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For Indian doctors completing their MBBS, there are several well-defined pathways to advance their medical careers:
- NEET PG (India): The most common route for those wishing to pursue postgraduate specialization and practice within India.
- USMLE / AMC (International): Preferred by doctors aiming to train and practice in countries like the USA (via USMLE) or Australia (via AMC).
- UK Pathway: Typically pursued through the PLAB examinations or by obtaining Royal College Memberships/Fellowships, which open opportunities to train and practice within the UK’s NHS and globally.
What fuels Indian medical graduates to pursue a medical career in the UK and other advanced healthcare systems in various countries around the globe is probably the better training, wider career opportunities and enhanced remuneration.
However, most doctors face the problem of not being able to choose the right pathway. Royal College Membership and Fellowship Exams and the Professional and Linguistic Assessments Board (PLAB) exam are the most common and most sought-after routes to career advancement in this direction. Royal College Membership and Fellowship Exams enables them to pursue advanced training in the fields of their specific interest. In this regard for those who are interested in building their career in Emergency Medicine, MRCEM opens up wider opportunities for speciality training and practice. Meanwhile PLAB provides entry and licensing opportunities for doctors soon after their primary medical qualification like the MBBS. Let us understand both these in detail:
Understanding MRCEM
MRCEM is a globally recognised postgraduate qualification conferred by the Royal College of Emergency Medicine, specifically for those who want to specialize in Emergency Medicine. The MRCEM exam assesses knowledge, clinical skills, and decision-making in acute and emergency settings, to ensure that you are eligible for the membership.
The Three-Step Examination Structure
- Primary Exam with 180 MCQs focusing on core sciences relevant to acute care.
- Intermediate SBA covering clinical reasoning via SBAs focusing on common emergency scenarios.
- OSCE, a 16-station practical exam testing procedures, communication, and acute interventions.
Career Advantages Post-MRCEM
- Access to ST1–ST3 level roles in the UK.
- Salary: Approx. £49,000–£68,000/year (~INR 55–70L)
- Facilitates swift progression to Consultant after FCEM.
Unlike PLAB, which is general, MRCEM positions you as someone already trained in emergency medicine principles. For MBBS graduates keen on emergency medicine, MRCEM can serve as a direct entry route to the UK, bypassing PLAB.
Understanding PLAB
The PLAB exam is designed to assess whether international doctors have the knowledge and skills equivalent to a UK-trained doctor who has completed the Foundation Year 1 (F1) level. Passing PLAB allows you to register with the General Medical Council (GMC) and begin practicing medicine in the UK under supervised training roles. Once registered with the GMC, doctors can apply for foundation and specialty training. It is also recognised in various other countries.
Core Details
- PLAB 1: Consists of 180 MCQs and can be attempted in centres in India and various other countries.
- PLAB 2: An OSCE-style exam with 16 stations conducted in the UK only.
- English: IELTS or OET required before GMC registration.
- Number of attempts limited to 4 per exam
After GMC registration, you can enter FY2 or CT1 roles.
Choosing Between MRCEM and PLAB
For an international medical graduate, both MRCEM and PLAB are considerable. If you are already passionate about Emergency Medicine and want to dive directly into this field, MRCEM provides a focused alternative. However, it has some training criteria attached to its eligibility. If you are uncertain about specialization and want to first understand the UK system, PLAB may be the better first step.
Features of MRCEM and PLAB
| Feature | MRCEM | PLAB |
| Qualification | Higher level of qualification at the completion of core training | License exam for medical graduates |
| Prerequisites | Full primary medical qualification needed | Can be given after undergraduate training; internship not required for PLAB 1 |
| English Proficiency | IELTS/OET needed before GMC application | IELTS/OET required before application |
| Exam Location | Part 1, 2 & 3 available in India | Only Part 1 is available in India |
| Pass Rates | Part 1: 58%, Part 2: 47%, Practical exam: 86% | ~72% (PLAB 1 in 2023), ~62% (PLAB 2) |
| Attempts | Multiple attempts: 6 each | Lower number of attempts: 4 each for PLAB 1 & 2 |
| Prep Time | 3–6 months prep time individually (for each part) | Part A – 3–4 months; Part B – 3–6 months |
| Format | Primary – Theory MCQ; SBA – Theory MCQ; OSCE – practical | PLAB 1 – Offline 180 MCQ; PLAB 2 – Offline 16-station OSCE |
| Cost | MRCEM Primary: £498; MRCEM SBA: £498; MRCEM OSCE: £1,103 | PLAB 1: £443; PLAB 2: £974 (plus stay, visa extra—total approx £5,000) |
| Job Security | Higher preference in the job market, although not mandatory for core training | (Not explicitly stated in the table) |
It would not be right to say that one path is better than the other, since both serve different purposes.
MRCEM Clinical Training Program
For those who have already decided on their specialisation in Emergency Medicine, MRCEM could be a great choice.
Explore our Advanced Clinical Training Program, a 2-year hospital-based training with clinical rotations aligned to the Royal College curriculum. This program provides the essential clinical exposure and hands-on experience needed to build confidence in real-world practice. Along with this, we also focus on strengthening your theoretical knowledge and practical skills to help you successfully clear the MRCEM exam.
Authored By: Pooja Premraj
By : Admin