GMC Registration for IMGs in 2026: The Full Process, Step by Step

The GMC registration process for an international medical graduate (IMG) has five fixed parts: an acceptable primary medical qualification verified through EPIC, evidence of English — IELTS Academic 7.5 overall with at least 7.0 in every skill, or OET Medicine grade B — proof of your knowledge and skills (for most doctors, passing PLAB), evidence of an acceptable internship, and a certificate of good standing from every regulator you have held registration with in the last five years. The registration fee is £408, or £157 at the discounted newly-qualified rate, as of April 2026. Sequence the steps well and you can go from PLAB 2 pass to licence in around two to four months.

The four routes to GMC registration

The GMC must see evidence of your knowledge and skills before it registers you, and an IMG can provide it in one of four ways.

• PLAB. Two exams: PLAB 1, a written test you can sit at British Council centres in Pakistan, India, Nigeria and elsewhere, and PLAB 2, a clinical exam held only in Manchester. Both parts are now set against the UK Medical Licensing Assessment (MLA) content map, though the exams are still booked as PLAB 1 and PLAB 2.
• An acceptable postgraduate qualification. If you hold a qualification on the GMC's published list — MRCP(UK), MRCS, FRCR, MRCOG and a number of named overseas awards — you can apply for full registration without sitting PLAB. Check the list itself: acceptance is by exact qualification name, not specialty.
• Sponsorship by an approved sponsor. A GMC-approved sponsor — usually a medical royal college running the Medical Training Initiative (MTI) — vouches for your knowledge and skills. This route was seriously disrupted in 2026 — see the MTI section below.
• A relevant European qualification. Doctors with recognised EEA or Swiss qualifications can still register on the strength of them post-Brexit — check the GMC's country-by-country guidance before relying on this route.

Route	Who qualifies	Typical time to registration	Typical cost
PLAB	Any IMG with an acceptable degree and English evidence	9–18 months from booking PLAB 1	£1,319 in exam fees; £2,300–£3,900 all-in
Postgraduate qualification	Holders of a qualification on the GMC's accepted list	2–4 months if you already hold it	Application and verification fees only
Approved sponsor (MTI)	Doctors offered a post through a GMC-approved sponsor	3–6 months once a post is secured	No exam fees — but paused for new visa applicants in 2026
Relevant European qualification	Recognised EEA or Swiss qualification holders	1–3 months	Application fee only

If PLAB is your route — and for most doctors from Pakistan, India and Nigeria it is — our PLAB and GMC registration service covers the whole pathway, and the PLAB 1 preparation guide covers booking, centres and a 12-week study plan.

An acceptable primary medical qualification — and EPIC verification

Your medical degree must be an acceptable primary medical qualification (PMQ): awarded by an institution listed in the World Directory of Medical Schools, with the directory note confirming it meets the GMC's criteria. Search the directory before you spend anything on exams.

The GMC does not take your degree certificate at face value. It must be independently verified through EPIC — the Electronic Portfolio of International Credentials — run by ECFMG, now delivered through the MyIntealth platform. You open an account, confirm your identity, upload your degree, and ECFMG writes to your medical school to confirm it is genuine. Budget about US$35 to establish the EPIC portfolio and around US$110 for each credential verified, as of April 2026 — check ECFMG's current schedule before you pay.

Verification is the slowest step in the process, because it depends on your medical school answering ECFMG. Some schools reply in a fortnight; some take three months. Open your EPIC account as soon as you decide on the UK — not when you have a PLAB 2 date.

The English language requirement

The GMC accepts two tests, and the thresholds are higher than most visa routes:

• IELTS Academic: at least 7.5 overall with a minimum of 7.0 in each of listening, reading, writing and speaking, achieved in a single sitting. The Academic test is required — the UKVI version is not necessary for GMC purposes.
• OET Medicine: at least grade B in all four sub-tests, in a single sitting.

Either certificate must still be under two years old when registration is granted — a test passed too early can expire before you reach the application. Many doctors find OET easier to pass at this level because the material is clinical. Our OET Medicine preparation course is built around the GMC's grade B requirement.

Narrow alternatives exist — such as a recent PMQ taught entirely in English, or recent practice in a majority-English-speaking country — but the GMC assesses them case by case; if in doubt, sit the test.

Internship evidence: provisional vs full registration

For full registration, the GMC expects evidence of an acceptable internship: normally 12 months of postgraduate clinical practice including at least three months in medicine and three in surgery, confirmed by a signed completion certificate from the hospital or medical school. Gaps and rotations that do not fit the pattern are queried, so get the certificate worded precisely.

If you passed PLAB but have no acceptable internship, you can apply for provisional registration instead. It only permits work in an approved Foundation Year 1 post — and stand-alone F1 posts for IMGs are scarce, so completing your house job at home first is usually faster and cheaper.

Separately, registration comes with or without a licence to practise. You need the licence to treat patients in the UK; registration without a licence exists mainly for doctors who need UK registered status while working abroad. Apply for registration with a licence unless you have a specific reason not to.

