Updated: January 17, 2023
The General Medical Council (GMC) is the medical authority in the UK. You need to be registered with the GMC and have a license to practise in order to work as a UK doctor. There are no exceptions.
The whole process of getting registered can be easy and quick, or difficult and long depending on how well you prepare your documents.
In this post I’ll walk you through all the requirements you’ll need to submit for GMC registration so your experience will be as smooth as possible.
The general requirements for GMC registration as an IMG are:
- Primary medical qualification and EPIC verification
- Proof of English proficiency
- Proof of clinical knowledge
- +/- Proof of an acceptable internship
- Record of activities from the last 5 years or since graduation from medical school
- +/- Certificate of good standing
- ID check
The exact combination of documents will be different for each doctor depending on individual circumstances but we go over the important requirements here.
1. Primary Medical Qualification (PMQ)
Your PMQ is your medical degree. The GMC will need to be satisfied that your PMQ is from a legitimate reputable university.
So is your university reputable according to the GMC? This is easy to check. It should be included on list A or B, and NOT on List C or D.
- List A: World Directory of Medical Schools
- List B: GMC approved list for schools not on the World Directory
- List C: GMC “blacklist”
- List D: GMC “greylist”
If your university is not on any of these lists, you should contact the GMC via email gmc@gmc-uk.org for further advice.
Your university can appear on more than one list:
- If your school is on list C, even if it is also on list A, then I’m afraid this is the end of your journey until the GMC removes your school from list C. You can email the GMC, but the chances of acceptance are low.
- If your school is on both list A and D, then you may still have a chance. Graduates from schools on the “grey-list” are assessed on a case-by-case basis. Again, it’s best to email the GMC for guidance.
ECFMG and EPIC verification
Once you’ve established that you have an acceptable PMQ, you will need to have your certificate or diploma verified by a GMC-trusted third party. That’s where the ECFMG and EPIC come in; they are US-based organisations specialising in verifying credentials.
The verification process can take time, so the earlier you do this the better. An ideal time to do this is between after you’ve taken PLAB 1.
The step-by-step instructions to do this can be found here:
Please take note that only your certificate needs to be verified. Transcripts do not need to be verified or submitted for GMC registration.
What if I already have previous ECFMG certification?
You can use your previous ECFMG certification for GMC registration. All you have to do is create an EPIC account then make a request to ECFMG to send the report to the GMC.
2. Proof of clinical knowledge and skills
On top of your PMQ with ECFMG certification, you will need to demonstrate that you reach the standard level of medical knowledge and skills expected of UK doctors who have just completed internship.
This can be achieved through 6 main routes.
- PLAB
- Acceptable overseas registration exam
- Relevant European qualification (REQ)
- Acceptable postgraduate qualification
- Sponsorship
- CESR/CEGPR
1. PLAB (UKMLA from 2024)
PLAB stands for the Professional Linguistic and Assessments Board. The exam has 2 components: PLAB 1 which is a written test, and PLAB 2 which is a practical test.
PLAB is specifically for IMGs who qualify outside the EU. UK graduates and EU graduates do not need to sit PLAB.
Fortunately with the right preparation, PLAB is a very manageable exam and there are good pass rates which are increasing year on year.
Related: What you need to know about PLAB
2. Acceptable overseas registration exam
As of January 12, 2021, you may be exempt from PLAB if you have previously passed any of the following licensing exams:
- USMLE (Step 1, Step 2 CK & Step 2 CS)
- AMC (MCQ Examination & Clinical Examination) or
- MCCQE (Part I & II in English)
This is only applicable if you passed the exams before a certain date:
- USMLE: On or before 13 March 2020
- AMC: On or before 5 March 2020
- MCCQE: On or before 27 October 2020
You must also have passed the exam in no more than four attempts. If you sat the exam more than four times before passing, you will not be eligible to use this route.
Also, if you have taken and failed PLAB part 1 or 2 after you passed one of the above exams, then you are not eligible for this route.
