Malawi licensing: the nurse and midwife exam, doctors and pharmacists

Medical and health education in Malawi

Malawi's main university health provider is Kamuzu University of Health Sciences (KUHeS), formed from the former College of Medicine and Kamuzu College of Nursing. It teaches medicine, nursing, pharmacy, physiotherapy, dentistry-related and laboratory programmes in Blantyre and Lilongwe. Alongside it sit mission and private nursing and midwifery schools, among them those run by the Christian Health Association of Malawi (CHAM), which supply a large share of the nursing workforce in rural districts.

An undergraduate medical degree takes five to six years and is followed by a supervised internship before full registration. Teaching is in English. Nurse and midwife training is split between degree programmes and shorter diploma or technician-level courses, which is why the NMCM exam names both a "technician" and a "registered nurse" level.

Graduation does not equal registration. A graduate must pass the council's licensure exam, or in the case of doctors complete the internship, before being entered on the register. The council is also the gatekeeper for foreign-trained clinicians, which is the source of much of the confusion on the internet about what Malawi requires.

The NMCM licensure examination

The NMCM holds national licensure examinations for nurse and midwife technicians and for registered nurses. According to our data the exam is a written paper; we found no published detail on the number of items or the pass mark. Midwifery has a separate component that our data describes as multiple-choice plus practical, but that entry is unverified.

The exam matters because the results have been reported publicly. A press report of the April 2016 sitting recorded a pass rate of 16% for candidates trained at CHAM institutions. One report does not make a trend, and results change by year, but it tells you that this is not a rubber stamp and that preparation based only on classroom notes can fall short.

1. Check your category with the NMCM: technician or registered nurse, and nursing or midwifery.
2. Submit your documents: school certificate, clinical record book and identification.
3. Register for the next national sitting as announced by the council.
4. Sit the written paper and, where required, the practical component.
5. Apply for the licence and annual practising certificate once you have passed.

What the exam rewards

The syllabus follows the national curriculum, so the best preparation starts from the Malawi Standard Treatment Guidelines, the national reproductive health guidance and the Ministry of Health protocols for HIV, TB and malaria. Candidates who fail often know the theory but lose marks on dose calculation, referral decisions and the order of actions in an emergency such as postpartum haemorrhage or severe malaria in a child.

• Practise short scenario questions: what do you do first, and why?
• Learn the national immunisation schedule and growth monitoring thresholds.
• Know the danger signs in pregnancy and the pathway for referral from health centre to district hospital.
• Revise infection prevention steps and safe injection practice.

Doctors

The Medical Council of Malawi registers doctors, normally after a medical degree and the internship. Our data states that foreign graduates may face a council assessment, but we could not verify its format, so ask the council. Postgraduate training in Malawi runs through KUHeS and regional bodies such as the College of Surgeons of East, Central and Southern Africa (COSECSA), which is a specialist training route and not a licensing exam.

Pharmacists, dentists and physiotherapists

The PMRA registers pharmacy professionals. Our data reports a registration or qualifying exam for foreign-trained pharmacists, unverified. Dentists and physiotherapists are not covered by a confirmed exam, and registration is by recognised qualification. Because these professions are small in Malawi, requirements are sometimes handled case by case; write to the registrar.

Planning your preparation around the national sitting

National licensure sittings in Malawi are scheduled by the council, and candidates from all schools sit the same paper. That has two consequences. First, you are measured against every other candidate, including those from schools with more resources, so structured revision matters more than hours. Second, you cannot count on a retake date; ask the council how often sittings are held and how many attempts you are allowed.

• Build a twelve-week plan that covers each module of the curriculum once, then spends the final four weeks on practice questions.
• Join a study group from your own class. Candidates from small mission schools often do better when they share past experience of how questions were worded.
• Do dose and fluid calculations every week, not once. They are a common source of lost marks.
• Rehearse clinical decision-making aloud: observation, action, reason, reassessment.

The council can tell you which areas of the curriculum are examined and in what proportion. If it will not publish a blueprint, ask your tutors which topics their students found hardest at the last sitting.

Exam comparison

Language and recognition

English is used for teaching and examinations, and Chichewa is the main language of patient care across much of the country, with Tumbuka, Yao and others in the north and south. Examiners expect you to explain advice in plain language and to take a history that respects those realities. Recognition of foreign diplomas is through the relevant council. Malawi belongs to the Southern African Development Community, but we found no mechanism that makes a Malawian licence valid elsewhere in the region automatically. If you plan to leave, check the target country first.

Last reviewed October 2026