The IMG route to UK practice: from PLAB to your first NHS job

The path from qualifying overseas to practising as a doctor in the UK has several well-defined steps. Seeing the whole journey at once makes each stage less daunting and helps you plan timing and budget. Here is the most common route, the PLAB route, step by step.

Step 1: Prove your knowledge of English

Before the GMC will let you sit PLAB or register, you must show your English is good enough for safe clinical practice — usually via the academic IELTS or the medicine version of the OET. Check the current required scores on the GMC English language requirements page before booking anything else.

Step 2: Pass PLAB 1

PLAB 1 is a written, multiple-choice exam testing the application of clinical knowledge. It is held at centres around the world several times a year. Most candidates prepare with question banks and focused revision of common UK clinical scenarios and guidelines.

Step 3: Pass PLAB 2

PLAB 2 is the practical OSCE in Manchester — a circuit of 16 clinical stations testing how you actually consult. It is the stage where structured, realistic practice matters most, because it assesses skills you can only build by doing. Our complete PLAB 2 guide covers the format, marking and preparation in depth.

Step 4: Apply for GMC registration with a licence to practise

Once you have passed both parts of PLAB and met the other requirements, you can apply for registration. You will need to provide evidence of identity, qualifications and fitness to practise. Plan for this stage to take time, and gather your documents early.

Step 5: Find your first NHS post

With registration in hand, many IMGs start in a trust-grade or training post. Building NHS experience, understanding local systems, and demonstrating safe practice opens the door to the wider training pathways. Your PLAB 2 preparation pays off here too — the consultation habits it builds are exactly what NHS clinical work rewards.

The journey is a marathon, not a sprint. Candidates who plan the whole route — and budget time and money for each stage — arrive far less stressed than those who tackle each step only when it arrives.

Wherever you are on this route, realistic consultation practice is the through-line. ZWIP lets you rehearse PLAB 2 stations with AI simulated patients from anywhere in the world, so distance never holds your preparation back.