Registration exam - NZREX Clinical
You are required to sit and pass NZREX Clinical, our registration examination, if you are not eligible for registration under any other pathway.
Council notes that there are a limited number of internship positions available for NZREX candidates and advise that if you are thinking about applying to sit the NZREX Clinical, we strongly recommend that you gather sufficient information on your employment prospects before applying to sit the NZREX Clinical. We recommend contacting your preferred District Health Board (DHB) to make your initial enquiries. Please also note that we do not hold information on your chances of employment or how long it will take you to find employment once you have sat and passed NZREX Clinical.
- About NZREX Clinical
- Eligibility requirements
- Structure and content of NZREX Clinical
- Preparing for NZREX Clinical
- How to apply
- Application forms
- Location of the exam
- Examination dates
- Fees for NZREX Clinical
- Examination marking and results
- Withdrawal process
- Examination date change / transfer
- Getting registered after sitting NZREX Clinical
- For further information / Policies
By passing NZREX Clinical, we know you are competent to have provisional registration in New Zealand. All doctors wanting to practise medicine in New Zealand must first gain registration from us.
A pass in NZREX Clinical is valid for 5 years from the date of the examination.
To find out if you need to sit NZREX Clinical as part of your pathway to gaining registration in New Zealand, use our Registration self assessment tool.
You are eligible to apply to sit the NZREX Clinical examination if you:
- hold a primary medical degree from a university medical school listed in the World Directory of Medical Schools.
- satisfy Council’s English language requirements.
- have passed one of the following within the last 5 years
- Professional and Linguistic Assessments Board (PLAB) test Part 1
- Medical Council of Canada Qualifying Examination (MCCQE) Part I
- Australian Medical Council MCQ
- United States Medical Licensing Examination (USMLE) Steps 1 and 2 (Clinical Knowledge). Please note that all results, including both USMLE Steps, must be within 5 years of the exam date you are sitting.
- do not hold New Zealand registration within a Special purpose scope of practice (post-graduate training) scope of practice.
There is no limit to the number of times you can sit this examination, however, you must meet our eligibility requirements each time you apply.
While it is not a requirement, we recommend you complete a minimum of 12-months postgraduate experience as a medical practitioner in your own country before applying to sit NZREX Clinical. With this experience you will be better prepared to sit our examination.
We use the 'Objective Structured Clinical Examination' (OSCE) format. There are 16 stations to be covered during the 3 hour examination. All stations in NZREX Clinical are weighted equally.
The primary competencies tested include:
- history taking
- clinical examination
- clinical reasoning
Secondary competencies will also be examined, such as requiring you to undertake a focused examination or focused history. You may also be asked to present a preferred diagnosis, management plan, and investigations to the examiner.
Your communication skills and professionalism will also be assessed.
Please refer to the sample questions for NZREX Clinical to see the marking scheme used.
The NZREX Clinical handbook has more detailed information about the examination.
Download NZREX Clinical handbook for candidates (May 2018, 437 KB)
Refer to our sample questions and reading list to help with your examination preparation.
You may be able to do a ‘clinical observership’ with the DHB of your choice. Observerships are organised by the DHB and you will need to approach them directly if you are interested in taking part.
You must apply in writing using the correct forms below. Full payment of the fee must be included with your application if you are paying via cheque or bank draft. If you are paying via credit card you can do this online and we will provide you with further instruction on how to do this once we have received and processed your application – refer to section 7 of the NZREX1.
You must send your application to us by post or courier – we do not accept applications sent by email or fax.
Once you are sure you satisfy the application criteria, please send your completed application to us at:
Professional Standards Coordinator (Examinations)
Medical Council of New Zealand
PO Box 10509
We will confirm by email the receipt of your application, within 5 working days of receiving your application.
We need up to 20 working days to process your complete application. If your application is incomplete it may be returned to you or we may need more time. Once we’ve processed your application we will write to you advising of the outcome of your application.
The form(s) you need to complete depend on your particular circumstances.
If you are applying to sit NZREX Clinical for the first time, please complete forms NZREX1 and NZREX3.
Repeat candidates need only to complete the NZREX4.
Download NZREX1 - for new candidates (September 2018, 499 KB)
Download NZREX3 - checklist (September 2018, 412 KB)
Download NZREX4 - for repeat candidates (September 2018, 476KB)
Download NZREX5 - withdraw from an examination (September 2018, 389 KB)
Download NZREX6 - examination date change (June 2018, 308 KB)
Download NZREX7 - recount of result (August 2015, 389 KB)
The NZREX Clinical is held in Auckland, New Zealand.
After you have confirmation of your acceptance into the examination, you are responsible for arranging your own transportation and accommodation. We recommend you do not make travel arrangements prior to receiving our confirmation letter or email.
