The validity of the Professional and Linguistic Assessments Board exam

Published 1 September 2014

What were the key findings?

  • The evidence suggests that the knowledge and skills of international medical graduates (IMGs) who had passed the PLAB test were not equivalent to those of UK graduates. This conclusion was based on the fact the PLAB IMGs were much more likely to experience at least one poor outcome at Annual Review of Competence Progression (ARCP), a (usually annual) overall assessment of a trainee’s progress in specialty training.

  • Even adjusting for possible confounding variables that data was available for (the number of ARCPs taken, age and sex), the odds for PLAB international medical graduates to have obtained satisfactory outcomes at all ARCPs taken were still roughly 40% lower compared to UK graduates.

  • Fewer attempts at both Parts 1 and 2 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 at all ARCPs taken.

  • Increased International English Language Testing System (IELTS) overall score independently predicted a higher probability of obtaining satisfactory outcomes at all ARCPs taken.

  • 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.

  • PLAB international medical graduates were more likely than UK graduates to have a fitness to practise complaint made about them and for that complaint to result in action by the GMC.

  • 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?

This research was commissioned as part of a wider project reviewing the PLAB test, the main route by which international medical graduates demonstrate that they have the necessary knowledge and skills to practise medicine in the UK. The purpose of the wider review was to ensure that the PLAB test continues to be an objective, fair, non-discriminatory and fit for purpose method of assessing the knowledge and skills of international medical graduates applying for registration with the GMC.

What did the research involve?

A number of data sets were analysed and the relationship between these explored. Included in this analysis were data relating to doctors outcomes for IELTS tests, PLAB tests, ARCP assessments and GMC fitness to practise data.

I want the 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.