Which exams do doctors need to work abroad?
The short answer
Choose the exam by the country. United States: USMLE Step 1 and Step 2 CK, then ECFMG certification and the residency match. United Kingdom: PLAB 1 and PLAB 2 with an English test, then GMC registration. Australia: the AMC MCQ exam, then a clinical exam or workplace assessment. Canada: the MCCQE Part I, then residency. Ireland: PRES unless exempt. New Zealand: NZREX Clinical for doctors without another pathway. Gulf: the licensing exam of the health authority (DHA, DOH, MOHAP, SCFHS, Qatar), often waived for doctors holding recognised Western specialist qualifications. Every route starts from registration in the country where you trained, and the Western routes add an English test (IELTS or OET). The basic and clinical sciences overlap across all of them.
Which exam does each country ask for?
| Destination | Licensing exams | Then | Practise |
|---|---|---|---|
| United States | USMLE Step 1 (pass or fail) and Step 2 CK, with an English requirement for ECFMG certification | Residency match; Step 3 during residency | USMLE Step 1 |
| United Kingdom | PLAB 1 (written) and PLAB 2 (clinical, in the UK), with IELTS or OET | GMC registration with a licence to practise, then a job | PLAB 1 |
| Australia | AMC MCQ exam, then the AMC clinical exam or workplace-based assessment | Registration with the Medical Board through Ahpra | AMC MCQ |
| Canada | MCCQE Part I, set by the Medical Council of Canada | Residency, or a provincial practice-ready assessment | The same basic and clinical sciences as USMLE |
| Ireland | PRES, the Medical Council's pre-registration exam, unless your route exempts you | Registration with the Medical Council | The same basic and clinical sciences as PLAB |
| New Zealand | NZREX Clinical, for doctors not eligible through another pathway | Registration with the Medical Council of New Zealand | Clinical practice |
| UAE, Saudi Arabia, Qatar, Oman | The health authority's licensing exam (DHA, DOH, MOHAP, SCFHS and others), often at Prometric | A licence from that authority; many waive the exam for recognised specialist qualifications | The basic and clinical sciences |
Routes change, regulators decide
Pathways, exemptions, English scores and exam formats are set by each regulator and revised. Confirm the current route on the regulator's own website before paying for any exam.
Do you need to be registered at home first?
Yes. Every overseas regulator verifies your primary medical qualification and your registration where you trained, usually through a primary source verification service. In Pakistan that is the Pakistan Medical and Dental Council (PMDC), with the NLE for its licence; elsewhere, it is your own country's medical council.
How do you choose between USMLE, PLAB and AMC?
- PLAB is usually the fastest route to a licence: two exams and an English test, then a job hunt in the NHS. The competition moves to getting into specialty training afterwards.
- USMLE is the longest and most expensive: two scored or pass-fail exams, ECFMG certification, US clinical experience and a competitive match. It leads to the best-paid training and the strongest research careers.
- AMC is a two-part exam; the hard part is usually finding a supervised post afterwards rather than the exam itself.
- The Gulf is often reached later in a career, with specialist qualifications that make the licensing exam simpler or unnecessary.
The full comparison on cost, time and specialty, written from a Pakistani graduate's position, is in USMLE, PLAB, AMC or FCPS. The individual routes are in USMLE Step 1, PLAB 1 explained and AMC explained.
How do you prepare for them?
Pick one country first
The exams share the sciences but differ in style and in what follows. Preparing for two at once usually means passing neither on time.
Rebuild the basic sciences in clinical form
Pathology, pharmacology and physiology asked as patient vignettes are the core of USMLE Step 1, PLAB 1 and the AMC MCQ alike. Practise them topic by topic with explanations.
Start the English test early
For the US, UK, Australia, Canada and Ireland the English score often takes longer than the licensing exam. OET is written for healthcare; see OET explained.
Finish with full-length timed mocks
Each exam page runs mocks on that exam's length and weighting.
Every licensing exam on the site is listed on the international licensing exams page. The nursing equivalent of this guide is exams for nurses to work abroad.