General Medical Council
Working with doctors Working for patients
16 Mar 2016
The General Medical Council’s (GMC) assessment for international doctors wanting to work in the UK is to be strengthened.
Improvements are being made to the Professional and Linguistic Assessments Board (PLAB) test following recommendations from an independent review commissioned by the GMC.
The PLAB test is taken by international medical graduates to assess whether they have the knowledge and skills to practise in the UK. It consists of a written knowledge test at various locations around the world and a practical assessment of clinical skills at the GMC’s Clinical Assessment Centre in Manchester.
In future, doctors will be required to undergo a broader knowledge test and a more thorough practical assessment, which reflect real life consultations in the UK health system.
Doctors will face a limit on the number of times they can sit the new test and a limit of two years to apply for a licence to practise in the UK after passing.
Niall Dickson, Chief Executive of the General Medical Council, said: ‘Doctors working in the UK must have the knowledge and practical skills to practise safely and effectively and they must demonstrate the professionalism patients expect. To make sure they are of the highest standard we are introducing changes to modernise the entry test for overseas doctors, making it even more robust.
‘The contribution made by doctors who come here from outside Europe is invaluable to healthcare throughout the UK and these changes will provide additional assurance to patients that they have passed a stringent assessment and have demonstrated high standards of care and knowledge.
‘Of course the GMC’s assessments are just part of the process and employers also have a vital role to play in carrying out pre-employment checks on all doctors they take on. This includes taking responsibility for making sure all doctors, including those from within Europe, have the relevant qualifications, skills and experience required for the role.’
The new assessment will be introduced from September 2016. The changes also include:
Last year, 69% of candidates who took the knowledge test, known as Part 1, passed and 68% passed Part 2 of the test, the practical assessment.
The GMC is working with partners to develop a unified assessment for doctors seeking to practise in the UK. It has been given a working title of the medical licensing assessment (MLA).
The MLA would replace the PLAB test at some point in the future and would give assurance that UK trained doctors and those trained overseas have been examined and evaluated to the same high level.
Professor Vikram Jha, Head of Undergraduate School of Medicine at the University of Liverpool, who chairs the PLAB Part 2 panel that creates the exam scenarios and passing criteria, said: ‘The practical test has been fully revised to make sure it genuinely reflects best practice in medical assessment. The longer, more integrated scenarios are more authentic and require candidates to demonstrate how they apply their knowledge and skills to provide safe patient care. That, along with a new way of setting the pass mark for the practical exam, will enhance the reliability of the test, making sure that only those doctors with a good level of knowledge and skills are allowed to practise in the UK.’
Dr Julian Hancock, Nuffield Department of Primary Care Health Sciences at the University of Oxford, who chairs the PLAB Part 1 panel, said: ‘To work here safely and effectively it is important that international medical graduates have a sound understanding of ethics and professionalism as applied in the UK. We have therefore expanded the scope of the test to include questions and practical stations on these areas.’
Dr Deji Ayonrinde, Consultant Psychiatrist at South London and Maudsley NHS Foundation Trust, who is vice chair of the PLAB Part 1 panel, said: ‘We are committed to fairness in this international exam and rigorously monitor how cultural and linguistic factors may influence how different groups perform in the tests, with a view to identifying and rectifying any potential anomalies.’
The PLAB test is taken by the majority of International Medical Graduates (IMGs), who have qualified outside Europe, to demonstrate their knowledge and skills before they can apply to practise in the UK.
The test is split into two parts: a written applied knowledge test delivered at locations around the world and a practical assessment held at the GMC’s Clinical Assessment Centre in Manchester. Candidates need to pass the written test before they can progress to the practical stage.
A pass in the PLAB test will enable the doctor to apply for registration with a licence to practise by the GMC and therefore apply for work in the UK as they will have demonstrated the required level of medical knowledge and clinical skills. To pass the assessment, candidates must reach the level we expect of doctors entering their second year of their Foundation Programme training.
International medical graduates must demonstrate their knowledge of English Language before being able to take PLAB. This evidence can be provided in a variety of forms including a valid International English Language Testing System (IELTS) certificate that meets the GMC’s criteria.
The report of the independent PLAB review was published in September 2014. It was chaired by Professor Ian Cumming, the Chief Executive of Health Education England.
New rules on the number of times the PLAB test can be taken and the time doctors have to apply for registration with a licence to practise after passing the test will also be introduced.
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