Choose your plan by your baseline, not by how much time you wish you had. Take a timed 100-question mixed test first. Below 45% you need the 16-week plan, between 45% and 55% the 12-week plan, and above 55% the 8-week plan. All three plans share the same shape: clinical core first (medicine and surgery are half the 200 marks), basic sciences as clinical correlation, Pakistan-specific programmes and law, then full timed papers. These thresholds are our planning rule, not a PM&DC figure. The pass mark is 60%, there is no negative marking, and the paper is 200 questions in a reported 210 minutes.
Step 1: measure where you are
Do not start with a textbook. Start with a number. In the first three days, complete 100 mixed questions in 105 minutes, spread over all domains in line with the blueprint: about 26 medicine, 24 surgery, 7 each of obstetrics and gynaecology and paediatrics, 6 eye and ENT, and 30 basic-science items. Mark by domain, not only overall.
| Baseline score | Plan | Hours per week | Reasoning |
|---|---|---|---|
| Below 45% | 16 weeks | 20 to 25 | Large gaps in both clinical and basic content. You need to relearn, not only practise. |
| 45% to 55% | 12 weeks | 25 to 30 | Knowledge is present but patchy. Systematic coverage plus questions will close it. |
| Above 55% | 8 weeks | 30 or more | You need targeting and exam technique more than coverage. |
If you work full time, take the longer plan whichever your score suggests. Eight weeks of 30-hour study is not possible alongside a house job or a clinic.
Principles all three plans share
- Medicine and surgery first. Together they are 100 of 200 items (52 and 48). A sound clinical core also makes basic-science vignettes easier, because the stem usually describes a patient.
- Questions every day, from week one. Reading without testing produces familiarity, not recall. Do 20 to 40 questions per day in the system you are revising.
- An error log. For every wrong answer write one line: the fact, and why your chosen option was wrong. Review the log weekly. Most candidates repeat the same twenty errors.
- Pakistani practice, not only textbooks. Learn the local first-line treatment and programme rules: local guidelines you must know.
- Timed practice. 200 items in 210 minutes gives 63 seconds each. Practise 50 items in 52 minutes until the pace is natural.
- No negative marking. Never leave a blank. Flag, move on, and return.
The 16-week plan
| Weeks | Content | Questions |
|---|---|---|
| 1 | Baseline test. Read the 2024 syllabus. Build the weakness map. | 100 baseline |
| 2 to 3 | Basic-science foundations: physiology, biochemistry, anatomy (neuroanatomy and lesion syndromes), as concepts needed for clinical reasoning. | 20 a day |
| 4 to 5 | Pathology (including microbiology, haematology, immunology) and pharmacology. | 30 a day |
| 6 to 8 | Medicine and allied: infections, cardiology, respiratory, GI and liver, renal, endocrine, haematology, neurology, rheumatology, poisoning, psychiatry, dermatology. | 30 a day |
| 9 to 11 | Surgery and allied: trauma, acute abdomen, hepatobiliary, colorectal, vascular, urology, orthopaedics, anaesthesia. | 30 a day |
| 12 | Obstetrics and gynaecology; paediatrics. | 40 a day |
| 13 | Ophthalmology and ENT; community medicine; forensic medicine and toxicology under Pakistani law. | 40 a day |
| 14 | Mixed-subject blocks of 50. Rework the error log. | 100 a day |
| 15 | Two full 200-question papers in 210 minutes. Review every item. | 2 papers |
| 16 | Error log, local-guideline sheet, high-yield list. One light half-paper. Rest the day before. | Light |
The 12-week plan
| Weeks | Content | Questions |
|---|---|---|
| 1 | Baseline test; weakness map; collect the 2024 syllabus. | 100 baseline |
| 2 to 3 | Medicine and allied part 1: infections (typhoid, tuberculosis, malaria, dengue, hepatitis, CCHF), cardiology, respiratory. | 30 a day |
| 4 | Medicine and allied part 2: GI and liver, renal and electrolytes, endocrine, haematology, neurology, rheumatology, poisoning, psychiatry, dermatology. | 30 a day |
| 5 to 6 | Surgery and allied: trauma, burns, acute abdomen, hepatobiliary, colorectal, vascular, urology, orthopaedics, anaesthesia. | 30 a day |
| 7 | Obstetrics and gynaecology; paediatrics. | 40 a day |
| 8 | Basic sciences as clinical correlation: physiology, biochemistry, anatomy. | 40 a day |
| 9 | Pathology, microbiology, haematology, immunology, pharmacology. | 40 a day |
| 10 | Ophthalmology and ENT; community medicine; forensic medicine. | 40 a day |
| 11 | Mixed blocks; error log; two full papers. | 100 a day |
| 12 | Final weak areas; no new topics in the last three days. | Light |
The 8-week plan
This plan assumes the content is mostly familiar and you are polishing weak areas. It is the shortest plan we would recommend, and it works only if you can give 30 hours a week.
