A lot of questions pop up when you’ve made the decision to go abroad. That is the first big step. Once it’s taken, the road to success will slowly materialise. The two most common paths like PLAB and USMLE will be discussed in this article. Instead of making it a comparison like PLAB vs USMLE, this will be more of a discussion than a comparison, as my purpose is neither to discourage or encourage you in any specific path. The information will be laid out in front of you, but at the end of the day- you’re the master of your fate, you’re the captain of your soul.

To have an overall idea about post-graduation options UK and also in the USA, Bangladesh, India, and Pakistan, please have a look at this post- Postgraduation Pathways in the UK and Postgraduation at home & abroad.

PLAB

The full form of PLAB is Professional Linguistic and Assessments Board.

It is a licensing examination to assess whether a doctor is eligible to obtain GMC Registration or not. It’s NOT a degree, or a certification by itself. It only makes you eligible to apply for GMC registration.

Why do I need GMC registration?

In the UK, to practice as a doctor, GMC registration is a MUST. Life as doctor in the UK pretty much revolves around the General Medical Council (GMC). They maintain their register of medical practitioners, general practitioners, and specialists. In order to practice at that level, you need to be registered with GMC. To make things clear, GMC will NOT provide you with any degree. That’s the job of the Royal Colleges’ and other training bodies’ function. But, GMC will just recognize your degree.

When in my career can I take the PLAB exam?

The earlier, the better. But it may not be possible for everyone. That being said, you can take PLAB anytime in your career, so long as you have received your primary medical qualification.

PLAB Exam Structure

The exam has two parts-

  1. PLAB 1
  2. PLAB 2

PLAB 1 is an MCQ exam

PLAB 1 is a 3 hour 180 MCQ (single best answer) exam which can be taken right after you obtain your primary medical qualification. It can be taken in many places around the world. They run March and November exams all over the world and also in the UK, where they have two extra exam dates usually in June and September.

But IELTS/OET is a pre-requisite. You will have to obtain 7.5 overall (with 7.0 in each module) in IELTS and “B” in OET to be able to sit for PLAB 1. To see how you can plan your IELTS and PLAB 1, please look here. Also you can use Occupational English Test (OET) to prove your english language proficiency. You will need grade B in all the sub-tests of the OET. Read further here.

PLAB 2 is an OSCE exam

PLAB 2, on the other hand, is a practical assessment and takes the form of an Objective Structured Clinical Examination (OSCE). Usually there are 18 stations spanning 8 minutes each, excluding at least 2 rest stations. It happens year round and ONLY takes place in Manchester, UK.

The only requirement to sit for PLAB 2 is passing PLAB 1. Also, you will have to take PLAB 2 within 2 years of passing PLAB 1.

PLAB Exam Fees and other associated costs

IELTS : ~£160 (IELTS) OR OET: ~£332
PLAB 1 : £239
PLAB 2 : £875

Please read how to plan funding for your PLAB journey for detailed breakdown of all the associated costs.

Where will I stand after passing PLAB?

Your career as a doctor in the UK starts with having GMC Registration as a medical practitioner. PLAB gets you that!

Unlike USMLE, PLAB will not make you eligible to apply for residency or training straight way. For each specialty training there are complete set of ‘person specifications’ – one of which is having GMC registration – PLAB will just help you to achieve that. You will still have to work to obtain other specifications before you can apply for a training/residency in the UK.

Also, unlike in the US, UK has the concept of non-training jobs. With just GMC registration (obtained via PLAB) you can start working as a doctor in the UK if you can manage to get a non-training job. But in the US – you have to wait till you can MATCH in a residency to start working as a doctor.

To know about the path after passing PLAB, please follow the flow diagram in Postgraduation Pathways in the UK.

Planning your PLAB journey

USMLE

USMLE stand for United States Medical Licensing Examination

What is the USMLE

The USMLE is an exam that must be taken by American medical graduates and IMGs alike. After ensuring your ECFMG registration is done, Steps 1, 2A, and 2B may be taken. Step 3 can be taken in between getting your ECFMG certification and applying for the Match, or even after you get a Match. American graduates typically take it at the end of their first year of residency.

To learn more about the structure of training/residency in the American healthcare system, please read the post on Postgraduation pathways at home and abroad.

Why do you need to take the USMLE?

It is the set of examinations needed for medical licensure in the United States. Physicians are required to pass this examination before being permitted to practice medicine in the United States. It will not give you any sort of a degree.

When can I take it?

