Zambia's LEX: abolished, revived and suspended

Medical and health education in Zambia

Medicine in Zambia is taught chiefly at the University of Zambia's School of Medicine, with other public and private universities adding programmes. The degree is a five- to six-year MBChB taught in English, and nursing and allied health are offered at diploma and degree levels. The Higher Education Authority accredits institutions, and the Health Professions Council of Zambia (HPCZ) registers and accredits training for health professionals. The Health Professions Act 2024 now sets the framework.

After graduation, doctors complete a supervised internship before full registration with the HPCZ. Nurses and midwives register with the Nursing and Midwifery Council of Zambia. The link between education and licensing is where Zambia is unusual: a national licensing exam has been introduced, revived and suspended at different points, so a graduate's route can depend on the year they qualified. Confirm the current requirement, and internship length, with the HPCZ.

Zambia's licensing exam has been abolished, revived and suspended

Most countries on this site have a stable exam with an annual calendar. Zambia's story is the opposite. The HPCZ licensure examination, known as the LEX, was abolished in February 2019, then brought back, and the sitting scheduled for October and November 2024 was halted by a court injunction. For candidates, that means the examination is as much a legal question as an academic one.

Anyone planning a sitting should treat the current status as the first thing to verify. This page explains the structure as published, and flags where a court or council decision could change it.

A short timeline

1. Before 2019: the licensure examination existed as a condition of practising.
2. February 2019: the LEX was abolished.
3. Later: it was reintroduced.
4. 2024: the Health Professions Act 2024 set the current legal framework.
5. October-November 2024: a sitting was suspended by an injunction from the Kitwe High Court.

Who needs a licensing exam in Zambia

How the LEX is structured

The published description is two-stage. Candidates sit a theory examination first. Only those who pass the theory proceed to the practical. This matters for planning: failing the theory means you never reach the practical, and the practical cannot be used to compensate.

• Eligible candidates: diploma and degree graduates. Certificate holders are exempt.
• Foreign-trained applicants: sit an assessment examination rather than the standard LEX.
• Legal basis: the Health Professions Act 2024, available on the ZambiaLII legal database.

The Council has not published a detailed blueprint in the sources we reviewed, so item counts, timings and domain weights are unknown. Anyone who tells you the exact structure is relying on candidate recall rather than official sources.

Doctors, pharmacists, dentists and physiotherapists

All four professions fall under the same HPCZ examination. The practical stage will vary by profession: clinical stations for doctors and dentists, dispensing and compounding tasks for pharmacists, and clinical reasoning and handling for physiotherapists. We do not have profession-specific blueprints, so ask the HPCZ for the syllabus for your cadre when a sitting is confirmed.

If you are a foreign-trained doctor, check carefully which assessment you are assigned to. The HPCZ treats you separately from local graduates.

Nurses and midwives: the NMCZ

The Nursing and Midwifery Council of Zambia (NMCZ) licenses nurses and midwives through a licensure, assessment or competence examination for graduates seeking full registration. Foreign-trained nurses may also be assessed. The Council's services page explains the process; the examination format is not published in the material we reviewed.

What to do while the status is uncertain

• Subscribe to the HPCZ and NMCZ notices and check them monthly.
• Keep your documents verified and up to date so you can apply the moment a sitting opens.
• Study by clinical domain rather than by rumour about question styles.
• Be cautious about paid "guaranteed pass" offers; no one can guarantee an exam outcome.

Language and recognition

English is the official language and the language of the examinations. No separate language test applies to Zambian graduates. For foreign-trained applicants, the Council assesses qualifications and requires the assessment examination before registration.

Zambians who plan to work abroad should note that the status of the home examination does not affect foreign tests such as PLAB, the NMC tests or NCLEX. Those remain available on their own timetables.

Where TriagePass fits

We cannot resolve the legal questions around the LEX, but we can help you stay exam-ready. Join the waitlist and we will tell you when Zambian practice content is available. We are independent of the HPCZ and the NMCZ.

How to prepare when the format is not fully published

With no official blueprint in the sources we reviewed, the safest approach is to prepare for the whole undergraduate curriculum with extra weight on the conditions most common in Zambian practice. That means infectious disease including HIV and tuberculosis, maternal and child health, malaria, trauma and surgical emergencies, and non-communicable disease.

• Theory: practise timed single-best-answer and multiple-choice questions, because a theory failure stops you before the practical.
• Practical: rehearse the skills of your cadre with a colleague. For pharmacists, that includes dispensing checks, calculations and counselling.
• Law and ethics: the Health Professions Act 2024 is the law under which you will practise. Read the sections on registration, discipline and professional conduct.

Reading court and council news carefully

The legal dispute around the LEX means information circulates quickly and unevenly. Rely on the HPCZ itself, on published court orders and on the legislation, and treat messaging-group summaries with caution. If you are asked to pay for registration or "guaranteed" slots, check with the Council that the payment is real. Genuine fees are paid through the Council's own channels.

If you trained outside Zambia, remember that foreign-trained applicants sit an assessment examination. Ask the HPCZ in writing whether your route is affected by the injunction and what the current timetable is.

Last reviewed October 2026