NZREX Clinical
NZREX Clinical is a standardised OSCE administered by the Medical Council of New Zealand, for overseas-trained doctors not eligible through another pathway. Passing it does not grant registration — you must then secure a PGY1 position.
Check the pathway guidance page first. If you hold full PLAB, or qualified and interned in the UK or Ireland, or have practised recently in one of 29 recognised health systems, you may not need this exam.
Exam Specification
| Feature | Details |
|---|---|
| Exam type | OSCE |
| Active stations | 12 |
| Linked stations | 2 of the 12, linked to pre-reading |
| Station duration | 12 minutes: 2 minutes reading + 10 minutes in station |
| Total exam time | Approximately 3 hours |
| Rest stations | 2–4, unscored |
| Weighting | All 12 equally weighted |
| Location | Auckland only |
Sittings and Capacity
For 2025, MCNZ ran three sittings — 8 March, 14 June and 13 September — 60 places each, 180 in the year.
For 2026–27 the current page lists 5 September 2026, 6 March 2027 and 4 September 2027 — March and September, with no June sitting.
Check the live schedule before planning. The difference between two and three sittings can move a start date by six months.
Content Blueprint
Official — seven assessed domains: Communication · Professionalism · Cultural safety · History taking · Physical examination · Investigations and clinical reasoning · Management.
Communication, professionalism and cultural safety are assessed at every station. Each station also assesses three of the other four.
| Primary competency | Cases |
|---|---|
| History taking | 3 |
| Clinical examination | 4 |
| Investigating | 2 |
| Management | 3 |
| Clinical reasoning | 4 |
These total 16 across 12 stations because several stations carry two primary competencies.
At least one case each in child health, mental health and women's health.
Eligibility and Prerequisites
An acceptable primary medical qualification from a school listed in the World Directory of Medical Schools, plus one prerequisite exam passed within five years of your allocated NZREX date: PLAB Part 1 · MCCQE Part I · AMC MCQ · USMLE Step 1 and Step 2 CK.
PLAB Part 1 does two different jobs. Alone it makes you eligible to sit NZREX. With Part 2 it replaces NZREX.
EPIC primary-source verification is required before applying. An application made before verification is treated as incomplete and will not be accepted.
Passing Standard and Validity
No fixed percentage pass mark. The exam uses a criterion-referenced, contrasting-groups method. Five-year average pass rate: 66%. A pass is valid 5 years from the exam date.
After You Pass
You must secure a PGY1 position with an accredited prevocational training provider. MCNZ states that passing NZREX does not guarantee employment and that the number of PGY1 roles is limited and outside its control.
Provisional general registration then carries a two-year prevocational training requirement — PGY1 and PGY2 — under a prevocational educational supervisor. Registration is the start of a supervised period, not the end of the process.
New Zealand runs an Advanced Choice of Employment scheme for allocating PGY1 posts.
Fees
| Item | Fee (NZD) |
|---|---|
| NZREX application | $860.92 |
| NZREX examination | $4,966.94 |
| Provisional general registration — NZREX graduates | $387.11 |
| Annual practising certificate | $1,000.00 |
| Disciplinary levy | $275.00 per 12 months |
All from the fee schedule effective 1 July 2026. Other pathways pay more for provisional registration.
What we offer
NZREX Clinical preparation mapped to the official seven domains, with OSCE-style simulated-patient stations at the 12-station format, examiner-style rubrics and cultural safety training.
If you are taking one of the prerequisite examinations: