PM&DC clarifies FMG registration and NRE requirement
The Pakistan Medical and Dental Council has clarified its legal position on the registration of foreign medical graduates, emphasizing that the National Registration Examination (NRE) is mandatory for all foreign medical graduates before they receive permanent registration or independent practice rights. The council said provisional registration will be issued only to graduates of institutions formally recognized by the council, and only graduates of foreign schools listed by the Educational Commission for Foreign Medical Graduates (ECFMG) will be eligible to sit the NRE. The measures, the council said, are lawful and aimed at protecting patients and maintaining medical education standards.
The council noted that Pakistani students have obtained medical degrees from a range of foreign institutions, including those in Afghanistan and several Central Asian countries. Many of these students began their studies under earlier regulatory frameworks. Following the enactment of the current PM&DC legislation and the establishment of a new council, a series of reforms was launched to strengthen medical education and safeguard the national health system.
Under the council’s legal mandate, foreign medical institutions are subject to review and only graduates of PM&DC-recognized schools may be considered for provisional registration. Provisional registration is a temporary measure; permanent registration and the right to practice independently require successful completion of the NRE. The council said this policy is intended to ensure that every doctor practicing in Pakistan meets established standards of competence and patient safety.
A systematic review of foreign institutions where Pakistani students are enrolled found that several institutions did not meet PM&DC eligibility criteria. Concerns about the quality of education at certain foreign universities were also raised by local medical universities. In response, the council decided that only graduates of institutions recognized by PM&DC will be eligible for provisional registration before taking the NRE. Graduates who enrolled under previous regulatory regimes but whose institutions have not yet been recognized under the current law will be eligible for provisional registration only after passing the NRE.
The council further clarified that eligibility to sit the NRE will be limited to graduates of foreign institutions listed by ECFMG. It noted that requiring a qualifying licensing exam for foreign-trained physicians is a widely accepted international practice and that the requirement to pass an examination for licensing is not a new policy but has precedent in earlier regulatory frameworks.
Addressing reports about large backlogs, the council rejected claims of thousands of pending foreign graduate registrations, stating that roughly 700 cases are currently pending review. Several candidates have asked to have their previous fees applied toward the NRE. The council has scheduled an upcoming NRE and will publish a detailed timetable soon.
The council reiterated that, as the country’s medical education and practice regulator, it cannot compromise on patient safety. Every graduate who enters clinical practice assumes responsibility for human life, and the council is obliged to ensure only practitioners who meet required standards are licensed. The council described its recent actions as lawful, transparent, and motivated by public interest and maintenance of professional standards.
Licensing and qualifying examinations provide a consistent, impartial way to assess whether graduates—regardless of where they trained—are familiar with local rules, clinical standards and decision-making required for safe practice. The council pointed to comparable international requirements, such as the USMLE in the United States, PLAB or other GMC-approved routes in the United Kingdom, and the MCCQE in Canada, to illustrate that such assessments are standard practice internationally and help maintain public trust in the healthcare system.
