PLAB and MRCP(UK) are not rivals. PLAB is a GMC test that is a licensing route for many international doctors seeking registration in the UK. MRCP(UK) is a postgraduate physician qualification needed for UK physician training. They serve different purposes, and many doctors take them in sequence.
PLAB vs MRCP at a glance
If you are an international medical graduate (IMG) comparing the PLAB exam and the MRCP exam, start with what each one is for. The table below sets the main differences side by side.
| Aspect | PLAB | MRCP(UK) |
|---|---|---|
| Purpose | Shows you have the knowledge and skills to practise safely in the UK; leads, with other requirements, to GMC registration with a licence to practise | A postgraduate qualification for physicians; it is not a licence on its own |
| Run by | The General Medical Council (GMC) | The Federation of the Royal Colleges of Physicians of the UK (London, Edinburgh, and Glasgow) |
| Who takes it | Many IMGs who need a route to GMC registration | Doctors working towards UK physician training and specialties |
| Parts | PLAB 1 and PLAB 2 | Part 1, Part 2 Written, and Part 2 Clinical (PACES) |
| Format | PLAB 1: 180 single best answer questions in 3 hours. PLAB 2: an OSCE with 16 marked clinical stations of about 8 minutes each, using simulated patients | Part 1 and Part 2 Written: best-of-five multiple choice. PACES: a practical clinical exam with real or simulated patients |
| Where | PLAB 1 in the UK and at overseas test centres; PLAB 2 in the UK (Manchester) | The UK and many international centres |
| Eligibility | A primary medical qualification accepted by the GMC, plus the English language and other GMC requirements | Part 1 can be sat from 12 months after graduation; Part 1 must be passed before Part 2 Written and PACES |
| What it leads to | GMC registration (with other requirements met), then NHS work | Completion of Internal Medicine Training and entry to most higher physician specialty training |
What is PLAB?
PLAB stands for the Professional and Linguistic Assessments Board test. The General Medical Council, which regulates doctors in the UK, runs it. For many IMGs it is the main way to show they can practise safely in the UK. Passing it does not register you by itself. You also need to meet the GMC’s other requirements, including English language evidence.
Since 2024, PLAB has been the IMG version of the Medical Licensing Assessment (MLA), the common standard for doctors who want to practise in the UK. From September 2026, PLAB is based on the updated MLA content map. If you are using older study materials, check the GMC’s current information on what the exam covers.
There are two parts. PLAB 1 is a written exam of 180 single best answer questions, sat in 3 hours at UK or overseas test centres. PLAB 2 is a practical exam, an OSCE (objective structured clinical examination), held in the UK. You rotate through 16 marked stations plus rest stations, spending about 8 minutes at each one with a simulated patient.
The GMC sets time limits. You must pass PLAB 2 within 2 years of passing PLAB 1, then apply for registration within 2 years of passing PLAB 2. Attempts are also limited: 4 for each part, with a fifth only after extra learning and GMC approval.
Once you hold GMC registration, you work within the NHS, the UK’s publicly funded health service. GPs provide primary care and hospitals provide secondary care. Before applying for posts, it helps to understand the career ladder, so read our guide to the levels of doctors in the NHS.
PLAB is not the only requirement on the road to registration. The GMC also asks for a primary medical qualification it accepts (listed on the World Directory of Medical Schools), verification of your qualifications through EPIC, a certificate of good standing, and evidence of internship. Without the internship evidence, you may receive provisional rather than full registration.
Think of the usual sequence like this. Many IMGs who want UK physician training take an English test, then PLAB 1, then PLAB 2, then secure GMC registration and an NHS job. MRCP(UK) often follows once they are working, leading towards Internal Medicine Training and higher training. Some doctors instead pass MRCP abroad first and use it for registration, if the GMC accepts it. Neither path is guaranteed to suit every doctor.
It is also worth knowing that the Medical Training (Prioritisation) Act 2026 now prioritises UK graduates, and some others, for UK foundation and specialty training places. This makes competition for training posts harder for IMGs. We cover what this means in the section on recent changes, and no exam on its own can promise a post.
The next sections cover PLAB 1 and PLAB 2 in more detail, the English tests, and what MRCP(UK) involves. Together they will help you decide whether PLAB or MRCP should come first for you.
PLAB 1 and PLAB 2 explained
The PLAB exam has two parts, and you take them in order. Both are run by the General Medical Council (GMC). Since 2024, PLAB has been the international medical graduate version of the Medical Licensing Assessment (MLA). From September 2026 it is based on the updated MLA content map, so use the GMC’s current material when you prepare rather than older question banks or forum advice.
PLAB 1: the written paper
PLAB 1 is a written exam of 180 single best answer (SBA) questions in 3 hours. Each question gives you a clinical scenario and a list of options, and you choose the one best answer. You can sit PLAB 1 in the UK or at overseas test centres, which means you can start the process before you move.
