PLAB and GMC Registration 2026: The Route to a UK Licence to Practise

What does the General Medical Council require from an international medical graduate in 2026?

The General Medical Council requires four things from an international medical graduate seeking registration with a licence to practise in the United Kingdom in 2026: a primary medical qualification the GMC finds acceptable, evidence of English language ability, evidence of medical knowledge and skills, and an application approved within two years of passing the final examination. For most applicants the third of those is the PLAB test.

Registration and the licence are two separate ideas that arrive together. Registration puts a doctor on the medical register. The licence to practise is what permits the work itself — prescribing, treating, signing. An international medical graduate applies for both in one application, and the General Medical Council charges one fee for it.

The GMC applies these rules to doctors whose primary medical qualification comes from outside the United Kingdom, the European Economic Area and Switzerland. Holders of relevant European qualifications remain outside the PLAB requirement under existing legislation.

What is the PLAB test, and what do PLAB 1 and PLAB 2 each assess?

PLAB is two separate examinations, sat months apart and booked separately. PLAB 1 is a written applied knowledge test of 180 single best answer questions, answered within three hours. PLAB 2 is an objective structured clinical examination of 16 scenarios, each lasting eight minutes, running about three hours in total. Both are pitched at the standard of a doctor starting the second year of the United Kingdom Foundation Programme.

Each PLAB 1 question opens with a short clinical scenario and offers five possible answers, of which one is best. The General Medical Council describes the paper as a test of applied knowledge rather than recall — the conditions a junior doctor meets, and the management decisions primary care asks for. Reciting a textbook does not carry a candidate through it.

PLAB 2 puts the same standard in a room. Sixteen stations, eight minutes each, built to imitate real clinical settings: a patient, a relative, a colleague, a task. The GMC assesses clinical knowledge, skills and behaviours, and the ability to apply that knowledge to the care of patients. Communication is assessed alongside the medicine, not after it.

During 2024 the General Medical Council made both parts compliant with the Medical Licensing Assessment. PLAB 1 now meets the requirements for the MLA Applied Knowledge Test and PLAB 2 meets the requirements for the MLA Clinical and Professional Skills Assessment, with questions and stations drawn from the MLA content map. The GMC states that eligibility criteria for PLAB did not change as a result.

Where can PLAB 1 be taken in 2026, and how often does it run?

The General Medical Council runs PLAB 1 four times a year, with sittings in February, May, August and November. Inside the United Kingdom it is held in Belfast, Birmingham, Cardiff, Edinburgh, London and Manchester. Outside it, the GMC runs sittings in Dublin and Madrid, and the British Council administers the examination in fourteen further countries.

Those fourteen span most of the regions from which international medical graduates come: Australia (Sydney), Bangladesh (Dhaka), Canada (Toronto), Egypt (Alexandria and Cairo), Ghana (Accra), India (six cities), Kenya (Nairobi), Nigeria (Abuja and Lagos), Pakistan (Islamabad and Karachi), Saudi Arabia (Riyadh), South Africa (Johannesburg), Sri Lanka (Colombo), Turkey (Istanbul) and the United Arab Emirates (Dubai). A candidate sitting PLAB 1 in Dubai in 2026 never needs a UK visa for that stage.

Booking runs through a GMC Online account. The General Medical Council notes that places are limited where demand is high and that a wait for a test date is possible, which is the single most common reason a personal timeline slips. Book early. The examination itself is the same paper wherever it is sat.

Where is PLAB 2 held, and what does the examination day look like?

PLAB 2 is held in one city only. The General Medical Council runs it at its Clinical Assessment Centre in Manchester, United Kingdom, at 3 Hardman Square, and every candidate in the world travels there for it. Unlike PLAB 1, PLAB 2 is not tied to four annual sittings — the GMC runs dates throughout the year.

A candidate can book PLAB 2 only once PLAB 1 results are published. That sequencing matters for anyone planning flights and a visitor visa, because the booking window and the travel window open at the same moment. The sixteen stations run back to back, eight minutes apiece.

Because PLAB 2 happens in the United Kingdom, its true cost is never only the examination fee. Travel from the country of residence, accommodation in Manchester and, for most nationalities, a visitor visa sit on top of the £1,036 the General Medical Council charges. Those are planning items, not surprises, and they are the reason the worked example further down adds travel in as its own line.

What are the PLAB and GMC registration fees in 2026?

From 1 April 2026 the General Medical Council charges £283 for PLAB 1 and £1,036 for PLAB 2. The application for full registration with a licence to practise costs £481, reduced to £184 for doctors who qualify for the fixed-term discounted rate. The annual retention fee for registration with a licence is also £481 in 2026.

The 2026 figures represent a rise on the year before: PLAB 1 stood at £273 and PLAB 2 at £998 from 1 April 2025. Fees change on 1 April, so a candidate sitting in February pays the old rate and one sitting in May pays the new one.

One discount is worth knowing about before the application goes in. The General Medical Council reduces the fee by 50% where a doctor's worldwide income falls below its income discount threshold, set at £38,500 from 1 April 2026. A doctor still working in their home country when they apply frequently sits below it.

