Updated: February 16, 2023
One of the great things about coming to work in the UK as a doctor is that there are so many options, there is no one way to gain GMC registration. But this can also make it very confusing! Today we’ll be tackling which exam is best for different situations to help you decide.
As a reminder, the GMC requires you to demonstrate that you meet a certain standard of clinical knowledge and skills. Most IMGs achieve this by passing PLAB but it is not the only way. Certain postgraduate qualifications can also be used to gain full registration in place of PLAB.
Postgraduate qualifications are generally awarded after passing the relevant exams. The most common exams that many IMGs consider taking instead of PLAB are MRCP (Membership of the Royal College of Physicians) and MRCS (Membership of the Royal College of Surgeons).
Other examples include MRCOG, MRCEM MRCPsych, FRCR etc. You can view the full list of UK and international qualifications accepted by the GMC here.
Which exam you take can also affect what training pathway you go down as an IMG. Find out how by enrolling in our FREE online course The IMG Shortcut where I show you how to get into UK training within 2 years.
Don’t take unnecessary exams!
If you’re considering MRCP/MRCS instead of PLAB, check first whether it is even required for your target specialty.
MRCP is only required for specialty training in medical specialties eg. Cardiology, Neurology, Gastroenterology. It is not required to enter training for other specialties such as Paediatrics, Psychiatry, GP, Ophthalmology, Surgery etc. This seems to be a common misconception. Make sure you know your training pathway so you don’t take unnecessary exams.
MRCS is required for most surgical specialties. It is not required for Obstetrics or Ophthalmology.
You can check the required exams for your target specialty on the GMC curricula. Use this guide to interpret the GMC curricula.
What factors need to be considered?If your specialty does require MRCP or MRCS at some point, there are several factors that you need to consider when deciding whether to take MRCP/MRCS or PLAB.
1. Pass rates
Many IMGs want to take MRCP/MRCS instead of PLAB to save time and money. This is perfectly reasonable but remember, you can only save time and money if you pass on your first attempt. MRCP/MRCS have much lower pass rates compared to PLAB. Have a look at the numbers so you can make an informed decision.
The pass rates for PLAB are higher than MRCP
|Year||PLAB 1||PLAB 2 (OSCE)|
The pass rates for MRCP are much lower than PLAB, especially for Part 1 and PACES. In particular, non-UK candidates have a lower passing rate for PACES compared to UK candidates. This may be due to lack of UK experience.
|2019 Pass rates for first attempt of MRCP 2-4|
|Overall||UK candidates||Non-UK candidates|
Recent pass rates are not published on the Royal College of Surgeons (RCS) website however I did find this Powerpoint presentation from RCS with these numbers. There is no year on the presentation nor is there any distinction between UK and non-UK graduates but these figures give you an overall idea.
|MRCS||Overall pass rate 5|
|Part B (OSCE)||57-60%|
Our official recommendation for PLAB 2 prep
Of all the providers out there, we recommend Arora Medical Education for your PLAB preparation. As a former PLAB examiner, Dr Arora is an expert in this exam, and his 10-day PLAB 2 Academy ticks all the right boxes.
- Live teaching, mock exams, and digital resources Taught by previous GMC examiners and senior NHS doctors (not former students)
- Latest mannikins including Simman
- Hands on practice for every attendee
- True preparation for NHS practise, no robotic scripts to memorise
2. Preparation time
Exams deserve and require dedicated preparation time. Being a more basic exam, PLAB is much easier to prepare for in a shorter period of time compared to postgraduate exams like MRCP and MRCS.
I’ve given the typical times that UK trainees tend to recommend for MRCP/MRCS when preparing for an exam alongside work. Keep in mind that the times may be shorter if you do not work while preparing for the exam, and longer if you work very long hours.
|Typical preparation time|
|PLAB 1||1.5 – 3 months|
|PLAB 2 (OSCE)||1.5 – 2 months|
|MRCP Part 1||3-6 months|
|MRCP Part 2||3-6 months|
|MRCP PACES (OSCE)||4-6 months|
|MRCS Part A||3-4 months|
|MRCS Part B (OSCE)||4-6 months|
When it comes to factoring in cost, there are 2 main things to look at:
- Exam fees – self-explanatory
- Location of closest testing centre – this will affect the cost of flights tickets, accommodation, and exam fees (fees can be higher if you take the exam overseas).
Here’s a table of the 2020 fees to compare:
|UK exam fee||Overseas exam fee||Locations|
|PLAB||TOTAL: £ 1,114|
|PLAB 1||£ 239||No additional fee||Worldwide|
|PLAB 2 (OSCE)||£ 875||N/A||UK only|
|MRCP||TOTAL: £ 1,487||£ 2,390 – 2,485|
|MRCP Part 1||£ 419||£ 594||Worldwide|
|MRCP Part 2||£ 419||£ 594||Worldwide|
|MRCP PACES (OSCE)||£ 657||£ 1,202 – £ 1,297||Worldwide|
|MRCS||TOTAL: £ 1,516||£ 1,573 – £ 1,671|
|MRCS Part A||£ 550||£ 596 – 659||Worldwide|
|MRCS Part B (OSCE)||£ 997||£ 977 – 1,012||Worldwide|
You’ll notice that exams for postgraduate qualifications tend to be more expensive than PLAB, especially when taken overseas. However being able to take MRCP and MRCS overseas may make up for the cost of flight tickets and accommodation of coming to the UK for PLAB 2.
Review your budget and the full cost of registration through PLAB route to make a decision.
4. Required clinical experience
PLAB 1 can be booked as soon as you have passed your final exams in medical school & have evidence of English proficiency (IELTS/OET/PMQ). Internship is not a requirement to sit PLAB.
