GMC Registration Guide: PLAB to Full Registration for IMGs
Securing registration with the General Medical Council (GMC) is a pivotal milestone for doctors who wish to practise legally in the United Kingdom. Whether you’re an international medical graduate (IMG) exploring the PLAB pathway, or you hold an overseas postgraduate qualification, understanding each step toward full registration is essential. In this blog, we’ll walk through the various routes to GMC registration, unpack the PLAB exams, explore alternative pathways, and explain what happens once you’ve passed the necessary hurdles.
1. Why GMC Registration Matters
Before diving into the nitty-gritty, it’s worth pausing to appreciate why obtaining GMC registration is so critical:
Legal Requirement: Practising medicine in the UK without GMC registration (and a licence to practise) is illegal.
Eligibility for Employment: Most UK hospitals and clinics will only employ you if you hold full registration and, in many cases, a licence to practise.
Career Progression: Specialty training posts, consultant jobs, and many locum roles require full registration rather than provisional or limited.
In short, GMC registration is your passport to working and progressing as a doctor in the NHS.
2. Overview of GMC Registration Routes
The GMC recognises several pathways to full registration. Broadly speaking, you can pursue:
PLAB (Professional and Linguistic Assessments Board) Route
Primary Medical Qualification (PMQ) Recognised by GMC
Postgraduate Medical Qualification (PG-MQ) Route (e.g., recognised postgraduate diplomas or memberships)
European Economic Area (EEA)/Swiss Qualification Route (less common since Brexit)
Exemptions (e.g., senior doctors with specific credentials)
For most IMGs who hold a medical degree from outside the EEA and whose degree isn’t on the GMC’s exempt list, PLAB remains the primary option. Let’s unpack PLAB first, then touch on alternative pathways.
3. The PLAB Route: Step by Step
3.1 Checking Eligibility
Before registering for PLAB, you must satisfy two core GMC requirements:
English Language Proficiency:
Achieve an acceptable score in IELTS (Academic) or OET.
IELTS: Minimum overall score of 7.5, with at least 7.0 in each of Listening, Reading, Writing, and Speaking.
OET: Minimum grade B in each of Listening, Reading, Writing, and Speaking.
Tests must be taken within two years of your PLAB 1 sitting.
Primary Medical Qualification (PMQ):
Your medical school must be listed on the GMC’s list of acceptable institutions.
You need to provide original or certified copies of your degree certificate (usually via the GMC’s Athena system after your initial application).
Once you have proof of your PMQ and your language test results, you can move forward with the PLAB application.
3.2 PLAB Part 1: Applied Knowledge Test
Format & Content
A multiple-choice question (MCQ) exam of 180 single-best-answer questions.
Duration: three hours.
These questions test clinical knowledge and scenario-based decision-making across the main specialties (Medicine, Surgery, Paediatrics, Obstetrics & Gynaecology, Psychiatry, Emergency Medicine, etc.).
Application & Fees
Applications are made through your GMC online account.
Fees (as of 2025) are approximately £240 for each attempt.
Exam sittings are held in the UK (Manchester, Liverpool, etc.) and a limited number of international centres (e.g., Dubai, Chennai, Algiers).
Preparation Tips
Use GMC’s blueprint: the “PLAB Blueprint” outlines clinical domains and competencies tested.
Invest in question banks (e.g., Passmedicine, PLABable) to build familiarity with exam style.
Form or join study groups—sharing questions and mock exams can be invaluable.
Book early: popular slots fill several months in advance, especially in the UK centres.
Results & Re-sits
You’ll typically receive your score within four weeks.
If unsuccessful, you may sit PLAB 1 up to four times in a five-year period (with a minimum four-month interval between attempts).
3.3 PLAB Part 2: Clinical Skills Assessment
Format & Content
Conducted only in the UK (currently held in Manchester).
Consists of 18 objective structured clinical examination (OSCE) stations—each lasting eight minutes with two minutes for reading instructions.