3. Relevant European qualification (REQ)
As of January 1, 2021, IMGs who completed their Primary Medical Qualification (medical school) or are on the specialist register in the EU may be exempt from PLAB. This is now applicable even if you are not an EU national. EU nationals are no longer exempt from PLAB if they went to a medical school outside the EU.
However, if your REQ is over 2 years old, you should be be able to show that you have been working since graduation. If you have not practiced for 60% of the time since graduation (or over the last five years, if you graduated more than five years ago) in a full time role, plus a minimum of 6 months in the last 12 months, then the GMC may require more information from you or they may require you to sit PLAB.
To check if you have a relevant European qualification, check this list on the GMC website.
4. Acceptable postgraduate qualification (PGQ)
The GMC has a list of postgraduate qualifications that they accept for full registration. This means you can bypass PLAB by having one of the qualification on the list.
This list includes UK postgraduate qualifications such as MRCP and MRCS, but also includes some overseas qualifications so it’s worth checking if yours is on the list.
- If you have a qualification on this list, then well done! You have already demonstrated your skills and knowledge for full registration. You do not need to take PLAB. All you need to do is have your certificate or diploma verified through ECFMG along with your PMQ.
- If you have a qualification that is not on this list, you could potentially write to the UK medical Royal College of your specialty to ask whether they would consider your qualification as equivalent to theirs. If your qualification is accepted, then great. If not, you can either obtain a new qualification that is accepted, or you can sit PLAB, or you can obtain sponsorship (see below).
- If do not have a qualification on this list, you could gain one by sitting the relevant exam eg. MRCP or MRCS, or you can sit PLAB, or you can gain sponsorship (see below).
5. Sponsorship
It is possible to gain GMC registration without sitting PLAB or having an accepted PGQ. This is achieved through sponsorship. Some institutions provide sponsorship for GMC registration allowing you to bypass PLAB and PGQ. This is the list of GMC approved sponsors.
For more information about how you can gain sponsorship, please check the official websites and contact them directly. It’s always best to contact the sponsors directly for more information because rules change frequently.
Medical Training Initiative (MTI)
MTI is a type of sponsorship that allows doctors to work in the UK for a maximum of 2 years. Although your visa to work in the UK is only for 2 years, the GMC registration you gain is permanent and will not be revoked after 2 years.
MTI is a great option to gain GMC registration for those who do not plan to migrate to the UK permanently. If you’re interested in short-term training in the UK, you can read more about the options here.
Suggested: How to find cheap short-term accommodation in the UK
6. CESR (Article 14)/CEGPR
If you are already a specialist overseas, then you may be able to gain direct registration as a specialties and be recognised immediately as a UK Consultant. This involves compiling a set of documents demonstrating that you have the equivalent training and experience of a doctor who has completed specialty training (residency in the UK). This is known as the CESR route.
If you are already a practising general/family medicine practitioner, then again, you may be able to do the same and be immediately recognised as a UK GP. This is the CEGPR route
It is a tedious process, and usually unsuccessful for those who do not have any UK experience, but it is a possibility and some IMGs have succeed with this.
Please note that is not enough to submit a CV of your work history for a successful application. The GMC typically expects 800-1,000 pages of documents detailing your training and experience.
You can read more about it in this article:
Which route should you take?
You need to go through one of these routes to gain GMC registration: PLAB, PGQ or sponsorship or CESR/CEGPR. There are no other routes.
To help you decide which route is most suitable for you, we’ve written a whole guide that you can check out:
3. English proficiency
There are different ways to prove to the GMC that you can communicate in English as a medical professional. Which evidence you use depends on whether you are taking the PLAB route or the PGQ/sponsorhip route.
PLAB route
There are 3 options:
1. IELTS Academic version
- To pass you need an overall score of 7.5 and a minimum score of 7.0 in each of the different sections (reading, writing, listening, speaking) all in the same test.
2. OET Medicine
- You’ll need to score at least a ‘B’ grade in all sections in the same test to pass GMC requirements.
