Latest update: From mid-2025, the FSMB will begin consolidating all USMLE service functions for International Medical Graduates (IMGs), including exam registration, score reporting, and eligibility management. 

Choosing between PLAB vs USMLE is a major decision for international medical graduates (IMGs) who want to practice medicine abroad. Both exams serve as licensing gateways, but the paths they open are very different.  

PLAB is required for doctors aiming to work in the UK, while USMLE is essential for practicing in the US. According to the GMC (General Medical Council, UK), over 16,000 doctors appeared for PLAB in 2023, showing its rising popularity. Meanwhile, the USMLE attracts more than 100,000 test-takers annually worldwide, making it one of the toughest and most competitive medical licensing exams.  

Understanding the difference between PLAB vs USMLE in terms of eligibility, exam format, fees, and long-term career opportunities is vital for IMGs. This guide gives you a clear comparison of both exams so you can make the right choice for your medical career in 2025. 

Start your medical or healthcare career abroad with these relevant study options:

• Diploma in Medical Field – Abroad
• Master’s in Pharmacy – Abroad

New to USMLE? Start here with the USMLE exam overview and understand how the steps are structured.

PLAB vs USMLE for Indian Doctors – Overview

Feature	PLAB (UK)	USMLE (USA)
Purpose	Register with GMC to practice in UK	Get ECFMG certification to enter USA residency
Accepted In	United Kingdom	United States
Eligibility	MBBS from a GMC-approved institution	MBBS from a recognized med school + ECFMG cert
Age Limit	No upper age limit	No age limit
Cost (Total)	₹2–2.5 lakhs (approx.)	₹10–15 lakhs (including Step 1, 2, OET, travel)
Exam Structure	PLAB 1 (MCQs), PLAB 2 (OSCE-style clinical)	Step 1, Step 2 CK, Step 3 (all MCQs + clinical)
Score Validity	2 years	7 years for Step 1+2, unlimited for Step 3
Training Pathway	NHS Foundation Year 2 > Specialty Training	USA Residency (via NRMP Match)
Completion Time	1–1.5 years (average)	2–4 years (full process)

Can you take USMLE as an Indian MBBS grad? Check your USMLE eligibility here before applying.

PLAB vs USMLE: Purpose and Use Cases

What’s the main difference between PLAB vs USMLE? It’s not just geography. It’s the system you want to enter.

• After clearing PLAB 1 and PLAB 2, you’re eligible to register with the General Medical Council (GMC) and apply for roles in the NHS. This route is ideal if your goal is to settle in UK or enter UK’s structured specialty training path
• The USMLE route prepares you for direct entry into a USA residency program via the NRMP Match system. You must pass Step 1, Step 2 CK, and Step 3, then apply for postgraduate training. Unlike PLAB, you can’t work in the USA as a doctor without completing residency. The entire process is longer and more competitive, but offers structured growth and higher long-term pay.

If you’re comparing PLAB vs USMLE for Indian doctors, ask yourself:
Do you want a faster job entry with fewer exams (PLAB), or a full clinical training track with higher future earning potential (USMLE)?

What does USMLE test you on? Explore the full USMLE syllabus and exam coverage.

Need a Step 1-specific breakdown? Here’s what you need to know about the USMLE Step 1 exam.

Eligibility Criteria for PLAB and USMLE

The PLAB vs USMLE eligibility and age limit differ based on education, internship status, and application bodies.

PLAB vs USMLE Eligibility and Age Limit Explained

Factor	PLAB	USMLE
Registration body	GMC (UK)	ECFMG, NBME (USA)
Degree requirement	Primary medical qualification (PMQ) listed in the World Directory	MBBS or equivalent from ECFMG-recognized med school
Internship requirement	Can take PLAB 1 before internship; PLAB 2 requires completion	Can take Step 1 before internship; Step 2 CK often post-internship
Age limit	No official limit, practical range: 22–40 years	No age bar, competitive applicants typically <35
English requirement	IELTS/OET mandatory (IELTS: 7.5 overall)	No English test needed; USMLE assesses medical English within the exam

PLAB vs USMLE for Indian doctors often comes down to timing. PLAB is open earlier and quicker to complete. USMLE demands more steps and preparation but leads directly to residency.

What are the exam costs? Check the detailed USMLE fee structure including Step 1, Step 2, and ECFMG charges.