What English language evidence does the General Medical Council accept in 2026?

The General Medical Council accepts five kinds of English language evidence in 2026: an IELTS Academic certificate, an Occupational English Test certificate, a primary medical qualification taught and examined in English, a reference from an employer, or a United Kingdom job offer. For IELTS Academic the GMC requires at least 7.0 in each of the four testing areas and at least 7.5 overall, achieved in a single sitting.

The single-sitting rule catches people out more than the scores do. Neither test lets a candidate carry a strong reading score from March into a retake in July; the General Medical Council reads the most recent sitting. IELTS offers one narrow exception — a One Skill Retake within 60 days, where the original test was computer-based and one component fell short.

Validity is counted against a moving target. An IELTS or OET certificate must still be valid on the date of the PLAB 1 examination, and again when the registration application is approved. A certificate taken very early in the process can expire mid-route, which is why the English test usually belongs close to the PLAB 1 booking rather than a year ahead of it.

The degree route removes the test entirely for some graduates. A primary medical qualification counts as English evidence where it was taught and examined solely in English, where at least 75% of course-related clinical interaction — patients, families, colleagues — was conducted in English, and where the qualification is less than two years old at the time of application. The university must confirm all of that in a letter, including the date the final examination was passed. Graduates of English-taught programmes abroad should ask their faculty whether it issues that letter as a matter of course, because many do.

Is my medical degree acceptable, and what does the World Directory of Medical Schools have to do with it?

The General Medical Council assesses every overseas primary medical qualification case by case and publishes no list of acceptable qualifications. What it does require is an entry in the World Directory of Medical Schools: the awarding institution must appear there with verifiable contact details, and the degree title, the duration, the name of the awarding body and any affiliations must match that listing.

The World Directory at wdoms.org is a joint venture of the World Federation for Medical Education and FAIMER, a division of Intealth. It lists more than 4,000 medical schools worldwide. Each record carries contact information, known affiliations, curriculum and enrolment details, and separate entries where a school runs several programmes.

One line in the World Directory's own terms deserves quoting plainly: a listing does not denote recognition, accreditation or endorsement. The directory is a register of what exists, not a seal of approval. Regulators use it as the reference against which they check a school's identity — the General Medical Council does exactly that, and the Educational Commission for Foreign Medical Graduates in the United States built its predecessor directory for the same purpose.

For anyone choosing a programme abroad, the practical consequence is small and worth acting on early. Look up the school in the World Directory before enrolling, and read the entry against the degree the programme actually awards. If the listing says a six-year MD and the marketing says something else, that mismatch is the thing a regulator will see years later.

Alongside the listing, the General Medical Council sets substantive criteria for the programme itself in 2026. The qualification must come from a programme of study over at least three years, comprising no less than 5,500 clock hours in allopathic and clinical medicine, including practical experience and any pre-graduate internship, but excluding personal revision. The majority of the programme, theoretical and clinical, must have been undertaken in person at the institution — significant online learning is accepted only in exceptional circumstances such as a pandemic or armed conflict. The course must include clinical placements or rotations covering medicine and surgery, with genuine in-person contact with patients and colleagues.

Those criteria are the reason the choice of university abroad and the licensing plan belong in the same conversation rather than five years apart. Medschool Experts places students at universities worldwide and assesses each profile individually, because whether a given programme fits a given regulator depends on the person as much as the school. Requirements differ by university and by individual profile, so the honest answer to “will this degree work for the United Kingdom?” comes from looking at the actual case: free individual consultation. The programmes Medschool Experts works with are set out under universities.

What are the PLAB pass rates, and how should a candidate plan around them?

The General Medical Council publishes pass rates for both parts. In PLAB 1 the rate moved from 74.1% in 2021 to 62.2% in 2025, the latter across 13,691 candidates. PLAB 2 moved from 69.9% in 2021 to 59.8% in 2025, across 14,689 candidates. Roughly six in ten candidates passed each part in 2025.

A pass rate is a description of a cohort, not a prediction about one person. What the 2025 figures do justify is building a calendar with room in it — a candidate who assumes one attempt at each part and books flights accordingly has no slack, while one who treats the sequence as a year rather than a quarter usually finds the exams fit around a working life. The PLAB 1 sittings in February, May, August and November set the rhythm.

Which routes to registration exist alongside PLAB in 2026?

Two alternatives lead to full registration with the General Medical Council without the PLAB test in 2026: an acceptable postgraduate qualification, or sponsorship by a GMC-approved sponsoring body. Both are aimed at doctors already some years into practice, and both replace PLAB as the evidence of knowledge and skills rather than replacing the English or the degree requirements.

The postgraduate route runs on a list the General Medical Council maintains by country and specialty. United Kingdom qualifications on it include MRCP (UK), FRCA, MRCOG and the FRCS awards of the surgical colleges. Overseas qualifications carry award-date conditions — the Australian FRACGP counts where awarded since 1 January 2007, the New Zealand FRNZCGP since 1 January 2012, the Australasian FACEM since 2001, and the Canadian CCFP since 1 January 2009. The qualification must have been awarded within three years of the date the GMC approves the application, and the same evidence goes to the Educational Commission for Foreign Medical Graduates for primary source verification.

