Introduction

The National Registration Examination (NRE) 2025, organized by the Pakistan Medical & Dental Council (PM&DC), The NRE-1 exam checks that MBBS graduates from local and foreign medical colleges meet the standards for safe and effective medical practice in Pakistan. This examination evaluates not only theoretical knowledge but also practical clinical competencies essential for independent practice as a general medical practitioner.

The NRE 2025 consists of two main components: a theory component comprised of 200 multiple-choice questions (MCQs) and a Clinical Skills Examination (CSE) that follows an Objective Structured Clinical Examination (OSCE) format. The theory component assesses applied knowledge in both basic and clinical sciences, with 30% weightage given to applied basic sciences and 70% to clinical disciplines. The CSE evaluates essential hands-on skills, including patient examination, diagnostic reasoning, procedural techniques, and formulation of treatment plans

Table of content

Section-I Preamble 3

Section-II Format and structure for National Registration Examination 2025  3-4

• Eligibility
• Centers
• Frequency
• Number of attempts
• Structure
• Passing of criteria
• Validity

Section-III Applied Basic Sciences disciplines in National Registration Examination 2025  5

Section-IV Weightage of Basic Sciences disciplines in National Registration Examination 2025 6

Section-V Clinical Sciences disciplines in National Registration Examination 2025 7

Section-VI Weightage of Clinical Sciences disciplines in National Registration Examination 2025 7-8

Section-VII Clinical Skills Examination (CSE) 8

• Distribution of disciplines
• Mandatory stations

Appendix-1 Syllabus for Applied Basic Sciences component of National Registration Examination 2025 9-46

Appendix-2 Syllabus for Clinical Sciences component of National Registration Examination 2025 47-82

Appendix-3 Skills and competencies required of an MBBS graduate and a house officer by the end of house job / internship / foundation year 83-84

SECTION-I

PREAMBLE

Pakistan Medical & Dental Council (PM&DC) will be conducting National Registration Examination (NRE) at a national level. This examination is being held under section 18 of the Pakistan Medical & Dental Council Act 2022.

FORMAT AND STRUCTURE OF NRE 2025

The National Registration Examination (NRE) 2025 has been designed under Section 18 of PM&DC Act, 2022. The exam tests the ability of MBBS graduates to practice independently. Passing the NRE (both the theory and clinical skills examination components) is mandatory for obtaining a full license to practice as General Practitioner.

Eligibility:

Candidates who have successfully graduated from PM&DC approved foreign medical colleges with an MBBS/MD or equivalent degree (as per the approved foreign degree Nomenclature) along with a provisional license issued by PM&DC are eligible to sit for NRE 2025.

Centers:

NRE 2025 will be conducted at multiple centers across Pakistan to facilitate the candidates.

Frequency:

The NRE will be held at least twice a year.

Number of Attempts:

There is no bar on the number of times a candidate can attempt the complete NRE.

Structure:

The NRE will consist of two components:

(i) a theory component and

(ii) a skill-based, clinical component - Clinical Skills Examination (CSE).

1. The theory component will consist of MCQs targeting higher cognition and will check a candidate's ability to apply knowledge. The theory component will have 200 MCQs in which 70% will be from clinical sciences disciplines and 30% from basic sciences disciplines. The NRE will be a substantially based on objective computer-based multiple choice questions. Only candidates qualifying in the theory (MCQs) component of NRE will be eligible for the CSE.
2. The Clinical Skills Examination (CSE) is meant to assess essential clinical skills required for practice by a general medical practitioner. The format of CSE will be similar to that of an Objective Structured Clinical Examination (OSCE).

Passing criteria:

Candidates will have to pass both the theory and the CSE components separately in order to be declared successful in NRE. The minimum pass percentage in the theory (MCQs) component is 60% and the minimum pass percentage of Clinical Skills Examination (CSE), including mandatory stations and each tangible's method will also be adopted for standardization of NRE Examination. There will be three mandatory stations in the CSE. A candidate must clear all three mandatory stations to pass the CSE. If a candidate scores 60% or more overall but fails any mandatory station, the exam board will declare them failed in the entire CSE. There will be no negative marking in both components of the NRE.

Candidates who pass the theory (MCQs) component but fail the CSE, will have to re-appear in the CSE component only. Such candidates will not re-sit for the CSE only. If a candidate fails in three (03) consecutive attempts of the CSE, s/he will have to appear in both the theory (MCQs) and CSE components in the fourth attempt. That is, after every three failed attempts at the CSE, candidates will have to sit the entire NRE.

Validity:

Passing of the theory (MCQs) component of NRE will remain valid for five (5) years from the date of passing the theory (MCQs) component. CSE component must be passed within five (5) years of passing the theory (MCQs) component of NRE. If a candidate fails the CSE in three consecutive attempts, h/she will have to reappear in both the theory and CSE components of the NRE. That is, after every three failed attempts at the CSE, candidates will have to sit the entire NRE.

SECTION-III.