Stations assess history-taking, physical examination, practical procedures, communication skills (e.g., breaking bad news, consent), and interpretation of clinical data.
Application & Fees
Must pass PLAB 1 before applying for PLAB 2.
Fee (as of 2025) is approximately £875 per attempt.
Booking windows are limited; sign-up opens in cohorts (e.g., quarterly, with 6–8 weeks allocated for a particular exam window).
Preparation Tips
Clinical Skills Practice: Find a local clinical skills lab or simulated patients, if possible. Practise basic procedures—venepuncture, catheterisation, suturing, and more.
Communication Scenarios: Pair up with friends or colleagues to role-play scenarios. Practise explaining diagnoses, obtaining consent, and managing difficult conversations.
Time Management: In a real OSCE, you have very little time. Time yourself when practising to ensure you’re not rushing or leaving crucial steps out.
Mock OSCE Sessions: Some prep courses are available (e.g., GMC-recognised courses run by medical schools or private providers). They can be costly but offer structure and feedback.
Results & Re-sits
Results are usually released within two weeks of sitting PLAB 2.
Up to four attempts are allowed, with at least three months between sittings.
If you fail PLAB 2 multiple times, consider pausing to reflect on your weaknesses — particularly in communication or clinical reasoning.
4. Beyond PLAB: Alternative Routes to Full Registration
Not everyone needs to follow the PLAB route. Depending on where you trained or what additional qualifications you hold, you may qualify for full registration via:
4.1 Recognised Postgraduate Medical Qualifications
The GMC recognises certain postgraduate diplomas, memberships, or fellowships—especially those from Australian, Canadian, Irish, or New Zealand medical colleges. If you hold one of the below recognised qualifications and your primary degree is acceptable, you may bypass PLAB altogether. Examples include:
MCGP (Member of the College of General Practitioners, Ireland)
FRACP (Fellow of the Royal Australasian College of Physicians)
FRCPS (Fellow of the Royal College of Physicians and Surgeons of Canada)
Key Steps:
Confirm that your specific PG qualification is on the GMC’s “List of Accepted Postgraduate Qualifications.”
Provide evidence of the qualification (e.g., original certificate, transcript).
Demonstrate English proficiency in the same manner as PLAB candidates.
Apply for registration, typically under the “Postgraduate” route.
4.2 EEA/Swiss Route
Historically, doctors who qualified in the EEA or Switzerland could register without PLAB by having their qualifications recognised under EU regulations.
Note: Post-Brexit, this pathway remains possible for those who held EEA/Swiss registration before the UK left the EU, but new applicants are assessed under the same criteria as other IMGs.
If you have an EEA qualification from before December 31, 2020, you may still use this route. In all other cases, you’ll likely need PLAB or a recognised postgraduate qualification.
4.3 Specialist Registration (CESR) or Senior Routes
For doctors who have substantial postgraduate experience but lack a UK-recognised postgraduate qualification, the Certificate of Eligibility for Specialist Registration (CESR) is an option.
This route is for doctors aiming to become specialists or consultants in the UK.
Requires a robust portfolio demonstrating equivalence to UK-trained specialists (e.g., logbooks, audit/QI documentation, publications, references, detailed job descriptions).
English language requirements still apply.
Some senior doctors with significant experience in high-income countries might be offered a “temporary registration” to work under supervision, then transition to full registration once they meet GMC requirements.
5. From Provisional to Full Registration
5.1 Provisional Registration
Who Needs It? Newly graduated UK medical students automatically receive provisional registration with a licence to practise for their FY1 year.
IMGs & PLAB: Once you pass PLAB 2 (or hold a recognised postgraduate qualification), you’ll receive full registration and a licence to practise, bypassing provisional registration.
Key Point: If you gain GMC registration before starting UK-based postgraduate training, you’ll still begin your first UK job under full registration.
5.2 Full Registration and Licence to Practise
Full Registration is granted once you meet all GMC requirements (PMQ, English language, PLAB or equivalent).