Sponsorship works differently. An approved sponsoring body — the General Medical Council lists over 150, among them NHS trusts, royal colleges and named fellowship programmes — satisfies itself that a doctor has the knowledge, skills and experience to practise as a fully registered practitioner, then issues a Sponsorship Registration Certificate. A core part of every sponsor's criteria is recent practice: engagement in medical practice for three of the last five years and ten of the most recent twelve months. English language evidence is still required, at the same IELTS or OET levels. One trap sits in the paperwork — the certificate must be a Sponsorship Registration Certificate for GMC registration, not the certificate of sponsorship an employer issues for a visa. They share a name and nothing else.

How long does the whole sequence take in 2026?

Three fixed points govern the length of the PLAB route to General Medical Council registration in 2026. PLAB 1 runs only in February, May, August and November. PLAB 2 can be booked only after PLAB 1 results are published, though the GMC runs dates across the year. And the registration application must be approved within two years of the day PLAB 2 was passed.

That last deadline is a limit, not a target. It gives a doctor two full years after PLAB 2 to gather documents, apply and be approved — enough room to finish an internship at home or serve out a contract before moving. Most people use far less of it.

Two variables stretch or compress that shape. The wait for a PLAB 1 seat where demand is high is one, and the wait for a PLAB 2 date is the other; both are booking-service realities rather than published intervals, and both reward early action. A doctor who starts the English test in January has a materially different year from one who starts it in September.

What does the PLAB route cost in 2026 — a worked example?

Adding the General Medical Council fees to the United Kingdom visa fee gives a hard floor of £2,124 for the PLAB route in 2026. The worked example below follows one case — a doctor sitting PLAB 1 in Dubai in 2026, travelling to Manchester for PLAB 2, then entering the United Kingdom on a Health and Care Worker visa for a three-year post.

The four fixed fees are PLAB 1 at £283, PLAB 2 at £1,036, full registration with a licence to practise at £481, and the Health and Care Worker visa for up to three years at £324. Together, £2,124. Where the fixed-term discounted registration rate of £184 applies instead of £481, the same four lines come to £1,827.

Three costs sit outside that total and belong in any honest budget. The English test fee is set by IELTS or OET, not by the General Medical Council, and varies by country and test centre. Travel and accommodation for PLAB 2 in Manchester depend entirely on the starting point — from Dubai this is a return flight and roughly a week on the ground. And the Health and Care Worker visa requires £1,270 to be held in a bank account for 28 consecutive days: money shown, not money spent, and waived where the applicant has held a UK visa for at least twelve months or the employer covers first-month costs.

Set against a doctor's earnings, the arithmetic is unremarkable — the whole regulatory stack costs less than the annual retention fee twice over. The expensive part of this route has never been the fees. It is the year of study and the travel, and both are things a person can plan for. Medschool Experts advises on that planning as part of its services.

What happens after registration: the Health and Care Worker visa and the first post?

Registration with a licence to practise lets a doctor work in the United Kingdom; the Health and Care Worker visa lets them enter. In 2026 the visa costs £324 for up to three years and £628 for more than three years, per person, whether applied for inside or outside the United Kingdom. It carries no immigration health surcharge, and the doctor can use the NHS free from the day the visa starts.

The visa is employer-led. It requires a confirmed job offer and a certificate of sponsorship from an employer approved by the Home Office, and the applicant must be a qualified doctor, nurse, health professional or adult social care professional working in an eligible job at or above the minimum salary. An application can go in up to three months before the start date, and a decision usually arrives within three weeks. The visa runs up to five years before it needs extending, after which settlement may become available.

A licence to practise and a place on a training programme are two different things, and 2026 drew that line more sharply. The Medical Training (Prioritisation) Act 2026 received Royal Assent on 5 March 2026 and came into force the following day. Its long title describes provision “about the prioritisation of graduates from medical schools in the United Kingdom and certain other persons for places on medical training programmes”, and it places United Kingdom medical graduates, together with a defined priority group — graduates of Ireland, Iceland, Liechtenstein, Norway and Switzerland — ahead of other applicants for the Foundation Programme and for specialty training. Registration and the licence are governed separately, by the General Medical Council, and the Act changes nothing about what the GMC asks of an international medical graduate.

What that means in practice is a sequencing question rather than a closed door. A doctor entering the United Kingdom on the PLAB route holds a full licence and can be employed on that basis; a place on a training programme is applied for separately and under the order of preference the Act sets. Planning the first post around the employer who will issue the certificate of sponsorship, rather than around a training number alone, is the version of this that works. The GMC-approved sponsorship route described above exists precisely because organisations want experienced doctors and will vouch for them.

Doctors remain scarce almost everywhere, and the United Kingdom register is open to graduates of more than 4,000 medical schools worldwide. The route has stages, fees and dates, all of them published, all of them plannable. Where the question is whether a particular degree and profile fit this route, that is a case-by-case matter of the individual transcript and qualification, and Medschool Experts assesses it directly in a free consultation.