Related: IELTS vs OET
Need help with IELTS or OET?
Swoosh English is a UK-based organisation with native English-speaking teachers. Their courses are officially endorsed by OET and they have already helped thousands of IMGs pass. If you want to save money by passing the exam on your first attempt, Swoosh English could be a good fit.
Check out their FREE video series with tips to help you pass IELTS or OET on your first attempt.
3. Your PMQ
- To use your PMQ as evidence of English it has to meet certain criteria:
- The PMQ was taught and examined solely in English, and
- At least 75% of your communication with patients, their relatives, and colleagues, was also in English.
- You cannot use this route in any of the following circumstances:
- Your university is on this list.
- You have failed IELTS or OET in the past.
- Your medical school is not willing to produce a certificate confirming that they fulfil the English requirements.
- It has been more than 2 years since you passed your final exam and you don’t meet the additional criteria (see below).
- Even if you meet all the criteria, the GMC still holds the right to reject your PMQ as proof of English proficiency, particularly if you studied in a country where English is not the first and native language.
What if my IELTS or OET has expired?
According to the GMC, you can prove you’ve maintained English skills if you’ve been employed or you’ve studied a postgraduate course in a country where English is the first and native language.
You’ll need to submit a reference from your employer, tutor or lecturer. The reference must cover at least three months full-time study or employment within the last two years. You can download the reference form and read more about it here.
If you can’t meet this requirement, then you need to retake IELTS or OET.
What if it has been more than 2 years since I passed my final exam?
According to the GMC, you can prove you’ve maintained English skills if you’ve been employed in a country where English is the first and native language.
You will need references from all your employers for the past 2 years. You can download the reference form and read more about this here.
If you can’t meet this requirement, then you need to take IELTS or OET.
Which countries and territories are considered to speak English as the first and native language?
Ascension, Australia, Bermuda, British Antarctic Territory (BAT), British Indian Ocean Territory (BIOT), Canada, Falkland Islands, Gibralta, Guernsey, Guyana (formerly British Guiana), Ireland, Isle of Man, Jersey, New Zealand, Pitcairn, Singapore, South Africa, Sovereign Base Areas of Akrotiri and Dhekelia on Cyprus (CBA’s), South Georgia and the South Sandwich Islands, St Helena, Tristan da Cunha, United Kingdom, United States of America, US Virgin Islands.
Caribbean Islands: Antigua and Barbuda, Anguilla, Bahamas, Barbados, British Virgin Islands, Cayman Islands, Dominica, Grenada, Grenadines, Jamaica, Montserrat, St Kitts and Nevis, St Lucia, St Vincent, Trinidad and Tobago, Turks and Caicos Islands
PGQ or Sponsorship route
There are 3 additional ways to prove your English proficiency if you are going through the PGQ route or the sponsorship route as long as you have not previously failed IELTS or OET.
- You’ve worked as a doctor in an English speaking country.
- This is an option if your PMQ was not taught in English but you have worked as a doctor in a country where English is the first and native language for the past 2 years.
- You have a UK job offer.
- If you already have a job offer in the UK and you have fulfilled your future employer’s own requirements for English then this is an option. However, most employers will require you to take an English test such as IELTS or OET.
- You passed an English test elsewhere.
- You can use this option if you have passed the English test for registration in a country where English is the first and native language. So for example, you passed the test for registration in Australia. This has to be within the last 2 years.
4. Proof of internship or equivalent experience
Provisional registration
If you are applying for provisional registration, then you can skip the requirement for internship. Keep in mind that with provisional registration, you can only apply to a formal FY1 training post through the UK Foundation Programme. You will not be eligible for any other type of job as a doctor, not even a non-training FY1 position.
Related:
Full registration through the PLAB route
If you’re applying for full registration through the PLAB route, the GMC will want to verify that you have had clinical-based experience and training equivalent to the first year of the UK Foundation Programme AKA Foundation Year 1 or FY1.
This can done through one of 2 ways:
- An internship programme of at least 12 months duration or
- Continuous postgraduate medical practice for at least 2 straight years.