Good standing, identity and declarations

A certificate of good standing (CGS) is required from every medical regulator you have been registered with in the past five years — even if you never practised there. Two rules catch people out: a CGS is valid for only three months from issue, and it must still be in date when the GMC approves your application, not merely when you submit. Order certificates last, and be ready to reorder if your application runs long.

You will also complete fitness-to-practise declarations covering criminal matters, regulatory findings and health issues, and attend an in-person identity check at a GMC office with your passport. Declare everything, however minor: a disclosed incident is usually assessable, an undisclosed one is a probity problem in its own right.

GMC fees in 2026

GMC fees change every 1 April. As of the 2026 fee schedule:

• Provisional registration application: £52.
• Full registration with a licence to practise: £408 — reduced to £157 at the newly-qualified discount, which the GMC applies for several years after your PMQ. Run its fee calculator for your exact rate.
• Annual retention: £408 a year thereafter, with a 50 per cent discount if your income is below the GMC's threshold — worth claiming in your first part-year of UK work.
• Degree verification: about US$35 to establish the EPIC portfolio plus around US$110 per credential verified, paid to ECFMG in US dollars.
• PLAB exams: £283 per PLAB 1 attempt and £1,036 per PLAB 2 attempt.

Check the current figure before you pay — and for the full route cost including travel, visas and English tests, see the PLAB cost breakdown.

A realistic timeline: PLAB 2 pass to licence to practise

You must apply for registration within two years of passing PLAB 2. Doctors who begin everything only after the PLAB 2 result routinely take twice as long.

Stage	Typical time
Internship certificate and English evidence (gather before PLAB 2)	2–6 weeks
Degree verification via EPIC/MyIntealth (start months ahead)	2 weeks–3 months
Certificates of good standing (order last — valid 3 months)	1–4 weeks
GMC Online application and assessment	1–8 weeks
In-person identity check and licence granted	Days
Job offers and Certificate of Sponsorship (search in parallel)	1–6 months
Health and Care Worker visa decision	About 3 weeks

Why applications stall

• A CGS expires mid-application because it was ordered first instead of last.
• The medical school ignores ECFMG's verification request — chase the registrar's office yourself.
• Name mismatches between passport, degree and CGS — even a missing middle name triggers queries. Fix them before applying.
• Internship evidence that misses the pattern — a certificate not showing three months each of medicine and surgery invites rejection.
• An English certificate that ages out at the two-year mark while the application is still open.
• Missing the two-year window after PLAB 2 — the pass lapses and there is no extension.

After registration: your first UK post and visa

A licence does not come with a job. Most newly registered IMGs start in non-training posts — trust-grade SHO, junior clinical fellow or stand-alone FY2 — advertised on NHS Jobs, then apply into specialty training from inside the system. A short unpaid clinical attachment (two to four weeks shadowing at an NHS trust) is worth arranging: it produces the UK referee shortlisting panels want to see.

MTI in 2026: NHS England's contract funding the scheme ended on 31 March 2026, the Academy of Medical Royal Colleges paused new applications, and in-progress cases had a grace period to 30 June 2026. Doctors already on placement complete their two years; confirm the current position with the relevant college before planning around MTI.

For employed posts, your NHS trust assigns a Certificate of Sponsorship and you apply for the Health and Care Worker visa. Since 8 April 2026 the fee is £324 up to three years or £628 for longer, and the route is exempt from the Immigration Health Surcharge — full figures are in our guide to the April 2026 visa fee increase.

Frequently Asked Questions

How long does GMC registration take for an IMG?

Most complete applications are decided within a few weeks; the whole run from PLAB 2 pass to licence typically takes two to four months. The slowest step is degree verification through EPIC/MyIntealth, which depends on your medical school answering ECFMG. Start verification months early and the GMC stage itself is quick.

Can I register with the GMC without PLAB?

Yes, in three ways: an acceptable postgraduate qualification on the GMC's published list (such as MRCP(UK), MRCS or FRCR), sponsorship by a GMC-approved sponsor such as a royal college, or a relevant European qualification. Each replaces PLAB as evidence of knowledge and skills — every other requirement, from verified degree to good standing, still applies.

Do I need an internship for GMC registration?

For full registration, yes — normally 12 months of postgraduate clinical experience including at least three months each in medicine and surgery, evidenced by a signed completion certificate. Without it you can seek provisional registration, which limits you to an approved Foundation Year 1 post — scarce for IMGs, so finishing your internship at home is usually faster.

How long is a certificate of good standing valid?

Three months from the date of issue — and it must still be in date when the GMC approves your application, not just when you submit it. You need one from every medical regulator you have been registered with in the last five years. Order certificates last, or you risk paying for replacements.

Is the MTI route still open in 2026?

Only partly. NHS England ended MTI funding on 31 March 2026, the AoMRC paused new applications, and in-progress cases had a grace period to 30 June 2026. Doctors already on placement complete their two-year attachments. Check directly with the relevant college before relying on this route.

Whether you sit PLAB or register through a postgraduate qualification, the order you gather your evidence in decides how fast you hold a licence. Global Pathways manages the full GMC route for IMGs — exams, verification, documents and the visa that follows. Book a free consultation.