The Savvy IMG

Which route to GMC registration is right for you?

Get to grips with the fundamentals of coming to the UK as an international medical graduate with our comprehensive easy-to-understand guide. In this post we discuss the requirements you’ll need to register with the GMC including PLAB and IELTS.

Table of Contents

Route to GMC

UPDATED: January 15, 2021

There are 4 routes to GMC registration for those who are not eligible for exemption from PLAB. Here I’ll discuss which pathway may be best for you depending on your profile.

The 4 routes are always the same for everyone regardless of specialty. You just have to select the most appropriate path that fits with your background and experience. 

So what are the 4 possible routes and which one could be right for you?


(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. Fortunately with the right preparation, PLAB is a very manageable exam and there are good pass rates which are increasing year on year.

This test is specifically for doctors who graduate outside the EU. UK graduates and EU graduates do not need to sit PLAB. In 2024, PLAB will be replaced by the UKMLA which will be required for both UK graduates and non-EU graduates. 

If you sit PLAB and have an acceptable pattern of internship, you can apply for full registration.

If you sit PLAB and do not have an acceptable pattern of internship, you can only apply for provisional registration. 

You can read about the different types of registration here.

The PLAB route is most suitable for you if you fit one of the following profiles:

  • You have not completed internship and you are applying for provisional registration OR
  • Your internship does not meet the GMC criteria for an acceptable pattern of internship and you are applying for provisional registration  OR
  • You have completed an acceptable pattern of internship and have no other postgraduate clinical experience and you’re applying for full registration  OR
  • You have completed an acceptable pattern of internship, you have worked after internship, but you have not completed any postgraduate training (residency) and you’re applying for full registration  OR
  • You have completed postgraduate specialist training (residency), and you want a faster route to full GMC registration.

The majority of IMGs will go through the PLAB pathway so we have summarized all important aspects of what you need to know about PLAB as an IMG.

Exemptions from PLAB

There are 2 scenarios that can lead to exemption from PLAB:

  1. Acceptable overseas registration exam
  2. Relevant European qualification (REQ)

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)

However, there are conditions to this.

  1. Date of the exams. You must have 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
  2. Number of attempts. You must 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.
  3. No failed PLAB attempts after the passing the USMLE, AMC, or MCCQE. 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.

If you meet the criteria and have an acceptable pattern of internship, you can apply for full registration.

If you meet the criteria and do not have an acceptable pattern of internship, you can only apply for provisional registration.

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, there are also conditions to this. 

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 they 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.

If you qualify from a medical school in the EU, you may be eligible for full registration even if you do not complete an internship. Please check the link above. 

Read more about this on the GMC website here

2. Acceptable postgraduate qualification (PGQ)

The GMC has a list of postgraduate qualifications that they accept for full registration. If you have a qualification on this list, then you do not need to sit PLAB and you will be eligible for full GMC registration.

This is the list of accepted postgraduate qualifications. 

Examples of some of the postgraduate qualifications include MRCP, MRCS, MRCOG etc. Some overseas qualifications are also on the list so it’s worth checking.

If you have a qualification on this list, then well done! You do not need to take PLAB.

If you do not have a qualification on this list, you can either gain one by passing the relevant exams, or you can sit PLAB, or you can apply for sponsorship, or you can try the CESR route.

The PGQ route is most suitable for you if you fit one of the following profiles:

  • You have postgraduate clinical experience and you want to go directly for a specialist qualification rather than take a general exam like PLAB   OR
  • Your internship does not fit the GMC criteria.

If you’re still deciding between PLAB and a postgraduate qualification such as MRCP or MRCS, then this article should help you decide.

3. Sponsorship

Some institutions provide sponsorship for GMC registration. This may allow you to be registered without sitting PLAB or having an accepted PGQ. 

This is the list of GMC approved sponsors

You can check on their official website and contact them for more information about how you can gain sponsorship. 

  • Most, but not all, sponsorship schemes require you to have a certain number of years experience in the relevant specialty. 
  • Some sponsors require you to pass at least the first part of a UK postgraduate qualification, while others don’t as long as you have an equivalent overseas qualification. 

It’s always best to contact the sponsors directly for more information because rules do change a lot.

Some sponsorship programmes allow you to obtain a Tier 2 work visa. This is best if you plan to stay in the UK long-term. If you only plan to ultimately return home, then the Medical Training Initiative (MTI) is more suitable. 

Medical Training Initiative (MTI)

This programme allows doctors to be work in the UK for a maximum of 2 years on a Tier 5 after which they must return home. You can always return to the UK on a different visa.

