas-Maude has won the Three Minute Thesis competition for Te Kunenga ki Pūrehuroa Massey University with her presentation A Hidden Story: Overseas trained doctors in Aotearoa New Zealand.
“Have you ever felt judged not by what you can do but by where you are from?” her presentation opened with. “In New Zealand, many overseas trained medical doctors face this reality.”
Johanna’s PhD was based in the College of Humanities and Social Sciences’ Institute of Development Studies. The focus of her research was driven by the personal experience of her husband, a trained doctor from Peru. Despite his qualifications and experience, they realised it could take up to five years before he would be able to work as a doctor in New Zealand, which was not something the couple could afford. So, for the past two years, he’s been living and working as a doctor in the United States (US). After two more years, he will be able to work as a doctor in New Zealand.
“That’s because the pathway to general registration depends on whether you trained in a country considered to have a comparable health system to New Zealand,” she explains. “This is a decision based on factors like government healthcare spending and doctors per capita. These relate more to the wealth and resources of a country, rather than an individual’s skills or training.”
As a result, doctors who trained in a list of 24 high-income countries – such as the US and the United Kingdom (UK) – have a smoother pathway to general registration here in New Zealand.
“For doctors from low- or middle-income countries, the process can take years, with many failing to secure jobs due to bureaucratic hurdles, despite passing all required exams.”
She interviewed 24 overseas trained doctors and surveyed a further 80. While all doctors from ‘comparable health systems’ secured registration, less than a third from non-comparable countries were able to succeed. Interviewees reported feeling discriminated against and that their competence was judged on where they were from, not their skillset.
“This research allowed me to showcase the experiences of these people who hadn’t had their voices heard much in this space.”
Johanna says this “unfair pathway” for overseas trained doctors is steeped in New Zealand’s history, dating back to the early 1900s.
In 1905, legislation for medical licensing prioritised overseas doctors whose training was considered "equal in status" to New Zealand graduates. In 2024, the policy wording hasn’t changed much – nowadays, overseas medical training must be "comparable" for a straight-forward general registration process.
She says this needs to be urgently addressed by policy makers and the Government.
“The outdated assumptions that shaped those policies differ significantly from the values we uphold today. Today’s policies may inadvertently carry forward biases from colonial times, perpetuating an unwritten discrimination that makes it harder for doctors from low- or middle-income countries to succeed.
“I want this research to contribute to positive changes in medical registration because no one’s professional ability should be based on where they are from, but on their individual knowledge, skills and experience.”
While living in Peru, Johanna studied a master’s in international development through Massey via distance. She completed her undergraduate in the UK but was looking to come back to New Zealand when the development studies programme caught her eye. “The programme itself is unique because it overlaps a lot of things and is interdisciplinary, covering geography, sociology, anthropology and more. That was the appeal, as well as the flexibility of studying in Peru.”
Johanna will soon be starting a position as a post-doctoral fellow involved in a three-year Marsden grant focused on health system resilience in Fiji.
Johanna was among 21 Massey doctoral students this year who entered the 3MT competition, developed by the University of Queensland. She will go on to represent Massey at the Asia Pacific finals online in October.
Runner-up was Dhanesha Nanayakkara from the College of Science’s School of Agriculture and Environment, focused on Making carrot safe from wild carrot and the People’s Choice Award went to Sheba Culas from the School of Food Technology and Natural Sciences with her presentation on Transforming Cinnamon into a Diabetes Fighter.