That timing works out at an average of one minute per question, with a small amount of time in hand. Practising under timed conditions matters as much as knowing the content.
PLAB 2: the clinical exam
PLAB 2 is an objective structured clinical examination (OSCE). It is held in the UK, in Manchester. You move through 16 marked clinical stations, plus rest stations, and each station lasts about 8 minutes. The stations use simulated patients, so you take histories, explain things and handle clinical situations as you would on a ward or in a clinic.
Communication, professionalism and safe decision-making are assessed alongside medical knowledge. A doctor who knows the facts but cannot explain a diagnosis clearly to a worried patient is not showing the full set of skills the exam is looking for.
Time limits and attempts
PLAB has time limits built into the pathway:
- You must pass PLAB 2 within 2 years of passing PLAB 1.
- You must apply for GMC registration within 2 years of passing PLAB 2.
- You have 4 attempts at each part. A fifth and final attempt is possible only after at least 12 months of further learning (such as clinical practice or a relevant postgraduate qualification) and with GMC approval.
Those two-year windows are the reason planning matters. A gap between exams, a delayed English test or a missing document can push you towards a deadline.
Your PLAB checklist
Here is the typical order of steps for a doctor taking the PLAB route. Tick each one off as you go; your ticks are remembered in your browser.
- Pass an accepted English language test (IELTS Academic or OET)
- Complete EPIC verification of your qualifications
- Pass PLAB 1
- Pass PLAB 2 within 2 years of PLAB 1
- Apply for GMC registration within 2 years of PLAB 2
- Start your job search in the NHS
Some of these steps can overlap. For example, you may be able to work on EPIC verification while you prepare for PLAB 1. The GMC website sets out what is needed and in what order.
English tests: IELTS vs OET
To register with the GMC you must show that your English is good enough for clinical practice. There are two accepted routes, and the right one depends on how you prefer to be tested.
| Test | Score needed for the GMC | Style |
|---|---|---|
| IELTS Academic | Overall 7.5, with at least 7.0 in each part | General academic English test, not specific to healthcare |
| OET (Medicine) | Grade B in each of the four sub-tests | Healthcare-specific, using medical scenarios |
IELTS is a general academic test taken by students and professionals in many fields. OET is built around healthcare, so the tasks look like real clinical communication: for instance, writing a referral letter or role-playing a consultation. Some doctors find OET closer to their daily work, while others prefer the familiar format of IELTS. Either way, the requirement is that you meet the stated scores, so check the GMC’s current English language requirements before you book.
Other GMC registration requirements
Passing an exam and an English test is not the whole picture. The GMC also asks for the following, whichever route you take:
- A primary medical qualification (PMQ) that the GMC accepts. Your medical school should appear on the World Directory of Medical Schools.
- EPIC verification of your qualifications, carried out through ECFMG, which checks that your documents are genuine.
- A certificate of good standing, which shows that you are in good standing with the regulator in the countries where you have worked or trained.
- Evidence of internship. Without it you receive provisional registration rather than full registration.
Document requests often take longer than expected, because they depend on universities, regulators and other organisations replying. Start early so that a slow certificate does not hold up everything else.
Nothing in this guide replaces the official source. Registration rules, accepted qualifications and English score requirements are set by the GMC, so always check the GMC website for the latest information before you plan your steps.
What is MRCP(UK)?
MRCP(UK) stands for Membership of the Royal Colleges of Physicians of the United Kingdom. It is a postgraduate qualification for doctors who want to work as physicians, the specialists who diagnose and manage medical conditions in adults, mostly in hospitals. It is not a licence on its own, and that point matters when you compare the MRCP exam with the PLAB exam.
The exam is run by the Federation of the Royal Colleges of Physicians. Three colleges make up the Federation: the Royal College of Physicians of London, the Royal College of Physicians of Edinburgh, and the Royal College of Physicians and Surgeons of Glasgow.
The three parts of MRCP(UK)
The full qualification has three parts, and you need to pass all of them to complete it.
- Part 1 is a written paper made up of best-of-five multiple choice questions. It tests clinical knowledge across medicine.
- Part 2 Written is also best-of-five, but it focuses on applying your knowledge to clinical cases.
- Part 2 Clinical, known as PACES, is the Practical Assessment of Clinical Examination Skills. You are assessed with real or simulated patients.
Compare that with PLAB. PLAB 2 is a simulated-station OSCE in Manchester, whereas PACES is a physician-level clinical assessment. Both test clinical skills, but they are set at different levels and for different purposes.
Eligibility and order of exams
You can sit Part 1 from 12 months after graduation. You must pass Part 1 before you can sit Part 2 Written and PACES, and a Part 1 pass stays valid for seven years — you need to pass Part 2 Written and PACES within that time.