While postgraduate work should obviously have taken place after graduation, internship can be either in your final year of medical school or the year right after graduation.
Both types need to have taken place at a public hospital under supervision. That means if you worked as a doctor seeing patients on your own in a private clinic or doing home visits, then this will not count.
There are also requirements for how much time was spent in medical and surgical rotations.
| Formal internship (12-18 months long) | Formal internship (longer than 18 months) | 2 years postgraduate medical practice | |
| Minimum time in medicine | 3 months | 6 months | 3 continuous months |
| Minimum time in surgery | 3 months | 6 months | 3 continuous months |
You will need a certificate or letter from the hospital you completed your internship or postgraduate experience at. The letter must contain the dates and specialties of all your clinical rotations.
Please read this article for more details about internship:
No. Clerkship refers to the clinical rotations undertaken during medical school. It is a basic GMC requirement of an acceptable medical degree (source). It is not considered the same as FY1 or internship.
FY1 prepares doctors for independent practise. At the end of it, doctors gain full registration. Clerkship or medical school clinical rotations do not result in full registration or a medical license.
The equivalent of FY1 is internship or a house job.
Be careful of labelling clerkship or clinical rotations as equivalent to FY1 in your CV or job application. You may be accused of inflating your experience which can turn into a serious probity issue with the GMC.
Full registration through the PGQ or Sponsorship route
In paragraph 6 of the GMC guidance for internship, it states that “applicants applying through the PGQ or Sponsorship routes are considered to have demonstrated the necessary experience for full registration.”
This means that your internship does not need to meet the same criteria as the PLAB route. If the GMC officer handling your case is giving you a hard time about internship even if you’re applying through the PGQ or Sponsorship route, do refer them to the guidance linked above.
5. Record of activity the past 5 years
The GMC want to know what you’ve been up to after your medical degree for the past 5 years only, or since you qualified from medical school if you qualified less than 5 years ago. You do not do provide a record of activities for anything more than 5 years ago. The sorts of activities you can include in your record are: medical work, non-medical work, clinical attachments, unemployment, maternity leave, study leave, vacation, and career breaks.
You only need employer references if you’ve done medical work without being registered, or any non-medical work.
Registration through the sponsorship route requires that you have been actively practising medicine in the last 5 years. You do not have to be continuously practising for the whole 5 years but you should have been active for 3 years in total, including the most recent 12 months. This is not a requirement if aim to gain GMC registration via PLAB or an acceptable postgraduate qualification such as MRCP, MRCS, MRCOG etc.
6. Certificate of Good Standing
If you’ve been working as a doctor overseas anytime in the past 5 years, then the GMC expects that you are registered as a doctor with the relevant medical authority in order to legally practise medicine there. You will need to obtain a Certificate of Good Standing (CGS) from that medical authority.
- If you are registered or hold a license with more than one medical authority, you need a CGS from each and every one you’ve been registered with over the last 5 years.
- If you have been registered somewhere in the past but haven’t been registered with them for more than 5 years, then you don’t need a CGS from them.
- If you are registered somewhere in the last 5 years but have never actually worked there, you still need a CGS.
- If there is no medical authority where you’ve worked, you’ll need to contact the GMC for further advice.
- If you have been working without any registration or official license to practise because it is not required to work as a doctor for any reason, you’ll need to contact the GMC about your situation for further advice.
- If you are not registered with any medical authority because you have not yet worked as a doctor, then you do not need to submit a Certificate of Good Standing
Some countries have a medical council or medical board for every region; check which ones the GMC accepts certificates from in this database.
7. ID Check
Once your application is approved, you will have to come to the UK to have your passport verified for ID checks.
For those going through the PLAB route, the ID can be checked on the day of the PLAB 2 exam to avoid an additional journey to the UK.
Deadlines
These tend to be strictly followed although sometimes the GMC may grant some leniency if you contact them directly. If you do not fall within the set time limits and the GMC does not grant any leniency, then you will have to repeat some of the steps so do make sure you adhere to rules!
