Work abroad as a doctor: UK, Ireland, EU and US (2026)

1. 1

   Verify your medical degree

   Have your primary medical qualification verified at source, usually through ECFMG's EPIC service, which the GMC and the Medical Council both use. The GMC says most medical schools reply within 90 days, so start this first. Check your school is listed in the World Directory of Medical Schools with the right sponsor note for the country you want.
2. 2

   Choose your route in each country

   Decide whether you need the licensing exam or qualify for an exemption: a postgraduate qualification for the GMC, a recognised internship or PLAB 2 pass for the Medical Council, or a specialist route. In Germany, decide which state you will apply in, because the authority and fees differ.
3. 3

   Reach the language level

   Take IELTS Academic or OET Medicine for the UK and Ireland, in one sitting at the required scores. For Germany, reach B2 in general German before the medical language test; for the Netherlands, reach Dutch B2+ and English reading. Language certificates expire, usually after two years, so time them with your applications.
4. 4

   Pass the licensing exams

   Sit PLAB 1 and PLAB 2, PRES Levels 2 and 3, the German knowledge test, the Dutch BI test or USMLE Step 1 and Step 2 CK. Check attempt limits and deadlines, such as the GMC's two years from PLAB 1 to pass PLAB 2, and the USMLE limit of four attempts.
5. 5

   Collect good standing and practice records

   Ask every regulator you have been registered with in the last five years for a certificate of good standing; the GMC accepts them only if issued in the last three months. Account for every gap in your career, with references where needed.
6. 6

   Get a post and the right visa

   Apply for jobs: NHS or HSE non-training posts, a supervised post approved by the HSE, a German hospital post under a Berufserlaubnis, or a US residency through the Match. Your employer usually sponsors the visa, such as the UK Health and Care Worker visa or a US J-1 sponsored by ECFMG.
7. 7

   Apply for registration and start work

   Complete your registration application with the fee and evidence. Do not start clinical work until your registration, licence or Berufserlaubnis is granted; pre-employment checks are no substitute.
8. 8

   Plan for specialist recognition

   Once working, plan your specialist route: GMC specialist training or the Portfolio pathway, Irish specialist registration, recognition of foreign specialist training by a German medical chamber, or US residency and board certification. Keep a structured record of your training and experience from day one.

Doctors' pay in the UK and Ireland follows national scales, quoted here from the official tables. German hospital doctors are paid under collective agreements, Dutch doctors under the CAO for their sector, and the USA has no national scale, so we give the federal median. Figures are basic annual pay before extra hours, on-call and allowances.

• UK (England)£41,226 (FY1) to £77,348 (ST7 to ST8); consultants £113,565 to £150,569, from 1 April 2026NHS Employers Pay and Conditions Circular (M&D) 1/2026 R2. Specialty doctors £63,696 to £102,689. Scotland, Wales and Northern Ireland set their own scales.
• Ireland€47,127 (intern); €55,292 to €75,623 (SHO); €70,276 to €82,756 (registrar), from 1 June 2026HSE consolidated pay scales. Specialist registrar €78,786 to €98,091. Consultant Contract 2023 (clinical): €238,221 to €286,151.
• GermanySet by collective agreementHospital doctors are paid under collective agreements such as TV-Ärzte, with tables by grade and years of experience. We could not confirm the current official table, so check the agreement your employer applies.
• NetherlandsSet by collective agreement (CAO)Pay depends on the CAO for your sector, such as university or general hospitals. Check the scale in your contract.
• USA$275,930 median for physicians and surgeons (May 2025)Bureau of Labor Statistics. Specialty medians range from $210,040 for pediatricians to $559,030 for pediatric surgeons. Residents are paid a set salary by their programme, which is much lower.

See your NHS band and annual pay

Most international doctors start in a junior, non-training or supervised post, then move into specialty training or specialist registration. Each country has its own route to becoming a consultant or specialist.

1. 1

   Specialty training

   Apply for a national training programme: UK core and specialty training, Irish training schemes, German Weiterbildung with a medical chamber, or US residency through the Match. In the UK, the Medical Training (Prioritisation) Act 2026 gives priority to UK graduates and certain other groups, so competition for international graduates is stronger.
2. 2

   Specialist registration without a training post

   Experienced doctors can apply for specialist recognition on the strength of their training and experience: the GMC's Portfolio pathway, the Medical Council's specialist division, or recognition of a foreign specialist qualification by a German medical chamber, which may need a knowledge test.
3. 3

   Specialty and specialist doctor roles

   Non-consultant career grades offer senior, stable posts. In the NHS, specialty doctors and specialists have their own contracts and pay ranges, and many international doctors build long careers in them.
4. 4

   General practice

   Becoming a GP requires completing GP training, or an equivalent specialist route, in the host country. Salaried GP pay in England ranges from £78,699 to £118,759.
5. 5

   Academic medicine and leadership

   Clinical academic, medical education and management roles open up once you are established. Ireland's Consultant Contract 2023 has separate academic scales.

1. 1

   Starting EPIC verification late; the GMC says schools can take up to 90 days to reply, and EPIC reports sent to the Medical Council are only available for 12 months.

2. 2

   Sitting IELTS General Training instead of Academic, or OET in a profession other than Medicine.

3. 3

   Combining scores from different sittings, which the GMC and the Medical Council do not accept.

4. 4

   Missing a deadline: PLAB 2 within two years of PLAB 1, or registration within two years of PLAB 2.

5. 5

   Applying for Irish supervised registration without an HSE-approved supervised post already offered; the Medical Council says fees are non-refundable.

6. 6

   Planning on the Dutch BI test without checking availability; places for doctors are currently full.

7. 7

   Reaching only B1 in German before applying; you need B2 general German and a medical language test oriented to C1.

8. 8

   Using up USMLE attempts: four failed attempts at any Step end your eligibility for the whole USMLE.

• Review of your qualifications, transcripts, experience and current registration

• Check against the published requirements of the regulators you choose

• Check of how recent your practice is and whether any gap in practice affects your route

• English or other language requirement for each route, with any exemption you may qualify for

• Comparison of routes and countries, with the trade-offs explained

• List of the exams, aptitude tests or adaptation periods each route is likely to involve

• Written roadmap: exams, English test, documents, fees and timeline

• Budget built from the official regulator, exam and verification fees, kept separate from our own fee

• Flags for slow steps to start first, such as primary source verification and language learning

• A call to walk you through the plan and answer your questions

What our eligibility assessment includesPackages and fees