Licence to practise
Definition
A licence to practise is the legal permission, granted by a health regulator, to work in a regulated health profession. In the UK the General Medical Council grants doctors registration with a licence to practise, while for nurses and most other professions being on the register is itself the permission to practise.
Also called: licence to practice, license to practice, GMC licence to practise, practising licence, registration with a licence to practise
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What is a licence to practise?
In everyday use, a licence to practise is whatever legal permission lets you work in your profession in a given country. In the UK the phrase also has a precise meaning for doctors. The General Medical Council (GMC) separates registration from the licence. The GMC says doctors who practise medicine in the UK need a licence to practise along with the right type of registration for their work, and that it is the licence which allows them to carry out certain activities such as prescribing medicines and treating patients. The licence gives legal rights and privileges in the UK only.
A doctor can be registered without a licence. The GMC says these doctors should not practise medicine in the UK but keep their registration to show they are in good standing. They pay a lower annual fee and do not revalidate.
How it works in each country
- UK, nurses and allied health professionals: there is no separate licence. Registration with the NMC or HCPC is the permission to practise and to use the protected title.
- Ireland: the Medical Council states that it is an offence to practise medicine in the State while unregistered. Doctors register in one of several divisions.
- Netherlands: BIG registration is mandatory to work in the 11 Article 3 professions and use their titles.
- Germany: doctors need the Approbation, or a temporary Berufserlaubnis.
- USA: licences are issued by each state, see state licensure.
How to get one
- Have your primary qualification verified, for doctors usually through EPIC.
- Meet the regulator's English requirement, for example IELTS or OET.
- Pass any exam the route requires, such as PLAB for the GMC or the NMC test of competence.
- Provide evidence of good standing from every regulator you have been registered with.
- Pay the registration fee and, for GMC doctors, apply for registration with a licence.
See our PLAB and GMC registration guide for the full doctor route.
What it costs and how you keep it
From 1 April 2026 the GMC annual fee for registration with a licence to practise is £481, and £172 without a licence. The GMC offers a 50% discount if your worldwide income is under its income threshold, which is £38,500 from 1 April 2026. To keep the licence, doctors must revalidate, usually every five years, and have an annual appraisal.
For nurses and midwives the NMC annual fee rose from £120 to £143 on 1 October 2026, and registration is renewed through revalidation every three years. If the fee is not paid on time, NMC registration lapses automatically and you cannot practise until you are readmitted.
Common problems
- Assuming a licence from another country transfers. It does not; see our guide to moving from a Gulf licence.
- Letting a fee lapse, which can stop you working immediately.
- Holding registration without a licence and then taking a clinical post that needs one.
- Not having indemnity cover in place, which the GMC can treat as grounds to remove a licence.
Questions
For UK doctors, no. The GMC says doctors who practise medicine in the UK need both a licence and the right type of registration, and it is the licence that allows activities such as prescribing medicines and treating patients. For UK nurses, midwives and allied health professionals, registration itself is the permission to practise.
Yes. You pay a lower annual fee and do not revalidate, but the GMC says doctors registered without a licence should not practise medicine in the UK.
No. Each regulator assesses your qualification and sets its own requirements. Your existing licence is evidence of your registration history and good standing, not a substitute for local registration.
Pay the annual fee on time, meet your regulator's revalidation or renewal requirements and keep appropriate indemnity cover. GMC doctors revalidate usually every five years and NMC registrants every three years.
Your registration can lapse or be removed, and you cannot practise until it is restored. The NMC says readmission after a lapse can take between two and six weeks.
If the job involves practising medicine in the UK, yes. The GMC says doctors who practise medicine in the UK need a licence along with the right type of registration for their work, and that employers must make sure their doctors hold appropriate registration for the role. Doctors who work wholly outside the UK do not need a GMC licence, except in the Crown Dependencies.