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Trained in Pakistan

Pakistani doctors and nurses to UK, Ireland, EU, US (2026)

Pakistan-trained professionals can register in the UK, Ireland, Germany, the Netherlands and the USA. Pakistan's place on the WHO safeguards list and the UK red list changes how you are recruited, not whether you can apply.

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Overview

If you trained as a doctor, nurse, dentist, pharmacist or allied health professional in Pakistan, you can apply to register in the UK, Ireland, Germany, the Netherlands and the USA.

Each regulator assesses your qualification, verifies it with your Pakistani council or university, and sets its own English or language test. What sets Pakistan apart is recruitment: Pakistan is on the WHO health workforce support and safeguards list 2023, and so on the UK Code of Practice red list. That limits what employers and agencies may do to recruit you, but GOV.UK states that employers may consider direct applications from individuals resident in red list countries.

Many Pakistani doctors sit PLAB 1 at the British Council in Islamabad or Karachi, or USMLE Step 1 and Step 2 CK before applying for US residency. Ireland is a particular option for Pakistani doctors: the Medical Council lists Pakistan among the countries whose internships count for its Certificate of Experience route, provided the house job started on or after 1 January 2009 and its rotations meet the Council's standards. Some first work in Saudi Arabia, the UAE, Qatar or Oman and apply onward from there.

Your Pakistani paperwork comes from three places. The Pakistan Medical and Dental Council (PM&DC) or the Pakistan Nursing and Midwifery Council (PNMC) confirms your registration and issues certificates of good standing. The Higher Education Commission (HEC) attests your degree through its online Degree Attestation System. The Ministry of Foreign Affairs (MOFA) issues the apostille where a destination needs one. Each has its own fee and queue, and foreign regulators will not finish your file until the council has replied.

Pakistan is not a majority English-speaking country on any destination regulator's list, so an English-taught MBBS, BDS or BSN does not exempt you from IELTS or OET. In Germany and the Netherlands the language requirement is German or Dutch. Germany adds a recruitment rule of its own: Pakistan is on the annex to section 38 of the Employment Ordinance, which reserves recruitment and job placement for health and care jobs from listed countries to the Federal Employment Agency.

This page is for Pakistan-trained professionals living in Pakistan and those working in the Gulf. It covers the documents to get in Pakistan, how verification with PM&DC and PNMC works, where you can sit each exam in Pakistan, and what the WHO list, the UK red list and Germany's rule mean in practice. Follow the links to each regulator and profession page for fees and step-by-step detail.

Where you can go

United Kingdom

Pakistani doctors usually register with the GMC through PLAB, which can be started at the British Council in Islamabad or Karachi, and Pakistani nurses through the NMC Test of Competence. Because Pakistan is on the red list, UK employers and agencies cannot actively recruit you there, but you can apply for jobs yourself.

  1. 1Check your qualification: the GMC's acceptable qualifications and internship rules (your house job must meet them) or the NMC eligibility check for nurses and midwives.
  2. 2Take IELTS Academic or OET. The GMC asks for IELTS 7.0 in each area and 7.5 overall, or OET Medicine grade B in each; the NMC asks for IELTS 7 in listening, reading and speaking and 6.5 in writing, or OET B in three and C+ in writing.
  3. 3Doctors start EPIC verification of the MBBS with ECFMG; nurses start PNMC's verification process for NMC UK at the same time as the NMC application.
  4. 4Doctors sit PLAB 1 in Pakistan and PLAB 2 in Manchester; nurses sit the CBT at a Pearson VUE centre and the OSCE in the UK.
  5. 5Apply directly for NHS posts, get a certificate of sponsorship and apply for the Health and Care Worker visa, with a TB test from an approved clinic in Pakistan.

Watch out: Pakistan is on the UK Code of Practice red list. GOV.UK says there must be no active recruitment from red list countries unless a government-to-government agreement allows it, and that employers may consider direct applications from individuals resident there. In practice, look for jobs on NHS Jobs and employers' own websites rather than waiting to be approached by an agency. GOV.UK lists Pakistan as a country where you need a TB test if you are coming to the UK for 6 months or more.

Full guide to working in the United Kingdom

Ireland

Ireland is unusual in that the Medical Council lists Pakistan among the countries whose internships count for the Certificate of Experience route to general registration. Pakistani nurses apply to NMBI for recognition, usually followed by an aptitude test or adaptation period.

