The NZREX Clinical pathway is one of several methods by which international medical graduates (IMGs) may enter the New Zealand medical workforce. The NZREX Clinical is the clinical component of the pathway and consists of a 16-station OSCE. The examination has previously been held twice a year, however due to applicant numbers NZREX Clinical is now held 4 to 5 times a year and 28 candidates are examined in each cohort. A comprehensive range of methods are used to promote validity and reliability of the examination. The mean pass rate over the last 5 years is 60%.