Dear Health New Zealand,

Tēnā koutou,

I am writing to request information under the Official Information Act 1982 regarding the NZREX Clinical Examination process, marking methodology, outcomes data, and the integrity of the overall assessment process.

Background and Context:

Publicly available data on the Medical Council website shows that between 2021 and 2026, 394 candidates sat the NZREX Clinical Exam. The overall pass rate across this period is 65.5%, with significant variation between sittings, ranging from 56.7% to 77.8%. Of those who passed, only 67.4% subsequently gained provisional general registration.

Since late 2023, I have been independently speaking with NZREX Clinical candidates approximately 15 days following their examination sittings to understand their results in the context of their preparation, study group feedback, and their own performance expectations on the day. I have gathered a substantial number of testimonials from candidates across multiple sittings. The pattern emerging from these conversations is deeply concerning and points to serious questions about the integrity of the marking and assessment process.

Candidates with significant overseas clinical experience, strong preparation histories, and positive performance expectations on the day are consistently receiving failing results. What makes this more alarming is that in several cases, candidates who passed the examination have also expressed genuine shock at their result, again raising serious questions about the consistency and reliability of the marking process. I have at least three such candidates who are willing to come forward with their accounts. These individuals are no longer residing in New Zealand, which is itself a reflection of the broader problem this examination is creating for the country's healthcare workforce.

I am now in the process of bringing these testimonials and this data to media outlets and community groups to raise public awareness of what I believe to be a systemic failure, and potentially corrupt practices, within the NZREX Clinical examination and assessment process. New Zealand is already facing a well-documented GP shortage. A significant number of internationally qualified doctors who fail NZREX subsequently emigrate to Australia or the United Kingdom, representing a direct and ongoing loss to the New Zealand healthcare workforce. This is not an abstract issue. People across New Zealand are experiencing longer wait times and reduced access to healthcare as a direct consequence.

The cost of sitting the examination is also substantial, and the recount process, which consistently returns the same result, raises further questions about whether the recount serves as a genuine review mechanism or simply as an additional fee collected from already frustrated candidates.

I am making this OIA request as part of a broader effort to hold the Medical Council publicly accountable and to ensure that the examination process is transparent, fair, and free from any form of bias, whether based on country of origin, gender, ethnicity, or any other characteristic.

I request the following information:

1. The full marking and assessment criteria used in NZREX Clinical examinations, including how individual station scores are weighted and aggregated to determine a pass or fail outcome.

2. The process by which the cut score (pass mark) is determined for each sitting, including who is involved in setting it and whether it varies between sittings.

3. The qualifications, selection criteria, and training requirements for NZREX Clinical examiners and assessors, including any conflicts of interest policy applicable to them.

4. Any internal audits, quality assurance reviews, or external reviews of the NZREX Clinical examination marking process conducted in the past five years, and the outcomes of those reviews.

5. The number of recount requests received for each NZREX Clinical sitting from 2021 to present, the number where the result changed following recount, and the number where it did not change.

6. Data on pass rates broken down by candidate country of origin, gender, and ethnicity for NZREX Clinical sittings from 2021 to present, to the extent this information is held.

7. Any complaints received regarding the NZREX Clinical examination marking or assessment process in the past five years, and how those complaints were handled, in aggregated and de-identified form if necessary.

8. The Medical Council's policy on providing detailed feedback to unsuccessful candidates, including what specific information is and is not shared, and the reasoning behind any limitations on feedback.

9. Any correspondence, reports, or internal communications regarding concerns raised about pass rate variability, marking consistency, or the integrity of the assessment process across NZREX Clinical sittings.

10. Whether the Medical Council has conducted or commissioned any analysis of the downstream impact of NZREX outcomes on New Zealand's healthcare workforce supply, including the emigration of unsuccessful candidates.

11. Whether any formal complaints or concerns have been raised internally or externally regarding potential bias, whether based on country of origin, gender, ethnicity, or any other protected characteristic, in the NZREX Clinical examination or marking process, and how those were addressed.

12. Any policies, procedures, or correspondence relating to the conduct and independence of examiners involved in NZREX Clinical assessments, including any investigations into examiner conduct.

If any part of this request is refused, I ask that you specify the grounds under the OIA for doing so.

I am making this request in the public interest. The integrity of this examination process has direct consequences for New Zealand's healthcare system, for the doctors who have invested years preparing for it, and for the patients waiting for care.

Yours faithfully,
Lee

Dear hnzOIA / Danielle Coe,

I received the following response today from MCNZ and this is very generic and I will publish it here so that people can easily find this information on search engines. I will also advice candidates to carry devices to record the conversations inside the exam hall and this should be legal to know and keep a record of the exams to challenge their markings later so that they don't face issues like some of our families.

My email to MCNZ was the following:
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To Whom It May Concern,

Medical Council of New Zealand

I am writing to you directly following an Official Information Act (OIA) request submitted through FYI.org.nz (Reference: https://fyi.org.nz/request/34277) regarding the NZREX Clinical Examination, its marking methodology, pass rate data, recount process, and potential systemic bias.

