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MCNZ Registration Pathways: What’s the Difference?

Written by Dr John Bethell | Nov 27, 2025 11:34:18 AM

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.)