Foreign Medical Graduates in South Africa: HPCSA Route, Internship and Visa (2027)
10.10.2026
Short answer
Foreign medical graduates in South Africa: the HPCSA board exam, the internship queue, community service, visa and every fee in rand, step by step for 2027.
Foreign medical graduates in South Africa: who counts and what changes
In short: A foreign medical graduate is anyone whose medical degree comes from a university outside South Africa. Citizens and foreign nationals follow the same HPCSA steps. They differ in the visa and in the place in the internship queue.
The Council does not ask where you were born. It asks where you graduated, and it checks that university first. If the university is not listed in the World Directory of Medical Schools, the file stops there.
| Question | South African with a foreign degree | Foreign national |
|---|---|---|
| Board exam | Yes | Yes |
| Visa | Not needed | Work visa, for example the Critical Skills route |
| Internship posts | Placed first | Placed after citizens and permanent residents |
| Registration category | Independent practice or public service | Independent practice or public service |
The HPCSA route step by step
In short: Check the university, have the degree verified, have the qualification evaluated, pass the board exam, complete the internship and community service, then pay the annual fee. Each step costs money and time, so file the documents in this order.
- Check the university. It must be listed in the World Directory of Medical Schools.
- Verification of the degree. The degree is verified through the EICS in Philadelphia, which costs about US$150.
- Evaluation of the qualification. SAQA evaluates the first qualification for R2,145.
- Board exam. R12,000 per attempt.
- Internship and community service. Posts are allocated by the Department of Health.
- Annual fee. R3,349 to R3,480 once you are registered.
Every fee, form and deadline is in our HPCSA registration guide. This page is the overview, that one is the checklist.
HPCSA board exam for foreign medical graduates
In short: The board exam has a theory part with multiple-choice questions online. Pass it and you sit the OSCE. UKZN has run the exam since September 2023, and the fee is R12,000 for each attempt.
Pass rates swing. Historically between 60 and 80 percent of candidates pass, but in October 2023 and February 2024 about 70 percent failed. A candidate who prepares for the exam as an afterthought pays for it twice.
Preparation for the exam starts in the clinical years, with a clear view of what the curriculum at your university leaves out. We come back to that in the guide to becoming a doctor in South Africa.
Internship and community service: where the queue forms
In short: Internship posts go to South African citizens and permanent residents first. Between 2019 and 2023 two foreign nationals were allocated a post, out of several hundred applications every year.
| Year | Applications from foreign nationals |
|---|---|
| 2019 | 435 |
| 2020 | 409 |
| 2021 | 520 |
| 2022 | 362 |
| 2023 | 343 |
The table explains why there are two registration categories. Independent practice needs the board exam, an internship and community service. The public service category is open to doctors with at least three years of general practice experience behind them.
If you are a foreign national, treat the internship as the hard part of the plan, and decide how you fill that year before you start the board exam.
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In short: Foreign nationals need a visa, and doctors usually apply under the Critical Skills route. The visa costs R1,520 plus R1,550 at VFS. After the visa is issued you have a 12-month window to complete the HPCSA registration.
The order matters. Start the HPCSA file before the visa application, because the visa clock starts running once it is granted.
What it costs: all fees in rand
| Item | Amount |
|---|---|
| Degree verification (EICS) | About US$150 |
| SAQA evaluation of the first qualification | R2,145 |
| Board exam, per attempt | R12,000 |
| Visa application (foreign nationals) | R1,520 plus R1,550 at VFS |
| Annual HPCSA fee | R3,349 to R3,480 |
If you still choose where to study
The way home is easier to plan before the first lecture than after the last exam. Pick a degree from a university listed in the World Directory, keep every transcript and curriculum document, and ask what the exam at home expects.
Countries, tuition and the way back are in our guide to studying medicine abroad from South Africa, and the programme in Havana is compared with Europe in Cuba versus Europe. South African applicants reach us fastest through the South Africa page.
The author's view
I am a dentist, not a doctor who went through the HPCSA, so I will not tell you what the exam feels like. What I see every year is the family that asks about tuition for ten minutes and about the way home for two.
My view: the internship queue is the real filter for foreign nationals, and no amount of exam preparation changes it. If you are a South African citizen, you hold the strongest card, and the best use of it is to choose a university that fits the file the Council wants to read.
Summary
Foreign medical graduates register with the HPCSA: university check, verification, SAQA evaluation, board exam, internship and community service. Foreign nationals wait behind citizens for internship posts, and the 12-month window after the visa limits the time you have.
Conclusion
Plan the route home while you choose the university. Request your free consultation and send us your matric results, and you will know within 30 minutes where you can start.
Foreign medical graduates in South Africa: 6 questions and answers
Can foreign medical graduates work in South Africa?
Yes, after registering with the Health Professions Council of South Africa. The degree is verified, you pass the board exam and complete an internship and community service.
How much is the HPCSA board exam?
R12,000 per attempt. The exam starts with an online multiple-choice theory part, and the practical OSCE follows when you pass it.
Do foreign nationals get internship posts in South Africa?
Rarely. South African citizens and permanent residents are placed first, and between 2019 and 2023 only two foreign nationals were allocated a post.
Is there a route without the internship?
Yes, the public service category exists for doctors with at least three years of general practice experience.
Which visa do foreign doctors need?
Most apply under the Critical Skills route. The visa costs R1,520 plus R1,550 at VFS, and you have 12 months after it is issued to complete the HPCSA registration.
Does the university have to be on a list?
Yes. The university must be listed in the World Directory of Medical Schools, otherwise the Council does not process the degree.
Further reading
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About the author
Marcel Kloos
Founder and owner of Medschool Experts, federally recognised dentist
Marcel Kloos is the founder and owner of Medschool Experts, a placement agency for medicine, dentistry, veterinary medicine and pharmacy degrees abroad. Since 2021 the team has secured more than 500 study places at 25+ partner universities in Europe and worldwide.
Study medicine abroad: Marcel's own path
Born in Stuttgart, Marcel started his degree late: at 24 he enrolled at the Medical University of Sofia, Faculty of Dental Medicine, and graduated in 2021 from the English-language programme. He went through the same steps his clients face today — nostrification of school certificates, entrance interviews, finding a flat in Sofia and later the recognition of a foreign degree. He is a federally recognised dentist.
What Marcel does at Medschool Experts
Today Marcel lives in Bern and runs Medschool Experts full-time. He visits every partner university in person, negotiates placement agreements directly with faculties and deans, and leads the free consultations in which applicants learn at which university they can start next semester. His YouTube channel on studying medicine abroad has helped thousands of applicants compare universities, costs and recognition.
Topics Marcel writes about
- Study medicine abroad independent of your high school diploma grades: universities, costs and admission
- Study dentistry, veterinary medicine or pharmacy in Europe in English
- Tuition fees and living costs at medical schools in Europe and worldwide
- Recognition of foreign medical degrees in the EU, Switzerland, the UK and the US
- Transferring between medical schools and returning home into a higher semester
All articles by Marcel Kloos are based on first-hand visits to the universities and conversations with current students. Book a free consultation to discuss your own path.
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