If you're an international medical graduate (IMG) looking to work in the UK, one of the first big decisions you’ll face is whether to take the PLAB route or pursue postgraduate qualifications like the MRCP. While both lead to General Medical Council (GMC) registration and open doors into the NHS, they differ significantly in terms of difficulty, timeline, and career impact.
Let’s explore what each path involves and help you figure out which one might be right for you.
What Is PLAB?
The PLAB (Professional and Linguistic Assessments Board) route is the most common entry point for IMGs with a general medical degree. It is designed to assess whether you have the skills and knowledge expected of a doctor starting the Foundation Year 2 (FY2) level in the UK. The exam is divided into two parts: PLAB 1 (a written exam) and PLAB 2 (an OSCE-style practical assessment).
PLAB is considered a straightforward, cost-effective way to gain GMC registration and begin working in non-training jobs in the NHS. Many IMGs use it to get their foot in the door, build local experience, and then apply for specialty training later.
What Is MRCP?
The MRCP (Membership of the Royal College of Physicians) is a postgraduate qualification that is more advanced and specialist in nature. It’s particularly suited for those pursuing internal medicine or aiming to apply for specialty training posts directly. MRCP consists of three parts—two written exams and one clinical exam (PACES)—and is known for its rigor and higher failure rate, especially among doctors without UK clinical exposure.
Passing MRCP shows that you possess the depth of knowledge expected of a specialty trainee in medicine. However, passing it doesn’t automatically grant you GMC registration unless your medical degree and internship also meet GMC requirements.
How Should You Decide?
The choice between PLAB and MRCP depends on several factors, including your experience level, long-term career goals, finances, and timeline.
PLAB might be ideal for someone who is early in their career, wants to enter the NHS quickly, and is open to exploring different specialties before committing. It provides a smoother transition into the UK healthcare system by focusing on practical knowledge, patient communication, and real-life scenarios you’ll face in NHS practice.
MRCP, on the other hand, is better suited to doctors who are already experienced in internal medicine and ready to commit to a specialty path. It can be a strategic move for those planning to enter specialty training directly—but it does come with added pressure, higher costs, and a steeper learning curve, especially without prior UK clinical experience.
What Do IMGs Say About Their Choices?
Many IMGs who started with MRCP share that they struggled initially with job interviews or integrating into the NHS, mainly because they lacked UK experience. Even with a prestigious qualification like MRCP, understanding the culture and expectations of NHS practice matters immensely. Some ended up doing non-training jobs anyway to gain local experience.
On the flip side, PLAB passers often feel more prepared for NHS roles from the get-go. They’ve gone through OSCE-based assessments similar to NHS patient interactions, and they’re more likely to secure support roles that help build their confidence and networks.
Final Thoughts
Ultimately, there’s no universal right answer. The best route depends on where you are in your journey. If your goal is to start working in the NHS quickly, build experience, and keep your options open, PLAB is the most practical path. If you’re deeply committed to internal medicine and confident in your clinical knowledge, MRCP can fast-track your career—provided you’re ready for its challenges.
Whichever path you choose, remember: every IMG’s journey is unique. What matters most is staying focused, prepared, and connected with others walking a similar path.
What about you? Are you leaning toward PLAB or MRCP? What challenges are you facing as you decide? We’d love to hear your thoughts!