The PLAB test explained: who needs it, what it costs, and what the two exams are really like
PLAB is the General Medical Council's two-part test for doctors who qualified outside the UK. PLAB 1 is 180 questions in three hours; PLAB 2 is a sixteen-station OSCE held only in Manchester. Together they cost £1,319 from 1 April 2026. Passing gives you the right to apply for registration — not a job, not a visa, and not a licence until the GMC approves you.
PLAB is the route most doctors with an overseas medical degree take onto the UK medical register. It is run by the General Medical Council, it comes in two parts, and it is the largest single piece of work between a foreign medical degree and a licence to practise in the UK. Here is what it is, who needs it, what it costs, and what the two exams are actually like.
What passing PLAB actually gets you
Not a job, not a visa, and not a licence. It gets you the right to apply for registration with a licence to practise — the thing that makes it lawful to work as a doctor in the UK.
The GMC’s stated purpose for the test is to make sure doctors who qualified abroad have the right knowledge and skills to practise medicine in the UK. Both parts are now built to the standard of the Medical Licensing Assessment, the same benchmark UK medical students graduating from 2024–25 onwards have to meet.
Practising without registration is a criminal offence. The GMC puts it plainly: it is a criminal offence in the UK for a doctor to give the impression they hold registration or a licence when they do not. Passing PLAB 2 is not registration. You are not licensed until the GMC approves your application.
Who has to take it — and who does not
PLAB is for doctors who qualified outside the UK. To sit it at all you need an acceptable overseas primary medical qualification. If you have not graduated yet, the GMC needs confirmation that you have passed your final examinations and met every other requirement for the qualification.
It is not the only way in. Some acceptable postgraduate qualifications lead to registration without PLAB, and there is a separate sponsorship route. Which one fits depends on your qualification, your experience and where you trained — the GMC runs a registration application finder that asks a series of questions and sends you to the guide for your own circumstances.
Start there. The two parts of PLAB cost more than £1,300 before you have booked a flight, and the cheapest sitting of this exam is the one you turn out not to need.
What you need before you can book
- An acceptable overseas primary medical qualification.
- Evidence of your knowledge of English — IELTS or OET.
- A GMC Online account, through which everything is booked and paid.
The English thresholds are exact. IELTS: the Academic version, at least 7.0 in each of the four areas and 7.5 overall, achieved in the same sitting, and in your most recent sitting of the test. The IELTS Indicator test is not accepted. OET: the Medicine version, at least grade B in each of speaking, listening, reading and writing, again in one sitting and your most recent one.
Both certificates are valid for two years, and yours has to be valid on the day you sit PLAB 1 — not the day you book it.
GMC English is not visa English. The GMC says so on its own page: IELTS may not be acceptable evidence of your English for the purposes of obtaining a UK visa. Two bodies, two rule sets, one skill. Clearing the GMC bar tells you nothing about whether you clear the Home Office one, and doctors discover this after they have passed.
One argument against skipping the test even if you could prove your English another way: the GMC’s own research into what influences PLAB pass rates found that candidates who had passed IELTS or OET were more likely to pass PLAB 1 at the first attempt than those who had not. The GMC recommends taking one regardless.
PLAB 1 — the written paper
An applied knowledge test: 180 multiple choice questions in three hours, which is a minute per question. Each opens with a short clinical scenario and asks you to choose one of five answers.
It is pitched at a doctor starting a Foundation Programme Year 2 post — the common, important and acute conditions seen in emergency departments, plus the management of long-term conditions in primary care. It excludes the advanced duties of a GP.
It runs four times a year, in February, May, August and November. In the UK it is held in Belfast, Birmingham, Cardiff, Edinburgh, London and Manchester; in the EU, in Dublin and Madrid; and at British Council centres elsewhere, Cairo, Alexandria, Dubai and Riyadh among them.
Answer for the UK, not for your own hospital. The GMC’s instruction is that questions relate to current best practice in the UK and to equipment routinely available in UK hospitals, and that you answer according to published evidence rather than your local arrangements. This is where experienced doctors lose marks — by answering correctly for the system they actually work in.
PLAB 2 — sixteen rooms in Manchester
A clinical and professional skills assessment, which you may know as an OSCE. Sixteen scenarios, eight minutes each, written to reflect real settings such as a mock consultation or an acute ward. There are at least two rest stations, and the whole exam takes around three hours.
You read the instructions and patient information outside each room, go in, carry out the task, and a timer announces when to move on. Drug names are those in the most recent edition of the British National Formulary.
