New Zealand Registration Examination (NZREX Clinical)

Route to registration

Before you apply to sit NZREX Clinical, please note:

  1. To be registered after passing the NZREX Clinical, you will need to secure a PGY1 role within a prevocational training provider in Aotearoa New Zealand. It is likely to be difficult for you to secure a PGY1 role as priority is given to graduates from Aotearoa New Zealand and Australian medical schools.
  2. If you need to sit NZREX Clinical, then securing a PGY1 training role with a prevocational training provider is your only pathway to registration in Aotearoa New Zealand. This is regardless of your previous experience.

Data on the number of NZREX Clinical graduates who gain registration in Aotearoa New Zealand can be found here.


Applications for the March 2023 NZREX Clinical are now closed.

Every doctor in Aotearoa 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.

NZREX Clinical

All doctors wanting to practise in Aotearoa New Zealand must be registered by Te Kaunihera Rata o Aotearoa | The Medical Council of New Zealand (Council). By passing the NZREX Clinical, we know you meet the required standard to be registered to practise in Aotearoa New Zealand. A pass in the NZREX Clinical is valid for 5 years from the date of your examination.

Use our registration self-assessment tool to find out if you need to sit the NZREX Clinical as part of your pathway to gaining registration in Aotearoa New Zealand.

Are you eligible?

You can apply to sit the NZREX Clinical if you:

  • Do not hold Aotearoa New Zealand registration within the special purpose postgraduate training scope of practice.

There is no flexibility with Council’s eligibility requirements.

You can sit the NZREX Clinical multiple times, but you must meet our eligibility requirements each time you apply.

We recommend you complete a minimum of one years 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 better prepare you to sit our examination.

NZREX Clinical practice requirement consultation

Between July and August 2022, we consulted on the merits of introducing a requirement that individuals applying to sit the NZREX Clinical must have clinical practice experience and if so, then what that should be. The Council considered the responses to this consultation at its October 2022 meeting. It decided not to introduce any additional eligibility requirements at this time.

See our consultation page for more information.

How to apply to sit NZREX Clinical

You must apply via email, using the correct application form for your circumstances. Links to the application forms are below.

Council only accepts scanned copies of original documents with your application.

A recent passport-sized photo is to be scanned, and you must declare that this has been taken within 4 months of your application.

Please send all applications to

Applications for the March 2023 NZREX Clinical are now closed.

Primary source verification

Your primary medical degree and prerequisite examination results (PLAB, MCCQE, or AMC MCQ) must be primary source verified, through EPIC. These credentials must be verified prior to submitting your NZREX Clinical application. If your prerequisite examination is the USMLE Steps 1 and 2, you must submit a transcript request through the Federation of State Medical Boards (FSMB) to release results directly to the Medical Council of New Zealand.

Any application to sit the NZREX Clinical before the required documents have been primary source verified will be considered incomplete and will not be accepted.

Primary source verification of qualifications (EPIC) | Medical Council (

We will confirm English language test results with the issuing organisation, either IELTS or OET. Make sure the Medical Council of New Zealand has access to your test results.

After you apply

Once we receive your application, we'll send you an email within 5 working days, telling you we have received it and explaining how you should pay the application fee online. We will not start processing your application until the application fee has been paid. This fee is non-refundable and, if you do not meet the requirements to sit NZREX Clinical, you will not be refunded.

Once paid, 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.

At least three months before your examination, we will email you a link to pay your examination fee.

Application forms

The form(s) you need to complete depend on your circumstances.

If you are applying to sit the NZREX Clinical for the first time, please complete forms NZREX1 and NZREX3.

Repeat candidates only need to complete the NZREX4 form.

Structure and content

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:

  • history-taking
  • clinical examination
  • investigating
  • management
  • 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

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 Aotearoa New Zealand health system. These are organised by some accredited prevocational training providers.

Dates and location

The NZREX Clinical is held in Auckland, Aotearoa New Zealand.