How should you prepare? Use these USMLE preparation tips and study strategies for a realistic and focused plan.

PLAB vs USMLE: Exam Structure and Number of Steps

The exam structure PLAB vs USMLE is a significant differentiator. PLAB is simpler two exams. USMLE has three, each with higher complexity and competition.

Exam Structure PLAB vs USMLE – Steps, Format, and Attempts

Exam	Structure & Mode	Attempts
PLAB 1	180 MCQs – clinical scenarios Computer-based (India & abroad)	4 attempts max
PLAB 2	16-station OSCE – patient interactions In-person (UK only)	4 attempts max
USMLE Step 1	Systems-based MCQs – basic sciences Computer-based (Prometric)	6 attempts total (max 3 per Step)
USMLE Step 2 CK	Clinical knowledge – MCQs Computer-based	Same
USMLE Step 3	Patient management – case simulations + MCQs 2-day test, computer-based	Same

So, which is better PLAB or USMLE for you? If you prefer a shorter route to clinical work, PLAB offers that. But if you're aiming for long-term clinical training and specialization in the U.S., USMLE builds that foundation.

Curious about PLAB? Get the full PLAB exam overview and see how it compares to USMLE.

Are you eligible for PLAB? Check the PLAB eligibility criteria and registration conditions.

PLAB and USMLE Cost Comparison in 2025

Trying to decide between PLAB and USMLE? Cost is one of the biggest factors for most Indian doctors. Here’s what you’ll need to spend from registration to travel for each exam in 2025.

Cost of PLAB vs USMLE 2025 – Full Fee and Expense Breakdown

Cost Factor	PLAB (2025)	USMLE (2025)
Registration – Part 1/Step 1	£255 (₹27,000)	$1,000+ (₹85,000)
Registration – Part 2/Step 2 CK	£934 (₹1 lakh+) + UK travel	$1,000+ (₹85,000)
Step 3 (USMLE only)	Not applicable	$895 (₹75,000)
English test (IELTS/OET)	₹15,000–₹25,000	Not required
Total estimated cost (without coaching)	₹2.2 – ₹2.8 lakhs	₹5.5 – ₹7.5 lakhs
Test centers in India	Yes – PLAB 1 only	Yes – Step 1 and Step 2 CK
Rescheduling penalties	£25–£100 (varies by notice)	$50–$300 depending on step & timing

Cost of PLAB vs USMLE 2025 clearly shows that PLAB is more budget-friendly, especially for Indian candidates. However, USMLE leads to higher long-term earnings due to U.S. residency salaries.

Taking PLAB 1 soon? Don’t miss this complete PLAB 1 exam guide with format and tips.

Where can you take PLAB in India? Here’s a list of official PLAB test centres.

PLAB vs USMLE: Test Format and Content Differences

What’s tested and how is another aspect of the USMLE vs PLAB exam comparison. PLAB focuses on real-world clinical skills. USMLE emphasizes both clinical knowledge and biomedical science.

USMLE vs PLAB Exam Comparison – Format, Content, and Question Types

Feature	PLAB	USMLE
Question type	MCQs (PLAB 1), OSCE (PLAB 2)	MCQs (Step 1 & 2), simulations (Step 3)
Focus area	Practical clinical reasoning, patient communication	Pathophysiology, pharmacology, clinical decision-making
Test duration	PLAB 1: 3 hrs; PLAB 2: 3 hrs	Step 1: ~8 hrs, Step 2 CK: ~9 hrs, Step 3: 2 days
Delivery	Paper + in-person OSCE	Fully computer-based
Interface	Basic interface, less time pressure	USMLE software is complex, with time-bound blocks and NBME tools
OSCE component	Yes – PLAB 2 (UK only)	No – all USMLE steps are digital

Difficulty Level – PLAB and USMLE Compared

• PLAB is more communication-focused (esp. in PLAB 2)
• USMLE is knowledge-heavy with longer duration and complex interfaces
• Prep time difference (e.g., 6–8 months vs 1–2 years)

When’s the next PLAB test? Check PLAB exam dates for 2025.

What’s the fee like? See the latest PLAB exam fees and payment process.