| Weeks | Content | Questions |
|---|---|---|
| 1 | Baseline test. Rank domains by marks lost per hour of study required. Medicine and surgery weak areas go first. | 100 baseline, then 40 a day |
| 2 to 3 | Medicine and surgery weak systems only, plus Pakistan infections and trauma/acute abdomen. | 50 a day |
| 4 | Obstetrics and gynaecology; paediatrics; eye and ENT in two days each. | 50 a day |
| 5 | Basic sciences: anatomy, physiology, pathology, pharmacology, biochemistry. Questions first, notes only for errors. | 60 a day |
| 6 | Community medicine (EPI, TB, malaria, dengue, hepatitis, epidemiology and biostatistics) and forensic medicine. | 60 a day |
| 7 | Two full 200-question papers. Review everything. Fill gaps. | 2 papers |
| 8 | Error log, local-guideline sheet, high-yield list. One half-paper mid-week; rest the day before. | Light |
You can check the number of marks each domain carries on the NRE Step I overview, and rank your time using the high-yield topics guide.
Try PMDC NRE Step I practice questions free
Create a free account and answer sample questions with full explanations before you buy a pass.
A week in practice
The rhythm below fits the 12-week plan and can be compressed or stretched.
| Day | Morning (3 hours) | Evening (2 hours) |
|---|---|---|
| Monday to Thursday | New content for one system, with notes limited to one page | 40 questions on that system; log errors |
| Friday | Questions on the week's systems, 60 mixed | Review the error log |
| Saturday | One timed block of 100 mixed questions (105 minutes) | Review block; weak topics list |
| Sunday | Rest or light revision only | Plan next week |
Four weekdays of new content, one consolidation day and one timed test is enough. Seven days of reading does not improve retention; it only extends the plan.
Resources, honestly
You do not need a large library. PM&DC lists a syllabus rather than a book list. Pakistani MBBS students commonly use standard references such as Kumar and Clark or Davidson for medicine, Bailey and Love for surgery, Robbins for pathology, Guyton or Ganong for physiology, Katzung for pharmacology, Park for community medicine and Nelson for paediatrics. Use them as references for the topics you get wrong. Do not read cover to cover.
Avoid shared recalled-question sets. PM&DC writes new items. Such sets teach you to recognise a stem, not to reason, and they often contain wrong keys. A bank of original questions with explanations (ours, or another) is a better use of time. Our questions are original and are not taken from any exam.
A weekly scorecard
Every Sunday, spend ten minutes filling in the same five numbers. If you cannot fill them in, you are not tracking your preparation.
| Measure | Why it matters |
|---|---|
| Questions completed this week | A volume check: most plans need 200 to 500 a week early on and 500 to 700 later |
| Accuracy on new questions, by domain | Shows which domains are lagging; ignore repeated questions, which inflate accuracy |
| Timed block score (100 questions) | The only number that resembles exam conditions |
| Errors logged and reviewed | If errors are logged but never reviewed, they will be repeated |
| Hours studied against plan | Catches a slide before it becomes a missed week |
If you work or train while preparing
Many candidates sit the NRE while working in another job, a clinic or a hospital, often after returning from abroad. Three adjustments help.
