PLAB 1 Guide 2026: Format, Fees, Dates and the UKMLA AKT

PLAB 1 is the first step on the most common route to UK registration for doctors who qualified outside the UK and Switzerland and do not hold an accepted postgraduate qualification. It is a written knowledge test run by the General Medical Council (GMC). Pass it, then pass the practical PLAB 2, and you can apply for registration with a licence to practise.

For a week-by-week study plan, see our companion guide How to pass PLAB 1.

PLAB 1 at a glance

Who needs to take PLAB 1?

The GMC uses PLAB to check that doctors who qualified abroad have the knowledge and skills to practise safely in the UK. In general you will need it if you graduated from a medical school outside the UK and Switzerland and you are not applying through another route, such as an acceptable postgraduate qualification or sponsorship by an approved body. Our guide on working as a doctor in the NHS compares the routes side by side.

You also need an acceptable English language result (IELTS or OET at the GMC's required scores) and a primary medical qualification the GMC accepts before you can book.

PLAB 1 and the UKMLA AKT: what changed

Since the UKMLA came in, UK medical students sit two assessments before graduating: the Applied Knowledge Test (AKT) and the Clinical and Professional Skills Assessment (CPSA). The GMC has aligned PLAB with this structure rather than replacing it:

• PLAB 1 meets the requirements of the MLA AKT.
• PLAB 2 meets the requirements of the MLA CPSA.
• Eligibility to sit PLAB has not changed, and both parts still carry the PLAB name.

For you as an international graduate, that means three practical things:

1. The content map is shared. PLAB 1 questions are written against the MLA content map, the same blueprint UK students revise from. Use the content map as your syllabus rather than older topic lists.
2. The standard is FY2-level. You are tested on what a safe doctor starting the second foundation year should know, so the emphasis is on common and important presentations, first-line management, prescribing safety and UK professional guidance.
3. You still book through the GMC. You do not sit the AKT itself; PLAB 1 is your AKT-equivalent.

PLAB 1 vs UKMLA AKT side by side

The practical takeaway: resources written for UK finalists revising for the AKT are relevant to you, and resources written for "old PLAB" may not be. When a book or bank does not mention the MLA content map, check how recently it was updated.

Format: what happens on exam day

PLAB 1 is a single paper of 180 SBA questions answered in three hours. Each question is a short clinical vignette followed by five options, and you choose the single best one. Some options may be partly correct; the task is to choose what a UK FY2 doctor should do first or what is most likely.

As long as no negative marking applies, never leave a question blank. With about 60 seconds per item, pacing matters more than in most exams you will have sat: a single long calculation can cost you three easier questions.

The GMC publishes free sample questions. Do them early. They show the vignette length and the style of distractors better than any commercial bank.

What topics come up

There is no fixed percentage per specialty, so be wary of claims of exact weightings. What you can rely on:

• Questions follow the MLA content map, organised by areas of clinical practice and by presentations and conditions.
• The focus is on common and serious presentations a junior doctor meets, not rare diseases.
• Professional knowledge (consent, capacity, confidentiality, safeguarding, duty of candour) runs through the whole content map.

Our PLAB 1 study guide breaks the content map into a practical revision order.

Fees (as of October 2026)

Refugee doctors living in the UK can sit PLAB 1 free of charge for their first two attempts.

Fees are set annually.

Dates and booking

The GMC runs PLAB 1 in four diets a year: February, May, August and November. Upcoming sittings as of October 2026:

Venues vary by sitting and seats are limited, so book as soon as your English result and GMC Online account are in order.

Booking checklist

• GMC Online account created, with your name exactly as on your passport
• Primary medical qualification checked against GMC requirements
• Valid IELTS or OET result at the required level
• Preferred sitting and centre chosen, with a backup
• Cancellation deadlines (42 days) noted in your calendar

Pass mark and results

The GMC sets the PLAB 1 pass mark for each sitting using a standard-setting process, so the exact number of marks required varies from diet to diet; it represents the level expected of a doctor at the start of FY2. Your results letter shows your score and the pass mark for your sitting.

Attempts and validity rules

• Attempts: you can sit PLAB 1 up to four times. After a fourth fail you may apply for one final attempt by showing evidence of additional learning over a 12-month period.
• Window to PLAB 2: you must pass PLAB 2 within two years of the date you sat PLAB 1, not the date results came out.
• Window to registration: after passing PLAB 2, your application for registration with a licence must be approved within two years.

Plan backwards from these windows. If you know a PLAB 2 seat may take months to get, book PLAB 1 only when you can realistically follow through.

Planning your timeline

Work backwards from when you want to start in the NHS. Results arrive roughly six weeks after the exam (for example, the 5 November 2026 sitting reports on 17 December 2026). Then allow time to secure a PLAB 2 seat, sit it, and get your registration approved. Build in a buffer for a possible resit of either part, so that neither two-year window runs out on you.

From PLAB 1 to your first NHS job

1. Pass PLAB 1.
2. Book and pass PLAB 2, the 16-station clinical exam in the UK.
3. Apply to the GMC for registration with a licence to practise.
4. Apply for posts (trust-grade or locally employed roles, then training posts via Oriel). See working as a doctor in the NHS.
5. If you are aiming for internal medicine, MRCP Part 1 is often the next exam.

Common mistakes

• Revising from your home country's guidelines. Questions follow UK practice. Learn NICE-style first-line management.
• Ignoring the professional domain. Ethics, consent and capacity questions are some of the most predictable marks.
• Poor pacing. 180 questions in 180 minutes leaves no room to get stuck. Flag and move on.
• Booking too early. The two-year clock to PLAB 2 starts on your exam date.
• Trusting unofficial weightings. There are no official topic percentages; work from the MLA content map.

How to practise

Volume of realistic questions is what moves scores. MediFlow's PLAB 1 course gives you UK-style SBA questions with explanations, free test questions to start, and the same bank in our app so you can practise in short sessions. Start with the free questions on the PLAB 1 course page and keep the GMC sample questions as your benchmark.

Summary

PLAB 1 is a 180-question, three-hour SBA paper that the GMC accepts as meeting the UKMLA AKT requirements, set at FY2 standard, and costs £283 from April 2026. You have four attempts (plus a possible final one), and two years from your exam date to pass PLAB 2. Treat the MLA content map as your syllabus, practise with UK-guideline questions, and plan your bookings around the validity windows.