PLAB 2: The Complete Guide for International Medical Graduates

What is PLAB 2?

PLAB 2 is the second part of the Professional and Linguistic Assessments Board test, administered by the General Medical Council (GMC) — the regulator that licenses doctors to practise medicine in the United Kingdom. It is a practical Objective Structured Clinical Examination (OSCE) made up of 16 short stations and is the final hurdle most international medical graduates clear before applying for full GMC registration with a licence to practise.

PLAB 1 is the written, multiple-choice paper testing applied medical knowledge. PLAB 2 is what tests whether you can use that knowledge under exam pressure — taking a focused history from a simulated patient, explaining a diagnosis in plain English, managing a difficult conversation, demonstrating a procedure, or working through a clinical-ethical dilemma. The exam mirrors the kind of work an FY2-grade doctor does on a typical NHS shift.

The GMC publishes definitive guidance on the structure, booking, marking and results of PLAB at gmc-uk.org/plab. Every clinical claim on this page traces back to GMC guidance or to UK primary clinical sources (NICE, NHS, BNF).

PLAB 2 vs UKMLA: what changed in 2024-2026

Since August 2024, the clinical content of both PLAB tests has been aligned to the UKMLA content map. The UK Medical Licensing Assessment (UKMLA) is the GMC's project to standardise the clinical knowledge and skills expected of every doctor entering UK practice, whether they qualified at a UK medical school or overseas. PLAB 2 is the IMG pathway's equivalent of the UKMLA Clinical and Professional Skills Assessment, commonly abbreviated as CPSA.

In practical terms: UK medical school students sit the UKMLA Applied Knowledge Test (AKT) and the UKMLA CPSA. International medical graduates sit PLAB 1 (which mirrors AKT content) and PLAB 2 (which mirrors CPSA content). Both groups are now tested against the same content map — covering the same conditions, the same management standards and the same professional behaviours. The headline change for IMG candidates is that the syllabus is now broader and more explicit; the marking philosophy and the eight-minute station length are unchanged.

The GMC has not announced a fixed date for retiring PLAB as a separate test — for now, IMGs continue to sit PLAB 1 and PLAB 2 on the same UKMLA-aligned content. Read the GMC's UKMLA page for the current position.

Eligibility: who can sit PLAB 2

To book a PLAB 2 place you must meet four GMC requirements:

1. A recognised primary medical qualification. Your degree must be awarded by a medical school listed in the World Directory of Medical Schools and accepted by the GMC.
2. A passed PLAB 1. You cannot book PLAB 2 until you have a confirmed PLAB 1 pass on your GMC Online record.
3. Evidence of English-language proficiency. Either IELTS Academic 7.5 overall with at least 7.0 in each of the four sub-tests, or OET Grade B (350+) in each of Speaking, Listening, Reading and Writing. Test results must be less than two years old at the time you book PLAB 2 and less than three years old when you apply for GMC registration.
4. An eligible internship. Most candidates need to have completed (or be near completion of) a 12-month internship before they can be registered, though the internship is checked at registration, not at PLAB booking.

Some IMG routes are exempt from sitting PLAB altogether — notably doctors with EEA/EU primary qualifications recognised by the GMC, and those joining via approved sponsorship schemes such as MTI. The GMC's English-language evidence page explains the full set of accepted certificates.

Exam format and structure

PLAB 2 is a "circuit" OSCE. You move between 16 cubicles, each carrying a single eight-minute station. Each station begins with two minutes outside the cubicle reading the task card — a one-page brief with five fields: where you are (A&E, GP surgery, ward), who the patient is, what you are told the patient is presenting with, what you have already done, and what you must do in the eight minutes ahead. When the bell rings you enter the cubicle and the timer starts.

Inside, you face a simulated patient (an actor playing the role) and, where relevant, an examiner observing and marking. You take a history, request examination findings or investigations, explain a diagnosis, counsel, deliver bad news, manage an ethical dilemma, or carry out a procedure on a mannequin — whatever the task card asked for. A bell signals when two minutes remain, and a final bell ends the station. You move to the next cubicle.

Station types are deliberately varied to test the breadth of an FY2 doctor's work:

• Focused history-taking with a working differential
• Counselling and breaking bad news (cancer, HIV, miscarriage)
• Clinical-ethical scenarios (capacity, confidentiality, safeguarding)
• Examination skills with a real-time examiner asking for findings
• Practical procedures on mannequins (cannulation, ABG, suturing)
• Communication with a relative, colleague or angry patient

The total contact time is approximately three hours. Most candidates find the cognitive load — switching specialty every eight minutes — harder than any individual station.

Where and when PLAB 2 is held

PLAB 2 is held at one location worldwide: the GMC Clinical Assessment Centre in Manchester, UK. There is no overseas test centre. Candidates travel to Manchester for the exam, sit on a single day, and travel home. Most IMG candidates allow two to three days for the trip: one to arrive and settle, one to sit, one as a buffer in case of travel disruption.

