Foreign Medical Graduates have formally raised concerns over recent regulatory changes requiring clearance of the National Registration Examination before house job training, saying the new framework has produced redundant testing, mounting costs and prolonged uncertainty for junior doctors.
Under the revised policy, candidates must pass NRE Step 1 and NRE Step 2 before starting mandatory house job rotations. Graduates say abrupt implementation produced delays of seven to eight months that stalled careers and increased financial pressure for many who expected to begin clinical training.
Some hospitals have added internal induction exams even for candidates who already passed both theoretical and clinical components of the NRE, a move FMGs describe as an unnecessary third layer of assessment that does little to improve standards but amplifies duplication.
The financial burden on trainees is significant: candidates pay Rs. 20,000 for NRE Step 1 and another Rs. 20,000 for NRE Step 2, Rs. 10,000 for a temporary PRMP license and an additional Rs. 10,000 to Rs. 20,000 for hospital-level examinations, pushing cumulative costs beyond Rs. 60,000 to Rs. 70,000 excluding preparation and related expenses.
The FMG community recommends that the NRE qualification be accepted as sufficient for house job eligibility or that hospital induction exams be waived for those who have already qualified the NRE, and it calls for a fixed and transparent timeline for house job allocations to prevent future delays.
About 700 graduates had earlier paid Rs. 10,000 each for temporary house job licenses before the revised NRE policy came into force. Although the regulatory body publicly assured they would be refunded, many months have passed with refunds still pending. The community is urging an independent audit, a public update on refund status and a clearly defined refund timeline not exceeding 30 days.
Dr Rafey Sher, speaking for stakeholders within the Foreign Medical Graduates community, said he is confident higher authorities will take timely notice and ensure a fair, transparent resolution. He stressed that once graduates pass the prescribed examinations they meet professional standards and must receive equal, non-discriminatory treatment to support merit-based progression and strengthen Pakistan’s health services.
