Medical Council of Ireland: Registration, PRES and Fees 2026

Every doctor who practises medicine in the Republic of Ireland must be on the Register of Medical Practitioners kept by the Medical Council. For international medical graduates (IMGs), the Council is the body that decides which division of the register you join, whether you need to sit its Pre-Registration Examination System (PRES), and which English evidence it accepts.

The Council has announced fee increases for 2026 and 2027, so confirm the current amount before you pay.

Key facts

What the Medical Council does

The Council describes its purpose as protecting the public by promoting and better ensuring high standards of professional conduct, education, training and competence among doctors. Its main functions are:

• maintaining the Register of Medical Practitioners, which the public can search;
• setting standards for medical education and training in Ireland;
• promoting good medical practice and overseeing doctors' continuing professional development;
• investigating complaints about doctors.

The Council has 25 members, elected and appointed, and is funded by annual payments from registered doctors; it states that it receives no State funds.

Divisions of the register

Your division decides where and how you can work. The Council currently lists six:

Every doctor is responsible for keeping their registration current and appropriate to their circumstances. Doctors in the General Division may practise independently but may not present themselves as holding specialist or trainee specialist registration.

The Supervised Division

The Supervised Division is for doctors who have been offered a post approved by the Health Service Executive (HSE) with specific supervisory arrangements. Applicants must pass or be exempt from the computer-based pre-registration examinations, and registration in this division covers an aggregate of two years in a supervised post.

The PRES examinations

The Pre-Registration Examination System (PRES) is the Council's assessment for applicants who are not exempt. It is primarily a test of knowledge and clinical skills in the main disciplines: obstetrics and gynaecology, paediatrics, psychiatry, surgery, and medicine/general practice.

• PRES Level 2 is a multiple choice examination.
• PRES Level 3 is an objective structured clinical examination (OSCE).

The Council first assesses your application and then tells you whether you must sit PRES or are exempt. Exemption rules depend on your qualifications and experience; the Council's PRES FAQ and registration rules explain them.

Route for international medical graduates

A typical sequence for a non-EEA graduate applying for the first time:

1. Check which division fits. Your planned post (training, supervised, or general) determines this.
2. Prepare English evidence that meets the current rules.
3. Submit your application and supporting documents to the Council.
4. Sit PRES if required after the Council assesses your file.
5. Register in the right division and pay the registration fee.

For the Trainee Specialist Division, non-EU/EEA graduates must have completed an internship in a listed country and have passed or been exempted from PRES.

English language requirements

For applications from 1 March 2025, the Council accepts several forms of evidence, including a medical degree and internship completed through English in a listed English-predominant country. The accepted tests are:

• IELTS Academic: overall band 7.0 with at least 6.5 in each module, in a single sitting within the last two years. IELTS Indicator and IELTS Online are not accepted.
• OET Medicine: at least grade B in each module, in a single sitting within the last two years. OET@Home results are not accepted.

Certificates must be dated within two years of the date of registration. EU citizens have separate rights under EU law, explained on the Council's EEA pages.

Fees (stand October 2026)

The Council publishes these fees for 2026/2027 and states that fees increase by 10% in 2026 and a further 10% in 2027:

The retention year runs from 1 July to 30 June, and a €50 late payment fee may apply. The Council accepts card or bank draft only.

Checklist before you apply

• Post identified. Know whether you are aiming for a training post, an HSE-approved supervised post or a general post, because this decides your division.
• Internship history ready. For the Trainee Specialist Division, non-EU/EEA graduates need an internship in a listed country.
• English evidence in date. IELTS Academic or OET Medicine in a single sitting within two years, or another accepted form of evidence.
• PRES budget planned. If you are not exempt, allow for Level 2 (€352) and Level 3 (€1,500).
• Fees checked on the Council's fees page, because increases apply in 2026 and 2027.

After registration

Registration is not a one-off step. Each year you renew by paying the annual retention fee and completing the retention form by 1 July. The Council also oversees continuing professional development, so keep records of your learning from your first year. If you later move from the Supervised Division to the General or Trainee Specialist Division, a transfer fee applies.

Typical mistakes

• Applying to the wrong division. The post you hold decides the division.
• Using an IELTS Online or OET@Home result. These are not accepted.
• Letting test results expire. Certificates must be within two years of registration.
• Budgeting with last year's fees. The Council has announced two 10% increases.

Next steps

1. Read the Council's registration overview.
2. Check the English language rules.
3. Review the PRES FAQ.
4. Compare conditions in Working as a doctor in Ireland.

Contact and official links

• Website: medicalcouncil.ie
• Fees: Medical Council fees
• Examinations: PRES and examinations
• Supervised Division: Supervised registration

Contact details are listed on the Medical Council website.