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For IMGs · The written exam
PLAB 1 explained: format, sittings, results and how to prepare
Published 11 July 2026 · Checked against sources current July 2026
PLAB 1 is the written half of the exam that stands between an international medical graduate and GMC registration: 180 questions, three hours, one sitting — in an exam hall that might be in Manchester, Mumbai or Lagos. This guide covers the format, the booking mechanics, where and when you can sit it, how the pass mark actually works, and how to prepare for an exam that cares less about how much you know than about whether you would make safe decisions as a doctor starting F2.
Core Lens
PLAB 1 in six points
- The format. PLAB 1 is 180 five-option questions over three hours, answered on paper and pitched at a doctor entering F2.
- Four sittings a year. PLAB 1 runs in February, May, August and November in six UK cities and at overseas centres, though in 2027 February is UK and EU only.
- Booking and the fee. Booking opens once the GMC has verified your English evidence, and from April 2026 each attempt costs £283, lost in full if you cancel in the last 42 days.
- A pass mark per sitting. Each sitting’s pass mark is set by the Angoff method plus one standard error of measurement, so the score needed varies from paper to paper.
- The clock starts early. Results arrive about six weeks after the exam, but the two years to pass PLAB 2 run from the day you sat PLAB 1.
- For the exam. Build preparation around timed questions mapped to the MLA content map, and sort each wrong answer into a gap in medicine or a gap in UK practice.
Figures checked against the GMC’s own pages on 28 September 2026; the Deep Dive has the detail and the sources.
You are reading the Core Lens — the points that matter. Open the Deep Dive for the full article.
Sitting PLAB 1? Try twenty questions free.
Twenty original PLAB 1 questions, two from each of the ten clinical areas, with the reasoning after every one and a marked report. Free, no card and the first five are open to all.
Everything below is checked against the GMC’s own PLAB 1 guide and fees pages as of July 2026, but exam logistics move — treat GMC Online and the GMC’s PLAB pages as the final word on dates, venues and fees, always.
What PLAB 1 actually is
PLAB 1 is an Applied Knowledge Test (AKT): 180 single-best-answer questions, each a short clinical scenario followed by a question and five options, of which you pick one. You have three hours. And — a detail that surprises candidates every sitting — it is a paper-based written exam. The claim that PLAB 1 is computer-based circulates endlessly in forums, and it is simply wrong: you will be marking answers on paper, not clicking a screen.
The exam is pitched at the level of a doctor entering Foundation Year 2 (F2) in a UK hospital. It covers common, important and acute presentations, plus the management of long-term conditions as they present in primary care. Two framing points matter enormously if you trained abroad: the correct answers follow current UK best practice — not local practice, and not necessarily what you were taught — and scenarios assume UK-standard equipment. Excellent medicine filtered through the wrong health system still loses marks; we come back to this under preparation.
Since 2024, PLAB has been MLA-compliant: the questions map to the MLA content map, the same framework UK medical students are assessed against. In the GMC’s own words, the exam “will still be called PLAB for a while longer” — the name persists, the content is already aligned. If you have heard that PLAB is being replaced and wonder whether to wait, do not: our PLAB vs UKMLA explainer untangles exactly what changed and what did not.
- Format
- 180 single-best-answer questions · 3 hours · paper-based. Scenario, question, five options, choose one.
- Level
- A doctor entering F2 — common, important and acute presentations plus long-term condition management, answered to current UK best practice.
- Sittings
- Four a year: February, May, August and November (the February 2027 sitting is UK/EU only). Exact dates are published in GMC Online.
- Fee
- £283 (from 1 April 2026; it was £273 in 2025/26). Refugee doctors sit their first two attempts free.
- Results
- Around six weeks after the exam, published by 4pm on a stated date, via GMC Online.
- Then
- You must pass PLAB 2 within 2 years — and the clock runs from the date you sat PLAB 1.
A three-hour, 180-question written paper testing whether you would make safe F2-level decisions to current UK practice. Sit it at home or in the UK, four chances a year, £283 a time, results in about six weeks — and the moment you sit it, the two-year countdown to a PLAB 2 pass has already begun.
Booking: English evidence first, then My Tests
You book through the My Tests section of your own GMC Online account — and there is a gate before the gate: your English language evidence must be verified before you can even access the PLAB 1 booking service. In practice that means an IELTS Academic result of at least 7.5 overall with at least 7.0 in each of the four skills, or OET (Medicine) at grade B in all four — each from a single sitting, your most recent attempt, and valid for two years. Be aware that some English routes open to other applicants are closed to you: the employer-reference and UK-job-offer routes are not available to PLAB applicants, and while a degree taught in English can sometimes count, the conditions are strict — the GMC itself advises PLAB candidates to strongly consider taking IELTS or OET. The eligibility checklist walks through the English routes in detail, along with the degree and internship requirements you will meet later at registration.
The fee is £283 per attempt from 1 April 2026. Cancellation terms are worth knowing before you book optimistically: cancel more than 42 days out and you lose £28.30; cancel with 42 days or fewer to go and you lose the full £283. If you hold refugee status, your first two PLAB 1 attempts are free.
