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Licensing pathway

Getting licensed in New Zealand

IMGs who do not qualify for a recognised-country route pass an accepted knowledge exam and the NZREX Clinical (or hold PLAB 1 and 2), secure an accredited PGY1 job, and complete two years of supervised prevocational training.

The Medical Council of New Zealand (Te Kaunihera Rata o Aotearoa) registers doctors into scopes of practice. Most IMGs start in a provisional general scope under supervision and later move to the general scope. Doctors with recent experience in one of 29 comparable health systems, UK and Irish graduates, and doctors already fully registered in Australia or the UK can use faster supervised routes. These need a job offer but no New Zealand exam. Everyone else uses the Examinations pathway: a prerequisite knowledge exam, evidence of English, the NZREX Clinical in Auckland, then a PGY1 position with an accredited training provider. Specialists have separate provisional vocational routes, including a fast-track for some UK, Irish and Australian qualifications. Key documents must be verified through ECFMG's EPIC service, now reached through MyIntealth, before you apply.

Checked against official sources on 17 October 2026Licensing bodyMedical Council of New Zealand (Te Kaunihera Rata o Aotearoa)

Main route

Examinations pathway (NZREX Clinical)

Who it is for: IMGs with an acceptable primary medical qualification who are not eligible for a comparable health system, competent authority or registrant pathway.

  1. Step 1

    Check your eligibility and best pathway

    Use MCNZ's online self-assessment tool and confirm you hold an acceptable primary medical qualification. Doctors with recent work in a comparable health system, UK or Irish graduates, and doctors fully registered in Australia or the UK usually have shorter routes than NZREX.

    Run by
    Medical Council of New Zealand

    Where people get stuck

    • MCNZ states there is no flexibility on its eligibility rules, so near-misses are not accepted.
    • Experienced doctors are often unsure whether their past work counts towards a non-exam pathway.

    What it opens up

    • Choosing the right pathway before paying exam fees
    SourcesMCNZ - Registration pathways for IMGs (June 2025)MCNZ - NZREX Clinical
    New Zealand

  2. Step 2

    Pass an accepted prerequisite knowledge exam

    Before NZREX you need a pass in one of: USMLE Step 1 and Step 2 CK, the AMC MCQ, MCCQE Part I, or PLAB Part 1. The pass must fall within five years of the NZREX Clinical date you are allocated.

    Run by
    Medical Council of New Zealand (sets the requirement)

    Where people get stuck

    • The prerequisite pass can go out of date while you wait for an NZREX seat.
    • Each accepted exam has its own body, fees and booking rules, and USMLE results must be verified through an FSMB transcript request.

    What it opens up

    • Eligibility to apply for the NZREX Clinical (with English evidence and EPIC verification)
    SourcesMCNZ - NZREX Clinical
    New Zealand

  3. Step 3

    Verify your degree and exam results through EPIC

    Your primary medical degree and prerequisite exam results must be verified at source through ECFMG's EPIC service, via MyIntealth, before you apply to sit NZREX. Verification does not expire, so you can start early. You will need your MyIntealth ID when you apply to MCNZ.

    Run by
    ECFMG / Intealth (for the Medical Council of New Zealand)

    Where people get stuck

    • Waiting for your medical school to respond to ECFMG can delay your NZREX application.
    • MCNZ does not accept incomplete applications, so missing verification means losing your place in the queue.

    What it opens up

    • A complete NZREX application
    • Verified documents reused later for registration
    SourcesMCNZ - Primary source verification (EPIC via MyIntealth)MCNZ - NZREX Clinical
    New Zealand

  4. Step 4

    Meet MCNZ's English language requirement

    Provide evidence for one of MCNZ's English options with your NZREX application. For IELTS or OET, the result must be no more than two years old on your allocated exam date.

    Run by
    Medical Council of New Zealand

    Where people get stuck

    • MCNZ accepts only IELTS Academic and OET Medicine as tests, so other tests recognised elsewhere do not count.
    • A test result can expire before your allocated NZREX date if seats are booked far ahead.
    • Each component has its own minimum score, so one weak component means retesting.