MRCP(UK) exams are held in the UK and at many international centres. That is one reason some doctors start MRCP while still working in their home country. Exam centres, dates and application rules change, so always check the MRCP(UK) website for the latest details before you plan.
MRCP and UK physician training
To understand where MRCP fits, it helps to know how UK hospital training is organised. The NHS is the UK’s publicly funded health service. GPs provide primary care, and hospitals provide secondary care. Physician training happens in the hospital system, and MRCP(UK) is built into it.
Full MRCP(UK) is needed to complete Internal Medicine Training (IMT), which lasts 3 years. It is also needed to enter most higher physician specialty training, usually at ST4. Examples include cardiology, respiratory medicine, gastroenterology and endocrinology. If you want to understand what the training grades mean in practice, our guide to the levels of doctors in the NHS may help, though you should check it against current NHS and GMC information.
In the typical sequence for an international doctor who wants UK physician training, the steps look like this: English test, PLAB 1, PLAB 2, GMC registration, an NHS job, then MRCP, then IMT or higher training. The NHS job might be a clinical fellow or locally employed doctor post, or a foundation or IMT post. Treat that as a common pattern rather than a rule, because some doctors follow a different order.
Competition for training posts is also a factor. The Medical Training (Prioritisation) Act 2026 now prioritises UK graduates, and some other groups, for UK foundation and specialty training places. This makes competition for training posts harder for international medical graduates. Nobody can promise a post at any stage, so read the current guidance from the GMC and the relevant training bodies.
Can MRCP replace PLAB?
For some doctors, yes. PLAB is the main route to registration for many IMGs, but it is not the only one. Passing all of MRCP(UK), or certain other UK Royal College exams, can be an acceptable postgraduate qualification for GMC registration. In other words, it can be used as an alternative route to registration if the GMC accepts it.
The key phrase is if the GMC accepts it. Check the GMC’s list of acceptable postgraduate qualifications and the current requirements before you decide. You will usually still need to meet the other registration requirements, such as an accepted primary medical qualification, verification of your qualifications, a certificate of good standing and the English language standard.
Some doctors pass MRCP abroad first and then use it for registration. Others take PLAB first, get registered, work in the NHS, and sit MRCP later while in a UK job. Neither path is automatically better. It depends on your career stage, your specialty and where you are working now.
| Route | Good for | Watch out for |
|---|---|---|
| PLAB, then GMC registration | Doctors who want a licensing route built for IMGs; those not yet in physician training; those aiming for GP, surgery or other specialties | Limited attempts per part; deadlines between PLAB 1, PLAB 2 and applying for registration; PLAB 2 is held in the UK |
| MRCP(UK), if accepted by the GMC | Doctors already well into physician training abroad who plan a physician career in the UK | Must pass all parts; the GMC must accept it as an acceptable postgraduate qualification; it suits physician careers more than other specialties |
| Other GMC routes | Doctors eligible for sponsored schemes such as the Medical Training Initiative, or with EU/EEA/Swiss qualifications | Each route has its own specific rules and eligibility, so check the GMC site |
Many countries run their own licensing exams too. If you are also weighing up work in the Gulf, our article on the DHA, MOH, HAAD and DHCC exams in the UAE explains how that system differs. Rules in every country change, so confirm details with the official regulator before you commit to an exam.
Which should you take first?
The honest answer is that it depends on where you are in your career right now. PLAB and MRCP(UK) do different jobs, so the better question is which one matches your next step. Always check the GMC and MRCP(UK) websites for the latest rules before you commit to a plan, because requirements are updated.
Here are the most common situations international medical graduates describe.
- You want to start working in the UK as soon as you can. PLAB is the main route many IMGs use to show the GMC they can practise safely. The usual order is an English test, PLAB 1, PLAB 2, then GMC registration and a job search.
- You are already in physician training abroad. MRCP(UK) may suit you. Passing all of MRCP(UK) can be an acceptable postgraduate qualification for GMC registration, if the GMC accepts it. Check the GMC’s list of acceptable postgraduate qualifications first.
- You want to become a GP or a surgeon. PLAB is the more likely starting point, followed by the exams for your chosen specialty. MRCP(UK) is aimed at physician training, so it is not the natural fit for these paths.
- You want a hospital physician career (cardiology, respiratory, gastroenterology, endocrinology and similar). You will need full MRCP(UK) at some point, because it is required to complete Internal Medicine Training and to enter most higher physician training, usually at ST4.
MRCP(UK) is a postgraduate qualification, not a licence on its own. PLAB sits on the licensing side. That is why many doctors take them in sequence rather than choosing one forever.