The centre sits within easy reach of Manchester Piccadilly station and Manchester Airport. Most candidates book accommodation within walking distance of the centre or a short taxi ride away. The GMC's booking page lists the precise address and access information.

PLAB 2 runs on multiple sitting days throughout the year (typically a small batch of dates each quarter). Booking opens on the GMC Online portal once eligibility is confirmed, and slots tend to fill quickly — especially the sittings within three months of major exam-prep course cycles. Book as soon as your PLAB 1 pass is confirmed, even if you are not yet ready to sit; you can rebook to a later date for a small administrative fee, but you cannot manufacture an earlier slot once they are full. Current availability is published on the GMC's PLAB 2 booking page.

PLAB 2 fees in 2026

The PLAB 2 exam fee in 2026 is £1,036, paid to the GMC at the time of booking through GMC Online. The fee rises annually — typically by inflation plus a small adjustment for delivery cost — so candidates booking late in the year should expect a higher fee than the figure on older preparation blogs.

Other costs to budget for:

• PLAB 1 fee, paid earlier in the process
• IELTS Academic or OET fee, payable to the test provider (~£200 in the UK; varies by country)
• Travel to Manchester — flights for overseas candidates, plus train or taxi inside the UK
• Accommodation for two to three nights
• Preparation costs: textbooks, online subscriptions, mock courses (£400+ for a one-day in-person mock)
• GMC registration fee, paid after you pass

Cancellation and rebooking rules and any current concession arrangements are listed on the GMC's PLAB 2 booking page linked above; check before paying as these change annually.

How PLAB 2 is marked

The marking philosophy is the part of PLAB 2 that most candidates misunderstand. There is no single overall percentage. Every one of the 16 stations is marked across three independent domains, each scored on a 0–4 scale:

1. Data Gathering, Technical and Assessment Skills — did you take a thorough history, request the right examinations and investigations, and organise the information? Worth up to 4 marks per station.
2. Clinical Management Skills — did you reach the right working diagnosis and differentials, suggest appropriate investigations, propose safe initial management and plan safety-netting and follow-up? Worth up to 4 marks per station.
3. Interpersonal Skills — were you empathic, clear, respectful, jargon-free, and did you check the patient's understanding and respond to their ideas, concerns and expectations? Worth up to 4 marks per station.

Each station therefore carries a maximum of 12 marks, and the exam as a whole carries a maximum of 192 marks (12 × 16). The pass mark is not fixed at "X marks out of 192". Instead, the GMC uses a borderline regression method: for each station the cut score is recalculated based on the performance of borderline candidates on that station in that sitting, and one standard error of measurement is added to give the minimum pass score. This means the pass mark moves with station difficulty: a harder exam has a lower pass mark, a kinder exam has a higher one.

From November 2024 the GMC removed the previous fixed rule that you had to pass a minimum of 10 stations to achieve an overall pass. Instead, the minimum number of stations passed is now also calculated per exam, alongside the overall mark.

One feature of the marking that surprises candidates: a missed safety-critical action — for example, sending a chest-pain patient home before serial troponins, missing a red flag in a thunderclap headache, or failing to safeguard a vulnerable child — can collapse the Clinical Management band to Clear Fail regardless of how well the rest of the station went. Safety-critical items are weighted heavily because they are exactly the actions a regulator cares about in a doctor entering UK practice. The GMC's guide to understanding your results explains the full marking model.

PLAB 2 pass rates

Recent overall PLAB 2 pass rates published by the GMC:

• 2024: 65.8% overall pass rate
• 2025: approximately 60% overall pass rate (slight decline from 2024)
• Five-year average: around 65%

The 2025 dip is widely attributed to the broader UKMLA content map — candidates report being tested on a wider range of presentations than the older PLAB-only blueprint covered. First-attempt pass rates are typically higher than overall pass rates, because the overall figure includes candidates resitting after a previous fail.

A pass rate is a property of the exam, not a property of you. The single strongest predictor of passing on the first attempt is repetition of timed spoken cubicles — not how many textbooks you read or how many MCQ banks you grind. Candidates who sit 40 to 60 timed practice cubicles in the run-up to exam day, with feedback after each, consistently outperform those who do twice as much passive revision. The GMC's current pass-rate breakdown by attempt and demographic is published at gmc-uk.org/plab/recent-pass-rates.

Common station types and what to expect

PLAB 2 covers the breadth of an FY2 doctor's daily work. The stations rotate across systems but cluster into a small number of recognisable archetypes. The Plabity station library is organised against the same categories so candidates can drill any weak area to the timed-cubicle standard.