As an IMG, you may take it at any time during your career, even during medical school. You don’t need to complete any sort of internship or get clinical experience in order to take the exams. Observer-ships, externships, sub-internships may be considered to bolster your CV, but are not prerequisites for the USMLE.

USMLE Exam Structure

STEP 1 consists of an 8 hour exam that is divided into 7 blocks, each of which are 60 minutes long. The exam tends to consist of around 280 questions, roughly 40 per block.

STEP 2A (or the CK/Clinical knowledge exam) is a 9 hour exam that is further divided into 8 blocks that are each 60 minutes long. Each block will not exceed 40 questions.

STEP 2B (or the CS/Clinical skills exam) will also last approximately 8 hours, and consists of 12 room patient encounters that last 15 minutes each. You will be expected to read the task, assess the patient, and type up the patient’s note in that amount of time.

STEP 3 is the final part. The exam is a two day event, with the first day consisting of 233 questions divided into 6 blocks. You are given 60 minutes per block, and including a break, the entire exam will take about 7 hours.

On the second day, you will face a 9 hour exam of 180 questions divided into 6 blocks. After that, you will have to undergo 13 case simulations where you’ll be allotted 10 or 20 minutes to complete.

Where can I take USMLE?

STEPs 1 and 2A can be taken in most overseas centers and the United States, but STEPs 2B and 3 can only be taken within the United States.

USMLE Exam Fees

ECFMG certification$145
STEP 1$965
STEP 2A/CK$965
STEP 2B/CS$1,600
STEP 3$895

Now this isn’t as cut and dry as it may seem. If you intend on attending the STEP 1 and 2A back home, there are added fees you must incorporate.

Not only that, but if you wish to change your eligibility period, reschedule, change your testing region, or any other support related to your exam/application, you can expect an additional cost every step of the way.

Just taking into account the fees listed in the chart above, you can expect all parts of the USMLE to set you back a cool $4570 (~£3725), excluding all expenses related to travel, living, and study materials.

Where do I stand after USMLE?

Unlike PLAB, after completing all the requirements and formalities needed for the STEPs in USMLE, you can now apply for residency. Congrats! The Match is the name given to the program used to allot residents to their intended paths of training. It provides a uniform process in that all the steps of the process are completed in the same fashion and at the same time by all applicants and participating institutions. So, having passed all the steps doesn’t confirm your residency, you will still have to apply and MATCH!

To understand how the algorithm works, please look here. To understand when it takes place, and to further understand the system, read more here.

You can apply for up to 20 programs at a cost of $80. If you wish to apply for more, there will be another cost of $30 per program. The full breakdown can be found here.

PLAB vs USMLE

The comparison made below between PLAB and USMLE is mainly focused on the nature of the exam. There are so many other factors to consider apart from these. So, I urge not to just just decide on one path just because the next person is doing it.

At the end of the day, job satisfaction and having a good quality of life should be given priority even though it may seem too early to think about.

So there you have it a run down on how PLAB and USMLE exams are structured. A somewhat concise discussion regarding the two major exams most IMGs choose to go for after completing their degree. At the end of the day the choice is yours to make.

Good luck!

74 thoughts on “PLAB vs USMLE: What do you need to know”

  1. JEEWA VENGADASALAM

    What would be the entrance point to training for an IMG with full MRCP. This is taking into consideration that there is 4 years experience in the home country after passing PACES. Already passed IELTS 7.5
    Is he able to enter ST1 or ST3? I need your advice on this
    What is the usual entry point?

    1. MRCP is one the major criteria for getting into specialty training (ST) but you also need to get other requirements as well. So it entirely depends upon you whether you want to make yourself eligible for IMT 1 (which is ST1 from all uncoupled medical specialties) or you want to pursue getting into ST3/4 of your chosen speciality.

  2. Pranabashish BANERJEE

    Is IELTS absolutely essential for doing any fellowship or applying for any job in UK? I passed my MRCS in 2011 and i am an ENT Surgeon.
    Plz give your opinion
    Warm regards
    DR.PRANABASHISH BANERJEE
    MS, MRCS

    1. Yes. IELTS/OET is absolutely necessary if you hadn’t graduated from the UK/EEA countries.
      Even an born and raised British, if goes for medical study in a non-English speaking country, they will have to take IELTS/OET for GMC registration

  3. Hi! Thanks for your helpful post. I want to know one thing, which countries (except UK) can I migrate to if I passed MRCP? Is there any way to go to Australia with MRCP without passing AMC totally/partially? What other countries recognize MRCP? Thanks.

  4. Nripesh Sadasukhi

    I am a urologist in India.i want to apply for fellowship in UK.what exam I need to clear and what is the procedure.