- Use the longer plan. Twenty hours a week for 16 weeks is more realistic than 30 hours for 8 weeks.
- Split sessions. Forty minutes of questions before work and an hour in the evening beat one four-hour block on a day off.
- Protect one weekend block. The Saturday timed block is the session that matters most. Do not skip it.
If a workplace shift pattern changes, reduce the number of new topics, not the number of questions.
When the plan goes wrong
- Falling behind by a week. Cut a low-yield topic, not the questions. Forensic medicine at 2% of the paper can be trimmed. Medicine at 26% cannot.
- Mock scores flat for two weeks. You are probably reading more than testing. Reverse the ratio for a week.
- Mock scores fall after a new topic. This is normal. New content lowers accuracy for a few days.
- Mock scores above 65% in week 6. You are on track. Do not add more content; add more timed papers.
- Poor sleep before exam week. Fix it first. A candidate who sleeps six hours and revises ten loses more than they gain.
Sit a timed PMDC NRE Step I mock exam
Blueprint-weighted questions under exam timing, then a breakdown of your result by domain.
The last seven days
Do not learn new subjects in the final week. Review the error log twice, read the local-guideline sheet once a day, and do one half-paper (100 questions) on day five, not day one. On the evening before the paper, check your roll number slip, centre address, travel time and identity documents. The paper is reported at 3 hours 30 minutes, and recent notices asked candidates to report well before the start time, so plan to arrive early. See booking, fees and dates for the process.
Frequently asked questions
How long should I study for NRE Step I?
It depends on your baseline. As a planning rule, a timed 100-question test below 45% suggests 16 weeks, 45% to 55% suggests 12 weeks, and above 55% suggests 8 weeks. These cut-offs are our own guidance, not a PM&DC figure.
Can I pass NRE Step I in one month?
It is possible only if you already score near the pass mark on a timed mixed test and can study full time. For most candidates one month is too short to cover 12 domains and practise full 200-question papers.
Which subjects should I study first?
Medicine and allied (about 26%) and surgery and allied (about 24%) together carry about 100 of 200 items, so start there. Add basic sciences as clinical correlation, then Pakistani community medicine and forensic medicine.
How many questions should I do each day?
Twenty to forty on the system you are revising in early weeks, rising to 60 to 100 mixed questions in the last third of the plan. Timed blocks of 50 questions in 52 minutes train the pace needed for 200 items in 210 minutes.
Should I use recalled NRE questions?
We advise against them. PM&DC writes new items and the pool changes, and recalled sets often carry errors. Use original questions with explanations and review your errors.
How many full mock papers should I sit?
At least two full 200-question papers under 210-minute conditions in the final three weeks, with each error reviewed. Aim for a stable score above 65%, five marks over the 60% pass mark, to leave a margin.
Is there negative marking, so should I guess?
PM&DC states there is no negative marking. Answer every question. If you are unsure, remove options you can exclude and choose the best remaining one.
What should I do in the last week?
No new subjects. Review the error log, the Pakistan-specific guideline sheet and the high-yield list. Do one half-paper early in the week and rest the day before the exam.
Do I need to study differently if I graduated from China, Russia or Kyrgyzstan?
The exam is the same. The gaps may differ. Programmes can teach different guidelines and less on Pakistani programmes such as EPI, NTP and the Lady Health Worker Programme. Use your baseline test by domain to see where your own gaps are.
How many hours a week do I need?
Roughly 20 to 25 hours for the 16-week plan, 25 to 30 for 12 weeks and 30 or more for 8 weeks. If you work full time, choose the longer plan regardless of your score.