The Licence to Practise is automatically added once you’ve secured a UK employment contract and your employer confirms you’ve met their pre-employment checks (e.g., DBS, occupational health).
Maintaining Your Licence: You must engage in revalidation every five years—this involves annual appraisals, supporting information (e.g., audits, significant event analyses), and demonstrating continuous professional development (CPD).
6. Timeline & Practical Tips
6.1 Expected Timeline (IMG via PLAB)
Month 0: Book and sit English language test (IELTS/OET).
Month 2: Receive language scores; gather PMQ documentation.
Month 3: Apply to GMC and pay registration fee for PLAB eligibility.
Month 5: Book PLAB 1 (depending on test centre availability).
Month 6: Sit PLAB 1; wait 4–6 weeks for results.
Month 10: Assuming PLAB 1 pass, book PLAB 2 (consider a 3–4 month gap to prepare).
Month 14: Sit PLAB 2; receive results within two weeks.
Month 15: Apply to GMC for full registration; you receive a GMC number and confirmation.
Month 16–18: Secure a UK job (locum or training post), complete pre-employment checks, and activate licence to practise.
6.2 Time-Saving Strategies
Stack Your Prep: Book your language test and PLAB 1 in close succession so you can prepare for both concurrently.
Document Readiness: Have notarised or certified copies of your degree, transcript, and any postgraduate qualifications ready before applying.
Mock OSCE Partners: Join online IMG forums to find partners for PLAB 2 practice—this can be more economical than private courses.
Local Support: If you’ve already moved to the UK, many hospitals and deaneries offer “IMG induction courses” that cover PLAB 2-style OSCEs, local guidelines, and hospital systems.
7. Common Pitfalls & How to Avoid Them
Expired English Scores: Remember: IELTS/OET scores must be less than two years old on the date you sit PLAB 1. Plan your exam so it doesn’t expire mid-process.
Missing PLAB Deadlines: Plan for busy exam centres: UK-based PLAB 2 slots fill quickly, especially after each PLAB 1 cycle. Set reminders as soon as results are released to book Part 2.
Misunderstanding Documentation Requirements: GMC may request your university transcript in a sealed, stamped university envelope. If they ask for additional proof, delays can push back your registration. Always check “ahead of time.”
Underestimating PLAB 2 Prep: Many candidates excel at PLAB 1 but struggle with OSCE-style stations. Schedule at least 4–6 weeks of dedicated PLAB 2 practice, focusing on communication scenarios and practical skills.
Forgetting to Activate Licence: After full registration, you still need your UK employer to confirm pre-employment checks before you can practise. Stay in close communication with your prospective HR department.
8. Life After Full Registration
Once you have full registration and your licence, you can:
Apply for Foundation Programme or Core Training: If you aim to enter UK postgraduate schemes, you’ll need to register through Oriel once you’re eligible.
Take Locum Posts: Many IMGs begin with locum shifts in A&E, wards, or GP surgery, gaining UK experience while they await training applications.
Pursue Academic Positions: With GMC registration in hand, you can apply for clinical research fellowships and combine research with clinical work.
Plan for Specialty Exams: If you’re in a specialty post, start scheduling MRCP, MRCS, MRCGP, or other membership exams early in your training.
Remember, achieving GMC registration is a major accomplishment, but it’s only the beginning. Staying proactive in your learning, networking with UK-based peers, and engaging in continuous professional development are the keys to thriving in the NHS.
Conclusion
Navigating the GMC registration process, from fulfilling English language requirements to mastering PLAB and eventually securing full registration, can seem daunting. Yet, with meticulous planning, targeted preparation, and a clear understanding of the timelines and requirements, many IMGs successfully cross this bridge each year. By avoiding common pitfalls, leveraging study resources, and staying organised, you can fast-track your journey. Once registered, the NHS doors open to countless training and career opportunities. Best of luck on your path to practising medicine in the UK!