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For IMGs · The next step
After PLAB 2: GMC registration and your first NHS job
The Core Revision Team
Written with the IMG Hub · 10 min read
Published 11 July 2026 · Checked against sources current July 2026
Passing PLAB 2 is the moment the exam years end and the paperwork sprint begins. Two pieces of work now stand between you and your first NHS payslip: a GMC registration application, and a job hunt in a market that changed shape in 2026. Neither is mysterious — but both reward doing things in the right order, and one clock is already running.
Core Lens
After PLAB 2: registration and your first job
- The two-year clock. The GMC wants registration approved, not just applied for, within two years of passing PLAB 2; after that, it asks for more evidence of knowledge and skills.
- Start EPIC early. Most medical schools respond to EPIC verification within about 90 days, while the GMC keeps an application open for only 90 days.
- What registration costs. The application fee is £481, or £184 for applicants within five years of qualifying; holding a licence then costs £481 a year, halved below £38,500 worldwide income.
- The first job matters. With the Medical Training (Prioritisation) Act in force, a non-training NHS post is the realistic next step for most IMGs, building UK experience, references and CREST evidence.
- Choose the job for supervision. To sign your CREST, a consultant or equivalent must have supervised you for at least three continuous whole-time-equivalent months in the 3.5 years before the training post starts.
- The week you pass. Get EPIC running, gather your documents in one go, apply once the file is complete, and start job applications at the same time.
Figures checked against the GMC’s own pages and the current CREST guidance 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.
First, the result itself
PLAB 2 results arrive within a month of the exam, via GMC Online — the same account you have used for everything since booking PLAB 1. From the moment that pass appears, your status changes: you are no longer a candidate, you are an applicant. Everything below assumes you have the pass in hand; if you are still preparing, start with our PLAB 2 guide and come back.
Start EPIC verification now if you have not already. Gather your documents in one sweep — good standing certificates also take time to arrive. Apply through GMC Online (£481, or £184 within five years of your primary medical qualification), complete the Digidentity identity check, and aim to have registration approved well inside two years of your pass. Run the job hunt in parallel: a non-training NHS post is the strategy now, not the consolation prize.
The clock that starts the moment you pass
Your registration application should be approved within two years of your PLAB 2 pass. Note the GMC’s wording carefully: approved within two years, not merely submitted. After two years you will need additional evidence of your knowledge and skills. Two years sounds generous, and for most people it is — but document-gathering, verification and overseas checks all take time, so the safe habit is to treat registration as the very next project, started the week your result arrives.
There is a second, shorter timing quirk worth knowing: a recent PLAB 2 pass extends the life of your English evidence at registration — an IELTS or OET up to three years old still counts, provided you passed PLAB 2 less than three months before applying. If your English evidence is nearing its expiry, applying promptly matters twice over.
What the GMC will ask for
Eligibility for full registration rests on three pillars: an acceptable primary medical qualification, a pass in both parts of PLAB, and an acceptable internship — broadly, at least 12 months’ continuous practice in an approved training post including three months each of medicine and surgery, or the two-year supervised-practice alternative — two years’ continuous post-graduation practice in a regulated public hospital, including at least three continuous months each of medicine and surgery under supervision. (Our eligibility checklist unpacks the internship rules properly.) If you have got this far, the first two pillars are already standing; the application itself is built from documents:
- Your primary medical qualification, independently verified through EPIC (more on this below);
- Your English language evidence;
- A certificate of good standing from every regulator you have ever held registration with — every one, not just the current one;
- Evidence of your internship;
- Your passport;
- A list of your activities for the last five years — work, study, gaps, everything accounted for;
- Fitness-to-practise declarations.
Before registration is granted you will also complete a digital identity check via the Digidentity app, the GMC’s identity provider. Two items on the list deserve early attention because they depend on other organisations’ speed, not yours: good standing certificates come from regulators who work to their own timetables, and the five-year activity list needs every month accounted for — work, study and gaps alike — which is far easier to assemble carefully now than to reconstruct under a deadline.
EPIC: the slowest item on the list
The GMC requires independent verification of your final medical diploma through EPIC, the verification service run by ECFMG (a division of Intealth). Your medical school has to respond to the verification request, and schools vary enormously in how quickly they do — verification commonly takes up to around 90 days. That number matters because a GMC application stays open for only 90 days: if verification is still in the post when your window closes, you are restarting, and the £110 scrutiny portion of your fee is not refundable. The fix is simple and cheap in effort: set up your EPIC account and start verification early — ideally before you sit PLAB 2, not after. EPIC fees are set by ECFMG in US dollars; check the current amounts on their site.
The application itself
- Application fee
- £481 (from 1 April 2026; was £463), or £184 with the GMC’s fixed-term discount if you apply within five years of your primary medical qualification being awarded.
