How Foreign-Trained Doctors Can Work in the UK: PLAB, GMC Registration and Costs in 2026

The National Health Service depends on doctors who trained abroad. A large share of the doctors joining the UK medical register each year qualified outside the country, with Nigeria, Egypt, Pakistan, India and Sudan among the biggest sources.

The route is open, but it changed in an important way in 2026. A new law gives UK medical graduates priority for training posts, which makes it much harder for overseas doctors to enter specialty training straight away. This guide covers the registration process step by step and gives an honest picture of the job market on the other side.

The overall route

Check that your medical degree is acceptable to the General Medical Council (GMC)
Prove your English
Pass PLAB 1
Pass PLAB 2 in the UK
Have your degree verified and apply for GMC registration with a licence to practise
Secure an NHS job and a Health and Care Worker visa

The GMC is the regulator. You cannot work as a doctor in the UK without its registration, and no agent or hospital can bypass it.

Step 1: Is your degree acceptable?

Your medical school must be listed in the World Directory of Medical Schools, and the degree must meet the GMC’s criteria for an acceptable overseas qualification. The GMC publishes a list of qualifications it does not accept or accepts only with conditions, so check your school before you pay for any exam. You must also have completed an internship or be able to show equivalent experience to gain full registration. Without it, you may be eligible for provisional registration only.

Step 2: English language

You must meet the English requirement before you can book PLAB 1. The GMC accepts two tests:

Test	Required score
IELTS Academic	Overall 7.5, with at least 7.0 in each of listening, reading, writing and speaking, in a single sitting
OET (Medicine)	Grade B in each of the four skills, in a single sitting

Certificates are valid for two years. For PLAB 1 the certificate must be valid on the day of the exam, and for registration it must be valid when the GMC approves your application. Plan your dates so the certificate does not expire in the middle of the process. A degree taught in English is not automatically accepted as proof.

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Step 3: PLAB 1

PLAB 1 is a three-hour written paper of 180 single-best-answer questions, set at the level of a doctor completing the first year of UK foundation training. It tests applied clinical knowledge, not memorised facts. The exam is held several times a year in the UK and in a number of other countries, including centres in Africa, the Middle East and South Asia. Dates and locations appear when you log in to your GMC Online account.

Step 4: PLAB 2

PLAB 2 is a practical examination held only at the GMC’s clinical assessment centre in Manchester. It consists of 16 scenarios of eight minutes each, such as a consultation with a simulated patient or a task on an acute ward, and it assesses clinical skills, communication and professionalism. You will need a UK visitor visa to attend, so allow time for that application. You must pass PLAB 2 within two years of passing PLAB 1.

The content of both parts is aligned with the Medical Licensing Assessment that UK medical students now sit, so preparation materials based on the MLA content map are relevant.

Step 5: Verification and GMC registration

Before the GMC will register you, your primary medical qualification must be independently verified through the Electronic Portfolio of International Credentials (EPIC), run by the ECFMG in the United States. You upload your degree, and EPIC confirms it directly with your medical school. Start this as soon as you begin preparing for PLAB, because some medical schools take months to respond.

You then apply online for registration with a licence to practise, providing a certificate of good standing from every medical council you have been registered with in the past five years. Your application must be approved within two years of passing PLAB 2.

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GMC fees from 1 April 2026

Item	Fee
PLAB 1	£283 per attempt
PLAB 2	£1,036 per attempt
Full registration with a licence to practise	£408

Those three items come to £1,727 if you pass first time. On top, budget for the English test, EPIC verification, a UK visitor visa, flights and accommodation in Manchester for PLAB 2, preparation courses if you take them, and living costs while you look for work. Most doctors spend between £3,000 and £6,000 in total before their first salary.

Routes that do not need PLAB

An accepted postgraduate qualification, such as the MRCP, MRCS, MRCOG, MRCPCH or FRCA examinations of the UK royal colleges. Parts of these can be taken overseas
Sponsorship by an approved body, for example through the Medical Training Initiative, which brings doctors to the UK for up to two years of training
The Portfolio pathway to the specialist or GP register, for experienced specialists who can show training equivalent to a UK consultant

For doctors with several years of specialty experience, a royal college membership exam is often the better choice. It leads to registration and is also the qualification UK employers look for in middle-grade and senior roles.

The job market in 2026: read this before you start

Passing PLAB gives you registration. It does not give you a job, and competition for posts is now intense.

Under the Medical Training (Prioritisation) Act 2026, UK medical graduates and certain other groups are prioritised for foundation and specialty training places. The number of overseas-trained doctors accepted into specialty training fell sharply in the 2026 recruitment round, and from 2027 the priority applies at the shortlisting stage as well.

The law does not restrict non-training NHS jobs. These posts carry titles such as trust grade doctor, clinical fellow, junior clinical fellow or specialty doctor. They are where most new international graduates now begin. They pay on similar scales to training posts, offer NHS experience and allow you to build the portfolio you need for later applications. But there are many applicants for each vacancy, and doctors commonly wait several months after registration before receiving an offer.

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Before you commit thousands of pounds, be clear about your plan. The route makes most sense for doctors who can afford a job search of six months or more, who are willing to work in less popular specialties and locations, or who already have postgraduate experience that makes them competitive for non-training roles.

Pay for resident doctors in England

Basic annual pay from April 2026 on the national resident doctor scale is approximately:

Grade	Approximate basic pay
Foundation Year 1	£40,000 to £41,000
Foundation Year 2	£46,000 to £47,600
Core or specialty training, years 1 and 2	£54,500 to £55,400
Specialty training, year 3 and above	£67,000 to £77,000

Basic pay covers a standard 40-hour week. Most doctors earn more through additional rostered hours, night and weekend enhancements and on-call supplements. Doctors working in London receive a weighting allowance.

The visa

Doctors use the Health and Care Worker visa, which is cheaper than the standard Skilled Worker visa and exempt from the Immigration Health Surcharge. The fee is £324 for up to three years or £628 for longer. You need a certificate of sponsorship from the NHS trust that employs you, and £1,270 in savings unless the trust certifies your maintenance. Your partner and children can come as dependants and are also exempt from the surcharge.

A sensible timeline

Stage	Typical time
English test and results	1 to 2 months
PLAB 1 preparation and exam	3 to 6 months
PLAB 2 booking, visa, preparation and exam	3 to 6 months
EPIC verification and GMC registration	1 to 3 months, run in parallel where possible
Job search	3 to 9 months
Visa and relocation	1 to 2 months

Eighteen months to two years from the first exam to the first day of work is realistic.

Related guides

Official sources

Fees and rules were checked in October 2026. GMC fees, pay scales and recruitment rules change, so confirm the current position with the GMC and NHS employers before you commit money. This article is general information and not career or immigration advice.