Emigrating as a Doctor to New Zealand: MCNZ Registration, Pathways and Salary in 2026

What does the Medical Council of New Zealand require from an overseas doctor in 2026?

Four things, in every case: an acceptable primary medical qualification verified at source, proof of English, evidence that you are fit for registration, and a New Zealand job offer that comes with an approved supervisor. The job offer is not a formality you attach at the end. The Medical Council will not register anyone into the provisional general scope without a position and a supervisor already approved, because the model assumes you learn the New Zealand system on the ward.

Verification runs through EPIC, the Educational Commission for Foreign Medical Graduates' electronic portfolio service. Your medical school confirms your degree to ECFMG, ECFMG confirms it to the Medical Council, and nothing moves until that chain is running. Start it early. Applications go through the myMCNZ portal, which needs a PIN issued by the Council before you can create an account.

The last step is a registration meeting, held in person, where the Council confirms your identity, talks through the supervision arrangement and takes payment for your practising certificate.

Which countries count as a comparable health system?

Twenty-nine of them, and the list is published. Australia, Austria, Belgium, Canada, Chile, the Czech Republic, Denmark, Finland, France, Germany, Greece, Hong Kong, Iceland, Israel, Italy, Japan, Luxembourg, Norway, Portugal, Croatia, the Republic of Ireland, South Korea, Singapore, Spain, Sweden, Switzerland, the Netherlands, the United Kingdom and the United States. Chile, Luxembourg and Croatia are the newest additions.

The Medical Council of New Zealand builds that list from three measurable things: health system infrastructure such as doctors and hospital beds per head of population, population health outcomes including life expectancy and cause-of-death data, and the strength of medical regulation. Nationality is irrelevant. Where you practised is what counts.

The practice test is specific. You need at least 33 months of clinical practice at a minimum of 20 hours per week, inside the 48 months before you apply, in one or more of those comparable health systems. That practice has to match the New Zealand position in both specialty and level of responsibility, and you need current registration with a regulator in at least one of the countries where you worked. General practitioners have a variant built around a completed postgraduate general practice qualification.

Three years of recent work. That is the shape of it.

How does the competent authority pathway work for graduates of the United Kingdom and Ireland?

The Medical Council recognises exactly two competent authorities: the General Medical Council in the United Kingdom and the Medical Council in Ireland. If your primary medical degree comes from an approved medical school in either country and you completed your internship there as well, you apply through this route. It is the shortest supervised period of the three.

Six months of approved supervised practice, two consecutive satisfactory reports and a supervisor's recommendation move you from provisional general scope to general scope. Half the comparable health system requirement, a quarter of the NZREX route.

The internship is the detail to check first. A UK degree followed by an internship somewhere else does not qualify automatically — the Medical Council assesses that internship separately before accepting an application on this pathway. Degree and internship in the same competent authority country is the clean case.

Who has to sit NZREX Clinical, and what is the exam actually like?

Everyone whose training sits outside the comparable health system list and outside the two competent authorities. NZREX Clinical is the New Zealand Registration Examination, and it is the Medical Council's own clinical assessment rather than a knowledge test bought in from elsewhere.

Before sitting it you need a pass, within the previous five years, in one of four external examinations: Part 1 of the Professional and Linguistic Assessment Board test, Part I of the Medical Council of Canada Qualifying Examination, the Australian Medical Council multiple-choice examination, or Steps 1 and 2 of the United States Medical Licensing Examination. English and primary source verification come first.

The exam itself is an OSCE. Twelve stations, three hours, every station weighted the same, run twice a year. Stations test communication, professionalism, cultural safety, history taking, physical examination, clinical reasoning and management. The Medical Council reports an average pass rate of 66 per cent across the last five years, and a pass is valid for five years.

What a pass buys you is the right to apply, not a job. Provisional general scope registration follows only once you hold a postgraduate year 1 position in accredited clinical attachments with an accredited New Zealand training provider. That is the real bottleneck on this route.

