NRE Step 1 while working or after an internship abroad
Most foreign graduates prepare for NRE Step 1 alongside a job, an internship abroad or family duties. Here is a realistic way to do it.
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Who this is for
The NRE is for Pakistani and foreign nationals who graduated from medical schools outside Pakistan. You need to pass it before PM&DC registration, so you cannot use a Pakistani house job as preparation time. Many candidates instead prepare while doing an internship or a job abroad, a non-clinical job, or while managing family responsibilities after returning home.
How NRE differs from FCPS Part 1
NRE Step 1 is clinically weighted: about 70% clinical sciences and 30% applied basic sciences, with basic science tested through clinical scenarios. If you are seeing patients in an internship abroad, the daily work itself becomes revision. If you are not working clinically, you need more structured case-based practice.
A realistic pace while working
- Treat the working months as foundation: cover medicine, surgery, gynaecology and paediatrics at a steady pace.
- Do short timed sets of 20–30 questions on working days, and longer blocks on days off.
- Keep a running list of topics you keep getting wrong; that list becomes your revision plan.
- Plan a focused block of 6–12 weeks before the exam for full timed papers and revision.
Using clinical work as revision
- When you manage shock, sepsis, dengue or an acute abdomen, spend ten minutes that evening on the related physiology and the first-line management.
- Learn Pakistani practice as well as the system you trained in: local diseases such as typhoid, dengue, malaria, TB, hepatitis and snakebite appear often.
- Review every explanation, including for questions you got right.
When to switch to full-time study
If your timed scores are well below the 60% pass mark six to eight weeks before the exam, it is usually better to reduce working hours or move the attempt than to sit under-prepared.
Frequently asked questions
Can I do a house job in Pakistan before passing the NRE?
No. Foreign graduates need to pass the NRE before registering with PM&DC, and registration is needed for a house job in Pakistan.
Is an internship abroad useful preparation?
Yes. Clinical work makes the clinically weighted questions feel familiar, but you still need timed practice and a structured syllabus.
Should I prioritise NRE or other exams?
If you plan to work in Pakistan, the NRE comes first, because registration depends on it.