  1. 1Doctors check whether the house job meets the Medical Council's Pakistan conditions: started on or after 1 January 2009, with rotations that meet the Council's internship standards. From 1 December 2025 the Council accepts only internship certificates issued by the relevant competent authority, not by hospital sites.
  2. 2Verify your MBBS (and internship, depending on route) through EPIC, and ask PM&DC to send a certificate of good standing directly to the Council, dated within three months.
  3. 3Sit OET Medicine (grade B in each module) or IELTS Academic (7.0 overall, 6.5 in each) in a single sitting; online versions are not accepted. If your house job does not qualify, use PRES, a recognised higher qualification or a PLAB 2 pass.
  4. 4Nurses open a MyNMBI account, ask your college for the qualification form and ask PNMC to send a Certificate of Current Professional Status, then meet NMBI's IELTS or OET scores in one sitting.
  5. 5Get a Critical Skills Employment Permit or the permit your hospital employer arranges, then apply for an Irish employment visa.

Watch out: PRES Level 2 is held in Dublin and Dubai in 2026, which suits Pakistani doctors already in the Gulf. Neither NMBI nor the Medical Council exempts Pakistan-trained applicants from English testing.

Full guide to working in Ireland

Germany

Germany recognises Pakistani medical, dental, pharmacy and nursing qualifications through the authority of the state where you will work, and the language is German. Pakistan is on the annex to section 38 of the German Employment Ordinance, so only the Federal Employment Agency may recruit or place health workers from Pakistan.

  1. 1Find your authority with the Recognition Finder on anerkennung-in-deutschland.de.
  2. 2Learn German to B2; doctors, dentists and pharmacists also pass the Fachsprachprüfung at the state chamber.
  3. 3Have your HEC-attested degree, transcripts, PM&DC or PNMC registration and good standing translated into German by a translator the authority accepts, and apostilled by MOFA where the authority asks.
  4. 4Apply for recognition and receive the notice listing any substantial differences, then sit the Kenntnisprüfung or complete an adaptation period.
  5. 5Apply for the visa that fits your stage, for example the recognition measures permit, the recognition partnership or the skilled worker permit once recognised.

Watch out: Section 38 BeschV says recruitment in, and job placement from, the listed countries for health and care occupations may only be carried out by the Federal Employment Agency. As worded, it governs who may recruit and place; it does not say that individuals from these countries cannot apply for recognition, a job or a visa themselves. Treat any private agency offering to place you in a German health job with caution.

Full guide to working in Germany

Netherlands

The Netherlands has a certificate of competence route for Pakistan-trained BIG professionals, but Dutch at B1 to B2+ and, for doctors, dentists and nurses, the BI-test come first. Expect a long timeline.

  1. 1Use the BIG register's advice wizard and book a free consultation hour.
  2. 2Reach the Dutch level for your profession and show English reading at the level the BIG register sets.
  3. 3Have your documents certified by an authorised body; the BIG register does not accept an apostille for this step.
  4. 4Sit the BI-test if you are a doctor, dentist or nurse, then attend the CBGV meeting.
  5. 5Register with a recent CCPS from PM&DC or PNMC and a certificate of good conduct, then complete three months of supervised work.

Watch out: The BIG register has said BI-test places for doctors and dentists are full, so check availability before you plan around a date.

Full guide to working in the Netherlands

United States

Pakistani doctors reach US residency through ECFMG certification, USMLE Step 1 and Step 2 CK, OET Medicine and the Match. Pakistani nurses can take the NCLEX-RN in Lahore, the only Pakistani centre on NCLEX's October 2026 list.

  1. 1Doctors check the medical school's sponsor note in the World Directory of Medical Schools, open a MyIntealth account and ask ECFMG to verify the diploma and transcript with the school.
  2. 2Pass Step 1 and Step 2 CK (a region fee applies outside the US and Canada) and OET Medicine, then apply to a Pathway and request an ERAS token.
  3. 3Nurses choose a state board, order a credentials evaluation and have the college and PNMC send documents directly to the agency.
  4. 4Pass an English test that both the board and VisaScreen accept, then register for the NCLEX-RN and book the Lahore centre ($150 international scheduling fee).
  5. 5Get an employer to file your immigrant petition (nurses) or a J-1 or H-1B through your residency programme (doctors).