What is the difference between provisional general and general scope registration?

Provisional general scope means you are registered and working, with a named supervisor and a supervision plan the Medical Council has approved. General scope means you practise without that supervision. Every international medical graduate starts in the first and applies to move to the second. Nobody skips it.

The clock length is the difference between pathways. Competent authority doctors need six months and two satisfactory reports. Comparable health system doctors need twelve months of full-time equivalent practice and three satisfactory supervision reports, then apply on form COS4. NZREX graduates run the full two-year prevocational programme — postgraduate year 1 as a house officer under a prevocational educational supervisor, then postgraduate year 2, then an application to remove the PGY2 endorsement.

One detail catches comparable health system applicants off guard. General scope on that pathway is limited to the specialty you were practising when you arrived, unless you complete six months of supervised practice in medicine and six months in surgery in an accredited hospital during the provisional period.

Progression is never automatic. You apply, every time.

What English language score does the Medical Council accept?

Two tests, and the thresholds are published in the Medical Council's English language policy, which took effect on 1 November 2025. IELTS Academic asks for 7.0 in speaking, 7.0 in listening, 7.0 in reading and 6.5 in writing. The Occupational English Test medicine module asks for 350 in speaking, listening and reading, and 300 in writing.

Results stay valid for two years from the date of your registration application, and two years from your NZREX Clinical examination date if you are a new candidate. Repeat NZREX candidates who have lived continuously in a listed English-speaking country since their last attempt can stretch that to five years.

Several exemptions exist. A primary medical qualification from a New Zealand medical school removes the requirement outright. So does being a first-language English speaker with a medical degree from Australia, the United Kingdom, Ireland, the United States, Canada or South Africa where English was the sole language of instruction. Two years of registered practice in a country where English is the first and prime language, backed by referee attestations, also works — as does a NZREX Clinical or PLAB pass within the previous five years.

Sit the test early. An expired certificate stalls an otherwise complete application.

What does registration cost in New Zealand dollars in 2026?

The current Medical Council fee schedule took effect on 1 July 2026, and every figure includes 15 per cent goods and services tax. The spread between pathways is large. A comparable health system application costs more than three times the competent authority one, because the assessment behind it is heavier.

A worked example makes the first-year outlay concrete. Take a hospital physician arriving on the comparable health system pathway with an accredited employer already lined up:

Three items sit outside that total and vary too much to fix a number to: EPIC primary source verification through ECFMG, billed in United States dollars; the IELTS or OET sitting, priced by the test centre; and flights, shipping and the first month of rent. Budget for them separately.

What does Health New Zealand pay a house officer or a registrar?

More than most people expect, and the reason is the category system. Resident doctors employed by Health New Zealand are paid on a scale where base salary is set by rostered hours as well as by year of experience. A house officer working 40 to 44.9 hours a week sits in category F. One working 65 or more hours sits in category A, and earns roughly 82 per cent more for the same training year.

The figures below come from the collective agreement between Health New Zealand and Specialty Trainees of New Zealand, at rates effective 24 February 2025, before allowances.

First-year house officers on the separate schedule start lower — NZD 75,790 in category F at the 2025 rates, rising to NZD 138,200 in category A. Registrars climb nine steps rather than three years, and a category A registrar on step 9 reaches NZD 246,510.

Two things follow. Your salary offer is a function of the roster attached to the post, so two identical registrar jobs in different hospitals can differ by tens of thousands of dollars. A smaller regional hospital often carries a heavier roster than a metropolitan post, which flips the usual assumption about where the money is. Ask for the category before you ask for the number. Our team walks through what we do for doctors comparing offers.

How does the Green List straight-to-residence route work for doctors?

