Who Must Pass the NRE? PMDC Rules for Foreign Medical Graduates Explained

Every few months the same questions appear in FAME's inbox: "I graduated from China, do I need the NRE?", "Is Step-II an OSCE?", "Can I do my house job first?". The rescheduling of the October sitting to 8 November 2026 has brought them back. This article sets out what the National Registration Examination is, who it applies to and where it sits in the path to a Pakistani licence, using the council's own notices and recent reporting.

What the NRE is

The National Registration Examination is the examination that foreign medical and dental graduates must pass to be registered by the Pakistan Medical and Dental Council (PM&DC). It exists under the PM&DC Act 2022, and the council describes it as a measure for transparency, standardisation and quality in medical and dental practice. The examination has two steps and, according to the council, is held at least twice a year. The council has handed the conduct of the NRE to the National University of Medical Sciences (NUMS) in Rawalpindi, a decision it explains in terms of credibility, integrity and transparency.

Who has to sit it

The requirement applies to graduates of foreign medical and dental institutions who want to practise in Pakistan. Dawn's 7 October report, citing the council, puts it this way: foreign graduates whose degrees were obtained in a language other than English must clear both steps of the NRE before starting their house job and before obtaining a licence. In practice, most candidates are Pakistani students who studied abroad, with China, Kyrgyzstan, Russia and several Central Asian and Caribbean countries well represented at recent sittings.

Graduates of PM&DC-recognised Pakistani colleges do not sit the NRE; their route is the usual provisional registration followed by house job and full registration. If you hold a foreign qualification and are unsure whether an exemption applies to you, the council's registration department is the only body that can confirm it; prep providers, including FAME, cannot.

Step-I and Step-II in one paragraph each

Step-I is the written step: a multiple-choice examination that samples the basic and clinical sciences a new graduate is expected to know. Registration opens on the NRE portal (nre.pmdc.pk) before each sitting and closes several weeks before the exam; the September 2026 window was extended once and is now closed. The next Step-I is on Sunday 8 November 2026, after the council moved it from 11 October.

Step-II is the clinical step, taken after Step-I. The council's notice about the November date says nothing about Step-II, so candidates should rely on the portal's own announcements for its schedule. FAME's earlier guide on NRE Step-II document verification covers the paperwork side.

Where the NRE sits in the licensing path

1. Degree from a foreign institution, with the documents the council asks for (transcripts, degree, verification of the institution).
2. NRE Step-I: registration on the portal, fee, exam, result.
3. NRE Step-II: the clinical assessment.
4. Provisional registration and house job in a PM&DC-recognised hospital.
5. Full registration, and from there the postgraduate route of your choice (FCPS, MS/MD, or an overseas licensing exam).

Common misunderstandings

• "The NRE replaces the house job." It does not. The house job comes after the NRE for graduates who must sit it.
• "NUMS sets the rules." NUMS conducts the exam; PM&DC sets eligibility, fees and dates and issues the notices.
• "A postponement reopens registration." The 2026 postponement did not. The portal still reads "Registration is closed".

What this means for you

If you graduated abroad, build the NRE into your timeline from the final year onward rather than discovering it on your return. Registration windows are short, the council changes dates at short notice (as October 2026 showed), and the exam is a basic-plus-clinical sciences paper that rewards steady, question-based preparation rather than a last-minute sprint. FAME's NRE-1 and NRE-2 resources are organised around that reality.

Sources and references

• Dawn, 7 October 2026: PMDC reschedules NRE Step-1 for foreign medical graduates to Nov 8
• PM&DC public notice: NRE Step-I rescheduled (5 October 2026)
• PM&DC public notice: extension of the NRE registration portal (9 September 2026)
• Pakistan Medical and Dental Council Act 2022 (Gazette of Pakistan)