GMC (General Medical Council): Registration, Exams and Fees

• The medical register: provisional registration (for doctors who still need to complete their first year of practice) and full registration, each with or without a licence to practise.
• The Specialist Register: needed to take up a substantive consultant post in the NHS. Entry is through a UK certificate of completion of training (CCT), the Portfolio pathway or a recognised specialist qualification.
• The GP Register: needed to work as a GP in the UK health services other than in a training post. Entry routes mirror the Specialist Register.
• Physician associates and anaesthesia associates, who are regulated by the GMC on their own registers.

• A primary medical qualification the GMC accepts. Check your medical school and qualification against the GMC's acceptable overseas qualifications guidance before you book anything.
• Acceptable practical training: at least 12 months' continuous internship in an approved post, with at least three months each in medicine and surgery (12 to 18 months) or at least six months each (18 months or longer). If you did not complete an internship, the GMC accepts two years' continuous supervised postgraduate practice in a public hospital, including at least three months each of medicine and surgery.
• Observerships, clinical attachments, shadowing and clerkships do not count as practical training.
• A registration route: a pass in both parts of the PLAB test, a postgraduate qualification on the GMC's accepted list, a Sponsorship Registration Certificate from an approved sponsor, or a recognised specialist qualification.
• Evidence of English: IELTS Academic with at least 7.0 in each area and 7.5 overall, or OET Medicine with at least grade B in each area, in the same sitting and your most recent sitting. Other evidence is accepted in some cases.
• Your primary medical qualification verified by ECFMG through EPIC (and your postgraduate qualification too if you apply on that basis).
• A certificate of good standing from each medical regulator you have been registered or licensed with in the last five years, even if you did not work in that country.
• For sponsorship, every sponsor requires that you have been in medical practice for three of the last five years, including the most recent 12 months.
• For the Specialist or GP Register through the Portfolio pathway, a specialist qualification in the specialty or at least six months' continuous specialist training in it, plus full registration with a licence when the specialist registration is granted.

Check your route with the route finder

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   1. Check your qualification and open a GMC Online account

   Confirm that your primary medical qualification is acceptable to the GMC and that your internship or postgraduate experience meets its criteria. Then set up a GMC Online account, which you use to book PLAB, pay fees and apply. Doctors who skip this check sometimes pay for exams and only later find their training does not meet the internship rules.
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   2. Start EPIC primary source verification early

   Create an account with ECFMG (a division of Intealth) and submit your final medical diploma for verification through EPIC. ECFMG checks it directly with your medical school; the GMC says most schools respond within 90 days, and postal requests take longer. Fees are set by ECFMG in US dollars and paid to ECFMG, and refunds are not available once verification starts.
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   3. Prove your English

   Take IELTS Academic (including UKVI, IELTS Online or One Skill Retake under the GMC's conditions) or OET Medicine and reach the GMC's minimum scores. Enter your results in the 'My Tests' section of GMC Online; verification can take up to two working days. Your certificate must be valid on the day you sit PLAB 1 and again when the GMC approves your registration.
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   4. Pass PLAB 1

   PLAB 1 is a three-hour written exam of 180 single best answer questions. It runs four times a year, in February, May, August and November, in UK cities and at overseas centres. Results come out about six weeks after the exam, and you can book PLAB 2 only once you have them.
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   5. Pass PLAB 2 in Manchester

   PLAB 2 is a clinical and professional skills assessment (an OSCE) of 16 eight-minute scenarios, held only at the GMC's clinical assessment centres in Manchester. You must pass PLAB 2 within two years of passing PLAB 1. Demand is high, so you may wait for a date; the GMC asks candidates with an NHS job offer or UK refugee status to contact it about earlier places.
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   6. Gather your registration evidence

   You will need your passport, proof of internship or experience, English evidence, certificates of good standing and a record of everything you did in the last five years, including gaps. References are needed for non-medical work, unregistered medical work and observerships over two months. Certificates of good standing are valid for only three months from signature, so time your requests carefully.
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   7. Apply for registration with a licence to practise

   Apply through GMC Online and pay the registration fee when you submit. You have three months to complete an application once you start it. Your application must be approved within two years of your PLAB 2 pass date; after that the GMC asks for more evidence. If your application is refused, closed or withdrawn, a scrutiny fee is kept.
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   8. Complete the identity check and start work

