Practising healthcare in the UK: which exam, which regulator

Medical and health education in the UK

UK medicine is normally a five-year undergraduate degree (MBBS or MBChB), or six years with a foundation or intercalated year, and four years for graduate-entry courses. There are more than 40 medical schools, all quality-assured by the General Medical Council (GMC). Teaching is in English, with Welsh available in parts of Wales.

UK graduates are tied into registration by the GMC’s UK Medical Licensing Assessment (MLA), which is built into final-year assessment rather than sat as a separate national exam. After graduation they enter the two-year Foundation Programme; the GMC sets when provisional registration becomes full registration, so check its current rules. Nursing and midwifery are three-year degrees approved by the Nursing and Midwifery Council (NMC). Pharmacy is a four-year MPharm plus a foundation training year before the General Pharmaceutical Council (GPhC) registration assessment. Dentistry is a five-year degree, followed by a year of foundation training for most NHS work.

The distinctive point is that UK graduates do not sit PLAB. That test exists for overseas applicants.

How the UK system works

There is no single UK licensing exam. Each profession has its own statutory regulator, its own test and its own rules for overseas applicants. That makes the UK the most fragmented system among the large English-speaking markets, and it is why candidates often prepare for the wrong thing: the PLAB that suits a doctor is irrelevant to a nurse or a dentist.

The second feature is the split between home-trained and overseas-trained applicants. UK graduates mostly register through their degree. Overseas applicants meet a test, and the test is designed to confirm that you can practise safely to UK standards, not to rank you.

Who needs a licensing exam in the UK

Doctors: PLAB 1, PLAB 2 and the UKMLA

The General Medical Council (GMC) runs the Professional and Linguistic Assessments Board test for international medical graduates who are not covered by another route. It has two parts.

PLAB 1 is a single-best-answer paper: 180 questions with five options each, three hours, sat on paper at a test centre. The questions are mapped to the same Medical Licensing Assessment content map that underpins the UKMLA applied knowledge test taken by UK students. In practice, that means the content is the level of a newly qualified UK doctor starting foundation training, applied to UK guidelines and law.

PLAB 2 is a clinical skills assessment run as an OSCE, held in Manchester. You must pass PLAB 1 first.

PLAB 1 has value outside the UK. The Medical Council of Ireland already treats it as equivalent to PRES Level 2, and the Medical Council of New Zealand accepts it as one of the written prerequisites for NZREX. If you are choosing between destinations, a PLAB 1 pass keeps two other doors open.

1. Check your route. Confirm on the GMC site whether you need PLAB at all or hold a qualifying postgraduate qualification.
2. Prove English. Language evidence is required for registration, so settle this early.
3. Book and pass PLAB 1. Prepare on UK guidelines such as NICE, not on the practice you know from home.
4. Book PLAB 2 in Manchester and prepare for communication and data-gathering stations, not recall.
5. Apply for registration with a licence to practise once both parts are passed.

Nurses and midwives: the NMC Test of Competence

The Nursing and Midwifery Council (NMC) tests overseas-trained nurses and midwives in two parts, and you must pass both within two years.

Part 1 is a computer-based test delivered by Pearson VUE, which means you can sit it in your home country. It has a numeracy section of 15 short-answer calculations and a clinical section of 100 multiple-choice questions, 115 items in all, in three hours. The NMC publishes a candidate booklet with the exact format, and you should read the current edition because the figures can change. Nursing candidates sit a field-specific test: adult, mental health, learning disabilities or children's.

Part 2 is a 10-station OSCE, held at UK test centres. Pass rates and candidate numbers are published by the NMC quarterly, and they are worth reading before you book a flight.

Midwives follow the same structure with a midwifery-specific test, and the NMC publishes the test specification. The UK is one of the largest destinations for nurses trained in India, the Philippines, Nigeria and Ghana, so the CBT is among the most heavily sat healthcare exams in the world.

Pharmacists: no overseas exam, but a long road

The General Pharmaceutical Council (GPhC) does not run a stand-alone exam for overseas applicants. Instead, pharmacists qualified outside the UK must complete the Overseas Pharmacists' Assessment Programme (OSPAP), a one-year university course, then a foundation training year, then the GPhC registration assessment. UK MPharm graduates join the same route after their degree.

The registration assessment is computer-based and has two parts:

• Part 1: 40 calculation questions in two hours.
• Part 2: 120 questions in two and a half hours, made up of 90 single-best-answer items and 30 extended-matching questions.

The GPhC publishes an assessment specification for each sitting. Download the one for your sitting date, because the blueprint is the best guide to what is tested.

Dentists: the GDC Overseas Registration Exam

The General Dental Council (GDC) runs the Overseas Registration Exam (ORE) for dentists whose degree is not recognised.

Part 1 is two computer-based papers of three hours each. Paper A covers dental science and human disease. Paper B covers clinical dentistry, including law and ethics. The questions are single-best-answer and extended-matching items. Around 600 places are offered per sitting, with roughly four sittings a year, a fee of GBP 485 per attempt and a limit of four attempts. Check the exam provider site for current dates.

Part 2 is practical and runs over several days: an OSCE, manikin exercises, a dental treatment planning exercise and medical emergencies. Only candidates who pass Part 1 may enter.

Places are limited, so booking windows matter. Treat the booking date as the first deadline in your plan.

Physiotherapists: assessed on paper, not by exam

The Health and Care Professions Council (HCPC) does not set a licensing exam for physiotherapists. International applicants submit a paper assessment of their qualification and experience against the HCPC Standards of Proficiency. The scrutiny fee is GBP 495 and the process has been quoted at around 60 working days. Some applicants are asked to complete an aptitude test or an adaptation period to close gaps. English at IELTS 7 or OET grade B is the usual standard, and the same HCPC route applies to paramedics, radiographers and biomedical scientists.

If you are a physiotherapist, an exam bank will not help with registration. Spend the time on your documentation instead.

Exams compared

Language requirements and recognition

All UK exams are written and delivered in English, and every regulator asks for separate evidence of English language ability, usually IELTS or OET. The required scores differ by regulator and change from time to time, so take the figure from the regulator and not from a recruitment agency.

Recognition of overseas qualifications runs through each regulator's own process. Check the current position on the regulator's site before assuming that your qualification, European or otherwise, exempts you from an exam.

Where to start

Start with the regulator page for your profession, listed under sources, and write down three things: which exam you must sit, the earliest booking date, and the evidence you must collect first. Then decide whether practice questions help. For PLAB 1, the CBT and the ORE Part 1 they do. For HCPC registration they do not.

TriagePass is independent of every regulator named on this page. We write original practice questions in the style of the published blueprints and do not use recalled exam content.

Last reviewed October 2026