A typical sequence
For an IMG aiming at UK physician training, the common order is: English test, PLAB 1, PLAB 2, GMC registration, an NHS job, then MRCP(UK), then Internal Medicine Training and higher training. Some doctors pass MRCP(UK) abroad first and use it for registration instead. Neither order is “correct”. It depends on your experience and your goals.
The GMC sets time limits that shape your planning. You must pass PLAB 2 within two years of passing PLAB 1, and apply for registration within two years of passing PLAB 2. Attempts are limited too: four for each part, with a fifth only after extra learning and GMC approval. The planner below helps you lay out each step across the months.
Use this step-by-step planner to estimate how many months you might give to each stage: the English test, PLAB 1, PLAB 2, GMC registration and your job search.
Treat the result as a rough personal plan, not a prediction. Your own study speed, test dates and paperwork will decide the real timeline.
Recent changes IMGs should know
Two developments are worth knowing about. Both affect how you plan, so read the latest official guidance rather than relying on this summary.
PLAB and the Medical Licensing Assessment
Since 2024, PLAB has been the IMG version of the Medical Licensing Assessment (MLA). From September 2026, PLAB is based on the updated MLA content map. If you are revising from older books or notes, check them against the current GMC content map so you study what is actually examined.
The Medical Training (Prioritisation) Act 2026
This Act now prioritises UK graduates, and some other groups, for UK foundation and specialty training places. In practical terms, competition for training posts is harder for IMGs. That is a factual change, not a judgement on any individual doctor, and nobody can promise a particular post. Read the official guidance to see how it applies to your situation.
Tips for success
Study with the exam format in mind
PLAB 1 is 180 single best answer questions in 3 hours, so practise answering in timed blocks. PLAB 2 is an OSCE with 16 marked stations of about 8 minutes each, so practise with a partner and simulated patients. MRCP(UK) Part 1 and Part 2 Written use best-of-five questions, while PACES tests your clinical examination skills with patients. Match your practice to the format you will face.
Plan around shift work
Many IMGs study while working or after joining the NHS. Broken sleep makes revision less effective, so build a routine early. This guide to sleep hygiene for shift workers has practical ideas you can adapt around nights and long days.
Think about the longer career
Exams are steps, not the destination. It helps to see how qualifications support the career you want, and our article on why education matters for your career is a good prompt for setting goals beyond the next exam date.
Frequently asked questions about PLAB and MRCP
What is the difference between PLAB and MRCP?
PLAB is the GMC’s test that many international doctors use to show they can practise safely in the UK, leading to registration with a licence to practise. MRCP(UK) is a postgraduate physician qualification needed for Internal Medicine Training and most higher physician training. They serve different purposes and are often taken in sequence.
Can I get GMC registration with MRCP instead of PLAB?
Possibly. Passing all of MRCP(UK) can be an acceptable postgraduate qualification for GMC registration if the GMC accepts it. It can be used as an alternative route to registration, so check the GMC’s list of acceptable postgraduate qualifications and the current rules before relying on it.
Which is harder, PLAB or MRCP?
They are not directly comparable because they test different things. PLAB checks readiness to practise safely, while MRCP(UK) is a postgraduate physician exam with three parts, including PACES. Difficulty depends on your experience, training and preparation, so judge by the content and format of each exam.
How many attempts do you get at PLAB?
You have four attempts at each part of PLAB. A fifth and final attempt needs at least 12 months of further learning and GMC approval. You must also pass PLAB 2 within two years of passing PLAB 1. Check the GMC website for the current attempt and time limits.
Do I need IELTS or OET for the GMC?
You need to show the GMC your English language ability. The accepted tests include IELTS Academic, with an overall score of 7.5 and at least 7.0 in each part, or OET (medicine) with grade B in each of the four sub-tests. Confirm current requirements on the GMC website.
Where can I take PLAB 2?
PLAB 2 is taken in the UK, in Manchester. It is an OSCE with 16 marked clinical stations of about 8 minutes each, plus rest stations, using simulated patients. PLAB 1 is different, because it can be taken in the UK and at overseas test centres.
When can I take MRCP Part 1?
You can sit MRCP(UK) Part 1 from 12 months after graduation. You must pass Part 1 before Part 2 Written and PACES, and you must pass them within seven years of passing Part 1. Exams are held in the UK and at many international centres.
Do I need MRCP to become a GP?
No. MRCP(UK) is aimed at physician training, such as Internal Medicine Training and higher physician specialties. GP training has its own route and its own membership exam, MRCGP. If general practice is your goal, look at the requirements for GP training and the GMC’s registration rules.
What comes after PLAB?
After passing PLAB 2, you apply for GMC registration within two years, provided you meet the other requirements, such as an accepted medical qualification and evidence of internship. Then comes the job search in the NHS. Many doctors later take MRCP(UK) for Internal Medicine Training and higher training.