    What it opens up

    • Eligibility to sit NZREX Clinical (with the other requirements)
    SourcesMCNZ - Policy on English language requirements (September 2026)
    New Zealand

  5. Step 5

    Pass the NZREX Clinical

    NZREX Clinical is an OSCE with 12 equally weighted stations over three hours. It assesses communication, professionalism, cultural safety, history taking, examination, clinical reasoning and management. It is held in Auckland, with sittings listed for September 2026, March 2027 and September 2027. You apply by email, and eligible applicants get places in the order applications arrive. Processing can take up to 20 working days.

    Run by
    Medical Council of New Zealand
    Timing
    One 3-hour exam; a pass is valid for five years from the exam date.
    Fee
    NZD 748.63 application fee plus NZD 4,319.08 examination fee, excluding GST (MCNZ Fees Notice 2026, in force from 1 July 2026, checked 2026-10-17)

    Where people get stuck

    • Sittings often fill well before closing dates, so late applicants are moved to a later sitting.
    • You must travel to Auckland and arrange accommodation at your own cost.
    • Communication and cultural safety are assessed alongside clinical skills. If communication problems are noted, MCNZ can require English remediation or retesting before a resit or registration.
    • Withdrawal refunds get smaller the closer you are to the exam.

    What it opens up

    • Eligibility for the Examinations registration pathway while the pass is valid
    • Meeting the English requirement for registration through the Examinations pathway
    • NZREX is listed among the Australian Medical Board's Competent Authority routes
    SourcesMCNZ - NZREX ClinicalMCNZ - Fees Notice 2026 (NZ Gazette 2026-sl2847)MCNZ - Policy on English language requirementsMedical Board of Australia - Competent Authority pathway
    New Zealand

  6. Step 6

    Secure an accredited PGY1 job and apply for provisional general registration

    Get a job offer as a PGY1 (first-year house officer) with a prevocational training provider accredited by MCNZ. MCNZ says this is the only route to registration for doctors who need NZREX, whatever their past experience. Your employer helps complete the application. MCNZ processes complete applications within 20 working days and sends an eligibility letter. A Zoom registration meeting follows within two weeks of your start date, and you cannot practise until your practising certificate is issued.

    Run by
    Medical Council of New Zealand
    Timing
    Complete applications processed within 20 working days; practising certificate issued up to three working days after payment following the registration meeting.
    Fee
    NZD 336.62 provisional general registration application (NZREX graduate), plus the practising certificate fee (NZD 869.57 a year, with a reduced fee for appointments of six months or less), excluding GST (MCNZ Fees Notice 2026, checked 2026-10-17)

    Where people get stuck

    • There is no guaranteed job after passing NZREX. You must find an accredited PGY1 position yourself.
    • Doctors with years of experience still re-enter at intern level on this route.
    • Your practising certificate lists approved work locations, and any change needs prior approval.

    What it opens up

    • Working in New Zealand under prevocational supervision
    SourcesMCNZ - Examinations registration pathwayMCNZ - NZREX ClinicalMCNZ - Your registration meetingMCNZ - Fees Notice 2026
    New Zealand

  7. Step 7

    Complete PGY1 and move to the general scope

    Complete the PGY1 requirements: four accredited clinical attachments of at least 10 weeks full-time equivalent each, the learning outcomes, MCNZ's advanced cardiac life support requirement, and an advisory panel recommendation. Then apply in ePort. Progression is not automatic. You are then registered in the general scope with a PGY2 endorsement.

    Run by
    Medical Council of New Zealand

    Where people get stuck

    • Meeting the learning outcomes across rotations while adjusting to a new health system.
    • Missing items, such as a current life support certification, can delay moving to the next stage.

    What it opens up

    • Registration in the general scope with a PGY2 endorsement
    SourcesMCNZ - Examinations registration pathwayNZ Gazette - Scopes of practice Amendment Notice (No. 2) 2025
    New Zealand

  8. Step 8

    Complete PGY2 and remove the endorsement

    At the end of PGY2, apply in ePort to have the PGY2 endorsement removed. You then need a recertification programme (Inpractice or an accredited vocational training programme), with evidence of enrolment due within one month of applying.

