PLAB 1 is 180 single-answer questions with five options in three hours, taken in a test centre, for £283 (from 1 April 2026). There is no fixed pass percentage: the GMC applies the Angoff method plus one standard error of measurement, set at the level of a doctor starting F2. Results arrive about six weeks later, a pass is usable for two years, and you get four attempts. In 2025, 62.2% of candidates passed. Prepare from UK guidance, not home-country protocols.
What PLAB 1 is and who sits it
PLAB stands for the Professional and Linguistic Assessments Board test. It is the GMC's route for doctors who qualified outside the UK to show they can practise safely at the start of UK training. PLAB 1 is the first of two parts. It is an applied knowledge test: the GMC describes it as a test of how knowledge is applied to patient care, not of recalling facts.
The exam covers common, important or acute conditions that an F2 doctor sees, including those common in emergency departments, plus the management of long-term conditions seen in primary care. Advanced general practice duties are excluded. That boundary matters for revision. You are being tested on the safe first step, the correct escalation and the guideline-based plan, not on specialist detail.
PLAB 1 complies with the requirements of the Medical Licensing Assessment (MLA), and its questions are based on the MLA content map. Doctors who graduate from UK medical schools meet the MLA through their degree, while international doctors who want to join the register continue to take PLAB. Our guide to UKMLA and PLAB explains the relationship.
Most candidates are international medical graduates preparing for NHS posts, often while working full time in another country. The people who tend to do well plan the whole route, not only the first exam: PLAB 1, then PLAB 2, then registration. This hub covers PLAB 1 in depth and points to the GMC for the rest.
Eligibility and booking
To book PLAB 1 you need an acceptable overseas primary medical qualification and evidence of English language knowledge, and you need a GMC Online account. Booking opens only after the GMC has verified your English evidence. The GMC decides what counts as acceptable, so check its current requirements rather than relying on a forum thread. Our guide to GMC registration, English evidence and verification shows what to confirm and what we do not state.
- Create your GMC Online account. You need it to book PLAB 1 and, later, PLAB 2.
- Have your qualification and English evidence verified. You cannot book until the GMC has verified acceptable English language evidence.
- Choose a sitting. PLAB 1 runs four times a year, in February, May, August and November. Registration may close two to six weeks before the test date, and places can be limited, so do not leave booking late.
- Choose a centre. UK venues listed by the GMC include Belfast, Birmingham, Cardiff, Edinburgh, London and Manchester. EU venues include Dublin and Madrid. British Council centres overseas include Dhaka, Cairo, Lagos, Abuja, Nairobi, Islamabad, Karachi, Mumbai, New Delhi, Colombo, Dubai, Riyadh, Sydney and Toronto.
- Book and pay in GMC Online (My Tests). The fee is £283 from 1 April 2026. If you have an NHS job offer that needs GMC registration, or you hold UK refugee status, email plab@gmc-uk.org for priority. Refugee doctors living in the UK pay nothing for their first two attempts.
A cancellation fee, which is a share of the test fee depending on notice, is deducted if you cancel. A full refund is only considered for exceptional circumstances with evidence, such as visa refusal, ill health or bereavement. Details are in our booking and fees guide.
Format and scoring
Each of the 180 items presents a short clinical scenario and a question with five possible answers. You choose one. There is no select-all-that-apply format. The exam is not adaptive, so every candidate in a sitting works through a fixed paper. Three hours for 180 questions is about one minute each, which is tight when stems include a set of observations and blood results.
Scoring is where candidates are most often misled. The GMC does not publish a pass percentage, and it states that there is no expected pass rate or average. The pass mark is set with the Angoff method, in which expert judges estimate how a borderline candidate would perform on each question, plus one standard error of measurement. The result is a standard that reflects the level expected of a doctor starting F2, applied to each sitting. Experts review questions after each test. The GMC pages we read do not say whether wrong answers lose marks, so do not assume either way. Read the full explanation in PLAB 1 pass mark and scoring.
