Working as a Doctor in the UK: GMC, PLAB and NHS Guide 2026

The United Kingdom remains one of the most common destinations for international medical graduates. The route is transparent: the General Medical Council (GMC) sets the standard, publishes its fees, and runs the PLAB test for most doctors who qualified outside the UK.

Key facts

The UK healthcare system

Most doctors in the UK work in the National Health Service, which is organised separately in England, Scotland, Wales and Northern Ireland. Care is largely free at the point of use and funded through taxation. Doctors work either in hospitals (trusts and health boards) or in general practice. The career grades are foundation doctors, specialty trainees (resident doctors), specialty and specialist (SAS) doctors in non-training posts, general practitioners and consultants. For a detailed look at grades and pay structures, read working as a doctor in the NHS.

Authorities

• General Medical Council (GMC) keeps the medical register, issues licences to practise and runs PLAB. See /councils/general-medical-council-gmc/.
• NHS England (and the devolved equivalents) organises postgraduate training recruitment.
• Royal colleges set curricula and membership exams for each specialty.
• UK Visas and Immigration handles the Health and Care Worker visa; it is separate from GMC registration.

Recognition: routes to GMC registration

The GMC does not "recognise" a foreign degree on its own. Instead, it asks you to demonstrate knowledge and skills. The main routes are:

• PLAB test (the most common route for IMGs).
• An acceptable postgraduate qualification, such as certain royal college membership exams.
• Sponsorship by a GMC-approved sponsor, often linked to specific training schemes.
• Specialist or GP register routes for experienced specialists, via the GMC's portfolio process.

Your primary medical qualification must still be acceptable to the GMC and is verified as part of the application.

Exam process step by step

1. Check your degree and English. Make sure your primary qualification is acceptable and plan your English test.
2. Create a GMC Online account and book PLAB 1.
3. Sit PLAB 1. One three-hour paper of 180 single best answer questions, set at the standard of a doctor starting the second year of the Foundation Programme. Read the PLAB 1 guide.
4. Book PLAB 2 once you have passed. It is taken in Manchester and consists of 16 scenarios of eight minutes each, around three hours including rest stations. See the PLAB 2 guide.
5. Apply for registration with a licence to practise within two years of passing PLAB 2.
6. Find a job and arrange your visa. Many IMGs start in non-training posts before applying for specialty training.

Since the UK Medical Licensing Assessment (MLA) began, PLAB 1 meets the MLA Applied Knowledge Test requirements and PLAB 2 meets the Clinical and Professional Skills Assessment requirements. IMGs therefore keep using PLAB.

Costs

Stand October 2026, GMC fees from 1 April 2026:

Registration, English test, visa and the Immigration Health Surcharge come on top. Registration fees depend on your circumstances. Refugee doctors can apply for help with fees.

Timeline

Pass rates and booking availability shift over time, so build buffer into your plan rather than assuming the next PLAB 2 date will be free.

Language requirements

The GMC accepts IELTS Academic and OET (Medicine). For IELTS it asks for an overall score of 7.5 with at least 7.0 in each area; for OET it asks for grade B in each of the four areas. Results must be recent. Some doctors can use other evidence, such as a primary medical qualification taught and examined in English with patient-contact in English.

Specialist training

After registration, doctors can apply for specialty training through national recruitment, organised via Oriel. Training is run in programmes leading to a Certificate of Completion of Training (CCT) and entry on the Specialist Register or GP Register. Experienced specialists trained abroad can apply for specialist registration through the GMC portfolio route instead of repeating training. Royal college exams (for example MRCP, MRCS, MRCGP) are part of most training pathways.

Working conditions

Pay for NHS doctors in England is set nationally. For 2026/27, pay rose 3.5% from 1 April 2026 for resident doctors, SAS doctors, consultants and salaried GPs. Contracts in Scotland, Wales and Northern Ireland differ.

Rotas, on-call commitments and rest rules are defined in the national contracts. Non-training posts vary more between trusts, so read each job description carefully.

Document checklist

Prepare these before you apply for registration:

• Primary medical qualification certificate and evidence that it is acceptable to the GMC.
• English test result (IELTS Academic or OET) meeting the GMC scores and still valid.
• PLAB 1 and PLAB 2 results, inside their validity windows.
• Certificates of good standing from every regulator you have been registered with.
• Evidence of internship or equivalent clinical experience, if requested.
• Identity documents for the GMC identity check.

Keep scans in one folder with consistent file names. The GMC Online account shows exactly what is still missing.

Preparation strategy for PLAB

PLAB 1 tests applied knowledge at the level of a doctor entering the second Foundation year. It favours common UK presentations, NICE-style management and patient safety over rare diagnoses. A sensible plan:

1. Learn the UK frame. Read GMC guidance on good medical practice and get used to UK guideline language.
2. Question volume. Work through single best answer questions by system, reviewing every explanation.
3. Timed papers. PLAB 1 gives about 60 seconds per question; practise at that speed.
4. Weak-area loop. Revisit wrong topics with spaced repetition rather than rereading notes.

For PLAB 2, practise consultations aloud: history, explanation, breaking bad news, prescribing and ethics. Communication and structure count as much as content.

Choosing your first post

Many IMGs start in a non-training post (often called a trust grade or clinical fellow post) to gain UK experience before applying for specialty training. When comparing offers:

A first job with structured supervision and portfolio support usually pays off when you later apply through national recruitment.

Visa basics

Doctors from outside the UK generally need a visa, commonly the Health and Care Worker visa, sponsored by an employer. Visa rules and fees are set by UK Visas and Immigration and change separately from GMC rules. Do not assume GMC registration alone gives the right to work.

Typical mistakes

• Booking PLAB 2 too late and running out the two-year window.
• Letting the English test expire before submitting registration.
• Assuming PLAB guarantees a job. Registration and employment are separate steps.
• Ignoring the cancellation rules for PLAB 2, which can cost the full fee.
• Using old fees from 2025 or earlier; the GMC reviews fees every April.

Next steps

1. Check your English test plan and GMC eligibility.
2. Follow our PLAB 1 study plan.
3. Practise in the MediFlow PLAB 1 track with free test questions, or on the go in the MediFlow app.
4. Read about NHS grades and pay.
5. Compare options like Ireland or Australia, where a GMC pathway can count as a competent authority route.