    Run by
    Medical Council of New Zealand

    Where people get stuck

    • Planning the next career step, such as vocational training, while still completing prevocational requirements.
    • Keeping recertification enrolment on time after the endorsement is removed.

    What it opens up

    • General scope without the PGY2 endorsement
    • Entry to vocational (specialist) training or general practice under recertification
    SourcesMCNZ - Examinations registration pathway
    New Zealand

Official practice materials

Published by the exam bodies themselves. They show the real format and level, and they are the honest alternative to pirated question banks and "recalls". MedReady links to them; it never copies them.

NZREX Clinical

  • Sample questionsFree
    Sample questions for NZREX Clinical

    Example NZREX Clinical stations (mental health, musculoskeletal, child health and cardiovascular) with the marking grid used. The Council presents them as a guide to the format, not to the clinical detail to expect.

    From Medical Council of New Zealand

  • Candidate guideFree
    NZREX Clinical: Candidate handbook

    How to apply, the exam format, the seven assessed domains, the expected standard (a recent New Zealand graduate) and the exam blueprint and matrix (September 2024).

    From Medical Council of New Zealand

  • Candidate guideFree
    NZREX Clinical reading list

    Texts the Medical Council recommends reading before you sit NZREX Clinical.

    From Medical Council of New Zealand

Other recognised routes

Examinations pathway with PLAB 1 and 2 (no NZREX needed)IMGs who have passed both parts of the UK PLAB test within the last five years but do not hold full UK registration.2 steps

  1. Step 1

    Hold a PLAB Part 1 and Part 2 pass

    MCNZ accepts PLAB Parts 1 and 2 as an alternative to the NZREX Clinical for the Examinations pathway, and applies the same policies to both. The pass must be within the last five years.

    Run by
    Medical Council of New Zealand (sets the requirement)

    Where people get stuck

    • The PLAB pass can go out of date if finding a New Zealand job takes too long.
    • PLAB is run in the UK, so candidates face UK exam logistics before applying in New Zealand.

    What it opens up

    • Applying for the Examinations pathway without sitting NZREX
    • Meeting MCNZ's English requirement for registration through this pathway
    SourcesMCNZ - Examinations registration pathwayNZ Gazette - Scopes of practice notice 2023 (PLAB as alternative to NZREX)MCNZ - Policy on English language requirements
    New Zealand

  2. Step 2

    Secure an accredited PGY1 job, register and complete prevocational training

    As for NZREX graduates, you need a PGY1 job offer with an accredited provider and EPIC verification under way before you apply. You then complete PGY1 and PGY2 under supervision to reach the general scope.

    Run by
    Medical Council of New Zealand
    Fee
    NZD 336.62 provisional general registration application (NZREX graduate category), excluding GST (MCNZ Fees Notice 2026, checked 2026-10-17). Confirm with MCNZ which fee line applies to PLAB holders.

    Where people get stuck

    • You must find an accredited PGY1 job yourself.
    • Doctors with years of experience still re-enter at intern level on this route.

    What it opens up

    • General scope after PGY1 and PGY2
    SourcesMCNZ - Examinations registration pathwayMCNZ - Fees Notice 2026
    New Zealand
Comparable health system pathwayDoctors with recent clinical experience in one of the 29 countries MCNZ recognises as having health systems comparable to New Zealand's.3 steps

  1. Step 1

    Confirm your comparable health system experience

    You need at least 33 months of clinical practice (20 or more hours a week) in the 48 months before applying. It must be in comparable health systems, in the same or a similar area of medicine and at a similar level of responsibility. You also need current full or general registration with a comparable regulator, or participation in a recognised specialist training programme (American Boards, Canadian specialist colleges or Irish specialist trainee registration). GPs have a separate variant that requires a recent postgraduate GP qualification. The recognised countries are Australia, Austria, Belgium, Canada, Chile, Croatia, the Czech Republic, Denmark, Finland, France, Germany, Greece, Hong Kong, Iceland, Ireland, Israel, Italy, Japan, Luxembourg, the Netherlands, Norway, Portugal, Singapore, South Korea, Spain, Sweden, Switzerland, the UK and the USA.

