AdvanceMed

Tag: PLAB

  • The PLAB vs AMC: A comprehensive comparison

    The PLAB vs AMC: A comprehensive comparison

    Nick and Kim are guest authors who run a blog in the UK called the SavvyIMG. We partnered with them on this post to help answer a question that often arises for IMGs considering either the UK or Australia as a pathway.

    Life is full of choices, and for the aspiring IMG, one of the first choices is where to work? This choice is often heavily influenced by the difficulty of the licensing exam. So in this article, we’re comparing the UK and Australian licensing exams, otherwise known as the PLAB and AMC respectively, to help you make a choice.

    Questions about how PLAB impacts on the AMC examination process in Australia are some of the most common questions we get here at AdvanceMed. So we invited our guest authors Drs Nick and Kimberly Tan to collaborate with us on this post.

    So what factors should an IMG consider when contemplating which exam to take? These are the ones that we think are important and we’ll explain each in more detail below:

    • Eligibility requirements
    • Exam format
    • Pass rates
    • Fees
    • Test locations and dates
    • Maximum number of attempts allowed
    • Preparation time
    • Level of difficulty
    • Job prospects

    So let’s dig deeper into each of these factors.

    Eligibility requirements

    Before you can think about booking one of these exams, you’ll first need to meet the eligibility requirements. The requirements for the 2 exams are listed below:

    PLABAMC
    Acceptable medical degree (Primary Medical Qualification or PMQ)Verification not required to book PLAB 1Proof of English Proficiency which can be one of the following:IELTS Academic – overall score of 7.5 with a minimum of 7.0 in each sectionOET Medicine – Grade B or score of 350 in all sectionsPMQ was taught in English (this one is quite complex, you can read more about it here)
    Internship is NOT a requirement to sit PLAB.    		ECFMG/EPIC verified medical degree (Primary Medical Qualification or PMQ)
    Proof of English proficiency is not required to sit the AMC, however it is required later on as part of your application for AMC registration.Internship is also not required to sit the AMC, however it is a requirement for provisional registration that you prove that you completed an internship in your own country. (This can be a particularly confusing point for more on this issue check out this post.
    PLAB vs AMC a quick comparison of eligibility requirements

    Source: General Medical Council (2020). How do you book or cancel a place [for PLAB 1]?  [Link] [Accessed 10 Mar. 2020]. Australian Medical Council (2020). AMC Portfolio [Link][Accessed 10 Mar. 2020]

    Exam format

    Both exams consist of 2 parts: a multiple choice test, and a practical exam. 

    PLABAMC
    Multiple choice testPLAB 1
    Paper-based written test with 180 questions over 3 hours    		AMC MCQ examination
    Computer-based test with 150 questions over 3.5 hours
    Practical examPLAB 2
    18 stations, each 8 minutes long    		AMC Clinical examination
    20 stations over 3 hours and 20 minutes
    PLAB vs AMC exam formats

    Pass rates

    In general, PLAB has quite good pass rates. More than two thirds of IMGs pass both exams.

    PLAB

    YearPLAB 1PLAB 2
    201463%65%
    201569%68%
    201672%73%
    201776%79%
    201869%66%
    PLAB pass rates

    Source: General Medical Council (2020). Recent pass rates for PLAB 1 and PLAB 2. [online] [Link] [Accessed 10 Mar. 2020].

    AMC

    The pass rates for AMC are lower than PLAB, especially for the clinical exam, so IMGs should be prepared for potentially multiple attempts. This will require a larger investment.

    YearAMC MCQAMC Clinical exam
    201556%30%
    201660%29%
    201758%28%
    201864%29%
    201963%27%
    AMC pass rates

    Source: Australian Medical Council (2020). Annual Reports. [Link] [Accessed 10 Mar. 2020].

    It is worth noting that there is an alternate option to the AMC Clinical exam called the workplace based assessment pathway. This pathway is only open to IMG doctors who are successfully employed at one of ten sites accredited by the AMC for this purpose in Australia. The rates of completion for this pathway are significantly better at around 99%.

    Fees

    The AMC is significantly more expensive than PLAB 1. Given the low pass rates and expensive fees, we would only recommend sitting for the AMC after very extensive preparation.

