NRE Exam for Foreign Medical Graduates in Pakistan: Complete Guide

If you completed your MBBS or BDS abroad and want to practise medicine in Pakistan, you must pass the NRE. Here is every step — eligibility, provisional licence, structure, and preparation.

Who Is Considered a Foreign Medical Graduate?

A foreign medical graduate (FMG) is any person who completed their MBBS, BDS, or equivalent medical degree outside Pakistan. This includes Pakistani nationals who studied abroad — in countries such as China, Russia, Ukraine, Bangladesh, Egypt, or elsewhere — as well as non-Pakistani nationals who wish to practise medicine in Pakistan. The NRE exists specifically for this group; graduates of Pakistani medical colleges follow a different registration route.

The Provisional Licence & Equivalence Process

Before you can sit the NRE, you need a PM&DC provisional licence, issued once your foreign degree and college's approval status are verified against PM&DC's Nomenclature of recognised foreign institutions. This is a separate step that must be completed before NRE registration.

The application typically requires:

Attested copies of your degree and official transcripts
Verification from the medical council or regulatory authority of the country where you studied
A copy of any medical licence or registration issued in the country of study (where applicable)
Your national identity card (for Pakistani nationals) or passport (for foreign nationals)

PM&DC reviews the submitted documents and may request additional information. Processing times vary. Begin this step as early as possible — waiting until you have a specific NRE date in mind often means missing that examination window.

NRE Structure for Foreign Graduates

Once you hold a provisional licence, the NRE itself has two components, both of which you must pass:

Theory paper (NRE Step 1): 200 computer-based MCQs — 140 from clinical sciences (Medicine, Surgery, O&G, Paediatrics, Ophthalmology, ENT) and 60 from applied basic sciences (Pathology, Anatomy, Physiology, Pharmacology, Biochemistry, Community Medicine, Forensic Medicine). Pass mark: 60%.
Clinical Skills Examination (CSE) (NRE Step 2): a 20-station OSCE-format practical exam, roughly 3 hours 30 minutes including briefing. Pass mark: 60%, and all three mandatory stations must be individually cleared.

You must clear theory before you're eligible to sit the CSE — they are not taken together. There is no negative marking in either component. See our full NRE structure and syllabus breakdown for the complete discipline-by-discipline weightage, or the dental NRE structure if you hold a BDS.

Internship Recognition for Foreign Graduates

Foreign graduates who completed their internship abroad may need to have that internship recognised by PM&DC, or may need to complete an additional period of supervised practice in Pakistan. PM&DC's requirements in this area have evolved; check the current rules directly on the PM&DC website, as they can differ based on the country where the internship was completed and the year of graduation.

Challenges Foreign Graduates Commonly Face

Curriculum gaps. Medical curricula vary significantly between countries. Some foreign graduates find they have strong coverage of certain disciplines but gaps in others. Running a diagnostic MCQ session across all disciplines early in preparation is the most efficient way to identify these gaps.
Different MCQ styles. Graduates trained in systems that emphasise essay questions or oral examinations may find the vignette-based MCQ format of the NRE theory paper unfamiliar. Regular timed MCQ practice is the cure — not more reading.
Delayed provisional-licence processing. Start the equivalence application well before you intend to sit the NRE. A delay in document processing can push your exam attempt back by an entire session.

Preparation Strategy for Foreign Graduates

The preparation approach is the same as for any NRE candidate, but foreign graduates should pay particular attention to:

Disciplines that were taught differently or in less depth in their foreign curriculum — commonly Forensic Medicine, Community Medicine, and Pakistan-specific clinical guidelines in Medicine and Surgery
Clinical vignette practice — work through as many vignette-style MCQs as possible to get comfortable with the format before exam day
Past papers — these reveal the specific style and difficulty level of questions PM&DC uses, which can feel different from exams sat in other countries
CSE station practice — since Medicine and Surgery carry 7 of the 20 CSE stations each, prioritise scenario-based practice in those two disciplines first

Begin Your NRE Preparation on HighYield

HighYield's NRE QBank is built for foreign-qualified graduates preparing for the theory paper. It covers every clinical and basic-science discipline with clinical vignette MCQs and detailed explanations. Whether you are just starting to prepare or doing final revision, consistent daily practice is the single most reliable predictor of NRE success. Try 20 questions free to see how the platform works.