APPLIED BASIC SCIENCES DISCIPLINES IN NRE 2025

Basic Sciences disciplines in NRE 2025 will include the following. However, the Basic Sciences content of the theory examination will be largely but not exclusively based on applied aspects of the following subjects:

• Applied Anatomy
• Applied Physiology
• Applied Biochemistry
• Applied Pathology
• Clinical Pharmacology
• Community Medicine
• Forensic Medicine & Toxicology
• Applied Pathology 11
• Applied Anatomy 11
• Applied Physiology 10
• Applied Biochemistry 9
• Clinical Pharmacology 6
• Community Medicine 6
•  

Forensic Medicine & Toxicology 7

SECTION IV

WEIGHTAGE OF APPLIED BASIC SCIENCES DISCIPLINES IN NRE 2025

Weightage of Applied Basic Sciences disciplines in the theory (MCQs) component of NRE 2025 will be as follows :

1. WEIGHTAGE: 30%
2. TOTAL MCQS: 60
3. Applied Pathology 11
4. Applied Anatomy 11
5. Applied Physiology 10
6. Applied Biochemistry 9
7. Clinical Pharmacology 6
8. Community Medicine 6
9. Forensic Medicine & Toxicology 7
10. Syllabus for Applied Basic Sciences:

For details on Applied Basic Sciences syllabus for NRE 2025, please see Appendix 1

SECTION V

CLINICAL SCIENCES DISCIPLINES IN NRE 2025

Clinical Sciences disciplines in NRE 2025 will comprise of the following:

❖ Medicine and Allied

❖ Surgery and Allied

❖ Obstetrics & Gynaecology

❖ Paediatrics

❖ Ophthalmology (Eye)

❖ Otorhinolaryngology (ENT)

SECTION VI

WEIGHTAGE OF CLINICAL SCIENCES DISCIPLINES IN NRE 2025

Weightage of Clinical Sciences disciplines in the theory (MCQs) component of NRE 2025 will be as follows:

• WEIGHTAGE: 70%
• TOTAL MCQS: 140
• Medicine and Allied 52
• Surgery and Allied 48
• Obstetrics & Gynaecology 19
• Paediatrics 14
• Ophthalmology (Eye) 6
• Otorhinolaryngology (ENT) 1

SECTION VII

WEIGHTAGE OF CLINICAL SCIENCES DISCIPLINES IN NRE 2025

CSE aims to assess essential clinical skills, including interpreting clinical data, formulating diagnoses, and developing management plans. It also assesses examination skills and key procedural skills.

The CSE format is similar to an Objective Structured Clinical Examination (OSCE). The exam will be approximately 3 hours and 30 minutes long, including the initial briefing, and will consist of 20 stations. The pass percentage is fixed at 60% for the final result.

Each CSE station is assigned 8 minutes with 2 minutes for the changeover.

The content and conduct of the CSE, including duration, number of stations, and pass percentage, are subject to change at the discretion of the PM&DC. Any changes will be notified and displayed on the PM&DC website at least 12 weeks before the exam date.

Syllabus for Applied Basic Sciences

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Distribution of disciplines for stations for CSE will be as follows:

• Medicine and Allied 07
• Surgery and Allied 07
• Obstetrics & Gynaecology 02
• Paediatrics 02
• Ophthalmology (Eye) 01
• Otorhinolaryngology (ENT) 01

Conclusion

The NRE 2025 ensures that MBBS graduates possess the necessary knowledge and clinical skills to practice safely and effectively in Pakistan. With a clear structure covering both theory and practical components, the exam evaluates applied basic sciences, clinical sciences, and essential hands-on competencies. Passing both the MCQs and CSE is mandatory for full licensure. The defined weightage and mandatory stations in the CSE ensure uniform assessment standards. Successful candidates demonstrate readiness to deliver quality healthcare as independent practitioners.

FAQs:

Q1: Who can appear for NRE 2024?

Candidates who have graduated with an MBBS or MD degree from a PM&DC-approved foreign medical college are eligible. They must also hold a provisional license issued by PM&DC, confirming that they meet the basic legal requirements to sit for the exam.

Q2: How is NRE structured?

The NRE consists of two main components. The first is a theory component with 200 multiple-choice questions, divided into 70% clinical sciences and 30% applied basic sciences. The second component is the Clinical Skills Examination (CSE), an OSCE-style practical assessment with 20 stations covering all major clinical disciplines.

Q3: What are the passing criteria for NRE 2025?

Candidates must pass both the theory and the CSE components separately. The minimum pass percentage is 60% for each, and all three mandatory CSE stations must be cleared. Failing any mandatory station results in failing the entire CSE, regardless of overall marks.

Q4: How often is NRE conducted, and are there attempt limits?

NRE is held at least twice a year at multiple centers across Pakistan to facilitate candidates. There is no overall limit on attempts, but if a candidate fails the CSE three times consecutively, they must retake both the theory and CSE components in the next attempt.

Q5: How long is the validity of passing the theory component?

Passing the theory component is valid for five years from the date of passing. The candidate must clear the CSE within this period; otherwise, they must retake both components. This ensures that clinical skills remain current and up to standard.

Q6: What subjects and skills are tested in NRE?

The theory component tests applied basic sciences such as anatomy, physiology, biochemistry, pathology, pharmacology, community medicine, and forensic medicine. Clinical sciences include medicine, surgery, pediatrics, obstetrics & gynecology, ophthalmology, and ENT. The CSE assesses hands-on clinical skills, interpretation of data, diagnosis, and procedural competencies.