These exams test the basic and most important clinical knowledge and skills of competent doctors. Many IMGs are able to pass PLAB with or without completion of internship.
Similar to PLAB, you can book Part A of MRCS right after graduating from medical school provided you meet the rest of the eligibility criteria. You can also book Part B but passing it without clinical experience, especially UK experience, can be difficult.
The Royal College of Surgeons recommends that candidates attempt Part A during the first year of core surgical training (CT1) which is 2 years post-graduation, and Part B during the second year of core surgery (CT2). Many doctors who aim to pursue surgery sit Part A prior to CT1 applications, and clear Part B during CT1.
This exam requires 12 months postgraduate clinical experience before you can sit MRCP Part 1 which means you must complete internship first.
There are no further requirements for postgraduate experience for Part 2 or PACES however as a postgraduate exam, MRCP requires postgraduate experience to pass. It appears that UK clinical experience is also very important considering the lower pass rate of IMGs compared to UK candidates, especially for PACES which is an OSCE.
The Royal College of Physicians says that based on their data, the pass rates are highest when candidates:
- make their first attempt at the Part 1 Examination within 12 to 24 months of graduation
- make their first attempt at the Part 2 Written Examination within 36 months of graduation
- delay their first attempt at the Part 2 Clinical Examination, PACES, until 36 months after graduating
- pass the Part 2 Written Examination before attempting PACES.
5. Job prospects
So if you’re worried about not getting a job because you don’t have a postgraduate qualification like MRCP or MRCS, don’t be!
Full MRCP or MRCS are not entry requirements for the first-year of training (CT1). Passing Part 1 of MRCP or Part A MRCS will gain you points on your application to core training, but passing Part 2/PACES/Part B will not. So consider how much effort you’ll be putting into unnecessary exams – effort that can be spent improving other parts of your application eg. research, audit, and teaching.
You are only expected to pass all parts of MRCS or MRCP by the end of core training which is 2 years for surgery and 2-3 years for medicine. Only then will you need it to enter higher specialty training eg. Cardiology or Gastroenterology for medical specialties, or General Surgery or Orthopaedics for surgical specialties.
If you have already completed postgraduate specialty training (residency) overseas equivalent to UK core training, you can work towards having your training recognised and apply for higher medical or surgical training at ST3 level. In this case it may be worth your time to pursue MRCP or MRCS instead of PLAB.
For those who have just graduated or just finished internship, PLAB is the logical choice.
It does not require any further postgraduate experience, needs less preparation time, and allows you to start working in the UK sooner.
Your first job in the UK is going to be at SHO level and having MRCP or MRCS is not required for this role. Applicants without them are just as likely to get an SHO post. MRCP and MRCS can be cleared while working in the UK. The UK clinical experience will give candidates a higher chance of passing.
For those who have significant postgraduate experience or have completed residency overseas, you have a choice between a PGQ and PLAB.
PLAB is faster and has a higher pass rate, while a PGQ is more expensive and takes longer, but will be in your specialty.
Your first job in the UK can either be at SHO or Registrar level, most likely in a non-training role. For these types of jobs, MRCS and MRCP are also not required but can help when applying for Registrar level positions. Just keep in mind that the lack of UK experience can be an obstacle to passing.
Frequently asked questions
No, you need to pass all parts of a postgraduate qualification to use it for GMC registration.
Won’t I save time and money by taking one exam (MRCP/MRCS) instead of 2 exams (PLAB then MRCP/MRCS later on)?
Yes, you can certainly save time and money by clearing one set of exams instead of two, but that relies on you passing the first time. MRCS and MRCP have much lower pass rates compared to PLAB!
Being postgraduate qualifications, your success in MRCP/MRCS is generally tied to your postgraduate clinical experience. Postgraduate clinical experience (especially UK experience) is usually needed to succeed.
So if you have only completed internship, you may end up spending more time and more money with multiple attempts of MRCP/MRCS compared to PLAB. But if you feel up for the challenge then by all means, go for MRCP/MRCS.
If you have already completed postgraduate specialty training (residency) overseas, it may be worth your time to pursue MRCP or MRCS instead of PLAB.
Yes, you may need to pass MRCP or MRCS at some point but these exams are not entry requirements for first-year specialty training (CT1).
You are only expected to pass MRCS or MRCP by the end of core training which is 2 years for surgery and 2-3 years for medicine. Only then will you need it to enter higher specialty training eg. Cardiology or Gastroenterology for medical specialties, or General Surgery or Orthopaedics for surgical specialties.
For entry to the first year of core training, passing Part 1 of these exams is sufficient.
If you have already completed postgraduate specialty training (residency) overseas equivalent to UK core training, you may wish to skip UK core training and apply for higher medical or surgical training at ST3 level. In this case it may be worth your time to pursue MRCP or MRCS instead of PLAB.
Find this article useful? Check out more guides on this topic here: GMC registration
1. General Medical Council. (2019). Recent pass rates for PLAB 1 and PLAB 2. [online] [Link] [Accessed 6 Apr. 2019].
2. MRCP(UK) Part 1 2018 performance report. (2019). [ebook] MRCPUK. [Link] [Accessed 6 Apr. 2019].
3. MRCP(UK) Part 2 Clinical Examination performance report 2018. (2019). [ebook] MRCPUK [Link] [Accessed 6 Apr. 2019].
4. MRCP(UK) Part 2 Written 2018 performance report. (2019). [ebook] MRCPUK. [Link] [Accessed 6 Apr. 2019].
5. MRCS: when, what and how?. (2019). [ebook] Royal College of Surgeons. [Link] [Accessed 6 Apr. 2019].