Once you have a confirmed allocation to an exam, you are responsible for arranging your own transportation and accommodation. We advise you wait for your confirmation email before making travel arrangements.

Examinations tend to fill well in advance of the closing dates, so don't delay in getting your application in.

Applications for the March 2023 NZREX Clinical are now closed.

It is very unlikely, but we reserve the right to cancel an examination if there are insufficient candidates. We will email to let you know if this happens.


Please see our fees list for the current NZREX Clinical application fee and examination fee.

Exam marking and results

The average pass rate over the last 5 years is 60%.

Marking for the NZREX Clinical is done electronically using the Maxexam exam management system . Examiners enter candidate marks using a tablet. These marks are recorded in our system, which then calculates the results.

Your results

We will email your results to you within 10 working days from when you sat 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. Appeals on the grounds of temporary impairment must be made in writing within 3 working days of the exam.

Exam feedback

If you pass, we don't provide feedback to you. However, if you don't achieve the required standard, we'll give you some feedback to indicate the areas you need to improve on 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. There is a cost for this. Please see our fees page for more information.

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 received 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 NZREX Clinical

If you withdraw from the exam, you may be eligible for a refund of some of the fees you have paid. How much you will be refunded depends on how far in advance of the exam you withdraw.

  • If you withdraw six or more weeks before the date of the exam you are entitled to a refund of your NZREX Clinical examination fee less an administration fee (see fee schedule for more detail).
  • If you withdraw at least 20 working days before the date of the exam (but less than six weeks before), you are entitled to a refund equivalent to 20 percent of your NZREX Clinical examination fee (see fee schedule for more detail).
  • If you withdraw within 19 working days of the date of the exam, you are not entitled to a refund. We will, however, consider requests for refunds in exceptional circumstances. For example, an illness or accident that directly and significantly affects your ability to perform on the day of the exam. 

Our withdrawal policy still applies if you need to withdraw because you're travelling from overseas to sit the exam and your application for a New Zealand Visa is declined. 

Applications for withdrawals must be made using the NZREX5 application form. 

Changing your exam date

If you have been accepted to sit NZREX Clinical and you can no longer attend the exam 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.

  1. You can only transfer to a future exam if you continue to meet the prerequisite criteria for that exam.
  2. You can only apply to transfer into an exam that has positions available.
  3. You must give us at least 6 weeks notice (before your scheduled exam).
  4. There is an administration fee.
  5. Your application must be made using our 'NZREX 6 – Examination date change' form.

Getting registered after passing NZREX Clinical

If you pass NZREX Clinical, we'll send you information on how to register as a doctor in Aotearoa New Zealand. 

To apply for registration after passing NZREX Clinical, you will need to seek employment and receive a job offer as a postgraduate year 1 (PGY1) at an accredited training provider. Training providers are accredited by Council to provide a 2-year training programme with specific requirements for postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2).

This requirement applies to both graduates of Aotearoa New Zealand and Australian-accredited medical schools and doctors who have sat and passed the NZREX Clinical (interns).

Before applying for registration, you need to have key documents verified through the EPIC verification system. The verification process can take time and we cannot process your application until we have received the verification at source.

Te Whatu Ora pilot for Programmes for NZREX graduates

The Minister of Health has announced two pilot initiatives for selected NZREX Clinical graduates to be managed by Te Whatu Ora Health New Zealand. These are:

  1. NZREX Clinical Bridging Programme - The initial pilot will be for a cohort of up to 10 candidates and will be run in the Northern Region (based in Auckland).
  2. General Practice pathway internship - The initial pilot will be for a cohort of 8-10 candidates and will be delivered in partnership with primary care providers in the Waikato region.

See the following page on our website for more information:

Te Whatu Ora pilot for Programmes for NZREX graduates  

You'll need a job offer

Doctors who have sat and passed NZREX Clinical will need to seek employment at an accredited training provider 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 Aotearoa 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 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.