    PLABAMC
    Multiple choice testPLAB 1AUD 467 (£ 235) until 31 March 2020 AUD 474 (£ 239) from 1 April 202AMC MCQ examinationAUD 2,720(£ 1,366)
    Practical examPLAB 2AUD 1,708 (£ 860) until 31 March 2020AUD 1,738 (£ 875) from 1 April 2020AMC Clinical examinationAUD 3,530(£ 1,772)
    PLAB vs AMC a comparison of fees

    Source: General Medical Council (2020). Fees and funding [Link] Australian Medical Council (2020). Fees and charges [Link]  [Accessed 10 Mar. 2020].

    Test locations and dates

    The first parts of both PLAB and AMC are available worldwide, however PLAB 1 is only held a maximum of 4 times per year whilst the AMC MCQ is held on multiple dates every month.

    The practical exam of both PLAB and AMC are only available in their respective countries. There is currently no option to take PLAB 2 outside of the UK, or to take the AMC Clinical examination outside of Australia. 

    PLABAMC
    Multiple choice testPLAB 1
    Available 4 times per year worldwide.
    View the dates and locations here    		AMC MCQ examination
    Available on multiple dates every month worldwide.
    View the dates hereView the locations here
    Practical examPLAB 2
    Available on multiple dates every month in the UK only.
    Dates can only be viewed on your GMC online account once you have passed PLAB 1.    		AMC Clinical examination
    Available on multiple dates every month in Australia only.
    Dates are released monthly, view them here
    PLAB vs AMC a quick comparison of test locations and availability

    Correct as of March 10, 2020

    Maximum number of attempts

    There is a limit on the number of times you can attempt PLAB. You have a maximum of 5 attempts for both PLAB 1 and PLAB 2, however after the 4th attempt there are quite a few hurdles to overcome before you will be allowed your 5th and final attempt. You can read more about this here on the GMC website.

    If you fail your final 5th attempt at PLAB 1 or 2, you will no longer be able to gain GMC registration and cannot work as a doctor in the UK.

    There is no limit on the number of times you attempt any part of the AMC.

    PLABAMC
    Multiple choice testPLAB 1
    5     		AMC MCQ examination
    Unlimited
    Practical examPLAB 2
    5    		AMC Clinical examination
    Unlimited
    PLAB vs AMC a comparison of number of maximum attempts permitted

    Level of difficulty

    PLAB is set at the level of a doctor who has graduated from medical school and completed one year of internship, however internship is not a requirement to sit the exam.

    AMC is set at the level of a doctor who has just graduated from an Australian medical school, however despite the supposedly lower level of difficulty, the AMC has a much lower pass rate compared to the PLAB.

    Preparation time

    Since both these exams represent a large investment for IMGs, with the AMC more so than PLAB, it would be wise to dedicate enough time for preparation.

    These are the times that are recommended when preparing for these exams. Keep in mind that the shorter times are suitable if you do not work while preparing for the exam, and the longer times are for if you work while preparing.

    PLABAMC
    Multiple choice testPLAB 1
    1.5 – 4 months    		AMC MCQ examination
    3 months to 1 year
    Practical examPLAB 2
    1.5 – 4 months    		AMC Clinical examination
    3 months to 1 year
    PLAB vs AMC a comparison of recommended preparation times

    Job prospects

    PLAB 

    Once you have gained registration with the medical authority in the UK, the General Medical Council (GMC), you will be able to apply for jobs that are suitable to your previous experience and qualifications. 

    As of October 2019, all medical jobs were included in the UK Shortage Occupation List. This means that IMGs will be given equal opportunity for training and non-training jobs, and UK graduates and UK/EU nationals will no longer be given first priority. 

    So provided you work well on your CV, job application and interview skills, the doors are pretty much open.

    This is an incredible opportunity for IMGs that we write about more in this article: 9 ways the new Shortage Occupation List affects IMGs dreaming of UK specialty training.

    AMC

    The process for obtaining work in Australia via the AMC Standards Pathway is a bit different. You must be offered employment first and you will then be able to gain a conditional form of registration with the Medical Board.  You are essentially required to work for 12 months to prove that you meet a certain level of safety and competency.  However, you can actually start this process after obtaining the AMC Part 1 examination and don’t need to wait for your Part 2.

    The situation for IMG doctors in Australia who pursue the AMC Standard Pathway process is less positive than for the UK.  Good data is not kept but there are likely to be thousands of doctors who have completed the AMC Part 1 still waiting for a job opportunity and hundreds who have completed both Parts 1 and 2, similarly vying for the limited number of posts that are advertised where IMG doctors can apply for provisional and conditional positions.

    Generally the employers will only advertise these positions when they have exhausted the candidate pool for doctors who already have general registration.

