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How international medical graduates get registered as doctors in the UK: GMC registration, the PLAB test, how the MLA applies, and English requirements.
Canonical: https://www.prezumi.com/blog/how-to-become-a-doctor-in-the-uk-for-international-doctors
To work as a doctor in the UK as an international medical graduate (IMG) you must hold registration with a licence to practise from the General Medical Council (GMC). Registration is the gate: no employer can appoint you to a medical post without it. Getting there means proving three things to the GMC — your identity and fitness to practise, your knowledge and skills, and your knowledge of English — and then finding a job. Most IMGs prove their knowledge and skills through the PLAB (Professional and Linguistic Assessments Board) test, a two-part exam. There are also routes based on an acceptable postgraduate qualification and routes based on relevant European qualifications. This guide walks each one, and explains where the PLAB test now sits alongside the UK's Medical Licensing Assessment (MLA). Facts here were checked against gmc-uk.org; medical-registration rules change, so confirm the current requirements with the GMC before you plan around them. Last reviewed: August 2026.
This is medical-registration (YMYL) information and it changes. The GMC updates its routes, exams, fees, and English requirements regularly, and the PLAB-to-MLA alignment is recent. Use this as orientation and verify each step against the official source — gmc-uk.org — before you make decisions. Last reviewed: August 2026.
One body decides: the General Medical Council. The GMC keeps the medical register and grants registration with a licence to practise, which is what actually lets you work as a doctor in the UK. Registration and a licence are two linked things — you need both to practise, prescribe, and sign legal documents. The GMC does not employ you or find you a post; NHS trusts, health boards, and other employers do that, but they can only appoint someone the GMC has registered and licensed. Which GMC route you use depends mainly on where you trained and what qualifications you already hold.
Every IMG has to give the GMC evidence of their knowledge and skills. There are three main ways to do that, and you use the one that fits your qualifications.
PLAB is the default route for most international medical graduates, and it has two parts. PLAB 1 is a written, computer-marked exam of multiple-choice questions that tests applied medical knowledge; you can sit it at centres in the UK and in many countries overseas. PLAB 2 is an OSCE (objective structured clinical examination) — a practical exam of clinical and professional skills made up of a series of short scenario stations — and it is held at the GMC's clinical assessment centre in Manchester. You must pass PLAB 1 before you can book PLAB 2. Passing both, together with your English evidence and an acceptable primary medical qualification, lets you apply for registration with a licence to practise.
If you already hold a postgraduate qualification the GMC accepts, you may be able to register through that qualification instead of sitting PLAB. These are specific qualifications the GMC lists as acceptable evidence of knowledge and skills, such as certain UK Royal College memberships or fellowships (for example MRCP, MRCS, or their equivalents in other specialties). The exact list and the specialties it covers are set by the GMC and change, so check whether your qualification is currently accepted before you assume it replaces PLAB.
Doctors who hold relevant European qualifications may have a separate route into GMC registration that does not require PLAB. The rules here shifted after the UK left the EU, and the GMC continues to update how European primary medical qualifications and specialist or GP qualifications are recognised. If you trained in the EU, EEA, Switzerland, or another country with a recognition arrangement, check the current GMC guidance for your exact qualification rather than relying on the pre-Brexit position.
How the MLA applies to IMGs — the current position. The UK introduced the Medical Licensing Assessment (MLA), and this is the part most often misread. As of 2026, international medical graduates do not sit a separate MLA exam. The GMC's stated position is that international doctors joining the UK register "continue to take PLAB, which is compliant with our MLA requirements." PLAB 1 and PLAB 2 are now built to the same MLA content map that UK medical students are assessed against, so in practice you still book and sit PLAB 1 and PLAB 2 — there is no extra MLA step bolted on top. Because this alignment is recent and the GMC keeps refining it, confirm the current mechanics on the GMC's "PLAB and the MLA" page before planning around any hard rule.
| Route | Who it's for | Main requirement |
|---|---|---|
| PLAB test | Most IMGs without a GMC-accepted postgraduate or European qualification | Pass PLAB 1 (written) and PLAB 2 (OSCE), now aligned to the MLA content map |
| Acceptable postgraduate qualification | Doctors holding a GMC-accepted qualification (e.g. certain Royal College memberships) | The qualification itself is the evidence of knowledge and skills |
| Relevant European qualifications | Doctors with recognised European primary medical, specialist, or GP qualifications | Recognition of the qualification under current GMC rules |
Every IMG must give the GMC evidence of their knowledge of English. The two accepted tests are IELTS Academic and the OET (Occupational English Test) in the medicine version. For IELTS Academic the GMC generally requires an overall score of 7.5 with at least 7.0 in each of the four areas (reading, writing, speaking, and listening), achieved in one sitting. For the OET (medicine) the GMC generally requires at least a grade B in each of the four areas. There are also non-test ways to satisfy the requirement, for example an acceptable qualification taught and examined in English or recent English-language practice, but the conditions are specific. Confirm the current thresholds and accepted evidence on the GMC's English-language page before you book a test.