Results are published about six weeks after the exam in GMC Online. The GMC no longer offers result checks, though appeals are possible. Here is how recent sittings have gone.
| Year | Candidates who sat | Candidates who passed | Pass rate |
|---|---|---|---|
| 2021 | 10,431 | 7,728 | 74.1% |
| 2022 | 14,470 | 10,259 | 70.9% |
| 2023 | 21,916 | 15,781 | 72.0% |
| 2024 | 21,058 | 14,849 | 70.5% |
| 2025 | 13,691 | 8,513 | 62.2% |
These figures count every candidate who sat, including repeaters. The 2025 fall of more than eight percentage points from 2024 shows that the standard is not a formality. The GMC data do not explain the reason, so treat any single explanation online with caution.
Blueprint by domain
The GMC does not publish percentage weights for PLAB 1. It publishes the MLA content map: 24 areas of clinical practice, 13 areas of professional knowledge, about 221 patient presentations and about 428 conditions. Our twelve revision domains group that content so you can plan study time. The weights below are editorial estimates derived from the breadth of the content map and the GMC's statement about scope. They are not official percentages.
The largest block is the professional and therapeutics domain. It collects ethics, consent, capacity, confidentiality, safeguarding, prescribing safety, screening, immunisation and population health. Candidates who treat it as the soft option often lose marks there, because several answers can sound reasonable and the GMC position decides. For the full map of clinical and professional areas, see the syllabus guide.
How to read a PLAB 1 question
Because the exam tests applied knowledge, the stem usually contains more than you need. A reliable routine keeps you inside the minute. Read the final sentence first, so you know whether the question asks for the most likely diagnosis, the most appropriate next step or the most appropriate drug. Then read the stem for age, sex, setting, observations and any result outside the reference range. Decide on your own answer before you look at the five options, then find the option closest to it.
When two options both look correct, ask three things. Which is safer for the patient right now? Which would a UK guideline put first? Which sits at F2 level, rather than being a specialist decision? Many apparent ties break on the word "next" or "initial". A test that would be right later in the pathway is wrong as a first step. In professional-values items, the best answer is usually the one that keeps the patient informed, protects confidentiality unless disclosure is justified, and escalates early rather than acting alone.
Mark and move on if you are stuck after about 90 seconds. Because the paper is not adaptive and the GMC pages we read do not forbid moving between questions, check on exam day whether you may return to earlier items, and practise the habit of flagging on your answer sheet. If you leave a gap, keep your answer-sheet numbering aligned with the booklet.
The route in order, with costs
Candidates often budget for PLAB 1 only. The exam fees are the part of the cost you can plan precisely. The figures below are the exam fees published by the GMC from 1 April 2026.
| Stage | What happens | Fee (GMC, from 1 April 2026) |
|---|---|---|
| Eligibility | Qualification and English evidence verified; GMC Online account | See the GMC pages |
| PLAB 1 | 180 questions, 3 hours, four sittings a year | £283 |
| PLAB 2 | 16 OSCE scenarios of 8 minutes, around 3 hours | £1,036 |
| Registration | Application to the GMC after the exams | See the GMC fees page |
Exam fees alone come to £1,319. We do not quote the registration fee or any English test fee here, because we have not verified them on the cited pages. The GMC fees page lists current charges.
Choosing when to sit
With four sittings a year, you can work backwards from the date you need to be working. Booking may close two to six weeks before the test date, results take about six weeks, and the PLAB 2 clock starts on the day you sit PLAB 1. If you are targeting a particular NHS start date, count from PLAB 2, not PLAB 1: allow time for your PLAB 1 result, preparation for the OSCE and a PLAB 2 booking that fits inside the two-year window. If you hold an NHS job offer that depends on GMC registration, email plab@gmc-uk.org about priority before you choose a sitting.
Do not book a sitting only because a friend booked it. Book when your timed practice scores have been stable for two weeks and your error log has shrunk. A failed attempt costs the fee, the wait for the next sitting and a pass rate that, in 2025, left more than one candidate in three without a pass.
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How to prepare: a phased plan
The right length depends on your starting point and your working hours. Our study plan guide gives 8, 12 and 16-week versions. All three follow the same four phases.
- Phase 1: map the content. Read the MLA content map and the GMC's own preparation page. Take a baseline set of questions untimed to find your weakest domains. Do not read a textbook cover to cover.
