PLAB vs MRCP: Understanding the Key Differences for IMGs

For IMGs who wish to work as doctors in the United Kingdom, the first essential step is obtaining GMC registration.

GMC stands for The General Medical Council, the public body responsible for maintaining the UK’s official medical register and regulating medical practice.

To gain GMC registration, IMGs generally choose one of two major pathways: the PLAB route or the MRCP route.

Historically, many IMGs chose the PLAB pathway. However, due to increasing competition and job shortages among junior doctors in the UK, more candidates are now pursuing the MRCP route, which allows entry into more senior-level positions.

This article provides a clear comparison of PLAB and MRCP to help you decide which pathway aligns best with your goals.

PLAB and MRCP: Basic Overview

Let’s begin by reviewing the fundamental characteristics of each pathway.

PLAB stands for the Professional and Linguistic Assessments Board.

It is designed to ensure that IMGs meet the minimum standards required to practise safely in the UK. Compared with MRCP, PLAB requires less time and cost, making it suitable for IMGs who want to start working in the UK as soon as possible.

MRCP stands for Membership of the Royal College of Physicians.

This is a postgraduate qualification recognised as the gateway to specialty training (ST). While more demanding than PLAB, MRCP allows IMGs to apply for ST3+ registrar-level roles, enabling a higher entry point in the NHS career structure.

In summary:

PLAB = early access to UK clinical practice
MRCP = entry into higher-level specialty training roles

NHS Job Structure and Career Entry Points

The NHS classifies doctors into several training and non-training grades:

Foundation Training (FY1–2)
Core Training (CT1–2)
Specialty Training (ST1+)
Consultant

PLAB Route

After passing PLAB and gaining GMC registration, IMGs usually begin their UK clinical career in:

FY2-equivalent or CT1/CT2-equivalent non-training posts,
commonly known as Trust Grade, Junior Clinical Fellow, or SHO-equivalent roles.

These are not official training posts but are a common and practical starting point for many IMGs.
Salary depends on the NHS pay scale, which is updated annually, so applicants should refer to the most recent NHS guidance.

MRCP Route

After achieving MRCP, IMGs can apply for ST3+ registrar-level positions, especially within general medicine and acute medicine.
This pathway enables a significantly higher starting point compared with PLAB.

A critical clarification:

Holding MRCP alone does not qualify someone to work as a Consultant.

To become a consultant, one of the following is required:

CCT (Certificate of Completion of Training)
Specialist Register entry via CESR / Portfolio Pathway

If an IMG has extensive prior experience, they may use the Portfolio Pathway to apply for specialist registration immediately after arriving in the UK.

Quick Comparison: PLAB vs MRCP

(Values below reflect common ranges but may change depending on updates from GMC or the Royal Colleges.)

Eligibility
- PLAB: IMGs seeking early entry into UK practice
- MRCP: IMGs aiming for specialty training or senior roles
Costs (approx.)
- PLAB 1: ~£268
- PLAB 2: ~£981
- MRCP Part 1: ~£616
- MRCP Part 2: ~£616
- MRCP PACES: ~£1,200
Required clinical experience
- PLAB: 1+ year recommended
- MRCP Part 1: 12+ months recommended
- MRCP PACES: 24+ months, including ≥4 months in medicine
Assessment format
- PLAB: MCQ + OSCE
- MRCP: MCQ (Part1/2) + PACES (clinical exam)

PLAB: Details of the Exam

PLAB consists of PLAB 1 and PLAB 2.

PLAB 1
A written exam with 180 multiple-choice questions.
PLAB 2
An OSCE-style practical exam held only in Manchester.
Candidates must take PLAB 2 within two years of passing PLAB 1.

MRCP: Details of the Exam

Part 1 & Part 2
Each consists of 100 multiple-choice questions in two sections.
PACES
A clinical examination with five stations assessing seven core clinical skills.

PACES requires ≥24 months of clinical experience, including at least 4 months of internal medicine.

Exam Locations

PLAB 1: Conducted worldwide
PLAB 2: Conducted only in Manchester
MRCP (Part 1, Part 2, PACES): Conducted in multiple countries (e.g., Hong Kong, Singapore, Malaysia)

Preparation Timeline

PLAB can often be completed within 6–12 months depending on prior knowledge and English proficiency.

MRCP typically requires 2–3 years or more, as candidates progress through Part 1 → Part 2 → PACES.

Pathway to Becoming a Consultant

Both PLAB and MRCP ultimately allow IMGs to pursue consultant-level roles.
However, the training length differs:

PLAB route: usually ST1/CT1 equivalent → ST3+ → CCT（approx. 8 years total）
MRCP route: allows entry directly at ST3+, shortening the pathway

Experienced IMGs may qualify for Portfolio Pathway and gain specialist registration sooner.

Conclusion

Both PLAB and MRCP lead to GMC registration.
PLAB is ideal for IMGs who want to enter UK clinical practice quickly.
MRCP is suited for those aiming for specialty training or higher-level NHS positions.
MRCP requires more time and financial investment, but offers a higher starting point.
The best choice depends on your long-term career goals in the UK healthcare system.

We hope this guide helps you choose the pathway that aligns with your plans.

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Registration & Pathways