Immigration New Zealand puts every medical occupation in Tier 1 of the Green List, the straight-to-residence tier. General practitioner (ANZSCO 253111), resident medical officer (253112), anaesthetist, psychiatrist, the run of specialist physicians from 253311 to 253399, surgeons from 253511 to 253521, and the specialists coded 253911 to 253918 all sit there. Tier 2, where you must work two years before applying, contains no medical occupations at all.

The requirement attached to every one of those roles is the same: New Zealand provisional general, general, provisional vocational, vocational or special purpose locum tenens registration with the Medical Council of New Zealand. Provisional general scope counts. That is the single most useful sentence in New Zealand's immigration rules for an international medical graduate, because it means the residence route opens on the day you are first registered rather than after you have earned full general scope.

Immigration New Zealand's operational manual sets the employment conditions: a current job or offer in the listed occupation, at least 30 hours a week, permanent or on a fixed term of twelve months or more, with an employer whose accreditation is in good standing. Tier 1 health roles must be paid at least the median wage. A resident doctor salary clears that with room to spare.

Most doctors arrive on an Accredited Employer Work Visa first, priced from NZD 1,540 in 2026 and granted for up to five years, then apply for residence once registration is confirmed. Marina, who works in visa and immigration law and has lived in Dubai and India before settling in Belgrade, makes the same point to every doctor she advises: employer accreditation is the one variable you cannot fix yourself, so confirm it in writing before you sign. An unaccredited employer stops the visa whatever your registration file looks like.

Check accreditation first. Always.

What do the first eighteen months look like, month by month?

The sequence below assumes a comparable health system applicant who already holds an English certificate. On the NZREX route, add the examination cycle and the search for an accredited postgraduate year 1 post at the front. Everything else is the same.

The parts of that timeline you control are worth listing separately, because they are the ones that slip:

• Six months out. Book IELTS Academic or the OET medicine module. Results are valid two years, so an early sitting protects the rest of the schedule.
• Five months out. Start EPIC primary source verification through ECFMG. It is the longest external dependency in the process.
• Four months out. Set a budget in New Zealand dollars covering the registration fee, the practising certificate, the visa and three months of living costs.
• Three months out. Confirm in writing that your employer holds current accreditation with Immigration New Zealand and that the supervisor named on form REG4 has Council approval.
• Two months out. Request your myMCNZ PIN, submit the application, and file the Accredited Employer Work Visa in parallel rather than in sequence.
• One month out. Arrange housing near the hospital and an Inland Revenue number. Book the registration meeting before you fly.
• Month one on the ward. Agree the supervision plan and report schedule in your first fortnight. Missing reports, not missing skills, is what delays general scope applications.

A booked free consultation at the start of that sequence saves more time than any single document does later.

What happens after general scope, and how do you actually become a specialist?

General scope is a licence to practise without supervision. It is not a specialist qualification, and that gap is where most planning stops too early. In New Zealand the specialist title lives in the vocational scope, which the Medical Council grants on the recommendation of the relevant medical college rather than on time served.

Two routes exist. You enter a New Zealand vocational training programme and complete it, which is what most doctors arriving as house officers or junior registrars end up doing. Or, holding a specialist qualification from overseas, you apply for vocational registration and the relevant college assesses you. That assessment is where the large fees sit: under the 2026 schedule a full vocational practice assessment costs NZD 20,336.96, a paper-based college assessment NZD 5,617.06, and an interview NZD 2,376.45.

A second thing is worth knowing before you accept a first post. Prevocational and vocational training places are tied to accredited hospitals and accredited attachments, so the hospital you join shapes which programmes are open to you next. A category A roster in a hospital with no accreditation in your intended specialty pays well and leads nowhere in particular. Choose the post for the next step.

In our own placements the doctors who move fastest are the ones who picked their first New Zealand employer with the college requirements already in front of them. Marcel Kloos, who founded Medschool Experts after studying dentistry in Sofia between 2015 and 2021 and now practises as a licensed dentist in Bern, built the service around that sequencing problem. Reading how others did it is a reasonable place to start.