Mangaia is to become the next island in the Cook Islands without a resident doctor.
The Cook Islands News reported that the Ministry of Health's doctor has resigned and won't be replaced.
The health secretary Elizabeth Iro said she couldn't say why the Mangaia doctor had resigned before the contract expires in June.
Primary health care will be offered by a nurse practitioner just like on Mauke, Atiu, Mitiaro, Manihiki, Rakahanga, Penrhyn and Pukapuka.
Ms Iro said nurse practitioners on outer islands were being supported by doctors at Rarotonga hospital through computer technology, early medical intervention and medical evacuation flights.