Watch out: Pakistani programmes taught in English do not exempt nurses from the VisaScreen English requirement or doctors from OET Medicine. Immigration rules change often; use USCIS and State Department pages and ask an immigration attorney about your case.

Full guide to working in the United States

Documents to gather

  1. CNIC, passport and name consistency

    Make sure the name on your passport, CNIC, degree, PM&DC or PNMC registration and test certificates match exactly, including the order of names and any father's or husband's name. MOFA, HEC and foreign regulators all check identity documents, and the NMC and others ask for legal evidence of any change of name. Fix mismatches before you book IELTS or OET.

  2. Degree, transcript and HEC attestation

    Collect your final degree and transcript (detailed marks certificate) from your university. HEC now runs a fully online, paperless Degree Attestation System, charging Rs. 3,000 per document (degree, transcript, provisional certificate or equivalence letter). If your degree is in medicine or nursing, HEC asks you to upload your PM&DC or PNMC registration card or certificate with the application.

  3. House job and experience certificates

    Doctors need a house job certificate showing each rotation and its dates, because the GMC checks internship structure and the Irish Medical Council's Certificate of Experience route depends on it. The Council accepts only certificates issued by the relevant competent authority, not by hospital sites, from 1 December 2025. Get experience letters from every hospital you have worked in, in Pakistan and the Gulf, before you leave each job.

  4. PM&DC or PNMC registration and good standing

    Doctors and dentists apply for a Certificate of Good Standing through the PM&DC doctor portal dashboard; the PM&DC FAQ lists the fee as Rs. 7,000. Nurses and midwives apply to PNMC for verification of registration or a good standing certificate for a foreign regulator, with the application form, a processing fee of Rs. 10,000, the letter or form from the foreign council showing where it must be sent, and copies of the PNMC registration card and all diplomas and degrees. Keep your registration valid while you apply.

  5. MOFA apostille

    Where a destination asks for an apostille (German authorities may), MOFA's Consular Division issues it in Islamabad and at its offices in Lahore, Karachi, Peshawar, Quetta and Gujrat. MOFA says that from 27 July 2026 apostille requests must be registered first on apostille.mofa.gov.pk, after which you receive a challan and an appointment. The fee is Rs. 3,000 per personal or educational document, and authorised courier companies can submit for you for an extra charge. Ask MOFA whether your degree must be attested by HEC before it is apostilled.

  6. Police certificate

    Germany and the Netherlands ask for a certificate of good conduct, and some employers and visa offices ask for a police record. Get one from the police in your province, and from each Gulf country you have lived in if the authority asks. Many authorities want it to be no more than three months old.

  7. Translations

    Pakistani degrees and council documents are usually in English, which the UK, Ireland, the Netherlands and the USA accept. German authorities may ask for qualified German translations of all foreign-language documents, including English ones; the Bezirksregierung Münster does. Urdu documents such as some Nikah Namas or family records need a certified English translation for every destination.

Verification and good standing

  • UK, nurses: the NMC contacts PNMC directly to confirm your registration. PNMC says many NMC UK requests stay pending because applicants have not completed PNMC's own verification requirements, and it will not proceed with NMC cases until they are met, so apply to PNMC as soon as you start your NMC application.
  • UK, doctors: the GMC requires EPIC verification of your MBBS by ECFMG and a certificate of good standing from every medical regulator you were registered with in the last five years, valid for three months from signature. That includes PM&DC and any Gulf authority (DHA, DOH, MOHAP, SCFHS, QCHP, OMSB and others).
  • Ireland: the Medical Council needs EPIC reports before you submit and a certificate of good standing from every registration body in the past five years, dated within three months and emailed directly to [email protected]. NMBI asks for a Certificate of Current Professional Status issued in the last six months.
  • USA: ECFMG verifies your diploma and transcript with your medical school through MyIntealth, and for Pathway 1 asks each licensing authority to send a certificate of good standing directly. US nursing boards and TruMerit want PNMC to send license validation directly.
  • Germany and the Netherlands: both want a recent certificate of good standing or CCPS, no more than three months old, plus a certificate of good conduct.
  • PNMC runs a public register search at online.pnmc.gov.pk, and the PNMC homepage describes verification of nursing professionals for international placements in partnership with the Overseas Employment Corporation.

