PRES (Pre-Registration Examination System)

The Medical Council regulates doctors in Ireland. It says doctors intending to register in the General or Trainee Specialist Division may be required to sit PRES. The exams test knowledge and clinical skills in obstetrics and gynaecology, paediatrics, psychiatry, surgery, and medicine or general practice, and are based on the Council's Eight Domains of Good Professional Practice.

• PRES Level 2 is a written multiple choice exam answered within three hours. Each question starts with a short scenario.
• PRES Level 3 examines interpretation skills in one written or computer-based exam, and practical and communication skills in one clinical exam where candidates rotate through scenarios or skill stations, an OSCE format. Both are sat over one day.

You must pass Level 2, or an accepted alternative, before applying for Level 3.

The Medical Council publishes a blueprint for each level, setting out the knowledge, skills and behaviours expected, and a set of 90 sample questions for Level 2.

Yes. The Medical Council accepts these as alternatives to PRES Level 2, each valid for the same period as the awarding body allows:

• PLAB Part 1, valid for two years from the exam date from 31 March 2025.
• USMLE Step 1 and Step 2 CK, dated within seven years.
• Medical Council of Canada Qualifying Examination (MCCQE) Part 1.

With one of these you apply directly for PRES Level 3.

1. Verify your basic medical degree through EPIC before applying.
2. Create a Medical Council online account and start an application in the General Division, choosing the PRES route.
3. Upload evidence of effective communication skills and the other documents in the PRES checklist.
4. Ask every regulator you were registered with in the past five years to send an original certificate of good standing, dated within the last three months, directly to the Council.
5. Pay the application fee. Once assessed, the Council tells you how to book the exam.

The Medical Council's fee schedule lists €352 for PRES Level 2 and €1,500 for PRES Level 3, plus a General Division first-time application fee of €451. Registration and retention fees rose by 10% in 2026, with a further 10% planned for 2027.

For 2026, Level 2 was scheduled in August and November in Dublin and Dubai, and Level 3 in September, October and November at Irish venues. Results for both levels are issued about six weeks after the exam, as pass or fail. Places are limited and allocated first come, first served.

• Attempt limits. The Council says Level 2 candidates are typically permitted two years or three attempts to pass.
• Incomplete applications are closed and the application fee is not refunded.
• Missed withdrawal deadlines mean forfeiting the exam fee.

Our PRES guide covers registration after passing, including the Supervised Division.

Allocations to exam dates are made strictly on a first come, first served basis once a completed application form and payment are received. Late applicants may be offered a later preference or a place on a standby list.