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. You can read more about sponsorship in this article: 

The sponsorship route is most suitable for you if you fit one of the following profiles:

  • You have postgraduate clinical experience but you don’t have an accepted postgraduate qualification and you want to avoid PLAB,   OR
  • You have completed postgraduate specialty training ie. residency, but you don’t have an qualification on the GMC list of accepted postgraduate qualifications and you want to avoid PLAB,   OR
  • Your internship does not fit the GMC criteria AND you have not failed PLAB in the past.
The MTI route is most suitable for you if you fit one of the above profiles AND you do not plan to stay in the UK for more than 2 years.


This route involves compiling proof (ie. documentation), that you have gained the equivalent experience and training of a UK trained Consultant or GP. The GMC typically expects around 800-1000 pages of documents for this. All of your documents can be from experience and training overseas. 

CESR stands for Certificate of Eligibility for Specialist Registration. If you are successful with this route, it means that you will be automatically recognised as a Consultant in the UK for your specialty without undergoing any additional training.

CEGPR stands for Certificate of Eligibility for GP Registration. If you are successful with this route, it means that you will be automatically recognised as a GP without undergoing any additional training.

The CESR route is most suitable for you if you fit this profile:

  • You have completed full postgraduate specialist training overseas, you are confident that your training and experience is equivalent to the UK curriculum, and you have full documentation to prove this.

The CEGPR route is most suitable for you if you fit one of the following profiles:

  • You have completed postgraduate training in family and community medicine, you are confident that your training and experience is equivalent to the UK GP specialist training curriculum, and you have full documentation to prove this.
  • You have been working as a general physician for many years, you are confident that your experience and CPD is equivalent to the UK GP training curriculum, and you have full documentation to prove this.

To be frank, the CESR/CEGPR route is tedious and often takes years, but it is an option that some IMGs have been successful with.

Most IMGs who are already specialists overseas do not go through the CESR/CEGPR route directly, instead they come to the UK first via one of the first 3 routes (PLAB, PGQ or sponsorship), then work on the requirements for CESR/CEGPR once they are here.

You can read more about it in this article:

Frequently asked questions

I have several years of experience in my specialty. What are my options to gain GMC registration?

PLAB, an accepted postgraduate qualification, sponsorship, or CESR/CEGPR.

I want to work in a specific specialty, what is my path to GMC registration?

PLAB, an accepted postgraduate qualification, sponsorship, or CESR/CEGPR.

I have worked for a few years post-grad. How can I get GMC registration?

PLAB, an accepted postgraduate qualification, sponsorship, or CESR/CEGPR.

I haven’t worked after internship. How can I get GMC registration?

PLAB, or an accepted postgraduate qualification.

I have completed specialty training in my home country and have passed all my licensing exams back home. What are my options for GMC registration?

PLAB, an accepted postgraduate qualification, sponsorship, or CESR/CEGPR.

I have a long career gap of several years, what route can I take for GMC registration?

PLAB, an accepted postgraduate qualification, sponsorship, or CESR/CEGPR.


As you can see, whatever your background or experience, the options for GMC registration are essentially the same: PLAB, an accepted postgraduate qualification, sponsorship or CESR/CEGPR.

What if you’re not eligible?

  • If you aren’t eligible for 1 route, then obviously your options are the other 3.
  • If you aren’t eligible for 2 routes, then you can consider the other 2.
  • If you aren’t eligible for 3 routes, then your only option is the 1 that’s left.
  • If you aren’t eligible for all 4 routes, then you either work on meeting the requirements for 1 of the routes or you move on and forget about working as a doctor in the UK.
  • If you can’t meet the requirements for any of the routes either now or in the future no matter what you do, then you can’t get GMC registration and can’t come to work in the UK. 

Hope that clears up any confusion!

Now that you know your route, view the full list of GMC Requirements, and start planning to tackle them!

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41 Responses

  1. I qualify for sponsorship or accepted postgraduate qualification. Is there any benefit to sponsorship over direct application and registration to the GMC?

    1. Hi Jennifer! As long as you have a sponsorship that is approved by the GMC Sponsor, then you don’t have to do exams.

  2. Hello Nick
    I am in a bit of tricky situation. I am a EU citizen living in the UK who studied medicine outside the EU and UK. Before January 2021 I would have been exempt from sitting the PLAB but am not anymore. I have no problem sitting the PLAB but unfortunately there are no dates available at all. The earliest I could sit it is August and that is if I’m lucky to be able to book one on the 10th of December.
    I was wondering if anyone knows a way I can book plab 1 exam earlier . I have done some searching online and found that is possible to for someone to cancel their seat for me to book it but it’s super risky and also against the GMC rules.
    I was also wondering what my options are to work and make some money before I able to sit PLAB 1 and 2. I have National insurance number. My only option at the moment is the local Lidle .
    Any help would be appreciated.