    This all may sound a bit gloomy. But its important to understand that hundreds of IMG doctors do still make it through this journey each year in Australia.  And once you do obtain general registration the picture improves significantly.

    Once you have completed your provisional year and completed both the AMC Part 1 and 2 you are permitted to obtain general registration. Your job prospects at this point are much better and you will likely be able to obtain a training position. However, this may not be in the particular area you are most interested in.  Like most other places positions in areas such as surgery and anaesthesia are highly competitive whereas it is generally easier to get into specialty training programs in areas such as emergency medicine, general practice and psychiatry.

    There is also the small chance that you may be overlooked in favour of another suitable candidate who has Australian citizenship or permanent residency. However, once you have worked for a while in Australia as a doctor you can usually apply for permanent residency yourself.

    Summary

    Exams make up just one part of the IMG journey. This article has compared some of the major factors that may influence your decision and here are some take home points for each factor:

    • Eligibility requirements: You must provide proof of English proficiency before you can book PLAB 1. You must have your medical degree verified first before you can book AMC MCQ.
    • Exam format: Both exams have a multiple-choice test and a practical component. PLAB 1 is a written exam while AMC MCQ is a computer-based test. Both PLAB and AMC have a practical exam.
    • Pass rates: AMC pass rates are lower than PLAB, particularly for the practical exam.
    • Fees: AMC is significantly more expensive compared to PLAB.
    • Test locations and dates: PLAB 1 has very few available dates throughout the year. AMC MCQ is available on multiple dates each month. The practical exam of both AMC and PLAB can only be taken in their respective countries.
    • Maximum number of attempts: There is a limit to the number of times you can take PLAB (maximum of 5), while there is no limit for the AMC.
    • Preparation time: Since AMC has lower pass rates, preparation time is longer compared to PLAB.
    • Level of difficulty: PLAB is actually set at a higher level as it is designed for those who have completed internship, while AMC is for new medical graduates.
    • Job prospects: Recent changes in UK immigration law means that the UK currently has its doors open to IMGs. Prospects in Australia are more difficult for IMGs but not impossible.

    Final Thought

    Most IMG doctors are not just seeking to work abroad anywhere. Many have personal reasons for choosing one particular country over another. Having read through all of the above you may be reconsidering your choices. Or you may now be considering a more complicated plan to ultimately work in country X by first working in country Y.

    At the end of the day if you have a definite preference for a certain country then it likely still makes sense to take the direct route for that country.

    Now that you’ve had a chance to compare the 2, which exam do you think you’ll take?

    If you would like to know more about the process of working in the UK we recommend checking out Nick and Kim’s blog thesavvyimg

    Related Questions.

    Question. Is the PLAB A Route to Working in Australia?

    Answer. Yes. But only if you fully complete all steps of the PLAB including working 12 months supervised. Read more here.

  • PLAB to Work in Australia? Alternative or Exemption to AMC Exam?

    PLAB to Work in Australia? Alternative or Exemption to AMC Exam?

    For many international medical graduates (IMGs) the pathway to being registered as a doctor involves the Australian Medical Council exams. But for doctors who have worked in more than one country already there are sometimes other options, such as the PLAB. But you need to be careful that you meet all the required criteria for your PLAB to be recognised.

    Doctors sometimes ask whether the Professional Linguistics Assessment Board (PLAB) is accepted or recognized in Australia. The simple answer to this question is yes. The PLAB will be recognized by the Medical Board of Australia and this will mean that you are not required to sit the AMC exams. You will be able to apply for registration via the competent authority pathway. As a bonus, you will also be exempt having to prove your English language proficiency. However, it is important to check the full requirements. In particular, doctors who complete the PLAB must also complete 12 months of supervised training in the United Kingdom. If you have not completed this training your PLAB will not be accepted.

    Lets dive a little deeper into the requirements of the PLAB. Why it is that the PLAB is accepted in Australia. As well as the other options for not having to undertake the AMC examinations.

    What is the Purpose of the AMC Examination?

    The AMC Examinations are the main route by which doctors from most other countries can apply to become registered as a doctor in Australia. Without medical registration in Australia it is illegal to work as a doctor.

    The AMC exams consist of a written (multiple choice) examination and clinical examination and are set at the equivalent standard as what would be expected of an Australian medical school graduate commencing their first working year in Australia, which is called an internship.

    Australia sets high standards for medical practice and therefore, with a few exceptions, we do not directly recognize the output of medical schools from many countries. So the AMC Examinations have been established as a process for testing the capability of IMGs.

    So Who Needs to Sit AMC Examinations?