The examination dates and associated application closing dates are below. While closing dates are provided, we expect that our exams may be full well in advance of the closing dates.
22 June 2019
THIS EXAM IS NOW FULL.
2 November 2019
THIS EXAM IS NOW FULL.
21 March 2020
We are currently accepting applications for the March 2020 NZREX Clinical examination. THIS EXAM IS NEARLY FULL
20 June 2020
We are not accepting applications for this exam at present.
Whenever there are too many applications for an examination date, candidates will be informed by email and offered the next available examination date. If available, you may also be offered a position on the waitlist for the exam which is already full. This means that if a candidate withdraws from the exam and you are next on the waitlist you will be offered this available space. However, the waitlist is at our discretion and we will only communicate with you about this on processing your application.
Please note we do not provide updates on your waitlist status even if you enquire. We will only contact you to offer you a position that has become available (this can happen at any time before the exam is due to take place).
In the unlikely event there are insufficient candidate numbers, we reserve the right to cancel an examination. In this situation, candidates would be informed in writing and moved to the next available examination date.
It is important to note we will not accept any applications received after the closing date.
Please see our fees list for the current NZREX Clinical application fee, and the NZREX Clinical examination fee.
The average pass rate over the last 5 years is 60% although this fluctuates.
Electronic marking will be introduced to NZREX Clinical from the June 2018 examination onwards. Examiners will enter candidate marks on a tablet, which will calculate candidates’ results. The supplier of the system, MaxInity, is based in the United Kingdom and is experienced in delivering OSCEs electronically.
We expect to email your results to you within 10 working days after you sit NZREX Clinical. Please note we cannot give results over the telephone.
Your final mark will either be ‘competent’ or ‘not yet competent’.
If you have concerns about the examination process, your results, or you feel you have been disadvantaged due to a temporary impairment, please read our policy and refer to page 13 of the NZREX Clinical Handbook.
We do not provide feedback to candidates who pass. Limited feedback is given to candidates who are found to be ‘not yet competent’, in order to indicate areas where improvement may be needed. This feedback will show you how you ranked overall against other candidates who sat the same exam as you, however we do not provide results per station as the NZREX Clinical is intended to be a summative assessment, not a formative one.
If after having sat NZREX Clinical you consider that your results do not accurately reflect your performance in the examination, you may request to have your results recounted.
Please note that the recount process only looks at whether your marks were correctly transcribed - the allocation of marks given to you by an examiner in individual stations may not be reassessed or altered as part of the recount.
Applications for a recount must:
- be lodged in writing, no more than 10 working days after receipt of written feedback from the Council office
- include specific reasons for requesting the recount, based on the feedback provided
- complete an NZREX7 form.
Re-applying to sit NZREX Clinical
We will not accept any applications to re-sit NZREX Clinical until the candidate has received their result and feedback.
You can withdraw from the examination in certain circumstances. A refund of your application fee is dependent on the timing of your withdrawal.
Applications for withdrawals must be made using our application to withdraw from an examination form.
Council’s fee schedule
If you have been accepted to sit NZREX Clinical and you can no longer attend on your confirmed date, there is an option to transfer your position to a later exam.
You can only transfer into a future examination if you continue to meet the application criteria for that exam. Furthermore, you can only apply to transfer into an exam with positions available. Sufficient notice must be given for transferring (more than 6 weeks’ notice before your scheduled exam) and you will be required to pay an administration fee.
Applications to change your examination date must be made using our ‘application to change examination date’ form.
Download Application to change examination date (PDF)
Information on how to register as a doctor in New Zealand is sent to all candidates who receive a ‘competent’ (pass) result for NZREX Clinical.
Please note: there is no guarantee of employment for doctors who have sat and passed NZREX Clinical. Statistics around NZREX Clinical pass rates and subsequent registration can be found below.
Download NZREX Clinical - Pass rates and subsequent registration (2019)
Doctors who have sat and passed NZREX Clinical will need to seek employment at an accredited training provider (DHB) prior to applying for registration.
Once you receive a job offer you can apply for registration in a provisional general scope of practice. You will be required to participate the intern training programme provided by your employer and meet the prevocational medical training requirements set by Council. For further information about these requirements please click here.
Prevocational medical training applies to graduates of New Zealand and Australian accredited medical schools and doctors who have sat and passed NZREX (interns). Interns must work at a Council accredited training provider (DHB) in accredited clinical attachments under the supervision of a prevocational educational supervisor. Prevocational medical training requires each training provider to deliver a 2-year intern training programme with specific requirements for postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2).
Although the intern training programme is for two years, you can apply for a general scope of practice once you have met the requirements (usually after one year).
For details about the prevocational training programme and the requirements for a general scope of practice please refer here.
Our NZREX Clinical handbook has more information about this examination. You may also wish to learn more about our policy for NZREX Clinical scopes of practice and how to register.