Communication Skills for IMGs

Why Communication Matters in NZREX

Communication is not just a soft skill — in the NZREX, it can make or break your result. Examiners specifically assess your ability to communicate clearly, empathetically, and professionally with patients and colleagues. Many IMGs lose marks not because of clinical knowledge, but because of communication style.

New Zealand has a distinct communication culture that values empathy, plain language, shared decision-making, and cultural awareness — particularly in relation to Māori health.

Key Communication Principles

1. Use Plain Language

Avoid medical jargon when speaking to patients. Say "high blood pressure" not "hypertension". Say "heart attack" not "myocardial infarction". The NZ examiner expects you to communicate at the patient's level.

2. Show Genuine Empathy

Acknowledge the patient's emotions. Use phrases like "That sounds really difficult", "I can see you're worried about this", or "I'm sorry you're going through this". Don't skip empathy — it's actively marked.

3. Shared Decision-Making

NZ healthcare values patient autonomy. Don't just tell the patient what to do — involve them in decisions. Ask "What are your thoughts on this?" or "Would you like to discuss the options together?"

4. Check Understanding

Use the "teach-back" method. Ask "Can you tell me in your own words what we've discussed?" This demonstrates that you care about the patient actually understanding the information.

5. Structure Your Consultation

Use a clear structure: introduction → history → examination → findings → management plan → safety net. This shows the examiner you are organised and thorough.

Cultural Competence in NZ

New Zealand has a unique cultural landscape. Understanding and demonstrating cultural competence is essential, particularly regarding Māori health and the Treaty of Waitangi.

The Treaty of Waitangi

Understand the three principles: Partnership, Participation, and Protection. These underpin NZ healthcare delivery and are assessed in NZREX.

Māori Health Models

Familiarise yourself with concepts like Whānau (family), Hauora (health/wellbeing), and the Te Whare Tapa Whā model (physical, spiritual, mental, family health).

Ask About Cultural Needs

Always ask "Is there anything cultural or spiritual I should know about to help care for you?" This shows respect and awareness.

Breaking Bad News — SPIKES Model

The SPIKES model is widely used and expected in NZ clinical communication:

S — Setting

Private, comfortable, all parties present

P — Perception

Ask what the patient already knows

I — Invitation

Ask how much detail they want to know

K — Knowledge

Deliver information clearly and gently

E — Empathy

Acknowledge and validate emotions

S — Strategy/Summary

Plan next steps together

Common IMG Communication Mistakes

Talking too much — Let the patient speak. Active listening is as important as giving information.

Using jargon — "You have a myocardial infarction" should be "You've had a heart attack."

Skipping empathy — Going straight to management without acknowledging feelings.

Being paternalistic — NZ expects collaborative, not directive, communication.

Poor body language — Avoid crossing arms, poor eye contact, or standing over the patient.

Explore More

Quick Tip

In OSCE stations, always start with: "Hello, my name is Dr. [Surname]. I'm one of the doctors here." Then confirm the patient's identity. This simple introduction immediately demonstrates professionalism.

Key Phrase Bank

"Can you tell me more about that?"
"I'm sorry to hear that."
"What are your main concerns?"
"Is there anything else?"
"Let me summarise what we've discussed."