    Run by
    Medical Council of New Zealand

    Where people get stuck

    • Gaps in recent practice or part-time hours can leave you short of the experience requirement.
    • Your experience must match the level and area of the New Zealand job you are offered.

    What it opens up

    • Provisional general registration without a New Zealand exam
    SourcesMCNZ - Comparable health system pathwayMCNZ - Comparable health system criteria (country list)
    New Zealand

  2. Step 2

    Get a supervised job offer and apply

    Secure a job offer that includes supervision, start EPIC verification of your key documents before you apply, and complete Checklist 4 with your employer's form. MCNZ processes these applications within 20 working days.

    Run by
    Medical Council of New Zealand
    Timing
    Applications processed within 20 working days (MCNZ)
    Fee
    NZD 1,683.09 provisional general registration application (comparable health system), excluding GST, plus the practising certificate fee (MCNZ Fees Notice 2026, checked 2026-10-17)

    Where people get stuck

    • You need a New Zealand employer willing to provide a supervised role before MCNZ can consider the application.
    • EPIC verification must already be under way, or processing cannot start.

    What it opens up

    • Provisional general registration and a practising certificate
    SourcesMCNZ - Comparable health system pathwayMCNZ - Faster, easier registration for overseas-trained doctors (15 Jul 2025)MCNZ - Fees Notice 2026
    New Zealand

  3. Step 3

    Complete 12 months under supervision and apply for the general scope

    Work 12 months full-time equivalent in the provisional general scope. You need three satisfactory supervision reports covering the final nine months and a recommendation from your Council-approved supervisor. For an unlimited general scope, you also need six months of supervised medicine and six months of supervised surgery, or accredited prevocational training approved by the hospital's Chief Medical Officer.

    Run by
    Medical Council of New Zealand
    Timing
    At least 12 months full-time equivalent in the provisional general scope

    Where people get stuck

    • Without the medicine and surgery experience, general scope may be limited to your area of practice.
    • Supervision continues if reports or recommendations are not in place by the end of the year.

    What it opens up

    • Registration in the general scope
    SourcesMCNZ - Comparable health system pathway
    New Zealand
Competent authority pathway (UK and Irish graduates)Doctors with a primary medical degree from an approved UK or Irish medical school who completed their internship in the UK or Ireland.2 steps

  1. Step 1

    Confirm your UK or Irish degree and internship

    You need a primary medical degree from an approved medical school in the UK or Ireland and an internship completed there. An internship done elsewhere must first be assessed under MCNZ's recognition of internships policy.

    Run by
    Medical Council of New Zealand

    Where people get stuck

    • Graduates who interned outside the UK or Ireland face an extra assessment step.
    • You still need a New Zealand job offer that includes supervision, and EPIC verification must be under way before MCNZ will process the application.

    What it opens up

    • Applying for provisional general registration without a New Zealand exam
    SourcesMCNZ - UK and Irish medical graduates (Competent Authority)
    New Zealand

  2. Step 2

    Get a supervised job, apply, and complete six months of supervision

    With a job offer that includes supervision and EPIC verification under way, apply online through myMCNZ. MCNZ aims to process applications within 20 working days. After six months full-time equivalent of approved supervised practice, with two consecutive satisfactory reports and your supervisor's recommendation, you can apply for the general scope.

    Run by
    Medical Council of New Zealand
    Timing
    Six months full-time equivalent supervised practice before applying for the general scope
    Fee
    NZD 538.59 provisional general registration application (competent authority), excluding GST, plus the practising certificate fee (MCNZ Fees Notice 2026, checked 2026-10-17)

    Where people get stuck

    • Progression is not automatic, and supervision continues until all requirements are met.
    • You need an employer and an approved supervisor before you can register.

    What it opens up

    • Registration in the general scope
    SourcesMCNZ - UK and Irish medical graduates (Competent Authority)MCNZ - Fees Notice 2026
    New Zealand
Australian or UK general registrantsIMGs who already reached full general registration in Australia (through the AMC route) or in the UK (through PLAB).2 steps

  1. Step 1

    Confirm your Australian or UK registration route

    Australian route: you passed the AMC MCQ and either the AMC Clinical exam or an AMC-approved workplace-based assessment, then completed 12 months of supervised practice leading to general registration with Ahpra. UK route: you passed PLAB Parts 1 and 2, completed FY1 or FY2 (or 12 months in an approved setting), and hold full GMC registration.

