Registration exam (NZREX)
Coronavirus (COVID-19) information
From 17 March 2020, due to the fast changing situation with COVID-19, the Medical Council of New Zealand is not accepting any new applications to sit NZREX.
We will keep our website updated so you will know when applications reopen.
Important note regarding employment opportunities
Before you apply to sit NZREX Clinical, please note the following:
- Even if you pass the exam and are an experienced doctor, it is likely to be difficult for you to secure a postgraduate year 1 (PGY1) training role with a District Health Board (DHB) in New Zealand. The number of PGY1 roles is limited and priority is given to graduates from New Zealand and Australian medical schools.
- Securing a PGY1 role with a DHB is your only pathway to registration as a doctor in New Zealand. This is regardless of your previous experience.
- This means it might take you a long time to gain employment as a doctor in New Zealand. There is a possiblity that you will not obtain a PGY1 role within the 5 years that your NZREX pass is valid.
Please refer to this link which provides data on the numbers of NZREX graduates that gain registration in New Zealand. Please note that this data does not provide information about when (in the 1-5 year timeframe of a valid NZREX pass) the doctor gained employment in New Zealand.
Every doctor in New Zealand must be registered to practise medicine. If you are not eligible for registration under any other pathway, you must sit and pass NZREX Clinical, our registration examination.
About NZREX Clinical
All doctors wanting to practise in New Zealand must be registered by us first. By passing the NZREX Clinical, we know you meet the required standard to be registered to practise in New Zealand. A pass in the NZREX Clinical is valid for 5 years from the date of your examination.
To find out if you need to sit the NZREX Clinical as part of your pathway to gaining registration in New Zealand, use our Registration self assessment tool.
Are you eligible?
You can apply to sit the NZREX Clinical if you:
Hold a recognised primary medical qualification obtained from a medical school listed in the World Directory of Medical Schools . If the medical school is located outside of Canada or the United States of America, the qualification must have been awarded during the graduation years for which the medical school meets the eligibility requirements for ECFMG Certification, as indicated by way of the ECFMG Sponsor Note.
Satisfy our English language requirements.
Have passed one of the following examinations within 5 years of the NZREX Clinical date you are applying for:
- 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)
- Do not hold New Zealand registration within a Special purpose scope of practice (post-graduate training) scope of practice.
You can sit the NZREX Clinical as many times as you like, but you must meet our eligibility requirements each time you apply.
We recommend you complete a minimum of 12-months postgraduate experience as a doctor in your own country before applying to sit the NZREX Clinical. This is not a requirement, but the experience will help you be better prepared to sit our examination.
Structure and content of NZREX Clinical
We use the 'Objective Structured Clinical Examination' (OSCE) format, which will test both your clinical skills and medical knowledge. You will rotate through 16 stations during the 3-hour exam. All stations are weighted equally.
You'll be examined on your:
- clinical examination
- clinical reasoning
The examiners will assess your communication skills and professionalism. You may also be required to undertake a focused history, or present a preferred diagnosis, management plan, and investigations.
Please refer to the sample questions below to see the marking scheme we use.
How to prepare for NZREX Clinical
The NZREX Clinical handbook has detailed information about the examination, take some time to read and understand it.
Our sample questions and reading list will help with your examination preparation.
You may be able to do a ‘clinical observership’ in a hospital to familiarise yourself with the New Zealand health system. These are organised by District Health Boards.
How to apply to sit the exam
You must apply in writing, using the correct application form for your circumstances; you'll see these forms below.
Council only accepts certified copies of original documents. Please do not submit any original documents with your application.
If you’re paying the fee by cheque or bank draft you must include the full payment in New Zealand dollars with your application form. If you are paying with a credit card we will explain how to pay online once we’ve received and processed your application.
You must send your application to us by post or courier – we do not accept applications sent by email.
Once you are sure you meet the application criteria, please send your completed application to us at:
Professional Standards Coordinator (Examinations)
Medical Council of New Zealand
PO Box 10509
Once we receive your application, we'll send you an email within 5 working days, telling you we have it. It may take us up to 20 working days to process your application. If it's missing something, we may return it to you, or we may need more time to process it. Once it's processed, we will email you to tell you what the next steps are.
The form(s) you need to complete depend on your particular circumstances.
If you are applying to sit the NZREX Clinical for the first time, please complete forms NZREX1 and NZREX3.
Repeat candidates please complete only the NZREX4.
Location of the exam
The NZREX Clinical is held in Auckland, New Zealand.
Once you have a confirmed place on an exam, you are responsible for arranging your own transportation and accommodation. It's a good idea to wait for your confirmation email before making travel arrangements.
