Medical Council of New Zealand (MCNZ): Registration and NZREX

To practise medicine in New Zealand you need to be registered with Te Kaunihera Rata o Aotearoa | Medical Council of New Zealand (MCNZ). MCNZ decides which scope of practice you can be registered in, which pathway applies to doctors trained overseas, and it runs NZREX Clinical, the exam for international medical graduates (IMGs) without another route.

Rules and fees change, so confirm the current requirements with MCNZ before you apply.

Key facts

What MCNZ does

MCNZ describes its role as protecting the public by ensuring that doctors and physician associates are competent and fit to practise. Its day-to-day work includes:

• Registration. Deciding applications for registration and maintaining the registers.
• Standards. Setting standards for doctors and publishing guidance.
• Scopes and qualifications. Defining scopes of practice and the qualifications prescribed for each.
• Information. Publishing annual reports, workforce survey reports and a data dashboard.

Doctors manage their registration through MCNZ's online account system, myMCNZ. From 1 October 2026 MCNZ also regulates physician associates, who have their own provisional and general registration types.

Scopes of practice

New Zealand registers doctors in a scope of practice rather than in a single list. MCNZ describes three main scopes for doctors:

Most IMGs start in a provisional version of a scope. A provisional general scope means practising in a Council-approved position under Council-approved supervision. A provisional vocational scope is limited to three years and also requires supervision and assessment as required. To reach vocational registration, a doctor must hold the prescribed qualification for that vocational scope or hold the corresponding provisional vocational registration and complete MCNZ's change-of-scope requirements.

Pathways for international medical graduates

For the general scope, MCNZ lists four main pathways:

1. Comparable health system. For doctors with recent experience in a health system MCNZ considers comparable. Conditions are set out on the pathway page.
2. UK and Irish graduates. For doctors with a primary medical degree from the UK or Ireland who completed their internship there.
3. Examinations pathway. For doctors who passed NZREX Clinical, or Parts 1 and 2 of PLAB, within the last five years.
4. Australian general registrants. For doctors who passed the Australian Medical Council examinations and are registered with Ahpra.

Specialists trained overseas follow MCNZ's vocational scope pathways, which involve assessment of their qualifications and experience with advice from the relevant medical college.

NZREX Clinical

NZREX Clinical is MCNZ's clinical examination for doctors who do not qualify for another registration pathway. In practice:

• it has 12 equally weighted stations over 3 hours;
• before you sit it, you must have passed one of PLAB Part 1, MCCQE Part I, the AMC MCQ, or USMLE Steps 1 and 2 CK within five years of the exam date;
• a pass is valid for 5 years from the exam date.

MCNZ lists upcoming NZREX dates on its NZREX page (it currently shows 6 March 2027 and 4 September 2027). Applicants not assigned to March are assigned to September, subject to eligibility.

Passing NZREX also counts beyond New Zealand: the Medical Board of Australia lists MCNZ (NZREX) as one of its competent authorities. Because a recognised knowledge exam is required before NZREX, a solid MCQ foundation matters; the MediFlow app has practice questions for several of these exams.

Fees (stand October 2026)

MCNZ publishes its registration fees on its fees page. Fees differ by scope and pathway and are quoted including GST on the website. Check the MCNZ fees page before you apply; NZREX fees are listed on the NZREX page.

Checklist before you apply

• Pathway confirmed. Check whether the comparable health system, UK/Irish graduate, examinations or Australian pathway fits you before considering NZREX.
• Knowledge exam in date. PLAB Part 1, MCCQE Part I, the AMC MCQ or USMLE Steps 1 and 2 CK within five years of your NZREX date.
• Position and supervision. Provisional scopes require a Council-approved position and supervision.
• Specialist route checked. If you are a specialist, read MCNZ's vocational scope pathways, which involve college advice.
• Fees checked on MCNZ's fees page on the day you apply.

Moving from provisional to full scope

Registration in New Zealand usually happens in stages. Doctors on a provisional general scope work in an approved position under supervision before they can move to the general scope, and specialists on a provisional vocational scope have up to three years to complete MCNZ's requirements. Plan your first job with this in mind: the position and supervisor need MCNZ approval, so confirm both before you relocate.

Where MCNZ fits with Australia

New Zealand and Australia have separate regulators, but their systems connect in both directions. Doctors who passed the AMC examinations and hold Ahpra registration have their own general scope pathway in New Zealand, and the AMC MCQ is one of the accepted prerequisites for NZREX. In the other direction, the Medical Board of Australia lists MCNZ (NZREX) as a competent authority. If you are undecided between the two countries, choose your knowledge exam with both routes in mind.

Typical mistakes

• Choosing NZREX when another pathway applies. NZREX is for doctors who do not qualify for another pathway.
• Letting prerequisite exams expire. The required knowledge exam must be within five years of the NZREX date.
• Confusing general and vocational scope. Only vocational scope is permanent specialist registration.
• Assuming a provisional scope is permanent. Provisional scopes require approved positions and supervision.

Next steps

1. Use MCNZ's registration pathways page and its IMG visual guide.
2. Check the general scope pathways.
3. If NZREX applies to you, read the NZREX Clinical page.
4. Compare conditions in Working as a doctor in New Zealand.

Contact and official links

• Website: mcnz.org.nz
• Registration pathways: MCNZ registration pathways
• NZREX: NZREX Clinical
• Fees: MCNZ fees

Contact details are listed on the MCNZ website.