    Run by
    Medical Council of New Zealand

    Where people get stuck

    • You must already have completed the full Australian or UK route. Partial progress, such as passing exams only, does not qualify for this pathway.
    • You still need a New Zealand job offer that includes supervision.

    What it opens up

    • Applying for provisional general registration in New Zealand without NZREX
    SourcesMCNZ - Australian general registrantsMCNZ - Registration pathways for IMGs (June 2025)
    New Zealand

  2. Step 2

    Apply with a supervised job and complete supervision

    Send documents for EPIC verification, then apply with your employer's forms. Australian general registrants spend at least 12 months in a provisional general scope under a Council-approved supervisor. They need satisfactory reports, a current advanced life support certificate and a supervisor's recommendation before applying for the general scope.

    Run by
    Medical Council of New Zealand
    Timing
    At least 12 months in a provisional general scope (Australian general registrants)
    Fee
    NZD 538.59 provisional general registration application (Australian or UK general registrants), excluding GST, plus the practising certificate fee (MCNZ Fees Notice 2026, checked 2026-10-17)

    Where people get stuck

    • Moving countries mid-career means restarting a supervised period.
    • Any change of job, supervisor or location needs Council approval in advance.

    What it opens up

    • Registration in the general scope
    SourcesMCNZ - Australian general registrantsMCNZ - Fees Notice 2026
    New Zealand
Specialist routes (provisional vocational scope)Overseas-trained specialists, including a fast-track for approved UK, Irish and Australian qualifications in seven specialties.2 steps

  1. Step 1

    Fast-track specialist registration (UK, Ireland, Australia)

    This route is for approved specialist qualifications from the UK, Ireland or Australia in anaesthesia, dermatology, emergency medicine, general practice, internal medicine, anatomical pathology or psychiatry. You need at least 24 months of practice in the specialty in the last five years at half-time or more, including 12 of the last 18 months in a comparable health system. You also need a New Zealand job offer. Applications are processed within 20 working days, without college advice.

    Run by
    Medical Council of New Zealand
    Timing
    Applications processed within 20 working days (psychiatry may take slightly longer)
    Fee
    NZD 4,039.42 application for provisional vocational registration (IMGs with overseas specialist qualifications), excluding GST (MCNZ Fees Notice 2026, checked 2026-10-17)

    Where people get stuck

    • Only listed qualifications and specialties qualify, and the recent-experience window is strict.
    • You need a New Zealand job offer before you can apply.

    What it opens up

    • Provisional vocational (specialist) registration
    SourcesMCNZ - Fast-track registration for provisional vocational registration (21 Oct 2024)MCNZ - Fees Notice 2026
    New Zealand

  2. Step 2

    Standard specialist assessment

    Other specialists are assessed against the New Zealand and Australian standard, with advice from the relevant medical college, and MCNZ makes the final decision. MCNZ says most applications are processed within three months. A process developed with the RNZCGP processes GP applicants from the USA, Canada and Singapore within two months. Since April 2025, doctors on provisional vocational registration have up to 24 months to reach full vocational registration.

    Run by
    Medical Council of New Zealand
    Timing
    Most applications processed within three months (MCNZ)
    Fee
    NZD 4,039.42 application for provisional vocational registration, plus college advice fees (for example NZD 4,884.40 paper-based assessment and NZD 2,066.48 interview), excluding GST (MCNZ Fees Notice 2026, checked 2026-10-17)

    Where people get stuck

    • College advice can require extra training or supervised practice to close gaps.
    • Assessment costs are high and mostly non-refundable.

    What it opens up

    • Provisional vocational registration, then vocational (specialist) registration
    SourcesMCNZ - Faster, easier registration for overseas-trained doctors (15 Jul 2025)MCNZ - Registration pathways for IMGs (June 2025)NZ Gazette - Scopes of practice Amendment Notice 2025 (2025-sl1765)MCNZ - Fees Notice 2026
    New Zealand