The NRE Step I pass mark is 60%, which on a 200-item paper means 120 correct answers. It was 70% in 2023 and was lowered in 2024; PM&DC restated 60% in its press release "NRE is a Standard Examination". There is no negative marking. The standard is set with the Angoff method, so your result depends on your own score against a fixed standard, not on how the other candidates performed. Even so, only about one candidate in five passed in December 2025. PM&DC's documents that we reviewed do not state any sectional cut-off or say whether raw marks are scaled.
The rule in one paragraph
The Theory component of the NRE is 200 computer-based MCQs. To pass you need 60%. PM&DC's 2024 syllabus says there is no negative marking and that the Angoff method is used for standardisation. A pass is valid for five years for the purpose of sitting Step II, and there is no limit on the number of attempts at the full NRE. Those are the facts PM&DC publishes. The rest of this page explains what they mean for how you prepare.
What 60% means in practice
| Your correct answers | Percentage | Outcome if raw marks are used |
|---|---|---|
| 110 | 55% | Fail |
| 119 | 59.5% | Fail by one mark |
| 120 | 60% | Pass |
| 130 | 65% | Pass with a margin |
| 140 | 70% | The pass mark in 2023 |
The table assumes marks are raw and each question is worth one mark. PM&DC's documents do not say whether scores are scaled, whether any item is removed after review, or how a borderline score is rounded. Do not plan around a margin of one or two questions. A single wrong answer on a flagged item is the difference between 119 and 120, so build a margin into your practice.
Why a fixed percentage is not "pass 60% of the room"
Angoff standard setting works in a particular way. A panel of experts reviews each question and estimates the probability that a minimally competent candidate would answer it correctly. These estimates are combined across questions to produce a cut score. PM&DC publishes 60% as the standard for this exam. The practical consequences:
- You are not ranked against other candidates. If every candidate in a sitting is well prepared, all may pass; if none is, none will.
- PM&DC publishes the standard as a flat 60%. The documents we reviewed do not say that the percentage changes from one sitting to the next, so plan around 120 of 200.
- What matters is whether you consistently reach the level of a minimally competent doctor across the whole blueprint, not whether you beat a particular neighbour.
"Minimally competent" is not a low bar in this exam. The questions are described as aimed at higher cognition. They are mostly clinical vignettes where you must choose the single best answer, and some answers are partially correct. Recognition from a textbook page is not enough.
History of the pass mark
| Period | Theory pass mark | Note |
|---|---|---|
| 2023 sittings | 70% | Reported by the press when PM&DC reduced it in May 2024 |
| 2024 onward | 60% | Stated in the 2024 syllabus and restated in the PM&DC press release "NRE is a Standard Examination" |
| December 2025 | 60% for new candidates | A PM&DC notice allowed one extra attempt to candidates who had used three chances under the old 70% requirement |
Do not quote 70% as the current rule. Some preparation sites and group chats still do.
What the published results show
A low pass mark has not made the exam easy. The numbers below are those reported from PM&DC releases.
| Sitting | Medical pass rate | Notes |
|---|---|---|
| June 2025 | 25.26% | Reported from the PM&DC result |
| December 2025 | 21.17% | 1,467 medical candidates passed. Overall including dental: 1,473 of 7,076 who appeared, about 20.8% |
The two reports use slightly different totals because they count medical and dental candidates differently. The direction is the same: roughly four candidates in five do not pass in a given sitting. Country-by-country figures are in pass rates by country of graduation.
Why does a 60% bar produce a 20% pass rate? PM&DC has not published an analysis. The likeliest explanations, as our inference, are that many candidates sit after a gap of years, that some foreign curricula differ from the Pakistani blueprint, and that many candidates prepare with recalled questions rather than reasoning practice. None of these is a statement of fact from PM&DC.
Three ways to reach 120
PM&DC sets one overall cut, so different strength profiles can pass. The worked examples below apply our scaled blueprint (medicine 52, surgery 48, obstetrics and gynaecology 14, paediatrics 14, eye and ENT 12, basic sciences 60) to three imaginary candidates. They show the arithmetic, not a prediction.
| Domain (items) | A: clinical strong, basics weak | B: basics strong, clinical weak | C: even |
|---|---|---|---|
| Medicine (52) | 70% = 36 | 50% = 26 | 62% = 32 |
| Surgery (48) | 70% = 34 | 50% = 24 | 62% = 30 |
| Obstetrics and gynaecology (14) | 60% = 8 | 50% = 7 | 62% = 9 |
| Paediatrics (14) | 60% = 8 | 50% = 7 | 62% = 9 |
| Eye and ENT (12) | 50% = 6 | 50% = 6 | 62% = 7 |
| Basic sciences (60) | 50% = 30 | 75% = 45 | 62% = 37 |
| Total (approx.) | 122 = pass | 115 = fail | 124 = pass |
Candidate B is strong where the paper is light. Even 75% in all seven basic-science domains does not compensate for 50% in medicine and surgery, because those two domains carry 100 items. This is why we tell candidates to protect the clinical core first. The totals are rounded per domain and treat each domain as scoring the same percentage across its items, which real candidates will not.
