Which Route to GMC Registration is Right For You as an Overseas Doctor?

All doctors wishing to practice medicine in the UK unsupervised are required to first obtain full registration with the General Medical Council (GMC). There are numerous routes to GMC registration if you went to medical school and qualified abroad. As such, this article aims to provide you with an overview of your options.

 

Eligibility Criteria:

If you are a graduate with an acceptable primary medical qualification from a country outside the UK and Switzerland, you must be able to demonstrate you have gained sufficient clinical experience to practice in the UK to be eligible for full registration. 

Depending on your background, this can be done via five pathways:

1. A pass in the Professional Linguistic and Assessment Boards (PLAB) test

2. Sponsorship by a GMC-approved sponsor

3. An acceptable postgraduate qualification

4. Relevant European Qualification (REQ)

5. Certificate of Eligibility for the Specialty/GP Register (CESR/CEGPR)

 

1 - PLAB:

If you are a doctor from outside the UK, the EU, or Switzerland, you will be required to sit the PLAB. This test is designed to ensure you have the same clinical knowledge and skills as a UK doctor starting their second year of Foundation Programme (FY2). It consists of two parts: PLAB 1 and PLAB 2. The former is a 3-hour written multiple choice exam consisting of 180 single best answer questions starting with a short scenario, whereas the latter is a practical objective structured clinical exam (OSCE) comprising 18 eight-minute scenarios, simulating real life clinical settings, e.g. mock consultations.

Prior to taking the PLAB, you must set up a GMC Online account and provide proof of an acceptable medical qualification and level of English. Once verified, you may go on to book the first part of your PLAB; note you may sit PLAB 1 in several countries, whilst PLAB 2 must be taken to the GMC clinical assessment centre. After you have completed and achieved a pass in both PLAB tests, you can apply for full registration, which must be approved within two years of sitting PLAB 2.

Lastly, you must have completed an acceptable internship in addition to passing both PLAB tests; otherwise, you can only apply for provisional GMC registrations. As articulated by the GMC, an acceptable internship must consist of at least 12 months' continuous medical practice in an approved training post in a public hospital. You must have done this either immediately before or after you graduated.

Your internship must have included:

• at least three months in medicine and three months in surgery, which lasted between 12 and 18 months,

OR

• at least six months in medicine and six months in surgery, which lasted for 18 months or longer.

 

2 - Sponsorship by GMC-approved sponsor:

One pathway to circumvent sitting the PLAB and obtain full GMC registration is to apply through a sponsor. You will need to provide your sponsor with evidence showing you possess the knowledge, skills, and experience required for practising as a fully registered doctor in the UK. 

Although each sponsor has their own scheme which is pre-approved by the GMC, they all require you to have been engaged in medical practice for three out of five years, including the last 12 months. A list of sponsoring bodies can be found on the GMC webpage.

Once your sponsor establishes you meet the requirements, you will be issued with a Certificate of Sponsorship. Ensure this is specific for GMC registration as a UK visa sponsorship certificate will not be accepted for your application. You will also need to demonstrate your English language skills by achieving their current minimum scores in the academic version of the IELTS test or the OET.

If you are planning to train and develop your skills in the NHS and then return to your country, you may wish to look into the Medical Training Initiative (MTI). This is a programme allowing international doctors to enter the UK on a Tier 5 visa and undertake a fixed period of training, lasting up to two years. In this case, the Academy of Medical Royal Colleges (AoMRC) acts as the national sponsor of this scheme and is responsible for issuance of

Certificates of Sponsorship for immigration purposes, and your employment sponsor will need to send relevant forms and documents to the AoMRC for approval. 

3 - Acceptable postgraduate qualifications:

In case you have already acquired one of the postgraduate qualifications listed in the table below, you are effectively exempt from taking the PLAB and can apply for full registration with the GMC. Your qualification should have been awarded no more than three years before the date on which the GMC approves your application. Otherwise, you will need to provide further evidence of your more recent medical experience. If your qualification is not listed below, you do not meet the criteria for exemptions and need to consider other routes.

 