    1. Hi Syed, did you manage to book PLAB in Aug/Nov 2023? It’s not possible for someone to cancel their seat and for you to book it. If they cancel, it goes back to the booking system, and then it’s open for anyone to book so there’s no guarantee you will get a booking. Also as you said, selling seats like this is not permitted so I would forget about that. But you can check regularly for cancellations. Try logging into your GMC account twice a day just to see if anything comes up. Other than that, there are no ways to get a PLAB seat sooner. You’re a medical graduate, trust me, there are more jobs you can apply to other than Lidl. Although Kim also worked in Debenhams for a couple of months while waiting for FY1 to start! You can look at non-medical jobs in a hospital like medical lab assistant, phlebotomist etc, or you can look for jobs in research or basically anything. What do you want work on in the meantime? Also, if you plan to apply to specialty training, you might want to think about how you’re going to use this time to improve your CV!

  3. Hi, I am foreign medical graduate with 2 years gap after Internship and working as volunteer in Hospital but not registered in local medical authority, Can I have full GMC registration via MRCP or PLAB pathway ?

  4. Hi Nick
    I am a bit confsued regarding the registration with gmc after plab2. I have completed my mbbs in 2014 and completed my internship with no gap. Then i came to my country and worked for a year . However i plan to give my plab in 2023. But there is no 3 year pactice in last 5 year .acc to gmc “gap in practice”is seen or not . If so will i be able to get full registration in gmc , if not then what can be done. Pls help me as i am in dilemma whether to give plab or not.

  5. Hi i am an indian national who graduated in eea country in 2018. after graduation in got registered into ireland medical council and couldn’t secure a job because of covid..and i am not offically registered in indian medical question am i eligible to get gmc registration without plab.

    1. Hi there, you may be able to get GMC registration based on your EEA medical degree. For an issue like this we recommend contacting the GMC directly for advice. Their email address is and the phone number is +44161 923 6602. They are open Monday to Friday 8 am–5.30 pm and 9 am–5 pm on Saturday. You can also send them a message on FB messenger, they usually reply within a day or 2.

      You do not need to registered in India if you have never worked there.

  6. Hi Nick ,
    Can you please guide me if I want to take the sponsorship route , how am I Supposed to contact the hospital ; is it through email and asking for a sponsorship, would they consider me like that.
    Thank you so much

  7. Hi Nick
    I have a question,
    Im a british med student. Currently studying in eu country. My last academic year is 2023-2024 and I graduate in 2024. Graduation will officially take place in around November 2024.
    Will i need to sit the ukmla exam?

    Thank you

    1. Hi there, so far it looks like EU graduates are exempt from UKMLA but that can always change. I would keep an eye on the GMC website and perhaps contact them closer to the time to see if their policy has changed. All the best!

  8. Hello nick
    I am registered with medical council of india and successfully completed my training after MBBS . Since 2017 i am working as resident medical officer. Now i want to relocate to uk for my further studies and practice. Can you please help me with sponsorship programmes so that i dont have to ho through plab or mrcs. moreover can you please tell i can directly apply to royal colleges for my further studies without any plab or gmc registration. I shall be highly thankful to you for this act of kindness amd help

    1. Hi Manpreet, if you’re looking for a classroom or lecture based degree with a university with no patient contact then you may be able to find some by searching “medical masters uk” and enquiring with the various universities. However if you want to have clinical experience, then you need GMC registration, there are no exceptions to this so I’m afraid there is no pathway for what you’re looking for. The pathways to GMC registration are the ones listed on this page. All the best!

  9. Hi Nick,

    I’m an internal medicine doctor in the US moving to the UK at the end of the summer. I attended medical school and completed my internship/residency at a US hospital. I’ve been practicing as an attending for the past three years. My internship year (post graduation) did not contain a surgical rotation, which is typical for US doctors not intending to become surgeons. But I did complete a 3 month surgical rotation in med school. Will this be a barrier to receiving full registration? How much discretion does the GMC have in determining if your training is sufficient for full registration?

    Thanks for your help!

    1. Hi there! We haven’t actually come across any US attendings who are working in the UK so I’m afraid I can’t provide any insight on this matter. The GMC tends to approve straightforward applications that meet their requirements very quickly, anything that doesn’t can take longer but if you’ve been in active clinical practise recently it shouldn’t take too long. We have heard of many cases of doctors with internship gaps, long career gaps, work periods without registration etc, who have gotten full registration after some back and forth with the GMC. Hope it works out! Let us know how it goes!

  10. Hi there, I have a question. I am a medical student in Ireland and will be graduating in May 2022. So if I want to apply for foundation years in UK, I dont have to take PLAB? Just to reconfirm.