English tests

  • Pakistan is not on the NMC's, GMC's, NMBI's or the Irish Medical Council's exempt or majority English-speaking lists, so an English-taught degree does not exempt you on its own. Most Pakistani applicants take IELTS Academic or OET.
  • IELTS is jointly owned by the British Council, IDP and Cambridge University Press & Assessment; find a centre and date in Pakistan on ielts.org.
  • OET is offered on paper, on computer at test venues and as OET@Home. Check what your regulator accepts: NMBI does not accept OET at home, the Irish Medical Council does not accept online tests, and ECFMG allows OET@Home only where there is no test venue in your country.
  • GMC: IELTS Academic with 7.0 in each area and 7.5 overall, or OET Medicine with grade B in each, in one sitting. NMC: IELTS 7 in listening, reading and speaking and 6.5 in writing, or OET B and C+ in writing.
  • USA: ECFMG accepts only OET Medicine (350 in listening, reading and speaking, 300 in writing), with no exemptions. For nurses, TruMerit lists IELTS 6.5 overall with 7 in speaking, or OET 360 speaking, 340 reading, 350 writing and 320 listening.
  • Germany needs German at B2 and, for doctors, dentists and pharmacists, the Fachsprachprüfung. The Netherlands needs Dutch at B1 to B2+ depending on the profession.

Sitting exams from here

  • PLAB 1: the GMC lists British Council venues in Pakistan in Islamabad and Karachi, according to the GMC venue page as archived in September 2025. Bookings for overseas venues close about six weeks before the exam. PLAB 2 is only in Manchester.
  • NMC CBT: delivered by Pearson VUE, which the NMC says has test centres in most countries. The OSCE is only in the UK.
  • NCLEX-RN: Pakistan is on NCLEX's list of international locations, and the October 2026 international test centre list shows one Pearson Professional Center, in Lahore. International centres add a $150 scheduling fee.
  • USMLE Step 1 and Step 2 CK: can be taken outside the US and Canada for a region fee ($210 for Step 1, $235 for Step 2 CK). Check centres in Pakistan when you schedule. Step 3 is only in the United States.
  • Irish Medical Council PRES Level 2: held in Dublin and Dubai in 2026, not in Pakistan.
  • German and Dutch exams (Fachsprachprüfung, Kenntnisprüfung, BI-test) and the RCSI nursing aptitude test are held only in those countries.

Ethical recruitment rules

  • WHO: Pakistan is on the WHO health workforce support and safeguards list 2023, one of six countries in the Eastern Mediterranean Region on it. WHO says listed countries should be given safeguards that discourage active international recruitment, and that government-to-government agreements are not ruled out if they meet its conditions. WHO's health workforce migration page still showed the 2023 list when this page was reviewed.
  • UK Code of Practice: Pakistan is on the red list, which NHS Employers last updated on 27 March 2025. GOV.UK says red list means no active recruitment unless a government-to-government agreement permits managed recruitment, and that employers may consider direct applications from individuals resident in red list countries.
  • What that means for you: UK employers and agencies should not target you or run recruitment campaigns in Pakistan, but you can find and apply for UK jobs yourself, and registration with the GMC, NMC or other regulators is not affected. If you live and work in the Gulf, the Code's wording refers to people resident in red list countries, so ask your employer how it applies the Code to you.
  • Recruitment fees: the Code says it is illegal under the Employment Agencies Act 1973 for a recruitment organisation based in Great Britain to charge a job seeker for finding work. Treat any request for a fee for a UK job with suspicion.
  • Germany: Pakistan is on the annex to section 38 of the Employment Ordinance (BeschV), so recruitment and placement for health and care jobs from Pakistan may only be carried out by the Federal Employment Agency.
  • Pakistan's own departure rules: emigration for overseas employment is overseen by the Bureau of Emigration and Overseas Employment through Protector of Emigrants offices. We could not confirm from official pages which requirements apply to a doctor or nurse moving to these destinations, so check with the Bureau before you travel.

Questions

Yes. The red list stops UK employers and agencies from actively recruiting in Pakistan, but GOV.UK says employers may consider direct applications from individuals resident in red list countries. Registration with the GMC, NMC or other regulators is not affected.

The GMC lists British Council venues in Islamabad and Karachi. PLAB 1 runs four times a year, in February, May, August and November, and bookings for overseas venues close about six weeks before the exam. PLAB 2 is only in Manchester.

