PLAB vs USMLE
Exam Comparison
Overview
PLAB is the gateway to practise medicine in the UK, while USMLE is the gateway to residency training in the US. Both are taken predominantly by international medical graduates. The choice depends entirely on whether you want to train/work in the UK (NHS) or the US. USMLE is significantly more expensive and competitive but offers higher earning potential.
Exam Profiles
PLAB
Professional and Linguistic Assessments Board
Full Name
Professional and Linguistic Assessments Board
Country
United Kingdom
Eligibility
International medical graduates (IMGs) with a recognised primary medical qualification, must pass IELTS/OET
Format
PLAB 1: 180 single best answer MCQs (3 hours). PLAB 2: 16-station clinical OSCE (3 hours 20 min)
Pass Mark
PLAB 1: variable (typically ~60-65%); PLAB 2: variable (standard-setting each diet)
Cost
PLAB 1: ~GBP 260; PLAB 2: ~GBP 935. Total: ~GBP 1,200
Frequency
PLAB 1: 4 times/year worldwide; PLAB 2: continuous booking at GMC centres
Career Path
GMC full registration with licence to practise, then Foundation/specialty training applications via Oriel
USMLE
United States Medical Licensing Examination
Full Name
United States Medical Licensing Examination
Country
United States
Eligibility
Medical graduates (US or international) with ECFMG certification for IMGs; Step 1 & 2 CK required before residency match
Format
Step 1: pass/fail (7 blocks, 280 MCQs, 8 hours). Step 2 CK: ~318 MCQs (9 hours). Step 3: 2-day exam (MCQs + CCS cases)
Pass Mark
Step 1: pass/fail (since Jan 2022). Step 2 CK: 3-digit score (passing ~209). Step 3: 3-digit score (passing ~198)
Cost
Step 1: USD 1,000 (IMG); Step 2 CK: USD 1,000; Step 3: USD 895. Total: ~USD 2,895 + Pathway application ~USD 900
Frequency
Year-round at Prometric centres (limited availability in some countries)
Career Path
ECFMG certification, then US residency matching (NRMP Match) for specialist training
Key Differences
| Category | PLAB | USMLE |
|---|---|---|
| Target country | United Kingdom (NHS) | United States |
| Total cost | ~GBP 1,200 (affordable) | ~USD 3,800+ (including ECFMG pathway) |
| Scoring | Pass/fail for both parts | Step 1: pass/fail; Step 2 CK: scored (competitive) |
| OSCE component | Yes — PLAB 2 is a 16-station clinical OSCE | No OSCE — all MCQ/CCS based |
| Time to complete | 3-6 months (both parts) | 12-24 months (all 3 steps) |
| Residency matching | Apply via Oriel (less competitive for IMGs) | NRMP Match (highly competitive, especially for IMGs) |
| Language requirement | IELTS 7.5 or OET B | ECFMG Pathway (includes English proficiency) |
Target country
United Kingdom (NHS)
United States
Total cost
~GBP 1,200 (affordable)
~USD 3,800+ (including ECFMG pathway)
Scoring
Pass/fail for both parts
Step 1: pass/fail; Step 2 CK: scored (competitive)
OSCE component
Yes — PLAB 2 is a 16-station clinical OSCE
No OSCE — all MCQ/CCS based
Time to complete
3-6 months (both parts)
12-24 months (all 3 steps)
Residency matching
Apply via Oriel (less competitive for IMGs)
NRMP Match (highly competitive, especially for IMGs)
Language requirement
IELTS 7.5 or OET B
ECFMG Pathway (includes English proficiency)
Our Verdict
Choose PLAB if you want to work in the UK NHS — it is faster, cheaper, and the pathway to practice is more straightforward for IMGs. Choose USMLE if you want to train in the US — it is more expensive and competitive but leads to higher earning potential and US residency.
Disclaimer: Exam details, costs, and formats are based on the most recent publicly available information and may change. Always verify directly with the examining body (GMC, NBME, NBE, Royal Colleges) before making decisions.
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