It is held in one city: Manchester. The GMC has two assessment centres there, and their addresses are almost the same — 3 Hardman Square (M3 3EB) and 3 Hardman Street (M3 3AW). Your booking confirmation says which one you are at. The GMC asks candidates to check that carefully, which tells you how often somebody turns up at the wrong door.
The clocks you are running against
Four deadlines, and they run at the same time:
| Clock | How long |
|---|---|
| IELTS or OET certificate | 2 years — must be valid on the day you sit PLAB 1 |
| PLAB 1 pass → PLAB 2 pass | 2 years |
| PLAB 2 pass → registration approved | 2 years |
| English evidence at registration | Must be valid when the GMC approves the application |
Your pass date is the day you sat the exam, not the day the result arrived. The GMC states this for both parts. The weeks between sitting and results come out of your two years, not theirs. Note too that registration must be approved within two years of PLAB 2, not merely applied for — if you pass that mark, the GMC will ask for additional evidence of your knowledge and skills.
How many attempts you get
Four at each part. Fail a part four times and you may apply for one final attempt, but only by demonstrating evidence of additional learning over a twelve-month period. Fail that fifth attempt and you are no longer eligible to take the exam at all.
There is no re-check of results. The GMC withdrew that service, saying it is confident its marking is robust and a manual check would not change the outcome. An appeal is still open to you.
What it costs
| Fee (from 1 April 2026) | Amount |
|---|---|
| PLAB 1 | £283 |
| PLAB 2 | £1,036 |
| Application for full registration with a licence | £481 |
| Annual fee to stay on the register | £481 |
Cancelling is where it turns expensive, because the penalty is a share of the fee and it steps up as the date approaches:
| Cancellation | You lose |
|---|---|
| PLAB 1, more than 42 days before | 10% — £28.30 |
| PLAB 1, 42 days or less before | 100% — £283 |
| PLAB 2, more than 42 days before | 10% — £103.60 |
| PLAB 2, between 42 and 29 days before | 50% — £518 |
| PLAB 2, 28 days or less before | 100% — £1,036 |
The PLAB 2 cliff is the one to diarise: cancel with 28 days or less to go and the whole £1,036 is gone. If a visa for the trip to Manchester is uncertain, that date matters more than the exam date.
Refugee doctors living in the UK pay nothing for their first two PLAB 1 attempts.
The pass rate fell sharply in 2025
| Year | PLAB 1 pass rate | PLAB 2 pass rate |
|---|---|---|
| 2021 | 74.1% | 69.9% |
| 2022 | 70.9% | 64.8% |
| 2023 | 72.0% | 62.9% |
| 2024 | 70.5% | 65.8% |
| 2025 | 62.2% | 59.8% |
Both parts hit their lowest figure in five years in 2025. Roughly two candidates in five now fail PLAB 2 on a given attempt. Budget for the possibility of a second sitting rather than treating one pass as the plan.
What changes in 2027
The GMC is reducing how much PLAB 1 it delivers overseas, because international demand has started to fall after years of growth. From 2027:
- Dhaka, Alexandria, Accra and Chennai stop running the exam.
- The February sitting will not run at any international location. UK and EU centres still run in February.
If your English certificate expires before 31 May 2027, this is live now. The GMC’s advice to anyone who planned an international February 2027 sitting is to sit in August or November 2026 instead. August has gone; November 2026 is the sitting that advice now points to. If your evidence expires between 1 February and 31 May 2027, the GMC may extend its validity so you can sit in May 2027 — but you have to ask by email, and the request must reach them by 19 March 2027.
Two things PLAB is not
It is not a job. The GMC states that the number of PLAB places is not linked to the number of jobs available, and tells candidates to look at real vacancies before booking. Many general practice and specialty roles require training and qualifications well beyond registration.
It is not a visa. Registration makes it lawful to practise; it says nothing about your permission to be in the UK. That is a separate application to the Home Office, on a separate route, with its own English requirement and its own fees.
Book it yourself — nobody can book it for you. The GMC is unambiguous: a PLAB place can only be booked through your own GMC Online account, only the account holder may access that account, and sharing your details with a third party is misconduct that can affect your booking and any future registration application. Any agency offering to book PLAB on your behalf is asking you to risk your registration to save yourself a form.
Where we fit, honestly. We file UK ETAs and nothing else. We are a private agency — not the GMC, not the UK Government, and not immigration advisers. Nothing here is medical or legal advice. Check every figure on the GMC’s own pages before you pay anything, and for the visa side of a move to the UK, take advice from a regulated UK immigration adviser.
Checked against the official sources below on 19 September 2026.