Examinations are open for applications up to 12 months in advance. Please note that examinations tend to fill well in advance of the closing dates, so don't delay in getting your application in. Exam and application closing dates are below.
21 March 2020
Due to the outbreak of COVID-19 and its increasing impact on public health, the Medical Council of New Zealand reluctantly decided to cancel the NZREX Clinical that was scheduled to take place on 21 March 2020. Council will write shortly to all affected candidates about options for either re-sitting the exam or obtaining a refund.
20 June 2020
Due to the outbreak of COVID-19 and its increasing impact on public health, the Medical Council of New Zealand reluctantly decided to cancel the NZREX Clinical that was scheduled to take place on 20 June 2020. Council will write shortly to all affected candidates about options for either re-sitting the exam or obtaining a refund.
31 October 2020
THIS EXAM IS NOW FULL
27 March 2021 (tentative date)
From 17 March 2020, due to the fast changing situation with Covid-19, the Medical Council of New Zealand is not accepting any new applications to sit NZREX.We will keep our website updated so you will know when applications reopen.
You can only apply for an examination that has positions available. If there are too many applications for an examination date, we will let you know by email and offer you the next available examination date.
If possible, we will offer you a place on the waitlist for an earlier exam. This means that if a candidate withdraws from the exam and you are next on the waitlist, we will offer you the space.
We compile waitlists in the order we receive complete applications, so the earlier we receive your application, the higher your place on a waitlist. A waitlist place is at our discretion; we do not provide updates on your status on the waitlist, even if you ask. We will only contact you regarding the waitlist to offer you a place on the exam, and this can happen at any time before it takes place.
It's very unlikely, but in the event there are insufficient candidates, we reserve the right to cancel an examination. We will write to let you know if this happens.
Fees for NZREX Clinical
Please see our fees list for the current NZREX Clinical application fee, and the NZREX Clinical examination fee.
Exam marking and results
The average pass rate over the last 5 years is 60% although this fluctuates.
Marking for the NZREX Clinical is done electronically. Markers enter candidate marks on a tablet, which then calculates the results. The system supplier, MaxInity, is based in the United Kingdom and is highly-regarded, in delivering objective structured clinical examinations (OSCEs) electronically.
We will email your results to you within 10 working days after you sit the NZREX Clinical. We cannot give results over the telephone.
Your result will show whether you achieved, or did not achieve, the required standard.
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 the NZREX Clinical Handbook.
If you pass, we don't provide feedback to you. If your result is that you did not achieve the required standard, we'll give you some feedback to indicate the areas you need to improve for next time. This feedback will show you how you ranked overall against other candidates who sat the same exam as you.
If you think that your exam results do not accurately reflect your performance in the examination, you may ask to have your results recounted.
Please note that any recount looks only at whether your marks were correctly transcribed - there is no reassessment or alteration of the marks given to you by an examiner at an individual station.
Applications for a recount must:
- be in writing, no more than 10 working days after you have your feedback
- include specific reasons for requesting the recount, based on the feedback we gave you
- be on an NZREX7 form.
Re-applying to sit NZREX Clinical
You cannot apply to re-sit NZREX Clinical until you have received your feedback.
Withdrawing from the exam
You can withdraw from the exam in certain circumstances, whether you receive a refund depends on when you withdraw, see our policy below.
Applications for withdrawals must be made using our application to withdraw from an examination form.
Changing your exam date
If you have been accepted to sit NZREX Clinical and you can no longer do so on your confirmed date, you may be able to transfer to a later exam.
There are a few things to note if you need to do this.
- You can only transfer to a future exam if you continue to meet the application criteria for that exam.
- You can only apply to transfer into an exam with positions available.
- You must give us at least 6 weeks’ notice (before your scheduled exam).
- There is an administration fee.
- Your application must be made using our 'NZREX 6 - Examination date change' form.
Getting registered after sitting NZREX Clinical
If you pass NZREX Clinical, we'll send you information on how to register as a doctor in New Zealand.
Please be aware that passing the exam doesn't guarantee you employment. You can see statistics around NZREX Clinical pass rates and subsequent registration are below.
You'll need a job offer
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 the provisional general scope of practice. You will need to participate in the intern training programme your employer provides, and meet the prevocational medical training requirements set by us.
Prevocational medical training applies to graduates of New Zealand and Australian-accredited medical schools and doctors who have sat and passed the NZREX Clinical (interns).
Interns must work at a Council-accredited training provider (DHB) in accredited clinical attachments under the supervision of a prevocational educational supervisor. This is 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 2 years, you can apply for registration in the General scope of practice once you have met the requirements (usually after 1 year).
Further information and policies
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.