Log in to the PM&DC doctor portal, choose the Certificate of Good Standing application from your dashboard, attach the required documents and pay. The PM&DC FAQ lists the fee as Rs. 7,000. Time it for the destination's validity window, which is three months for the GMC and the Irish Medical Council.

Apply to PNMC with its verification form, the Rs. 10,000 foreign processing fee, the NMC's request showing where it must be sent, and copies of your PNMC card and all diplomas and degrees. PNMC says it will not proceed with NMC cases until these requirements are met, so do it as soon as you apply to the NMC.

It can. The Irish Medical Council recognises Pakistani internships for the Certificate of Experience route if the house job started on or after 1 January 2009 and its rotations meet the Council's standards. From 1 December 2025 the certificate must be issued by the relevant competent authority, not by the hospital.

Only where the destination asks. The UK, Ireland and the USA verify your degree directly with your university or through ECFMG, while German authorities may want an apostille or legalisation. HEC attests degrees online for Rs. 3,000 per document, and MOFA charges Rs. 3,000 per educational document for the apostille.

Yes. Pakistan is on NCLEX's list of international testing locations, and the October 2026 list shows a Pearson Professional Center in Lahore. An international centre adds a $150 scheduling fee.

No. Pakistan is not on the exempt-country lists of the GMC, NMC, NMBI or the Irish Medical Council, and ECFMG requires OET Medicine from everyone. US nursing boards and VisaScreen also expect a test from Pakistani-trained nurses.

Not private ones. Pakistan is on the annex to section 38 of the German Employment Ordinance, which reserves recruitment and placement for health and care jobs from listed countries to the Federal Employment Agency. You can still apply for recognition and jobs yourself.

Yes, if you are coming to the UK for 6 months or more. GOV.UK lists Pakistan as a country where you need a TB test at a Home Office approved clinic, and the certificate is valid for 6 months from the date of your x-ray.

Yes. Many Pakistani doctors and nurses apply from the Gulf. You will need good standing from your Gulf authority as well as PM&DC or PNMC, and PRES Level 2 for Ireland and PLAB 1 are both offered in Dubai.

Sources

  1. 1WHO: Health workforce support and safeguards list 2023
  2. 2WHO: Health workforce support and safeguards list 2023 (PDF)
  3. 3WHO: Health workforce migration
  4. 4NHS Employers: Code of Practice red and amber list of countries
  5. 5GOV.UK: Code of Practice for the international recruitment of health and social care personnel in England
  6. 6GOV.UK: Tuberculosis tests for visa applicants
Show all 37 sources
  1. 7GOV.UK: Countries where you need a TB test to enter the UK
  2. 8GOV.UK: Health and Care Worker visa
  3. 9PNMC: Verification of registration and good standing certificate
  4. 10PNMC: Home
  5. 11PM&DC: FAQs (archived August 2026)
  6. 12HEC: Degree Attestation System (archived October 2026)
  7. 13MOFA: Consular services, attestation of documents (archived October 2026)
  8. 14GMC: When and where can I take PLAB 1 (archived September 2025)
  9. 15GMC: Using your IELTS certificate
  10. 16GMC: Primary source verification for international medical graduates
  11. 17GMC: Check if your practical training (internship) is acceptable
  12. 18NMC (UK): Registering as a nurse or midwife trained outside the UK
  13. 19NMC (UK): CBT
  14. 20NMC (UK): English language requirements
  15. 21Medical Council: Overseas internships recognised as equivalent
  16. 22Medical Council: English language requirements
  17. 23Medical Council: PRES Level 2 exam
  18. 24NMBI: English language requirements
  19. 25NCLEX: Testing locations
  20. 26NCLEX: October 2026 international test centres
  21. 27USMLE: Apply for exams
  22. 28ECFMG: OET Medicine
  23. 29ECFMG: Pathway 1
  24. 30TruMerit: Tests and scores for foreign health care workers (May 12, 2026)
  25. 31OET: Book a test
  26. 32IELTS
  27. 33Beschäftigungsverordnung (BeschV), section 38 and annex
  28. 34Recognition Finder (anerkennung-in-deutschland.de)
  29. 35Bezirksregierung Münster: Approbation for third-country qualifications
  30. 36BIG register: Certifying and translating documents
  31. 37BIG register: Dutch language proficiency

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