  11. I want to get sponsorship GMC registration in UK
    Am Medical graduate (MBBS-2016 from India. My husband is a MD Doctor working at NHS UK

  12. Hey myself a medical student currently studying in Poland . I will be graduated by 2024 , I was wondering whether I have to do the UKMLA inorder to get a full GMC registration in 2024 and I am also a non eu national.

    1. You probably won’t since you are studying in the EU but the GMC may change their rules. Please contact them for further advice.

  13. Hello!
    I have recently completed my internship from Pakistan. Due to unavailability of seats I booked my PLAB 1 exam in UK for November,21.
    However, now Pakistan is under travel ban list. How should I proceed now? Any guidance would be much appreciated.

    1. Hi there, travel bans are subject to change. It’s unlikely to be still be banned in November but in any case, best to contact the GMC for their guidance.

  14. Hi Nick,

    I will be applying via the USMLE pathway for GMC registration. I completed my MD at a caribbean school and completed my clinical rotations in USA. I have a few questions:
    1. A clarification: Based on your previous article, the clinical rotations I completed in the USA are not considered internships – so I shouldn’t fill out the internship experience portion on my application?
    2. Would I be applying for provisional or full GMC registration and if provisional does this mean only FY1 positions?

    Thank you for your help!

    1. Hi there! Thanks for visiting the site!
      1. No
      2. Provisional. And yes, that means you can only apply for FY1 through the official Foundation Programme. Please be aware that applications start 1 year in advance so do plan ahead!

  15. Hi Nick
    wonder if you can help me.
    I am finishing my studies this June (2021 ““`) from Charles uni in Czech and will get my medical degree after 6 yrs of study. I am a british citizen . I was looking up the GMC website and I can see that this is a relevant EEA qualification and will be awarded a full registration. I am getting a bit confused re the internship requirement – do I have to provide any document for this or will my degree certificate suffice ? in the website there are dropdown menus for completed internship – which one do I choose ? Thanks and apologies for bothering you.

    1. Hi there, it seems many EU graduates are eligible for full GMC registration without internship so I’m not sure how to complete the form. Please contact the GMC directly for assistance. Best of luck!

  16. Hi Nick,

    After UKMLA is introduced in 2024, will non-EU graduates be able to apply for full registration via the USMLE exemption route and not take the UKMLA?

    1. Hi there, you’d have to ask the GMC that. But the USMLE exemption route is only for those who have passed USMLE before 13 March 2020. We have not seen any news about it being applicable for those who have yet to pass it or plan to pass it in the future.

  17. Hi, thank you for these details
    I have finished my training in general surgery in 2015. after that I practice general surgery as specialist in Jordan (my country) for 5 years.
    I have passed all steps of USMLE (Step 1, Step 2 CS and CK) and I am ECFMG certified. how does that help me for full registration?
    I found this link on GMC website:

    Thank you in advance.

  18. Hi Nick,

    I’m a 5th year medical student from Turkey who wants to move to the UK right after graduation. I intend to become a psychiatry consultant and stay in the UK long-term so I think I need a Tier 2 Visa. I could not find any information about this elsewhere, how can I learn which sponsorships allow to obtain a Tier 2 visa?

    Thank you in advance.

  19. Dear Nick

    I’m a little overwelmed with all this new information.
    I’m an IMG willing to work in the UK and not sure of what path to follow. I have completed a residency in ENT. I have an MD title already reconized in spain and I’m a UE national. However my postgraduate studies are not in the acceptable postgraduate qualification list. What would you recommend?

    1. Hi there, that list is for IMGs (non-EU nationals) applying for Full registration. If you are an EU national you should be able to apply directly for CCT, please contact the GMC for further advice. Best of luck!

  20. Hi,

    I am a medical education consultant in India. I have some Indian students who have completed MBBS including 1 year internship there. Can they apply for GMC registration without license either from China or India.
    Can you pls clarify?
    Thanks in advance.


    1. Hi there, if they are registered with the council then they will need a certificate of good standing. If they are not registered with the council during internship and a provisional license is not required for internship, this needs to be explained in the GMC application because the GMC assumes that all countries follow the same system where you need a provisional license for the internship. If you require further clarification, I recommend contacting the GMC directly.

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Meet the Team

Hi, we’re Drs Nick & Kimberly Tan, the two IMGs behind The Savvy IMG. We write comprehensive guides, create courses, and provide one-to-one guidance to help other overseas qualified doctors on their journey to the UK.
We have scoured the official guidance to put these posts together, but we can make mistakes! If you spot anything that is incorrect, please get in touch and we’ll put it right.
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