  5. sravanthi sangana

    Hi..i have done DNB anaesthesia in INDIA..wanted to work in UK..can you suggest me best options in the same branch and also if i wanted to go to different branch..what are the best possible options and suggestions for me..can you please guide..

  6. hi suppose if i complete all 3 steps of mrcp and get gmc registered then how do i get into speciality training like internal medicine?

  7. Thanks for the informative article. I would like to ask how hard is it for an IMG to get into surgical training in the UK for Neurosurgery. Are the chances next to impossible or is there any hope for an IMG?

  8. Hi. I am currently doing my internship in India. I would like to work as a psychiatrist in the UK . Would it be better if I take plab or would it be better if I take mrcpsych directly??

    1. If you’d like to enter the NHS faster, go for PLAB. Yes you’d need to take MRCPsych eventually, but you can still work in the UK and prepare for it.

  9. Can u please explain all d different steps required to become a consultant in histopathology? Do we have to take mrcp for it? Also what are the chances of an img to get histopathology?

  10. Hello
    I have 5 year working experience after internship home(outside UK).
    I have passed MRCP 2 written , not PACES yet.
    My goal is to become a specialist in UK.
    So after OET, can I apply non training job ? Is it easier to get job and full GMC registration without PACES?)

    1. Hello, unfortunately you will not be able to apply for GMC registration with your MRCP until it is fully completed, i.e. you’ve passed your PACES as well.

  11. hi. i have completed MD Paediatrics in India and cleared all 3 parts of mrcpch and ielts. GMC registration is pending. i would like to know what post will i be getting in UK at the start of my practise. i would be offered specialty training right? is there any significance of the MD paediatrics degree from India in the UK?

    1. After GMC registration, you don’t automatically get any job offer. You will have to look for jobs yourself, attend interviews and get successful.
      With your professional experience, you can easily start with paediatric registrar level jobs in the NHS and then work your way to get into specialty training when the application rounds open.
      It’s always good to have some NHS experience before you would want to get into training.

  12. Hello,
    I have completed my MBBS in 2014 and have been working since that time.
    Now, I intend to be a consultant in the UK. What pathway should I choose? MRCP or PLAB?
    I have enough experience in the fields of my choice.

      1. Thank you for prompt response. I have two very highly specific questions which are beyond the scope of this flowchart. Can I post it here or email you in person. Please let me know, Thank you 🙂

        1. Thank you for the response –
          1. If I do a two year research course at an University(MD Res) will it count towards my ST1-ST2 training? During the course, I intend to give my MRCP.
          2. If I complete my training in UK and decide to move back to India, then will I be able to do so?
          Thank you.

        2. 1. There is no replacement of training per se. With the advent of IMT (3 years of core-training) from 2019, you can’t skip that untill and unless you can prove to the deanery that you had equivalent training similar to that, in your country.
          2. Yes. Once you become a GMC registered specialist, there is no reason why any medical council of India won’t recognise you as specialist also.

        3. Thank you for your prompt response.
          I think I got my question wrong. I meant if I do a MD research training in the UK will it count towards ST-1 and ST-2 training.
          I have been accepted in a course and the course directors claim after that I can join training as ST-3 but I dont feel confident.
          Thank you

        4. Will you be GMC registered while doing that training? If not then training won’t be in medical capacity at all. If you are not trained in a medical capacity how can that count towards your training?

  13. Greeting dear Madam/Sir
    I am asking about mrcpath/membership of royal college of pathology part one is it treated the same way as mrcp
    Is it considered as diploma.

    1. No. Fellowship of the Royal College of Pathologists (FRCPath) by examination only, is accepted by GMC for registration.

    1. You’re welcome!
      Yes, with MRCS completed and other prerequisites, you can apply for GMC registration. But one thing to remember that training for surgical specialties is not as abundant as medical specialties. It is almost impossible for an IMG to get into surgical training.

  14. respected doctor , I am right now working in department of public health India as a medical officer after my internship . I want to do surgery , is that possible in UK ?

  15. If I want to a consultant in internal medicine in uk can I give mrcp from india and do cmt training in uk and get a cct post?

    1. If you complete MRCP, you can’t get into CMT. And if you can’t get CMT you still can try and get core competences signed off from non-training job and try for ST3 training in any specialty. That will give you CESR-CP.
      In practicality, CCT or CESR-CP is not that different. Both are trained in the UK and can apply for specialist registration and work as consultant in the UK.