- Phase 2: learn UK practice by domain. Work through the twelve domains, weakest first. For each topic, learn the NICE-style first-line decision, the BNF-style prescribing point and the escalation step. Note every place UK practice differs from where you trained.
- Phase 3: timed practice. Move to mixed blocks at about one minute per question, with no calculator. Review every wrong answer and every correct answer you guessed, and log the reason: knowledge gap, misread stem, or home-country habit.
- Phase 4: full-length simulation. Sit at least two 180-question papers in three hours without breaks beyond what the exam allows, then spend the final week on your error log, the professional domain and the high-yield list.
The GMC names its own preparation resources: the MLA content map, the Foundation Programme curriculum, Good medical practice, Professional standards in action, Welcome to UK practice and the 85 sample questions with an answer sheet (valid at December 2024). The sample questions will not appear in live exams. The GMC also warns against courses that claim to supply live exam content, because using such material can be treated as misconduct. Everything in our question bank is original and written from guidance, never from candidate recall.
Common reasons candidates fail
The GMC does not publish a breakdown of why candidates fail, so these are editorial observations drawn from the exam design and the GMC's own wording.
- Answering from home practice. The GMC states that answers must follow UK best practice. A protocol that is standard in your hospital may not be the best answer here.
- Running out of time. One minute per question leaves little room for rereading long stems. Candidates who spend three minutes on a hard item pay for it at the end of the paper.
- Misjudging professional items. Consent, capacity, confidentiality, candour and safeguarding questions often have two defensible answers. The one that matches GMC guidance is the one that scores.
- Weak prescribing. Doses, interactions and renal adjustment are tested in the BNF style, using British Approved Names and units such as micrograms written in full.
- Aiming at the wrong level. Questions test the first safe step and escalation for an F2 doctor, not specialist-level detail.
- Studying only from recalls. Recall banks teach pattern matching, not reasoning, and the GMC treats use of live exam content as misconduct.
Do not use or share recalled live-exam questions. The GMC runs a misconduct procedure for PLAB candidates and describes this risk on its preparation page.
On exam day
Arrive at the time given. More than 30 minutes late means no entry, you cannot leave in the first or last half hour, and the GMC advises planning at least four hours at the centre. Bring photo ID that the GMC accepts (such as a passport) and your booking confirmation with the GMC reference number. Bring HB pencils, an eraser, a sharpener and water in a clear unlabelled bottle. Phones, calculators, smart wearables, bags, coats and wristwatches are not allowed. See the full exam-day guide.
After the exam
If you pass, the next step is PLAB 2, the clinical and professional skills assessment. The GMC describes it as an objective structured clinical exam (OSCE) with 16 scenarios of eight minutes each, lasting around three hours in all, with at least two rest stations. PLAB 2 costs £1,036 from 1 April 2026, which brings the two exam fees to £1,319 before travel, accommodation and other costs. You must pass PLAB 2 within two years of the date you sat PLAB 1. Our guide to PLAB 2: what comes next sets out what changes in your preparation.
If you do not pass, you have up to four attempts. A fifth needs an application with at least 12 months of additional learning. After five failed attempts there are no more. Read the GMC's pages on results and additional attempts before you rebook. Registration with a licence to practise follows the exams and has its own requirements, which the GMC sets out on its registration pages.
Sit a timed PLAB 1 mock exam
Blueprint-weighted questions under exam timing, then a breakdown of your result by domain.
What this hub does not do
This hub does not replace the GMC's own pages. It does not publish live exam content, it does not claim endorsement by the GMC, and it does not state any figure that we could not check on a primary source. Where the GMC publishes no number, such as a topic weight, a pass mark or the number of unscored questions, we say so rather than guess. Weights on this site are labelled as editorial estimates wherever they appear. Fees, dates and rules are shown with the date we checked them, 21 October 2026, and you should check the GMC pages again on the day you book. If anything here differs from the GMC, the GMC is right.
Guides in this hub
- PLAB 1 study plan: 8, 12 and 16 weeks
- Pass mark, scoring and pass rates
- Booking, fees and sitting dates
- High-yield topics
- Syllabus and the MLA content map
- UK guidelines you must know
- Exam day
- PLAB 2: what comes next
- UKMLA and PLAB compared
- GMC registration, English evidence and EPIC
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