Work as a physician associate in the UK: GMC and PARA

• Your PA qualification permits you to practise as a physician associate, physician assistant or comparable title in the country where it was awarded.
• Your qualification was awarded in a country where the profession is regulated by law and accepted for registration there, or accepted for PA registration in another country that regulates PAs by law. This criterion does not apply to qualifications from Ireland, EFTA countries or Switzerland.
• Your awarding institution is accredited by a recognised body in that country, such as a regulator or ministry of health or education.
• Your education was based in scientific, evidence-based medicine with biomedical science, took at least two academic years and contained approximately 3,150 hours of education and training.
• Your course included in-person clinical experience overseen by the institution of at least 1,400 hours or 40% of total course hours.
• That clinical experience covered general practice, acute and emergency medicine, general medical specialties, paediatrics, surgery, gynaecology and mental health.
• If you studied at more than one institution, the arrangement was a recognised twinning or campus programme or justified, and no transferred credits came from an institution where you failed or were excluded.
• You can meet the GMC English requirement, pass both parts of the PARA, and provide registration history, work history and fitness to practise and indemnity declarations.

Check your route with the route finder

• GMCGeneral Medical Council

  Doctors

  How to register with the GMC

1. 1

   Check the nine qualification criteria

   Read the GMC's acceptable overseas qualification criteria line by line against your transcript and clinical logbook. Pay particular attention to the clinical hours, the seven required areas and whether you were registered as a PA where the profession is regulated by law. If you cannot evidence every criterion, the GMC says it is unlikely to accept your qualification and you lose the fee.
2. 2

   Get the university letter and documents

   The GMC needs a letter from your university confirming course length in years and clock hours, any online study, in-person clinical hours, whether the university oversaw them, and which of the seven areas they covered. You also send copies of your qualification, passport, transcripts and proof of PA registration, with certified translations of anything not in English. Ask the university early.
3. 3

   Apply for the qualification assessment

   Complete the GMC's qualification assessment application and pay the £528 fee. The GMC may contact your course provider or other organisations to verify what you send, and may finish its assessment without information you fail to provide. There is no appeal against a decision that your qualification is not acceptable.
4. 4

   Book and pass the PARA

   Once the GMC accepts your qualification and tells the Royal College of Physicians, you can apply for the PARA during an application window using your GMC reference number (an A followed by seven digits). Pay in full by card when you apply. You must pass both the online knowledge test and the OSCE in Liverpool, within 18 months of each other.
5. 5

   Meet the English requirement

   Take Academic IELTS (7.0 in each area, 7.5 overall) or OET Medicine (grade B in each area), unless you qualify through two years' recent practice in a listed English-speaking country or another accepted route. Select the GMC as a recognising organisation in your OET account so it can verify your scores.
6. 6

   Start ECFMG primary source verification

   All internationally qualified PAs must have their PA qualification verified by ECFMG, a division of Intealth. ECFMG says most course providers respond within 90 days, and fees are charged in US dollars. Start as soon as the GMC accepts your qualification, because the GMC only keeps a registration application open for a limited time.
7. 7

   Apply for registration

   The GMC emails you an invitation once the RCP confirms your PARA pass. You can apply once you have English evidence and ECFMG has started verification, and your PARA pass must be less than two years old. Give five years of registration and work history with no unexplained gaps over 28 days, and pay the £337 registration fee.
8. 8

   References, good standing and identity check

   The GMC asks for an employer reference covering at least your most recent three months, and a certificate of current professional status sent directly by any regulator you were registered with in the last five years. You then have three months to complete a GMC identity check once invited, and the GMC cannot extend this.
9. 9

   Find a sponsored job and apply for your visa

   Look for PA posts with NHS employers or organisations providing services to the NHS that hold a sponsor licence. You cannot practise as a PA until the GMC grants your registration. With a job offer and certificate of sponsorship, apply for the Health and Care Worker visa if your job's occupation code and employer are eligible.

• PARA knowledge-based assessment (KBA)

  A 200-question single best answer test, taken online through the RCP's partner Orzone on your own computer with a webcam, at UK times. The RCP sets fixed application windows and exam dates, and results are released several weeks later. You may take the KBA up to four times.

• PARA objective structured clinical examination (OSCE)

  Fourteen clinical stations plus two rest stations, each with two minutes' reading and eight minutes in the station, at the RCP's assessment centre, the Spine, in Liverpool. You cannot change your allocated date. You may take the OSCE up to four times, and you must pass it within 18 months of passing the KBA (or vice versa).

• Curriculum the PARA tests

  The RCP says sittings between September 2025 and November 2026 use a hybrid blueprint drawing on the 2012 Competence and Curriculum Framework and the 2023 Physician Associate Curriculum. After the GMC transition period ends on 13 December 2026, the PARA assesses the 2023 curriculum only.

• English language test

  Academic IELTS (in person, online or with One Skill Retake on the conditions the GMC sets) or OET Medicine (on paper, on computer or OET@Home). The IELTS Indicator test is not accepted.