Awarding Body	Qualification
Joint Committee on Intercollegiate Examinations	Joint Surgical Colleges Fellowship Examination (JSCFE)
Royal College of Anaesthetists	Fellowship of the Royal College of Anaesthetists (FRCA) Primary FRCA examination
Royal College of Emergency Medicine	Royal College of Emergency Medicine Fellowship of the College of Emergency Medicine (FRCEM) awarded since 1 August 2018 Membership of the College of Emergency Medicine  (MCEM/MRCEM)
Royal College of Obstetricians and Gynaecologists	Membership of the Royal College of Obstetricians and Gynaecologists  (MRCOG)
Royal College of Ophthalmologists	Fellowship of the Royal College of Ophthalmologists (FRCOphth)
Royal College of Paediatrics and Child Health	Membership of the Royal College of Paediatrics and Child Health plus a letter from the Royal College of Paediatrics and Child Health confirming the date you completed the exam requirements and became eligible for membership of the College.
Royal College of Pathologists	Fellowship of the Royal College of Pathologists (FRCPath) by examination only
Royal College of Physicians and Surgeons of Glasgow	Fellowship of the Royal College of Physicians and Surgeons of Glasgow (FRCS Glasg Ophthalmology)
Royal College of Physicians London	Membership of the Royal College of Physicians MRCP (UK)
Royal College of Physicians Edinburgh
Royal College of Physicians and Surgeons of Glasgow
Royal College of Psychiatrists	Membership of the Royal College of Psychiatrists (MRCPsych)
Royal College of Radiologists	Fellowship of the Royal College of Radiologists (FRCR)
Royal College of Surgeons Edinburgh	Any of the following, awarded before September 2018: Intercollegiate Membership of the Royal College of Surgeons - MRCS Intercollegiate Membership of the Royal College of Surgeons - (MRCS (ENT)) Collegiate Membership of the Royal College of Surgeons - (MRCS) Membership of the Royal College of Surgeons of Edinburgh (MRCS Ed Ophthalmology) If you were awarded any of the qualifications above after September 2018, we will require a copy of your certificate and a letter from the Royal College of Surgeons Edinburgh confirming whether you were awarded MRCS in General Surgery, ENT or Ophthalmology. For MRCS Ed Ophthalmology, the College letter must also confirm whether you have sat the OSCE component.    Fellowship of the Royal College of Surgeons - (following examination) (FRCS) Fellowship of the Royal College of Surgeons of Edinburgh  (FRCS Ed Ophthalmology)
Royal College of Surgeons of England	Any of the following: Intercollegiate Membership of the Royal College of Surgeons - MRCS Intercollegiate Membership of the Royal College of Surgeons - (MRCS (ENT)) Collegiate Membership of the Royal College of Surgeons - (MRCS) Fellowship of the Royal College of Surgeons - (following examination) (FRCS)
Royal College of Physicians and Surgeons of Glasgow

 

4 - Relevant European Qualifications List:

Your qualification will be regarded as REQ if: 

• It is a primary medical qualification listed on the relevant GMC webpage and you have an accompanying certificate issued from the same country (if applicable)

OR

• It is a specialist or GP qualification listed in the GMC webpage document 

AND

• You started medical training for the qualification on or after the ‘reference date’ listed 

 

If none of these conditions apply, or you started training before the reference date, or you completed an internship in a different country to your primary medical qualification, you should select the country where you gained your qualification to determine whether you need to submit additional evidence.

 

5 - Eligibility for Specialist or GP Registration:

This route is intended for doctors who have not completed a GMC-approved training programme or internship, but can show they have knowledge, skills, and experience equivalent to the UK curriculum of their specialty. However, this process is incredibly meticulous and can take over six months. 

The type of evidence required is different for each specialty and royal college/faculty, and you should therefore carefully consult all provided guidance and documents on the relevant GMC webpages if you are considering this pathway.

 

References:

1. Full Registration. The General Medical Council. Available from: https://www.gmc-uk.org/registration-and-licensing/the-medical-register/a-guide-to-the-medical-register/full-registration

2. PLAB. The General Medical Council. Available from: https://www.gmc-uk.org/registration-and-licensing/join-the-register/plab

3. Your Internship. The General Medical Council. Available from: https://www.gmc-uk.org/registration-and-licensing/join-the-register/registration-applications/application-guides/full-registration-for-international-medical-graduates/your-internship

4. Approved Sponsoring Bodies. The General Medical Council. Available from: https://www.gmc-uk.org/registration-and-licensing/join-the-register/before-you-apply/list-of-approved-sponsoring-bodies

5. Acceptable Postgraduate Qualifications. The General Medical Council. Available from: https://www.gmc-uk.org/registration-and-licensing/join-the-register/before-you-apply/acceptable-postgraduate-qualifications

6. Relevant European Qualifications. The General Medical Council. Available from: https://www.gmc-uk.org/-/media/documents/factsheet---international-apps---relevant-european-qualifications-list---dc11865_pdf-78131156.pdf

7. Specialist Registration CESR or CEGPR. The General Medical Council. Available from: https://www.gmc-uk.org/registration-and-licensing/join-the-register/registration-applications/specialist-application-guides/specialist-registration-cesr-or-cegpr

8. Working in the UK and your Visa. British Medical Association. Available from: https://www.bma.org.uk/advice-and-support/international-doctors/coming-to-work-in-the-uk/working-in-the-uk-and-your-visa/before-applying-for-a-visa 

9. Medical Training Initiative. NHS Employers. Available from: https://www.nhsemployers.org/articles/medical-training-initiative

10. Savvy IMG - https://thesavvyimg.co.uk/which-route-to-gmc-registration-is-right-for-you/