• Cardiovascular — atrial fibrillation, hypertension counselling, syncope, palpitations, and the most heavily tested presentation: the PLAB 2 chest pain station.
• Respiratory — COPD exacerbation, pneumonia, smoking cessation counselling, inhaler technique, and the PLAB 2 acute asthma station with severity classification and management.
• Mental health — anxiety, capacity assessment, psychosis presentation, substance misuse, and the high-stakes PLAB 2 depression with suicide-risk station.
• Neurology — first seizure, stroke, MS diagnosis disclosure, and the PLAB 2 headache station covering thunderclap onset and subarachnoid haemorrhage red flags.
• Endocrine and metabolic — new diabetes diagnosis counselling, thyroid presentations, steroid counselling, DKA.
• Gastroenterology — abdominal pain (cholecystitis, appendicitis, pancreatitis), upper GI bleed, IBS vs IBD counselling.
• Obstetrics and gynaecology — miscarriage, antenatal counselling, contraception, termination, menopause.
• Paediatrics — crying baby, febrile child, vaccination refusal, safeguarding concerns.
• Counselling and ethics — HIV disclosure, drug error apology (SPIES framework), confidentiality dilemmas, domestic violence disclosure, and the PLAB 2 breaking-bad-news station with the SPIKES framework.
• Examination and procedures — cardiovascular and respiratory examinations, cranial nerves, cannulation, lumbar puncture consent.

Browse Plabity's full station library for the complete syllabus coverage.

How long should I prepare for PLAB 2?

Most candidates allow 8 to 12 weeks of focused preparation between passing PLAB 1 and sitting PLAB 2. Less than 8 weeks and most candidates report under-preparation across the breadth of stations; more than 12 weeks and many find their PLAB 1 knowledge fading.

The single biggest preparation mistake is treating PLAB 2 like PLAB 1. PLAB 1 rewards passive recognition — you read, you memorise, you recognise. PLAB 2 rewards active reproduction under time pressure. You can recognise the right answer to "next best step in chest pain" and still fail the cubicle because you froze, forgot to ask about family history, used the word "thrombolysis" without explaining it, or talked over the patient when they tried to tell you their concern. The fix is to sit cubicles, not read about them.

A workable preparation plan looks roughly like this:

• Weeks 1–2: Re-read the major textbook chapters and the published PLAB 2 syllabus. Build a one-page checklist of the structures (SOCRATES, PMAFTOSA, ICE, SPIES, the calmer end of the Calgary-Cambridge model).
• Weeks 3–6: Daily spoken cubicle practice. Aim for 4-6 cubicles per day with feedback after each. Cover every specialty cluster above. Repeat your weakest stations three or four times.
• Weeks 7–10: Full mock-length sits (18 stations back-to-back). Build the stamina to switch specialty every eight minutes for three hours. Identify and drill remaining weak spots.
• Weeks 11–12: Light revision, sleep, hydrate, travel to Manchester relaxed.

Plabity is built around the assumption that the candidate needs to sit thirty or forty cubicles in the run-up to the real exam, not three. A free station is included on signup so candidates can test the format before deciding whether the subscription value works for them.

Common mistakes that cost candidates a pass

The mistakes that cost passes are largely the same, year after year. They are not about clinical knowledge — most candidates know the medicine. They are about the cubicle itself.

• Talking over the patient. The single most common interpersonal-skills downgrade. If the patient starts to say something, stop.
• Skipping ideas, concerns and expectations (ICE). "Was there anything in particular you were worried about?" is one short question worth meaningful marks across every history-taking station.
• Not safety-netting. The clinical-management domain rewards explicit safety-net advice. "Come back immediately if X" earns marks every time.
• Jargon without translation. If you say "ACS", you must follow with "a problem with the blood supply to the heart". Every untranslated term loses interpersonal-skills marks.
• Forgetting family history. Particularly costly in cardiovascular and oncology stations. A first-degree relative with early heart attack is a top-weighted single item in many mark schemes.
• Running short or running over. Eight minutes is short — candidates who haven't drilled to the clock either rush the management plan or never reach it.
• Answering the wrong question. Some task cards ask only for history; some for management; some for both. Read the card properly.
• Missing safety-critical actions. Sending a chest-pain patient home before troponin, not requesting an ECG, not safeguarding a vulnerable patient. These collapse the relevant domain to Clear Fail regardless of the rest.

What happens after you pass PLAB 2

After passing PLAB 2 you have up to two years to apply for full GMC registration with a licence to practise. The application is made through GMC Online and requires:

• Your primary medical qualification certificate and transcript
• Evidence of internship or equivalent (12 months minimum, typically)
• Your in-date IELTS Academic or OET certificate (less than three years old)
• Identity documents and address verification
• A signed Declaration of Fitness to Practise
• The registration fee, paid online

Once registered you can apply for NHS roles: most IMGs enter through alternative Foundation Year programmes, locum work, or specialty training pathways. Many candidates find that the hardest part of becoming a UK doctor after PLAB 2 is not the registration itself but securing that first NHS job. Plan early — start applications before your PLAB 2 sitting where possible.

Frequently asked questions