Registration exam (NZREX)
NZREX and COVID-19
Please note that New Zealand's COVID-19 status may affect the Council's ability to hold the NZREX exam. If you are currently living outside New Zealand, please note the current New Zealand border restrictions which apply to non-New Zealand permanent residents and citizens.
If you are currently living outside New Zealand, please note the current New Zealand border restrictions which apply to non-New Zealand permanent residents and citizens.
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 possibility 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.
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.
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 New Zealand.
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 for the NZREX Clinical date you are allocated to (not the date your application is submitted).
- 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)
Have passed one of the following examinations within 5 years of the NZREX Clinical date you are allocated to:
- Do not hold New Zealand registration within a Special purpose scope of practice (post-graduate training) scope of practice.
There is no flexibility with Council’s eligibility requirements.
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.
How to apply to sit the exam
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. Where possible, we will confirm English language and knowledge examination results with the issuing organisation.
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 email@example.com.
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 prerequisite criteria to apply 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. Please note, Council is currently consulting on a proposed examination fee increase . If you are allocated to an examination after 1 July 2021, your examination fee will increase to a total not exceeding $3870.66.
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 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.
NZREX Clinical – Dates and location
The NZREX Clinical is held in Auckland, 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 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.
6 November 2021 - Exam cancelled due to COVID-19
26 March 2022 - THIS EXAM IS NOW FULL
18 June 2022 - THIS EXAM IS NOW FULL
10 September 2022 - positions currently available
You can only apply for an examination that has positions available. If your application for an examination date is unsuccessful, 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 is very unlikely, but we reserve the right to cancel an examination if there are insufficient candidates. 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%.
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.
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. 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 the exam
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. Specifically:
- 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 examination (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.
- You can only transfer to a future exam if you continue to meet the prerequisite criteria for that exam.
- You can only apply to transfer into an exam that has 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.
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 (DHB). DHBs 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 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.
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.