Reading a borderline result
If your marks arrive within a few points of 60%, look at the pattern rather than the number alone.
- Below 55%: content gaps are the main cause. Rebuild with a full plan, not a short revision.
- 55% to 59.5%: you are within about ten marks. The usual causes are two or three weak domains and time lost on hard items. A targeted 8-week plan, with two timed papers, is realistic.
- Close to 60% twice running: add more mixed timed blocks and work on pace. Content may no longer be the main problem.
These bands are our advice. PM&DC publishes no feedback categories.
Negative marking: what its absence changes
PM&DC states that there is no negative marking. That has three consequences.
- Answer every question. An unanswered item scores zero. A guess has a chance of a mark and no penalty.
- Eliminate, then choose. If you can remove two of five options, your chance of a correct guess rises from 20% to 33%. Practise elimination explicitly.
- Use flagging, not skipping. Flag a hard question, pick a provisional answer, and come back if time remains.
Sit a timed PMDC NRE Step I mock exam
Blueprint-weighted questions under exam timing, then a breakdown of your result by domain.
Setting a mock-score target
Practice questions are not the real paper, and your mock score has a spread. We suggest the following working targets. They are our planning rules, not PM&DC figures.
| Stage | Target mock score | What to do if you are below it |
|---|---|---|
| Mid-plan | 55% on mixed blocks | Check which domains drag the average. Revise medicine and surgery first. |
| Three weeks before | 60% to 62% on a full paper | Add two more mixed papers; rework the error log. |
| Final week | 65% or more, twice | Consider whether a later sitting would be wiser than paying for one more attempt. |
A stable 65% on original questions leaves five percentage points (ten marks) for variation between question sets and for the stress of exam day. A score of 61% once is not a safe pass.
After the paper: results and re-totalling
PM&DC publishes Step I results on its website, with detailed marks through the online portal. In recent sittings that has been about three to five weeks after the paper. The 2024 syllabus does not describe how an appeal works, but PM&DC states that re-totalling can be requested. Re-totalling, by its name, is a check of the addition of marks. PM&DC has not described it as a re-marking or a review of the key. If you miss by one or two marks, use the time for the next sitting instead of waiting for a re-total.
For what happens after a pass, including Step II and validity, see after the exam.
What the margin of error looks like
No mock paper predicts your result exactly. If your true knowledge corresponds to 64%, a 200-question paper can still produce a score a few marks either side by chance alone, simply because a different set of topics is sampled. The ten-mark margin we recommend is meant to absorb that sampling variation plus the stress of the real exam. Candidates who sit at 60% to 62% in mocks should regard a pass as a coin-flip, not a certainty.
Choose a pass for PMDC NRE Step I
Basic, Pro and Premium passes for 1, 3 or 6 months. One exam per pass, from $30, no auto-renewal.
Myths to ignore
- "They fail a fixed number of people on purpose." PM&DC publishes a percentage standard, not a quota. We have seen no PM&DC document that sets a pass rate.
- "You need 70%." That was the 2023 mark.
- "Each subject has a separate pass mark." Nothing in the documents we reviewed sets sectional cut-offs for Step I. Step II is different: it has mandatory stations.
- "Wrong answers cost marks." They do not.
Next: the study plan turns the 65% target into weekly work, and the NRE overview shows how the 200 items are distributed.
Frequently asked questions
What is the passing percentage for NRE Step I?
60%. It was 70% in 2023 and PM&DC reduced it in 2024. The current figure is stated in the 2024 syllabus and in the PM&DC press release 'NRE is a Standard Examination'.
How many questions must I answer correctly?
On a paper of 200 questions, 60% is 120 correct answers, assuming one mark per item and raw marks. PM&DC's documents do not say whether scores are scaled.
Is there negative marking in NRE Step I?
No. PM&DC states that there is no negative marking, so answer every question.
What is the Angoff method?
A standard-setting method where expert judges estimate how a minimally competent candidate would perform on each question. The estimates give the cut score. PM&DC says it uses the Angoff method, so you are measured against a standard, not against other candidates.
Is there a separate pass mark for each subject?
None is stated in the PM&DC documents we reviewed for Step I. The 60% applies to the theory component. Step II differs: it requires 60% in aggregate and all three mandatory stations.
Why do so few people pass if the pass mark is only 60%?
PM&DC has not published an analysis. The December 2025 medical pass rate was 21.17% and June 2025 was 25.26%. Our inference is that gaps between foreign curricula and the Pakistani blueprint, long gaps since graduation and preparation by recalled questions all contribute.
Can I ask for my paper to be re-checked?
PM&DC states that re-totalling can be requested. That checks the addition of marks. The syllabus we reviewed does not describe a wider appeal process.
When are Step I results published?
On pmdc.pk, with detailed marks through the PM&DC online portal, roughly three to five weeks after the paper in recent sittings.
What mock score should I aim for?
As a planning rule, a stable 65% or more on two full papers under timed conditions. That leaves a margin of about ten marks over the 120 needed. This is our guidance, not a PM&DC figure.
Does a pass in Step I expire?
A Step I pass is valid for five years for the purpose of sitting Step II. The Clinical Skills Examination must be passed within five years of the theory pass.