      1. Mahtalath Syeda

        Is it the same if I do FRCA? Can you please elaborate the pathway after doing frca. I have a settlement visa. and would like to become a consultant in the uk.

        1. Primary FRCA examination – will get you GMC registration a medical practioner. To become a consultant you need to go through training in the UK.

  16. Hello Sir, I am a practicing Peadiatrician in India . I am a M.D. in peadiatrics. How do I go about the MRCP course

  17. Hi. I am a paediatrician in India. I want to migrate to the UK for work. Can I apply for GMC registration after clearing MRCPCH? Or do I have to clear PLAB as well?

    1. Hello Dr Nikhil,
      Yes, after completing MRCPCH, you can apply for GMC registration in the accepted PG qualification pathway. You don’t need to take PLAB then.
      What you need is:
      1. Required score in IELTS/OET
      2. EPIC verification of your MRCPCH and primary medical degree (e.g MBBS etc)

  18. Hello,
    I’m an Algerian medical student, currently enrolled in a 12 months Internship which Is liste as our 7th year of studies to gain a medical degree. It follows 6 years of theorical studies at med school. Knowing that I will only get my diploma at the end of this Internship. Can I book the PLAB exam while I still an Intern or do I need to show my final diploma to sit at the exam ? Is is possible to book It If I prove that I’ll graduate this year ?
    Thank you

    1. Yes. You don’t need to finish your internship or show any diploma to book PLAB 1. If you have passed your final medical exams and obtained required score in IELTS/OET, you can book PLAB 1.

    1. OBGYN is a run-through training. There is no separation between Core and Specialty training.
      A trainee must have to complete MRCOG part 1, at ST2 level.
      And MRCOG part 2 and 3, by ST5 level.
      So if you are have already completed MRCOG, you can get GMC registered and get into training at whatever level you find empty posts.

  19. dear anita,would you contact me on telegram : @sahab_d , since we are on the same page and i intend to take the exames(MRCP).i am iranian.

  20. Thank you for providing insight into working in the UK as a doctor.
    Do I need the specified ‘acceptable postgraduate qualification'(fellowship of West African college of pediatrics) to enter for MTI in pediatrics? I am in Nigeria and presently am a member of the National postgraduate medical college of Nigeria. Is this postgraduate qualification acceptable for the purpose of MTI?
    Thank you.

  21. so no need of GMC registration before taking MRCP?
    after passing MRCP and IELTS then getting full GMC registration can I start speciality training?without any work experience in UK?then why hasn’t it mentioned on the diagrams?

  22. Hi.I graduated from med school in Iran about a year ago now I’m in my 2 years of compulsory placement(which we have to work for the government for 2 years as a GP)I am also fully registered with our medical council.
    Regarding this sentence you mentioned “Now if you want to complete the Full MRCP (UK) before coming to the UK, you can still do that” I was wondering if I could skip PLAB and after passing IELTS start preparing for MRCP without coming to UK or working there

    1. Yes you can do that, but IELTS is not needed before MRCP, rather you can appear in it after completion of MRCP and before GMC registration.

  23. Hello, I am a recent Medical graduate from India.
    i had a question regarding MRCP.

    Can a MBBS doctor apply for MRCP exams ?

    You mentioned that for certain parts of the MRCP exam, you need to have work experience ; so does that mean a recent Medical school graduate will not be eligible to sit for these parts of the MRCP exam ?

    Thanks in advance.

    1. You need at least a year of internship for part 1, but for the rest of the parts it’s recommended to at least have 2 years of clinical experience

  24. You need to get GMC registered first. With your MRCP, an accepted PG qualification, you can get registered by opening a GMC online account and getting your required score in IELTS/OET. Also you will need to get your Medical diploma and MRCP EPIC verified before you can apply for GMC registration.
    So after your MRCP and before you getting to apply for a job:
    1. Required score in IELTS/OET.
    2. Get MRCP and PMQ EPIC verified.
    3. Apply for GMC reg through GMC online.
    4. Attend GMC ID check physically in the UK with real documents as dictated by the GMC.
    After that you apply for jobs in the NHS jobs, whose link was given above.
    I think it will also help you:
    https://roadtouk.com/2017/12/31/postgraduation-pathways/

      1. Same as PLAB/GMC registration. For IELTS – 7.5 overall (no less than 7.0 in any module) For OET – B in all and overall.

  25. Hi, please I done MRCP part 1 and 2, currently preparing for my PACES but outside the UK.
    After being successful inshaALLAH, how do I get to UK, are there specific recruiter for non UK resident with such qualifications. How do get a training job also.
    Thanks

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