I want to be direct with you: we expect full transparency and honest answers to every question raised in that OIA request.

We have been privately investigating NZREX Clinical outcomes for the past several years. Over that period, we have gathered testimonials from a large number of candidates, both those who passed and those who did not. The patterns we have identified are deeply concerning and point to serious questions about the integrity of the examination. These include the very real possibility that racism, examiner partiality, and arbitrary decision-making are influencing who passes and who fails. In recent years, a number of candidates who received passing results have come forward saying they were genuinely shocked by their outcome, which raises serious questions about whether results reflect actual clinical performance at all.

Specifically, we are investigating:

1. Whether examiners from certain countries are deliberately marking candidates from other countries unfairly, and whether the Medical Council has any mechanisms in place to detect or prevent this.

2. Whether the recount process is a genuine review of a candidate's result, or whether it is simply collecting an additional fee from already distressed candidates while returning the same result regardless of merit.

3. Whether pass and fail outcomes are influenced, directly or indirectly, by a candidate's country of origin, gender, or ethnicity.

4. Why candidates with strong clinical backgrounds, extensive overseas experience, and positive performance expectations are consistently receiving failing results, while the variability between sittings remains unexplained.

We also hold accounts from candidates who passed the examination and were themselves shocked by their result, which raises serious questions about the consistency and reliability of the marking process overall.

New Zealand is facing a well-documented GP shortage. Qualified international doctors who fail NZREX are leaving for Australia and the United Kingdom. This is a direct consequence of a process that candidates and now the public no longer trust.

We are bringing this matter to the media. Doctors' groups on social media are already discussing this, and the volume of concern from candidates and overseas doctors is growing. We would strongly prefer that the Medical Council comes forward proactively, conducts a genuine internal investigation, and answers these questions openly and honestly on the public record, including through news channels, before this reaches the level of public anger that is clearly building.

This is your opportunity to lead with transparency. We are asking the Medical Council to:

- Answer every question raised in the OIA request fully and honestly
- Commission and publish an independent investigation into the marking and examiner conduct
- Publicly address the concerns around racial bias in the examination process
- Be honest about what the recount process actually involves and whether results have ever changed
- Come forward to media with answers, rather than waiting for this to become a public crisis

We are not going away. We will continue investigating, and we will continue speaking with candidates, doctors' groups, and journalists until there is full accountability.

We look forward to your response.

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Response from the MCNZ (Janette Deed - Principal Communications Adviser) below:

Kia ora Zhang Yu,

Thank you for your email and for raising your concerns about the NZREX Clinical examination.

Te Kaunihera Rata o Aotearoa | Medical Council of New Zealand’s role is to protect public health and safety by ensuring doctors who practise in Aotearoa New Zealand are competent and fit to practise. NZREX Clinical is one registration pathway for international medical graduates who are not eligible for registration through another pathway to demonstrate that they meet the required standard.

Council takes any concern about the fairness, robustness, or integrity of its processes seriously. We recognise that confidence in NZREX Clinical is important for candidates, the profession, and the public.

NZREX Clinical is supported by a range of quality assurance processes. These include examiner training and calibration, examiner unconscious-bias training, equity review processes, diverse scenario-development and examiner groups, electronic marking, and psychometric and statistical analysis of examination outcomes. These processes are part of Council’s ongoing approach to maintaining and improving the quality, consistency, and fairness of the examination.

Council also publishes information about NZREX Clinical outcomes, including pass-rate information and subsequent registration information, on our NZREX data dashboard. Information about the examination itself is available on our NZREX Registration Exam page, and information about results, feedback, and recount processes is available through our NZREX Clinical policies.

Council is careful not to comment on individual candidate results or circumstances. Where an individual candidate has a specific concern about an examination process, result, or incident at an examination, that should be raised by the candidate through Council’s published processes.

We also note your comments about the medical workforce. Council recognises the importance of a sustainable medical workforce, but its role is to set and apply the standards required for safe medical practice. Questions about employment after passing NZREX Clinical sit with employers and the wider health system. Successful candidates must secure a PGY1 role with an accredited prevocational training provider before they can be registered. Council is not involved in that employment process.

Thank you again for writing. Your concerns have been noted, and Council will continue to review and improve NZREX Clinical as part of its ongoing commitment to fair, robust, and high-quality regulatory processes.

Ngā mihi

Janette
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I am waiting for the response to all of my questions regarding the process of markings, results of recounts and the process of recounts.

We also hold accounts from candidates who passed the examination and were themselves shocked by their result, which raises serious questions about the consistency and reliability of the marking process overall.

Yours sincerely,

Lee

Dear Medical Council,

It also seems like you have made several errors in 2026 exams as well. Sending duplicate results emails as well. Noticed that on a public group. But we will investigate this further by reaching out everyone.

You will need to explain clearly, apologise and also publish everything on herald news and stuff news and do the proper investigation. Internal errors, investigations are not enough and need a proper in-depth investigation on this. Your letter is not enough and you need to make sure to ask every candidates to bring a camera or recording device with them to record the full exams. So that their results and performance during the exams reflect properly.

Yours sincerely,

Zhang Yu