The validity of the Professional and Linguistic Assessments Board exam

Published 1 September 2014

What were the key findings?

  • The evidence suggests that international medical graduates (IMGs) who passed the PLAB test did not have equivalent knowledge and skills to UK graduates.

  • This is based on the finding that IMGs were much more likely to experience at least one poor outcome at Annual Review of Competence Progression (ARCP). ARCP is a usually annual assessment of a trainee’s progress in specialty training.

  • Even after adjusting for possible confounding variables where data was available, including the number of ARCPs taken, age, and sex. IMGs were still less likely to achieve satisfactory outcomes.

  • The odds of PLAB IMGs obtaining satisfactory outcomes at all ARCPs taken were around 40% lower than for UK graduates.

  • Fewer attempts at both parts were predictive of an increased likelihood of obtaining satisfactory outcomes at all ARCPs taken.

  • Higher scores, relative to the pass mark, at both the first attempt at Part 1 and Part 2 were predictive of an increased likelihood of satisfactory outcomes.

  • Increased International English Language Testing System (IELTS) score predicted a higher probability of obtaining satisfactory outcomes.

  • The researchers identified the increases in the IELTS test (to 8.5 or 9.0) and Parts 1 (by 27 points) and 2 (by around 12 points) of the PLAB test that would be required to remove this difference in ARCP outcome. The identified increases would result in a significant impact on the numbers of candidates passing these tests based on previous data.

  • For the IELTS test, the reading component (of the four components of the test) was the subtest score most predictive of good ARCP performance and speaking was the least.

  • IMGs were more likely than UK graduates to have a fitness to practise complaint made about them and for that complaint to result in action..

  • Controlling for the effects of sex, age and UK-based experience greatly reduced (but did not eliminate) the difference in the likelihood of complaints being received.

Why did we commission this research?

As part of a wider project reviewing the PLAB test. PLAB is the main route IMGs show they have the knowledge and skills needed to practise medicine in the UK.

What did the research involve?

A wide range of data sets were analysed, and the relationships between them were explored.

This included data on doctors’ outcomes for IELTS tests, PLAB tests, ARCP assessments, and GMC fitness to practise records.

Full report

The Validity of the Professional and Linguistic Assessments Board (PLAB) Exam: Research Report.

To request a copy of the technical appendixes to the report please contact us at research@gmc-uk.org.