Healthcare licensing exams in Pakistan: NRE, FCPS and nursing boards

Medical and health education in Pakistan

Medicine in Pakistan is a five-year MBBS, and dentistry a four-year BDS, each followed by a compulsory one-year house job (internship) in a recognised hospital. Well over a hundred public and private medical and dental colleges teach in English. The Pakistan Medical and Dental Council (PM&DC) recognises colleges and regulates entry, and graduates are admitted through the MDCAT admission test. Pharmacy is a five-year Pharm.D., and nursing is a four-year BSN, with diploma routes through the provincial nursing boards.

The house job is the link to licensing. Local graduates complete it and then register with PM&DC, with no national licensing exam. Provisional registration is granted at the start of the house job, and full registration follows. The exam that matters is for Pakistanis who qualified abroad: the National Registration Examination (NRE) in two steps. Postgraduate training goes through the College of Physicians and Surgeons Pakistan (FCPS). Confirm current requirements with PM&DC.

Most countries ask one question of a new graduate: have you passed our licensing exam? Pakistan asks a different one: where did you qualify? The answer decides which of two very different routes you take, and the route for graduates of Chinese, Central Asian and Russian medical schools is one of the largest licensing cohorts in South Asia.

Who needs a licensing exam in Pakistan

The split is by place of training, then by profession.

• Doctors and dentists trained in Pakistan: register with PM&DC after the house job. No licensing exam. A National Licensing Exam for local graduates ran under the former Pakistan Medical Commission (1,470 candidates sat Step 1 in 2021-22, of whom 306 were local) but was dropped when PM&DC was restored in 2023. Confirm the current rule with PM&DC before you rely on this.
• Doctors and dentists trained abroad: Pakistani nationals with a foreign MBBS or BDS sit the NRE, which PM&DC conducts through the National University of Medical Sciences (NUMS).
• Nurses and midwives: licensed through the Pakistan Nursing & Midwifery Council (PNMC) and the four provincial Nursing Examination Boards.
• Pharmacists: registration by qualification with the provincial pharmacy council; no national exam found.
• Physiotherapists: registration with the Allied Health Professionals Council (AHPC); no exam announced.

Doctors: the National Registration Examination (NRE)

The NRE is the exam that matters for the Pakistani diaspora of medical students. PM&DC announced 7,076 registrations for the December 2025 Step I sitting (6,989 medical and 87 dental), and about 2,675 candidates appeared in August 2023. It runs twice a year.

Regulator: Pakistan Medical & Dental Council, with NUMS as the conducting body. Language: English. Format: Step I is a multiple-choice theory paper across basic and clinical sciences. Step II is the Clinical Skills Examination: 20 OSCE stations over 3 hours 30 minutes. Both steps need 60%.

Who is eligible: Pakistani nationals holding an MBBS or BDS from a foreign institution, which in practice means China, Central Asia, Russia and similar destinations. Pass rates for some source countries have been reported as low, so treat Step I as a serious test of recall and not a formality.

1. Check recognition. Confirm that your foreign school is on the PM&DC list of recognised institutions.
2. Apply for Step I. Submit documents through the PM&DC announcement for the current session.
3. Pass the Step I theory paper. Sixty per cent.
4. Sit Step II. The 20-station clinical exam, separate application.
5. Complete the house job and register. Follow the council’s current rules on internship for foreign graduates.

Dentists: the NRE (Dental)

Pakistani nationals with a foreign BDS sit a dental version of the NRE. The theory paper has 200 MCQs, is paper-based, carries no negative marking and needs 70%. The clinical skills examination (CSE) uses 15 OSCE stations plus 3 long stations, also with a 70% pass mark. The cohort is small: 87 registered for Step I in December 2025. Local BDS graduates register by qualification after the house job. For postgraduate dental training, the entry exam is FCPS Part I at CPSP.

Postgraduate entry: FCPS Part I and MDCAT

Two exams sit around the licensing system without being licences.

• FCPS Part I (CPSP): the College of Physicians and Surgeons Pakistan runs a specialty-specific MCQ (single best answer) exam for MBBS graduates entering residency. It is also the first hurdle on the way to FCPS Part II. The question count varies by specialty; the CPSP prospectus on the trainee e-portal is the authority. MCPS and provincial residency tests also exist.
• MDCAT: the Medical & Dental College Admission Test is an admission test, not a licence. In 2025 it had 180 MCQs (biology 81, chemistry 45, physics 36, English 9, logical reasoning 9) in 3 hours with no negative marking. Pass marks were 55% for MBBS and 50% for BDS. There were 140,071 registrations and a single sitting on 26 October 2025.

Nurses and midwives: PNMC and the examination boards

The Pakistan Nursing & Midwifery Council sets standards under the PNMC Act 1973. The Nursing Examination Boards in Lahore, Peshawar, Karachi and Quetta conduct the exams and grant diplomas and licences. Programmes covered include BSN, Post-RN BSN and diploma nursing, plus midwifery, Lady Health Visitor (LHV) and community midwife cadres.

The PNMC website carries a Licensing Exams section, and a 2022 notice shows an objective (MCQ) format for the licensure exam for Family Welfare Workers. We could not confirm blueprint, question counts or a single national format across all four boards, so check the board that covers your programme. Foreign-trained nurses seek equivalence through PNMC.

Pharmacists and physiotherapists

There is no licensing exam for either group on current evidence. Pharm-D graduates register in Category A with the provincial pharmacy council, and foreign-qualified pharmacists need degree recognition from the Pharmacy Council of Pakistan. The council’s site blocks automated access, so verify directly. Physiotherapists (DPT) and other allied professionals must register with the AHPC. Reports in February 2026 said registration was mandatory by 30 June 2026 and that unregistered staff could not be employed. No exam has been announced, and we could not confirm an official AHPC web address.

Exams in Pakistan at a glance

Language and recognition routes

Every exam named here is delivered in English, and the NRE has no separate language test. Recognition is the real question for foreign graduates. PM&DC decides which overseas institutions it recognises, and the NRE opens the door only for graduates of recognised schools. Pakistanis who plan to work in the Gulf or the UK later should note that those regulators have their own routes (Dataflow and Prometric in the Gulf, PLAB in the UK), and a PM&DC registration is usually a prerequisite for them.

TriagePass is an independent study platform and is not affiliated with PM&DC, NUMS, CPSP or PNMC.

Last reviewed October 2026