PLAB vs USMLE: Acceptance and Recognition in Different Countries

Wondering if PLAB vs USMLE - which one offers better opportunities glabally? While each test is tied to its home country PLAB to UK and USMLE to the US many international health systems also recognize these qualifications. Here's where your scores are valid beyond UK and USA, including countries like Australia, New Zealand, and the Gulf.

Where Are PLAB or USMLE Scores Accepted Internationally?

Country/Region	Exam Recognition (PLAB vs USMLE)	PLAB vs USMLE Recognition Notes
UK	PLAB accepted   USMLE not accepted	Only PLAB leads to GMC registration
USA	PLAB not accepted  USMLE required	USMLE is mandatory for ECFMG certification and the USA Match
Gulf Countries	PLAB accepted in some (e.g., UAE MOH)  USMLE accepted broadly	Exam recognition varies by emirate/country
Australia	PLAB not accepted  USMLE accepted for AMC Step 1 exemption	USMLE eases entry via AMC pathway
New Zealand	PLAB not accepted  USMLE conditionally accepted	Requires further approvals via MCNZ
Canada	PLAB not accepted  USMLE may offer limited exemptions with MCC	USMLE alone not sufficient; MCCQE needed
Ireland	PLAB may exempt from PRES  USMLE considered for training roles	Both exams may support supervised roles in specific scenarios

Career Path After PLAB vs USMLE

What happens after you pass? The career paths for PLAB and USMLE are very different. PLAB leads to UK Foundation Programme and NHS jobs, while USMLE puts you in line for the USA residency Match.

Residency options after PLAB vs USMLE differ widely. UK system offers more structured entry points with fewer exams, while USA system demands strong scores across all steps but rewards with higher pay and specialization opportunities.

Residency Options After PLAB vs USMLE – Training Path Differences

Pathway Feature	PLAB (UK)	USMLE (USA)
Next Step After Exam	Apply for GMC registration	Apply for ECFMG certification
Residency Process	UK Foundation Programme (2 years)	NRMP Match (highly competitive)
Work Permit/Sponsorship	NHS may offer Tier 2 visa sponsorship	J-1 or H-1B visa needed; often sponsored by hospital
Post-Residency Career Options	Specialty training (ST1+) or service posts	Fellowship or board certification
Job Market Access	High demand in NHS, especially IM, GP, psychiatry	Highly competitive in all specialities

How do you prepare? Use these PLAB exam preparation strategies to hit your target score.

Is PLAB accepted outside UK? Explore the countries that accept PLAB for medical practice or residency.

PLAB vs USMLE: Rescheduling and Exam Attempts

Missed a test slot or didn’t get the score? PLAB allows unlimited attempts, while USMLE has strict retake limits. Rescheduling rules also differ USMLE charges more if you delay.

Retake Rules & Rescheduling Policies – PLAB vs USMLE

Factor	PLAB Exam	USMLE Exam
Attempt Limit	PLAB 1: Up to 4 attemptsPLAB 2: 4 attempts allowed	Each Step: 4 attempts max per StepLifetime limit = 6 total attempts
Retake Cooling Period	Must wait 3 months before retaking PLAB 1	60-day wait between attempts for each Step
Rescheduling Policy	Free changes ≥28 days before testFee applies for late changes	Fees vary by how close you are to test date; no free rescheduling
Cancellation Policy	Partial refund if cancelled ≥28 days in advance	Refunds vary based on test center and timing
Failure Rate Impact	Failing PLAB 2 repeatedly may delay GMC registration	Failing Step 1 or Step 2 CK lowers residency match chances

Both PLAB and USMLE allow retakes but repeated failures can delay your career path. Plan your attempts and track deadlines carefully, especially if applying for competitive programs.

Conclusion

When it comes to PLAB vs USMLE, the decision depends on your career goals and preferred destination. PLAB is ideal for those planning to practise medicine in the UK, offering a faster and more affordable route. On the other hand, the USMLE is the mandatory exam for doctors aiming to work in the USA, known for its rigorous structure and longer pathway.

Both exams have their pros and cons. PLAB focuses more on clinical skills, while the USMLE tests in-depth medical knowledge and opens doors to highly competitive residencies. The best choice comes down to your long-term plan, budget, and the healthcare system you want to grow in. 

Free prep tools for PLAB & USMLE – mock questions, syllabus breakdowns, and timelines.

Still deciding between PLAB and USMLE? Speak with an expert to choose and plan your next step.