New Zealand Pathway Guidance
Before booking an NZREX sitting, work through this page. NZREX Clinical is the fallback route, not the default, and New Zealand opened two new fast-track pathways during 2025.
The Examinations Pathway — full PLAB replaces NZREX
Under an amendment made in March 2025, the Examinations registration pathway accepts full PLAB — Parts 1 and 2 together — as a direct alternative to NZREX Clinical for provisional general registration.
In plain terms: a doctor holding full PLAB does not need to sit NZREX at all.
| Qualification | What it does |
|---|---|
| PLAB Parts 1 and 2 (full PLAB) | Replaces NZREX Clinical |
| PLAB Part 1 alone | Prerequisite to sit NZREX |
| MCCQE Part I | Prerequisite to sit NZREX |
| AMC MCQ alone | Prerequisite to sit NZREX |
| USMLE Step 1 and Step 2 CK | Prerequisite to sit NZREX |
MCNZ's June 2025 IMG Registration Pathways document also lists full AMC — MCQ plus Clinical — as an alternative to NZREX, but that does not appear on the current general-scope webpage. The two MCNZ sources disagree, so the full-AMC alternative is not published here.
Competent Authority Pathway
The criterion is about where you trained, not which register you sit on. MCNZ requires a primary medical degree from the UK or Ireland, and completion of internship in the UK or Ireland. Holding GMC or Irish Medical Council registration on the strength of a degree from elsewhere does not satisfy it.
Comparable Health System Pathway
Criterion: at least 33 months of practice at 20 or more hours a week, within the previous 48 months, in one of 29 recognised countries following a July 2025 expansion:
Australia · Austria · Belgium · Canada · Chile · Croatia · Czech Republic · Denmark · Finland · France · Germany · Greece · Hong Kong · Iceland · Ireland · Israel · Italy · Japan · Luxembourg · Netherlands · Norway · Portugal · Singapore · South Korea · Spain · Sweden · Switzerland · United Kingdom · United States
UK and Australian General Registrant Pathways
Both are active routes to general scope registration, distinct from the Competent Authority route. If you hold general registration with the GMC or with Ahpra, check these first.
Fast-Track GP Pathway
Announced 15 July 2025. For general practitioners qualified in the USA, Canada and Singapore, developed with the Royal New Zealand College of General Practitioners, with a two-month processing target.
Fast-Track Specialist Pathway (VOC4)
| Feature | Details |
|---|---|
| Eligible countries | UK, Ireland, Australia only |
| Eligible specialties | Anaesthesia · dermatology · emergency medicine · general practice · internal medicine · anatomical pathology · psychiatry |
| Processing target | 20 working days |
| Experience | At least 24 months in the specialty at 0.5 FTE or more in the past 5 years, of which 12 months must fall within the 18 months before applying |
| Also required | A consultant or specialist-level job offer |
| Standard vocational applications | Approximately 3 months |
English Language Requirements
Policy effective November 2025.
| Test | Minimum score |
|---|---|
| IELTS Academic | Speaking 7.0 · Listening 7.0 · Reading 7.0 · Writing 6.5 |
| OET Medical | Speaking 350 · Listening 350 · Reading 350 · Writing 300 |
Validity: 2 years, extending to 5 years for repeat candidates resident continuously in New Zealand, Australia, the UK, Ireland, the USA, Canada outside Quebec, or South Africa since their last exam. MCNZ also publishes non-test exemption routes.
Fees by Pathway
The provisional general registration fee is not one number.
| Item | Fee (NZD) |
|---|---|
| Provisional general registration — NZ/Australian graduates and NZREX graduates | $387.11 |
| Provisional general registration — Competent Authority, UK and Australian General Registrants | $619.38 |
| Provisional general registration — Comparable Health System | $1,935.55 |
| Annual practising certificate | $1,000.00 |
| Disciplinary levy | $275.00 per 12 months |
The true recurring annual cost is $1,275, not $1,000. All figures from the fee schedule effective 1 July 2026.
What we offer
Pathway guidance for internationally trained doctors deciding between NZREX and the exam-free routes, including how full PLAB now substitutes for NZREX Clinical.