How to Gain Medical Registration in New Zealand: A Complete Guide for IMGs

Many IMGs consider New Zealand for its natural environment, safety, and education system—especially those planning for their family’s long-term future.

To practise medicine in New Zealand, you must be registered with the Medical Council of New Zealand (MCNZ) and hold a valid practising certificate.

Below is a clear, updated overview of the main pathways IMGs use to achieve registration.

Main Routes for IMGs to Work as Doctors in New Zealand

Broadly speaking, IMGs typically follow one of the following three pathways:

Pass NZREX Clinical and secure a PGY1 position
Use an existing specialist qualification to pursue Vocational Registration
Register first in Australia (AHPRA), then transfer to New Zealand through recognised pathways

Let’s examine each in detail.

1. NZREX Clinical

NZREX Clinical is an OSCE-style examination used by MCNZ to assess whether IMGs are competent to enter supervised practice as PGY1 doctors.

Key Features

The exam consists of 12 OSCE stations evaluating communication, professionalism, cultural safety, clinical reasoning, history-taking, physical exams, and management.
Eligibility generally requires:
- Proof of English language proficiency (e.g., IELTS or OET)
- Recent completion of a recognised licensing exam such as USMLE, PLAB, AMC, or MCCQE
- Primary Source Verification of medical qualifications
Exam dates are not fixed annually; MCNZ announces them when confirmed.

After Passing NZREX Clinical

Passing the exam is only the beginning. IMGs must then:

Secure a PGY1 position at an accredited training provider
Apply for provisional general registration
Complete the required prevocational training (PGY1, and often PGY2)
Apply for general registration

A major obstacle for many candidates is the limited availability of PGY1 positions, which makes this route challenging despite successful exam performance.

2. Vocational Registration (Specialist Pathway)

IMGs with recognised specialist qualifications may be able to apply for Vocational Registration, allowing them to work as specialists in New Zealand.

Key Points

MCNZ assesses whether your training and experience match New Zealand’s specialist standards.
A specialist qualification alone does not guarantee registration.
Some IMGs may first work in a supervised or fixed-term role, which serves as a transitional period before full vocational recognition.

For experienced specialists, this pathway can be efficient—but requires detailed documentation, strong evidence of training, and a polished CV.

3. Australia First: AHPRA and the Comparable Health System Pathway

A strategic route used by many IMGs is to first obtain registration and clinical experience in Australia, then later transfer to New Zealand.

How This Works

Register with AHPRA in Australia (usually via AMC exams and supervised training)
Complete the required period of clinical practice
Apply for New Zealand registration via pathways recognising comparable health systems or competent authorities

Why IMGs Choose This Route

Avoids the need to sit NZREX Clinical
Australia generally has more available hospital positions for newcomers
Provides the option to practise in both Australia and New Zealand, increasing career flexibility

For IMGs seeking stability and a wider range of opportunities, this pathway is often more predictable than competing for limited PGY1 posts in New Zealand.

English Language Requirements

Regardless of your chosen pathway, strong English proficiency is mandatory.

Most IMGs will need to meet one of the following:

IELTS Academic with required minimum scores
OET with required grades in all sub-tests

These requirements may change, so candidates should always verify the current policy before applying.

Preparing early for OET or IELTS is one of the most impactful steps an IMG can take—long before deciding on the final registration route.

Summary

New Zealand offers excellent clinical experience and a high quality of life, but securing medical registration requires careful planning. IMGs generally consider:

Passing NZREX Clinical and securing a PGY1 post
Leveraging a specialist qualification for Vocational Registration
Gaining AHPRA registration in Australia and transferring later

Whichever route you choose, English proficiency remains essential. For many IMGs, strengthening medical English and starting OET preparation early is the most reliable first step toward practising in New Zealand or Australia.

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Registration & Pathways