- 4 min read
MCNZ Registration Pathways: What’s the Difference?
MCNZ requirements
- By: Dr John Bethell
- November 27, 2025
If you’re an international medical graduate (IMG) planning to work in New Zealand, you’ll quickly discover that the Medical Council of New Zealand (MCNZ) offers several registration pathways, and choosing the right one can be overwhelming.
To make things easier, this guide breaks down the four most commonly used pathways, who they’re for, what they require, the fees involved, and how long they take.
The pathways we’ll cover are:
• Competent Authority Pathway (CAP)
• Comparable Health System (CHS)
• VOC4 Provisional Vocational (Specialist) Registration
• VOC3 Provisional Vocational (Specialist) Registration
1. What Each Pathway Is For
Competent Authority Pathway (CAP)
General Registration
Designed for doctors who completed both their primary medical degree and internship in the UK or Ireland
Comparable Health System (CHS)
General Registration
Designed for doctors who have recent experience in a comparable health system
VOC4: Provisional Vocational (Specialist) Registration
Specialist Registration
For doctors who hold an approved specialist postgraduate qualification
VOC3: Provisional Vocational (Specialist) Registration
Specialist Registration
For doctors whose postgraduate qualification is not on MCNZ’s approved list, but who have completed full postgraduate specialist training
2. Eligibility Requirements
CAP Requirements
You must have:
• A primary medical degree from an approved medical school in the United Kingdom or Ireland; and
• Completed your internship in either the United Kingdom or Ireland
CHS Requirements
You must have:
• An acceptable primary medical degree and
• Practised clinically for at least 33 months, for at least 20 hours per week in the last 48 months in one or more comparable health systems such as Australia, UK, Canada, Ireland and USA; and
• Practised in the same or a similar area of medicine, and at a similar level of responsibility to the proposed New Zealand position for those 33 months; and
• Hold current full or general registration with the regulatory authority of at least one of the comparable health systems worked in during the 48 months; and
• A job offer that includes supervision.
VOC4 Requirements
You must have:
• An acceptable primary medical degree; and
• An approved overseas specialist postgraduate qualification (MRCGP, MICGP, FRACGP); and
• At least 24 months’ (working at 0.5 FTE or more) clinical experience in the past 5 years practising in that area of medicine, including 12 months within the last 18 months in a country recognised as having a health system comparable to NZ; and
• A specialist-level job offer that includes supervision.
VOC3 Requirements
You must have:
• An acceptable primary medical degree; and
• completed postgraduate medical training and gained a postgraduate medical qualification awarded at the end of specialist training;
and
• A specialist-level job offer that includes supervision.
3. Fees
CAP Fee
Approx: NZD $600.76 (registration application fee)
CHS Fee
Approx: NZD $1,877.35 (registration application fee)
VOC4 Fee
Approx: NZD $4,505.65 (registration application fee)
Additional potential costs:
• VPA (Vocational Practice Assessment): ~NZD $19,725.47
(Only required if MCNZ places you on the assessment pathway)
VOC3 Fee
Approx: NZD $4,505.65 (registration application fee)
Additional potential costs:
• VPA (Vocational Practice Assessment): ~NZD $19,725.47
(Only required if MCNZ places you on the assessment pathway)
4. Supervision Requirements
CAP Supervision
• You must complete 6 months of supervised practice
• MCNZ requires two supervision reports before you can move to General Registration
CHS Supervision
• You must complete 12 months of supervised practice
• MCNZ requires three supervision reports before you can move to General Registration
VOC4 and VOC3 Supervision
Your supervision requirements are based on MCNZ’s assessment of your training and specialist experience. Under the VOC4 pathway, applicants fall into one of two categories:
Pathway 1: Supervision Only
MCNZ has assessed your qualifications, training and experience as equivalent to an NZ specialist. This means you must complete:
• 6–12 months of supervised specialist practice
Pathway 2: Assessment Pathway
MCNZ has assessed your qualifications, training and experience “as satisfactory as” (not fully equivalent) to an NZ specialist. This means you must complete:
• 12–18 months of supervised practice; and
• A Vocational Practice Assessment (VPA)
What is a Vocational Practice Assessment (VPA)?
A VPA is a full-day, workplace-based assessment conducted by two experienced medical assessors. They come onsite to observe your consultations, team interactions, and overall clinical approach. Throughout the day, they use a structured set of tools to assess your competence against New Zealand’s vocational standards.
You are most likely to need a VPA if:
• Your qualifications, training, or experience show gaps or areas that do not fully align with New Zealand’s specialist standards
• Your training programme did not include regular in-training assessments
• You have not completed any clinical examinations (e.g., workplace-based assessments, observed clinical tasks, or simulated patient interactions)
• You have not completed any external examinations (e.g., national or regional specialist exams)
• You did not complete a final or exit examination at the end of your postgraduate specialist training.
Eligibility requirements for the nominated supervisor:
• The supervisor must be a doctor who holds vocational registration in the same scope of practice.
• The supervisor should ideally be based at the same clinical site. If the primary supervisor is off-site (or if only one doctor is available), an additional on-site supervisor with vocational registration in the same or closely related scope must be nominated to provide adequate oversight.
5. Processing Times
• CAP: ~20 working days
• CHS: ~20 working days
• VOC4: ~20 working days
• VOC3: ~3 months
(Timeframes begin once MCNZ receives a complete application.)
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