The PLAB is a two-part medical exam run by the UK’s General Medical Council (GMC) that international medical graduates must pass before they can practise medicine in the United Kingdom. It stands for Professional and Linguistic Assessments Board, and it tests whether you have the knowledge and clinical skills equivalent to a doctor starting their second year of Foundation Programme training in the UK. If you graduated from a medical school outside the UK and want to work as a doctor there, this is the standard route in.
Who Needs to Take PLAB
PLAB is specifically for doctors who earned their medical degree outside the UK. To be eligible, you need a primary medical qualification from an institution listed in the World Directory of Medical Schools that the GMC accepts for limited registration. You also need to demonstrate English language proficiency before sitting the exam, with IELTS Academic scores of at least 7.5 overall and a minimum of 7.0 in each of the four skills (reading, writing, listening, speaking).
UK medical graduates don’t take PLAB. They sit a separate but related assessment as part of the Medical Licensing Assessment (MLA) framework. Graduates from certain countries with GMC-recognized postgraduate qualifications may also be exempt, but for most international medical graduates, PLAB is the required pathway.
PLAB 1: The Written Exam
PLAB 1 is a three-hour written exam consisting of 180 single best answer questions. Each question presents a short clinical scenario followed by five possible answers, and you choose the one correct option. There’s no negative marking for wrong answers.
The content covers common, important, and acute conditions that a second-year foundation doctor would encounter, including emergencies typically seen in emergency departments and long-term conditions managed in primary care. It does not test advanced general practitioner duties. Think of it as a broad test of whether you can safely recognize and manage the medical problems you’d face as a junior doctor in a UK hospital or clinic.
The exam is available at test centres in over 20 countries, making it accessible without travelling to the UK. You can sit PLAB 1 in cities including Dubai, Mumbai, New Delhi, Lagos, Nairobi, Cairo, Karachi, Toronto, Sydney, Dhaka, and Colombo, among others. European locations include Dublin and Madrid. The current fee is £273.
PLAB 2: The Clinical Skills Test
PLAB 2 is an Objective Structured Clinical Examination (OSCE), which means you rotate through a series of timed stations where you interact with simulated patients and demonstrate clinical skills in real time. Each station gives you eight minutes to complete a scenario.
Examiners assess you across three domains: data-gathering skills (taking a history, examining a patient), clinical management skills (forming a diagnosis and plan), and interpersonal skills (communicating clearly and professionally with patients). This part of the exam tests whether you can actually do the job, not just answer questions about it. You need to take a history, explain a diagnosis, counsel a patient, or perform a clinical examination while an examiner observes and scores you.
Unlike PLAB 1, PLAB 2 can only be taken in the UK. The fee is £998, which reflects the cost of running a practical exam with trained examiners and simulated patients at each station.
How the Pass Mark Works
Neither exam uses a fixed pass mark. For PLAB 2, the GMC uses a method called borderline regression scoring, where the passing threshold for each station varies based on how difficult that particular scenario turns out to be. After the exam, station-level cut scores are calculated and added together to produce the overall pass mark. You need to meet or exceed this total score and pass a minimum number of individual stations. The examiners themselves don’t know the passing score while they’re assessing you; it’s calculated afterward.
Because pass marks are generated separately for each testing venue and date, two candidates sitting PLAB 2 on the same day at different centres could face slightly different passing thresholds. This statistical approach is designed to keep the standard consistent even when the difficulty of individual scenarios varies.
What Happens After You Pass
Once you pass both parts, you can apply for GMC registration with a licence to practise. The key deadline to know: your application must be approved within two years of passing PLAB 2. If more than two years have elapsed, you’ll need to provide additional evidence that your knowledge and skills are still current.
At the point of application, you’ll also need valid English language evidence. If you apply within three months of passing PLAB 2 and your IELTS or OET scores are less than three years old, your PLAB 2 pass itself can serve as part of that language evidence. After that window closes, you may need to provide fresh test scores.
PLAB and the Medical Licensing Assessment
You may see references to the UK Medical Licensing Assessment (MLA) and wonder whether PLAB is being replaced. The short answer: not yet. The GMC has confirmed that PLAB is already compliant with MLA requirements. PLAB 1 meets the standards for the MLA Applied Knowledge Test, and PLAB 2 meets the standards for the MLA Clinical and Professional Skills Assessment. The eligibility criteria haven’t changed as a result of this alignment.
The GMC plans to modernize the name at some point, but for now the exam keeps its current PLAB branding. If you’re preparing for the exam today, the structure, content, and registration pathway remain the same.
Costs and Planning
For the 2025-2026 cycle, PLAB 1 costs £273 and PLAB 2 costs £998. Beyond exam fees, budget for travel (especially for PLAB 2, which requires a trip to the UK), accommodation, and study materials. Many candidates also factor in the cost of IELTS preparation and testing, which is a prerequisite before you can even book PLAB 1.
The total timeline from starting IELTS preparation to gaining GMC registration varies widely, but most candidates spend several months preparing for each part of PLAB. Since PLAB 2 is only offered in the UK and slots can fill up, booking early is practical. The two-year window for applying after passing PLAB 2 gives you some breathing room, but delays in gathering documents or meeting other registration requirements can eat into that time faster than expected.