   Once the GMC has assessed your evidence, you complete an identity check before registration is granted. You can then work as a doctor in the UK, subject to your employer's own checks. The GMC encourages new doctors to attend its free Welcome to UK practice workshop.
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   9. Keep your licence: annual fee and revalidation

   You pay an annual fee on the anniversary of your registration. You need a yearly appraisal and a connection to a responsible officer (or suitable person), who makes a revalidation recommendation to the GMC every five years. Doctors without a connection must send information directly to the GMC and sit a five-yearly assessment.
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    10. Specialist or GP registration (if relevant)

    If you trained as a specialist outside the UK, you can apply to the Specialist or GP Register through the Portfolio pathway, showing against the UK curriculum that you meet the level of a CCT holder. You have up to 24 months to build the application, and the GMC says processing takes 6 to 12 months after submission. Qualifications on the GMC's recognised specialist qualification list use a shorter route.

• PLAB 1 (applied knowledge test)

  A written exam of 180 multiple choice (single best answer) questions in three hours, each with a short clinical scenario and five options. It covers conditions a Foundation Year 2 doctor would see and is set at that level. The GMC holds it in Belfast, Birmingham, Cardiff, Edinburgh, London, Manchester, Oxford and Sheffield, in Dublin and Madrid, and at British Council centres in countries including India, Pakistan, Bangladesh, Egypt, Nigeria, Saudi Arabia (Riyadh) and the UAE (Dubai). Bookings for overseas centres close about six weeks before the exam.

  Read the guide

• PLAB 2 (clinical and professional skills assessment)

  An objective structured clinical exam (OSCE) of 16 scenarios, each lasting eight minutes, set in mock consultations and acute ward settings, with at least two rest stations. The whole exam takes around three hours. It is held only at the GMC Clinical Assessment Centre sites at Hardman Square and Hardman Street in Manchester. Drug names follow the latest British National Formulary.

  Read the guide

• Attempts and the MLA

  You can attempt each part until you have failed it four times, then apply for one final attempt with evidence of 12 months of additional learning. PLAB is now compliant with the Medical Licensing Assessment (MLA) requirements and is built on the MLA content map, though it keeps the PLAB name for now. Manual result checks are no longer offered, but you can appeal.

• Revalidation assessment (doctors without a connection)

  Licensed doctors who do not have a connection to a responsible officer or suitable person must sit a five-yearly revalidation assessment set by the GMC, as well as sending an annual return. A separate fee applies to each.

• IELTS: the Academic version only (including IELTS for UKVI and IELTS Online), with at least 7.0 in each of the four areas and 7.5 overall, in the same test and your most recent sitting. The IELTS Indicator test is not accepted.
• IELTS One Skill Retake is accepted once, for one section, if you sat the full test on computer at a centre that offers it and you retake within 60 days.
• OET: the Medicine version only (paper, computer or OET@Home), with at least grade B in speaking, listening, reading and writing, in the same sitting and your most recent sitting. Select the General Medical Council as a recognising organisation in your OET account.
• Validity: IELTS and OET certificates are valid for two years. They must be valid on the day you sit PLAB 1 and when the GMC approves your registration.
• Recent PLAB 2 pass: if your IELTS or OET is less than three years old and you passed PLAB 2 less than three months before applying for registration, the GMC treats your English as maintained.
• Older certificates: the GMC may accept references covering at least three months of full-time study or work in the last two years in a country where English is the first and native language.
• Employer confirmation: accepted for registration only if you have worked in a medical capacity for at least the past two years in a country on the GMC's list where English is the first and native language. It is not accepted for PLAB or for the sponsorship route.
• Sponsorship route: you must use an IELTS or OET certificate awarded within the last two years, unless you are a national of, and qualified in, a country where English is the first and native language.

Estimate your total cost

• PLAB 1 runs four times a year (February, May, August and November), and the GMC publishes results about six weeks after each sitting.
• The GMC says most medical schools answer EPIC verification requests within 90 days; it can keep a registration application open for only 90 days, so start verification first.
• You must pass PLAB 2 within two years of passing PLAB 1, and your registration must be approved within two years of passing PLAB 2. The GMC warns that you may wait for a PLAB 2 date.
• You have three months to complete an online registration application, and certificates of good standing are valid for three months from the date signed.
• Portfolio pathway: up to 24 months to build your application, then 6 to 12 months for the GMC to process it before evaluation, according to the GMC.
• Revalidation: an appraisal every year and a revalidation recommendation every five years.