NRE for Medical Graduates (MBBS)
The National Registration Examination (NRE) is the PM&DC licensing exam for graduates of PM&DC-approved foreign medical colleges. It is held under Section 18 of the PM&DC Act 2022 and exists to gauge whether an MBBS graduate is competent to practise independently. You must pass both components — the theory paper and the Clinical Skills Examination — to obtain a full licence to practise as a General Practitioner. Everything below is taken from the official 2024 Standard, Structure and Syllabus document, which you can download in full.
The essentials
| Item | Detail |
|---|---|
| Who it is for | Graduates of PM&DC-approved foreign medical colleges with an MBBS/MD or equivalent degree (per the approved foreign degree Nomenclature), holding a PM&DC provisional licence |
| Components | Theory (MCQs) + Clinical Skills Examination (CSE) — both must be passed |
| Theory | 200 MCQs, computer-based, targeting higher cognition |
| Theory split | 70% clinical sciences (140 MCQs) · 30% basic sciences (60 MCQs) |
| CSE | OSCE format · 20 stations · approx. 3 hours 30 minutes including briefing |
| Pass mark | 60% in theory and 60% in the CSE, each passed separately |
| Negative marking | None in either component |
| Frequency | At least twice a year, at multiple centres across Pakistan |
| Attempts | No bar on the number of attempts at the complete NRE |
| Validity | Theory pass valid 5 years; the CSE must be passed within those 5 years |
The passing rules that catch people out
- You must clear the theory component before you are eligible to sit the CSE at all.
- There are three mandatory stations in the CSE. You must clear all three — scoring an aggregate of 60% or above but failing even one mandatory station means you fail the entire CSE.
- Fail the CSE having already passed theory, and you re-register for the CSE only. But after three consecutive CSE failures you must sit both components again on the fourth attempt.
- Angoff’s method is used to standardise the examination, so the raw pass mark is set against expected candidate performance rather than a fixed curve.
- PM&DC may change CSE duration, station count and pass percentage, but must notify any change on its website at least 12 weeks before the CSE begins.
Clinical sciences weightage — 70% (140 MCQs)
How the clinical half of the theory paper is distributed:
| Discipline | No. of MCQs |
|---|---|
| Medicine and Allied | 52 |
| Surgery and Allied | 48 |
| Obstetrics & Gynaecology | 14 |
| Paediatrics | 14 |
| Ophthalmology (Eye) | 6 |
| Otorhinolaryngology (ENT) | 6 |
| Total | 140 |
Applied basic sciences weightage — 30% (60 MCQs)
As printed in the official document. Note the arithmetic: the per-discipline figures below add up to 56, while the stated total is 60 (which is what 30% of 200 gives). PM&DC’s table does not reconcile — treat the discipline figures as indicative of emphasis rather than exact counts, and confirm against the current notification.
| Discipline | No. of MCQs |
|---|---|
| Applied Pathology | 11 |
| Applied Anatomy | 11 |
| Applied Physiology | 10 |
| Clinical Pharmacology | 8 |
| Applied Biochemistry | 6 |
| Community Medicine | 6 |
| Forensic Medicine & Toxicology | 4 |
| Total (as printed) | 60 |
CSE station distribution — 20 stations
Each station is 8 minutes with 2 minutes for changeover. The CSE assesses interpretation of clinical and diagnostic data, formulation of diagnosis, development of management plans, examination skills and key procedural skills.
| Discipline | Stations |
|---|---|
| Medicine and Allied | 7 |
| Surgery and Allied | 7 |
| Obstetrics & Gynaecology | 2 |
| Paediatrics | 2 |
| Ophthalmology (Eye) | 1 |
| Otorhinolaryngology (ENT) | 1 |
| Total | 20 |
What the syllabus document contains
Beyond the structure above, the official PDF sets out:
- Appendix 1 — the full syllabus for the Applied Basic Sciences component, discipline by discipline.
- Appendix 2 — the full syllabus for the Clinical Sciences component.
- Appendix 3 — the skills and competencies expected of an MBBS graduate and a house officer by the end of house job / internship / foundation year.
- A Table of Specifications (TOS) mapping topics across the disciplines.
Download the official document
PM&DC’s NRE (Medical) Standard, Structure and Syllabus 2024, complete with all appendices.
Frequently asked questions
Who has to sit the NRE?+
Graduates of PM&DC-approved foreign medical colleges holding an MBBS/MD or equivalent degree and a PM&DC provisional licence. Passing it is mandatory for a full licence to practise as a General Practitioner.
Is the NRE the same thing as the NLE?+
They refer to the same PM&DC licensing route for foreign graduates — the examination is notified as the National Registration Examination (NRE) in the 2024 standard, which is the document on this page.
How many MCQs are in the theory paper?+
200, computer-based. 140 come from clinical sciences (70%) and 60 from basic sciences (30%).
What is the pass mark?+
60% in the theory component and 60% in the CSE. Both must be passed separately, and you must clear all three mandatory CSE stations regardless of your aggregate.
Is there negative marking?+
No — there is no negative marking in either component, so leaving a question blank gains you nothing.
How long is my theory pass valid?+
Five years from the date you pass it. The CSE must be passed within that window, and after every three consecutive CSE failures you have to sit the entire NRE again.
How many times can I attempt it?+
There is no bar on the number of attempts at the complete NRE.
More National Registration Examination (NRE / NLE) guidance
Know the rules. Now practise.
Understanding the exam is step one. Drill past-paper style MCQs with detailed explanations and track your accuracy by subject.
Practise NRE / NLE MCQsGuidance is provided for candidates' convenience and is not an official CPSP publication. Always confirm current rules and criteria at cpsp.edu.pk.