Working as a Doctor in New Zealand: MCNZ Pathways and NZREX

New Zealand registers doctors through the Medical Council of New Zealand (MCNZ). International medical graduates (IMGs) enter through one of several pathways depending on where they trained, where they have worked and which exams they have passed. For those who fit no other pathway there is NZREX Clinical, MCNZ's own clinical exam.

Scopes of practice

MCNZ registers doctors in scopes of practice:

Most IMGs start in a provisional version of the general or vocational scope, under supervision, before moving to the full scope.

Pathways to the general scope

The pathways into the general scope are:

Each pathway has detailed conditions, including how recent your experience must be and what supervision applies.

Vocational (specialist) registration

Specialists trained overseas apply for vocational scope. MCNZ assesses training, qualifications and experience, usually with advice from the relevant New Zealand or Australasian college, and may require a period of supervised practice or further assessment. Outcomes and timelines depend on the specialty.

NZREX Clinical in detail

Who needs it

NZREX Clinical is for doctors who do not qualify through another pathway. For doctors who need to sit the exam, securing a PGY1 job offer after passing NZREX is the only route to registration.

Eligibility

You need:

• An acceptable primary medical qualification.
• Evidence of meeting the English language requirement; IELTS or OET results must be no more than two years old on your allocated exam date.
• A pass, within five years of your allocated exam date, in one of: PLAB Part 1, MCCQE Part I, the AMC MCQ, or USMLE Steps 1 and 2 CK.
• Not holding NZ registration in the special purpose postgraduate training scope.

MCNZ recommends, but does not require, at least one year of postgraduate experience as a doctor in your own country. It applies eligibility strictly; you may sit more than once but must meet the requirements each time.

Format

2027 exam dates

The dates are 6 March 2027 and 4 September 2027. Applications are considered in order of receipt; if you are not assigned to March you are assigned to September, subject to eligibility.

Fees

MCNZ charges separate NZREX application and examination fees, set out in its current fees list.

After passing NZREX

1. Secure a PGY1 position with an accredited prevocational training provider.
2. Apply for registration in the provisional general scope.
3. Complete the employer's intern programme and MCNZ's prevocational training requirements, covering PGY1 and PGY2 within a two-year programme.

Preparing for NZREX

• Use the AMC MCQ as a stepping stone if Australia is also an option. It counts as an NZREX prerequisite and is the first exam on Australia's standard pathway. See the AMC CAT MCQ guide and our AMC MCQ study plan.
• Prepare for cultural safety. It is explicitly assessed. Learn the principles of culturally safe care in New Zealand, including care for Māori patients and the role of Te Tiriti o Waitangi in the health system.
• Practise all station types. History, examination, investigations, management and communication within time limits.
• Simulate the full exam: 12 stations in 3 hours.

New Zealand and Australia

The two systems are linked:

• MCNZ is a competent authority for Australia's Medical Board, with NZREX listed as the relevant assessment. Doctors assessed through NZREX may be able to use Australia's competent authority pathway, subject to its conditions.
• Doctors who passed the AMC exams and hold Ahpra registration have their own general scope pathway in New Zealand.

For the Australian side, read IMG doctor pathways in Australia.

Application checklist for NZREX

1. Confirm your primary medical qualification is acceptable to MCNZ.
2. Have your documents primary source verified before applying; incomplete applications are not accepted.
3. Check that your PLAB 1, MCCQE I, AMC MCQ or USMLE pass is within five years of your target exam date.
4. Check that your IELTS or OET result will be under two years old on the exam date.
5. Apply early, since applications are considered in order of receipt.
6. Plan travel to New Zealand for the exam and keep the September date in mind as a fallback.
7. Start looking for PGY1 positions with accredited providers while you wait for results.

Which route fits you?

• UK or Irish graduate with internship there: check the UK and Irish graduates pathway first.
• Registered in Australia after the AMC exams: use the Australian general registrants pathway.
• Recent work in a comparable health system: read the comparable health system conditions.
• Overseas specialist: apply for vocational scope.
• None of the above: NZREX Clinical, after one of the accepted written exams.

Common mistakes

• Letting the prerequisite lapse. The PLAB 1, MCCQE I, AMC MCQ or USMLE pass must be within five years of your NZREX date.
• Stale English results. IELTS or OET must be no more than two years old on the exam date.
• Applying before verification is complete. MCNZ does not accept applications before required documents are verified.
• Assuming NZREX equals registration. You still need a PGY1 job offer.
• Overlooking a faster pathway. Check the UK/Irish, comparable health system and Australian pathways first.

Prepare with MediFlow

If you are building toward NZREX through the AMC MCQ, MediFlow's Australia medicine track offers free sample questions, and the app supports daily practice wherever you are.