- Your registration must be approved within 2 years of passing any English test.
- PLAB 1 must be taken within 2 years of passing an English test, but if you wait this long you will have to repeat the English test for GMC registration.
- PLAB 2 must be taken within 2 years of passing PLAB 1.
- Your application for either provisional or full registration must be approved within 2 years of passing PLAB 2.
- Your application for full registration must be approved within 3 years of passing a postgraduate qualification, if it has been more than 3 years then you will need to show that you have been working and kept updated since then.
Take note that these time limits are for when your registration must be approved. This means you do not have up to 2 or 3 years to apply. If you apply too close to the time limit, your registration may not be approved in time.
- Any references from employers are only valid for 3 months.
- A Certificate of Good Standing is only valid for 3 months.
Once you submit all your documents to the GMC your application will stay open for 3 months. During that time the GMC may request for missing documents. Each time they ask you will have only 2 weeks to produce the missing paperwork. This is usually not enough time for a lot of things!
So make sure you give everything they ask for the first time.
If your application is not approved within 3 months then you will have to submit a new application and you might even need to repeat some of the requirements as they might be outdated by then.
Summary
In conclusion, the requirements you need to submit depend on which route you take. Which route to take will depend on your level of experience and training, and your ideal career pathway. PLAB is certainly the easiest starting point for the majority of IMGs who are quite early on in their careers. It is also the most flexible in terms of job and training opportunities.
Whatever you decide, I recommend creating an online GMC account as early as possible and start completing your requirements systematically. Once all requirements are complete, it’s time to hit submit!
What now?
Now that you know the requirements, its time to figure out your career path and plan ahead.
Watch our IMG Shortcut, a free course where we show you how to get into your specialty of choice.
Further resources
Find out what requirements you need for your individual circumstances with this GMC tool. I’ve completed the first 2 questions for you and you just need to complete the rest.
158 Responses
Hello,
I am an ECFMG(USMLE) certified doctor working as a house officer in Nepal. I do not have a post graduate qualification. Do I need to sit for PLAB/MRCP/MRCS before applying for GMC registration?
Hi there! You may be able to use your USMLE for registration. Please see this article under “Exemptions from PLAB” https://thesavvyimg.co.uk/which-route-to-gmc-registration-is-right-for-you/
Hi Nick,
thank you for the article! I am currently struggling to get CGS from where I am registered–I haven’t been able to get any response from the authorities and am not currently in the country. Do you know if there are alternatives we can provide the GMC with in stead of the CGS?
Thank you!
I’m not aware of any I’m afraid, it’s best to contact the GMC directly for advice. You may also be able to get some advice from one of the IMG groups on FB.
Hi.
I am short of 18 days for the 6 months in recent 12 months criteria for GMC registration. Otherwise I have been working for 7 yrs prior to that. How will this impact GMCs decision for my registration. I have no PLAB at all.
Hi there, did you graduate from a medical school in the EU? If so then it may be an issue. If the GMC do not accept that gap then they will most likely ask you to sit PLAB. Best to ask them directly for advice. Hope it works out!
Hi,
I booked plab2 nearly 1.5 years after plab1 due to covid. My question is if I pass plab2 and then apply for GMC registration after 2 or 3 years, will they accept it or should I apply soon after plab2 (I intend to do my post-graduation in my home country and then go to the UK later, that’s why the delay)
PLAB 2 is only valid for 2 years so I would just apply for GMC registration right away. You don’t need to come to the UK as soon as you have GMC registration.
Hi,
I am an International Medical Graduate. I am ECFMG certified.
I would like to know if PLAB is exempted for me.
Secondly, I have been graduated from english speaking foreign medical school and have been working in USA for 2 years. So, based on this will my IELTS be exempted ?
Thanks. Looking forward to hearing from you soon.
Best regards
Emad
Hi there, sounds like you should be exempt from PLAB and IELTS. Best to check with the GMC directly. Hope it all works out!