- Scrutiny fee risk
- £110 of the fee is retained if the application is refused or withdrawn.
- Initial assessment
- The GMC aims to make an initial assessment within 5 working days of a complete application; overseas checks and verification can add time.
- EPIC verification
- Commonly up to ~90 days, school-dependent — start early. A GMC application stays open only 90 days.
- The deadline
- Registration should be approved within 2 years of your PLAB 2 pass.
- Keeping it
- Annual retention fee with a licence: £481, or £240.50 with the 50% income discount below £38,500.
“Complete” is the operative word in that five-day figure: an application missing one good-standing certificate is not complete, and the clock does not start. Fees and processes move — check the registration pages on gmc-uk.org before you press submit rather than relying on any guide, including this one.
Then the real work: your first NHS job
Since the Medical Training (Prioritisation) Act came into force in March 2026, the realistic route into specialty training for most IMGs runs through NHS experience first. In the 2026 round, NHS England reports that 100% of GP training places were accepted by UK graduates or applicants already working in the NHS (provisional figures dated 27 June 2026). Your first job is therefore not a stopgap while you wait for a training post — it is the strategy. It does not by itself put you in the priority group, but it builds UK experience and references, and it generates the evidence your future application needs.
And the direction of travel points the same way: for 2026 the priority was applied at the offer stage, but from 2027 it applies at shortlisting and offer, and the announced intent is that regulations may define priority through “significant NHS experience” — regulations laid in September 2026 instead keep immigration status as the 2027 proxy, with an NHS-experience threshold left for future review. For now, time in an NHS post counts towards priority only indirectly: years of UK work can eventually lead to indefinite leave to remain, which does count.
These first jobs are non-training posts, commonly advertised as trust grade, clinical fellow, junior clinical fellow or standalone FY2-level positions — the titles vary and none is an official category. What they share is that they pay you to learn the NHS from the inside while you build a competitive application. We have mapped the whole road from here to a training number in the PLAB-to-specialty-training route.
Making the first job count
Choose the job for its supervision, not its title
For specialty training applications without UK foundation training, CREST — the Certificate of Readiness to Enter Specialty Training — is your evidence of foundation competence. It must be signed by a consultant (or eligible equivalent) who has supervised you for a minimum continuous 3 months whole-time-equivalent, wholly within the 3.5 years before your intended post’s advertised start date, and the 2024 or 2027 form is accepted for 2027 recruitment (2027 form only from 2028). A job with no consistent consultant supervision cannot produce one.
Run the job hunt and the paperwork in parallel
You do not need to be registered to start applying — you need to be registered to start working. Employers understand pending GMC applications, and a UK job offer in the NHS that requires registration is itself useful: it is one of the grounds for priority access to PLAB 2 dates for colleagues still in the queue, and it gives your own timeline a fixed point to work backwards from.
Set yourself up to arrive well
The first months in the NHS are their own curriculum — the jargon, the rota, the payslip, the escalation culture. Ask what induction the trust offers doctors new to the NHS, and do some of the acclimatisation before day one.
The visa for the first job
For a paid NHS post you will usually apply for the Health and Care Worker visa. The load-bearing facts, per GOV.UK: you need a certificate of sponsorship from an approved health or care employer; the fee is £324 for a visa of up to three years or £628 for longer; you are exempt from the immigration health surcharge, which removes one of the largest costs of other UK work visas; and dependants are allowed. One 2026 change worth knowing: from 8 January 2026 the Skilled Worker English requirement rose to B2, but doctors with a regulator-accepted English assessment — your GMC-accepted IELTS or OET — do not need to prove English again for the visa. As ever with immigration rules, read the current GOV.UK pages when you apply; the facts above are checked at July 2026 and visas change faster than exams do.
What it costs to stay registered
Registration is not a one-off purchase. Holding a licence carries an annual retention fee of £481, halved to £240.50 if your worldwide income is below £38,500 — which it may well be in the gap between registration and your first pay day, so check whether you qualify before paying full price. Build both figures into the budget alongside the application fee itself; the true cost of PLAB pulls all the numbers into one place.
The stretch between passing PLAB 2 and your first shift can feel like an anticlimax — months of certificates and portals after years of revision. Treat it as a project with a deadline and it goes quickly: EPIC first, documents gathered in one sweep, application in early, job hunt running alongside. The doctors who stall here are almost never blocked; they are waiting for one item they could have requested three months sooner.
Landing in the NHS soon?
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 that come next. Built for exactly the months this article describes.
Sources & the small print. GMC guidance on registration for international medical graduates and GMC fees pages; ECFMG EPIC verification guidance; GOV.UK Health and Care Worker visa and Standard Visitor visa guidance; current CREST guidance (2024 form). 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.