• Academic IELTS, including UKVI: at least 7.0 in each of reading, writing, listening and speaking, and at least 7.5 overall, in the same test and your most recent sitting.
• IELTS One Skill Retake is accepted once, if you sat a full computer-delivered test at a centre offering it and retake within 60 days.
• OET: the Medicine version only, with at least grade B in speaking, listening, reading and writing in the same test and your most recent sitting.
• IELTS and OET certificates must be less than two years old when you submit your registration application.
• Two years of continuous practice immediately before you apply, in a country on the GMC's list of English-speaking countries (such as Australia, Canada, Ireland, New Zealand, Singapore, South Africa and the USA), can count, using an English language reference form from your employers.
• A language test taken to register with a medical regulator in a listed English-speaking country may be accepted if it is less than two years old. Other evidence is at the GMC's discretion.
• The Health and Care Worker visa has its own English rule (CEFR B2). GOV.UK's exemption for an English assessment accepted by a regulator applies to doctors, dentists, nurses and midwives only, so PAs usually need a SELT, an Ecctis-assessed English-taught degree or an exempt nationality.

Estimate your total cost

• Allow time before you apply for your university's letter on hours and clinical areas, and for English test results. The GMC does not publish a target time for its qualification assessment.
• The PARA runs on fixed dates set by the RCP. For example, the RCP lists a KBA on 6 January 2027 and an OSCE period from 19 to 29 January 2027, with results on 25 February 2027, for its November 2026 application window.
• ECFMG verification depends on your university: the GMC says most course providers respond within 90 days, and slower if requests go by post.
• The GMC says it aims to carry out an initial assessment of your registration application within 10 working days, and can keep an application open for a maximum of three months.
• Once invited, you have three months to complete the GMC identity check, and the GMC says it cannot extend this.
• GOV.UK says a Health and Care Worker visa decision usually takes about 3 weeks from outside the UK after you prove your identity.

NHS Health Careers says PAs are paid on Agenda for Change, typically starting on Band 7, with internships starting at Band 6. Figures below are the NHS Employers 2026/27 annual pay points in England from 1 April 2026; pay in Scotland, Wales and Northern Ireland can differ, and London posts add a high cost area supplement.

• Band 6 (PA internship posts)

  £39,959 to £48,117

• Band 7 (typical starting band)

  £49,387 to £56,515

• Band 8a (senior posts, where employers use them)

  £57,528 to £64,750

  Grading above Band 7 depends on the employer and post.

See your NHS band and annual pay

• NHS hospital trusts, in medical and surgical teams supervised by senior clinicians.
• General practices and primary care networks.
• Emergency departments and acute medical units, within the limits employers set after the Leng review.
• Mental health and community services.
• Private hospitals and independent providers (these may not qualify for the Health and Care Worker visa unless they provide services to the NHS).

• The Health and Care Worker visa is for qualified health professionals with a job offer from a Home Office approved employer that is the NHS, an organisation providing medical services to the NHS, or an organisation providing adult social care.
• Your employer gives you the 4-digit occupation code for your job. GOV.UK lists the eligible codes, including 2259 (other health professionals not elsewhere classified), but does not name physician associates as an example title, so confirm the code and its eligibility with your employer before you apply.
• You must be paid the minimum salary or the going rate for the work, whichever is higher. For health roles the going rate comes from GOV.UK's national pay scale tables by NHS band.
• Fees: £324 for up to 3 years or £628 for more than 3 years, per person. GOV.UK says you and your family do not pay the Immigration Health Surcharge on this visa.
• English for the visa is separate from English for the GMC. You need CEFR B2, usually through a SELT, an English-taught degree assessed by Ecctis, or an exempt nationality.
• If your employer is not eligible for the Health and Care Worker visa, you may need a different route such as the Skilled Worker visa. Check GOV.UK before you accept an offer.

1. 1

   A Gulf licence does not transfer. You go through the GMC's international route, and the GMC assesses the qualification that first let you practise as a PA, not your Gulf registration.

2. 2

   Criterion 2 is the key test. If your qualification is from a country that does not regulate PAs by law, you need to have held PA registration in another country where the profession is regulated by law. The GMC decides case by case whether a Gulf registration meets this, so ask before you pay.

3. 3

   Clinical work in the Gulf does not replace missing training hours. The GMC's criteria look at the in-person clinical experience in your PA programme itself.

4. 4

   List every registration you have held in the last five years, including DHA, DOH, MOHAP, SCFHS or QCHP. Each regulator must send the GMC a certificate of current professional status directly, so request these well ahead.

5. 5

   Gulf practice does not count towards the English exemption, because GCC countries are not on the GMC's list of English-speaking countries. Plan for Academic IELTS or OET Medicine.

6. 6

   Ask your Gulf supervisor for an employer reference before you leave: the GMC needs one covering at least your most recent three months of healthcare work.

• Application plan with every step, fee and deadline

• Document checklist tailored to you, and a review of each document before upload

• Timeline built around the regulator's closure windows and document validity periods

• Help completing the application forms accurately and consistently

• Support with profession-specific evidence, such as the HCPC standards of proficiency mapping

• Guidance on certificates of good standing, references and certified translations

• Preparation for identity checks and declarations on health and character

• Tracking your application and help responding to regulator requests

• Next steps after the decision: exams, adaptation, PIN or licence and your first job

Regulators make all registration decisions and set all fees. Our fee is separate from the regulator's fees, exam fees and translation costs.

What our registration and licensing support includesPackages and fees