Passing PLAB (or qualifying through another route) makes you eligible to apply for registration; the GMC still verifies your primary medical qualification directly with the awarding body, which takes time, so start early. Once you are registered with a licence to practise, you need a post. Many IMGs begin in non-training NHS roles, often called trust-grade or service posts, such as a clinical fellow or a trust-grade SHO, which do not require you to have entered UK training. From there, doctors move into structured training. UK training runs through the Foundation Programme (the first years after medical school) and then specialty training, which you enter through national recruitment via the Oriel application system. Some IMGs apply directly into specialty training; others build UK experience in a service post first. Experienced specialists can also seek entry to the GMC's specialist or GP register through the Portfolio pathway, which assesses your evidence against the UK standard for that specialty.
For an IMG on the PLAB route, the process from starting PLAB 1 to holding registration commonly takes around one to two years, then more time to secure a training post. The main variables are exam scheduling and, in particular, the availability of PLAB 2 dates, because that exam is held only at the GMC's Manchester centre and slots can be booked up months ahead. Costs stack up across PLAB 1, PLAB 2 (the more expensive of the two), the English test, the GMC registration application and the annual retention fee, and relocation and visa costs where they apply. Every GMC fee is published and changes over time, so price your specific route from the current GMC fee schedule rather than a single quoted figure, and budget for the wait for a PLAB 2 slot.
Registration makes you eligible; a real person still reads your CV to decide on the post, whether it is a trust-grade role or a specialty training number. UK employers and recruiters want a clean medical CV that leads with your GMC registration status, your primary medical qualification, your PLAB or postgraduate progress, your clinical experience, and your referees. Our doctor resume examples show how a physician CV should look at each stage, with a copyable template and the sections a medical HR or recruitment office checks first. If you are weighing the UK against other destinations, our medical licensing comparison for foreign doctors lines up the exams, bodies, and language tests side by side, and you can reuse the same profile for becoming a doctor in Australia, becoming a doctor in the USA, or becoming a doctor in Canada.
You can build that CV in Prezumi: enter your training, GMC registration status, and clinical record once, render it into an ATS-friendly template, and export a text-based PDF for free. When you apply to a specific trust or training programme, the AI editor rewords your real entries to match the posting without inventing anything you didn't enter.
You need registration with a licence to practise from the General Medical Council (GMC). To get it you prove your knowledge and skills — usually by passing the two-part PLAB test, or through a GMC-accepted postgraduate qualification, or through recognised relevant European qualifications — plus your knowledge of English and your fitness to practise. Registration is the requirement to hold any medical post in the UK; after that you still need to secure a job. Confirm the current rules on gmc-uk.org.
PLAB (Professional and Linguistic Assessments Board) is the main route for international medical graduates and has two parts. PLAB 1 is a written, computer-marked multiple-choice exam of applied medical knowledge that you can sit in the UK and in many countries overseas. PLAB 2 is an OSCE, a practical exam of clinical and professional skills across a series of scenario stations, held at the GMC's clinical assessment centre in Manchester. You must pass PLAB 1 before booking PLAB 2, and passing both supports your application for registration.
No. As of 2026 international medical graduates do not sit a separate Medical Licensing Assessment (MLA) exam. The GMC's position is that international doctors continue to take PLAB, which is compliant with its MLA requirements: PLAB 1 and PLAB 2 are now built to the same MLA content map used for UK medical students. In practice you still book and sit PLAB 1 and PLAB 2. Because this alignment is recent, confirm the current mechanics on the GMC's 'PLAB and the MLA' page before planning around any fixed rule.
The GMC accepts IELTS Academic or the OET in the medicine version. For IELTS Academic it generally requires an overall score of 7.5 with at least 7.0 in each of the four areas, in one sitting. For the OET (medicine) it generally requires at least a grade B in each area. Some applicants can instead evidence English through an acceptable qualification taught and examined in English or recent English-language practice. Confirm the current thresholds and accepted evidence with the GMC before booking.
On the PLAB route, getting from PLAB 1 to GMC registration commonly takes around one to two years, driven by exam scheduling and especially the wait for a PLAB 2 slot at the GMC's Manchester centre, plus verification of your primary medical qualification. Finding a post and then entering UK training through national recruitment adds more time. The postgraduate-qualification and European-qualification routes can be faster because they skip PLAB. Confirm current timeframes and fees with the GMC.
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