Where and when you can sit it
There are four sittings a year — February, May, August and November — with the precise dates for each venue listed in GMC Online when you book. In the UK, PLAB 1 runs in six cities: Belfast, Birmingham, Cardiff, Edinburgh, London and Manchester.
Crucially, you do not need to travel to Britain for part 1. In 2026 the GMC runs overseas sittings in 16 countries across 24 cities: six cities in India (Bangalore, Chennai, Hyderabad, Kolkata, Mumbai and New Delhi), two each in Pakistan (Islamabad, Karachi), Nigeria (Abuja, Lagos) and Egypt (Alexandria, Cairo), plus Dhaka, Colombo, Nairobi, Accra, Dubai, Riyadh, Istanbul, Johannesburg, Sydney, Toronto, Dublin and Madrid. From 2027, Dhaka, Alexandria, Accra, Chennai, Hyderabad and Kolkata stop running PLAB 1 and the February 2027 sitting is UK/EU only, so overseas centres offer three sittings in 2027. For most candidates the sensible plan is to sit part 1 at home and save the travel — and the budget — for PLAB 2 in Manchester.
Results, and how the pass mark is really set
Results arrive around six weeks after the exam, published by 4pm on a stated date in GMC Online. There is no fixed percentage to chase, because the pass mark is set fresh for every sitting using the Angoff method plus one standard error of measurement. In plain words: a panel of examiners judges, question by question, how a just-safe-enough doctor entering F2 would perform on that specific paper, those judgements are combined into a pass mark, and one statistical safety margin (the SEM) is added on top. A harder paper gets a lower pass mark, an easier one a higher mark — the standard being held constant is the F2-entry doctor, not a number.
Your score report gives you more than a verdict: your own score, that sitting’s pass mark, the cohort average, and feedback across ten clinical practice areas drawn from the MLA content map (the GMC’s labels include ‘neurosciences and senses (including skins)’ and ‘endocrine, metabolic and clinical haematology’). Keep it whatever the outcome. If you pass, the ten-area breakdown tells you where to shore up before PLAB 2, which draws on the same content map. If you do not, it is a ready-made study plan — broad weakness argues for a longer runway before rebooking, while one or two weak areas against an otherwise solid picture argues for a targeted, earlier resit.
Passing PLAB 1 starts a timer: you must pass PLAB 2 within 2 years — and the two years run from the date you sat PLAB 1, not the date your result was published. Those six weeks of waiting are already inside your window. You may also have seen a three-year figure quoted; that was a temporary COVID-era rule and it has ended; the GMC’s pages now give two years. Book PLAB 1 with a rough PLAB 2 plan already sketched — the attempts and clocks guide lays out every deadline in one place.
How to prepare: three principles
The MLA content map is your syllabus
PLAB 1 questions map to the MLA content map, so preparation stops being guesswork: the same document that defines what UK medical students must know defines what you must know. Note that the content map is a live document and the GMC updates it — check the current version on gmc-uk.org when you book, and make sure any course or question bank you use is aligned to it.
Train the F2 decision, not the textbook chapter
Every question is a scenario asking what a safe F2-entry doctor would do next. That is a decision skill, and decision skills are built by making decisions — hundreds of timed single-best-answer questions, reviewed properly — not by re-reading notes. When you get one wrong, the useful question is why the safe UK answer beat your answer.
Right medicine, wrong system still loses marks
The exam is explicit that answers follow current UK best practice, not local practice. If your training leaned towards admitting, investigating and treating aggressively where UK practice manages in primary care and safety-nets, you will feel friction — and that friction is a syllabus item, not a character flaw. It is finite and learnable, and it is exactly the layer our free IMG Hub exists to teach.
If it goes wrong: attempts, briefly
You may keep sitting PLAB 1 until you have failed four times; after four failed attempts you can apply for one final attempt with evidence of at least 12 months’ additional learning. The rules, the strategy and the way the attempt limits interact with the two-year clocks all live in the attempts, resits and clocks guide — and if you are budgeting, plan with a resit in mind from the start rather than as an afterthought.

PLAB 1 rewards a very specific kind of doctor: one who makes calm, safe, guideline-shaped decisions at F2 level. Most IMGs already have the medicine; the work is aligning it to UK practice and training the decision reflex under time pressure. Start with the content map, live on questions, and book with the PLAB 2 clock already in view.
Build the UK layer before exam day
The IMG Hub is our free collection of guides, tools and videos for doctors joining the NHS — the jargon, the payslip, the first 90 days, and the exams. PLAB 1 tests UK practice; the hub teaches it.
Sources & the small print. GMC PLAB 1 guide and My Tests booking pages; GMC PLAB fees page; GMC English language evidence pages; GMC MLA content map pages. General careers information, not immigration or legal advice — always check the GMC’s current PLAB and registration guidance, GMC Online and GOV.UK before acting. Written by the Core Revision team.