    If you have graduated from the United Kingdom, New Zealand, Republic of Ireland, Canada or the United States you are not able to sit the AMC exams. Because you are not required to do so.

    If you are from any other country you are able to sit the AMC examinations. However, if you have specialist qualifications you probably want to try the specialist pathway instead.

    Also, if you are not from the United Kingdom, New Zealand, Republic of Ireland, Canada or the United States. But have worked in the United Kingdom, New Zealand, Canada or the United States. You may also be able to avoid the AMC Exam process and can apply via Competent Authority.

    Notice though we did not say “Republic of Ireland”. If you are an IMG who has worked in the Republic of Ireland before this does not help you avoid the AMC exams.

    Read on.

    The Competent Authority Pathway.

    The Medical Board of Australia recognizes the medical school training systems of the United Kingdom, New Zealand, Republic of Ireland, United States of America and Canada as equivalent to the Australian medical system and therefore does not require medical graduates from these countries to sit additional examinations to prove that they are capable of working as a doctor in Australia.

    New Zealand medical school graduates are treated as identical to Australian graduates. In fact New Zealand Medical Schools are accredited by the Australian Medical Council as well. New Zealand doctors can apply directly for general registration, so long as they have completed an intern year in either Australia or New Zealand.

    Graduates of the UK, Rep Ireland, US and Canada can apply for registration in Australia so long as they have also completed the basic requirements for being registered as a doctor in their country. You will also need a job offer prior to applying for registration. So long as the Medical Board is satisfied that you will be provided with sufficient level of supervision for 12 months you can work under “provisional registration”. Once this period is complete and you have returned satisfactory supervisor reports you will be able to apply for general registration.

    If You Are Not From the UK, US, Ireland, New Zelaand or Canada You Can Still Come Under the Competent Authority Pathway.

    Some doctors work in a range of countries. Countries like the UK and Canada have similar systems to Australia for allowing IMGs to work in Australia.

    So if you have completed any of the following:

    • PLAB in the UK;
    • NZREX in New Zealand;
    • USMLE in US; or
    • LMCC in Canada

    You are also able to apply for registration via the competent authority pathway and can skip the AMC exams.

    However, as mentioned earlier. You do need to do all the steps. One thing that can sometimes catch IMG doctors out is that they have completed all the examination steps of one of these processes BUT NOT completed the supervision steps. So, for example, have not completed a Foundation Year in the UK. Or have not completed 2 years of ACGME accredited training in the United States.

    The Specialist Pathway.

    The Specialist Pathway is for doctors from any country. Competent Authority or Standard Pathway. It enables a doctor to apply to be recognised as a specialist in Australia.

    So its another pathway which avoids the AMC exams. Which in the case of many specialists may be quite daunting as it will have been some time since you have studied such a broad range of medicine.

    Rather than going through the AMC examination process. The specialist pathway places you directly in contact with the specialist colleges. Who do a review of your training, qualifications, and experience to determine whether you are comparable or not. If you are found to be comparable. You will be offered a period of registration to demonstrate your performance and you may also have to sit further specialty examinations.

    Once again, you need a job offer to complete this process.

    If you are not found to be comparable you will have to either sit the AMC examinations or apply for competent authority if that option is available to you.

    I Really Don’t Want To Do The AMC Exams. Are There Any Other Options?

    There is one final option but its not particularly popular as it is time limited, has certain restrictions and is not meant as a mechanism for making a permanent move to Australia.

    This option is called the Short Term Training in a Medical Specialty Pathway. It is an option for gaining either provisional or limited registration for a period of up to 24-months to undertake additional specialty training in Australia. This registration category is generally made available to Advanced Trainees or Junior Consultants from other countries who are looking to augment their training experience.

    And. Once again. You do need a job offer to apply for the registration.

    Barring enrolling in medical school in Australia. There are no other options for not doing the AMC exams.

    Related Questions.

    Question: Do I Need to Do The Foundation Program to Complete the PLAB Requirements for Australia?

    Answer.

    It is generally a good idea if you can successfully complete the 1st Year of the Foundation Program in the UK. Note you only need to complete one year.

    However, if you are unable to do this the Medical Board of Australia will accept alternative evidence that you have worked successfully in similar posts:


    This is the direct quote from the Medical Board documents:

    There are two ways in which you can demonstrate that you meet the ‘12 months supervised training (internship equivalent) in the UK’ component of the eligibility criteria for category A (as per guidance initially provided in August 2015):

    1. Provide evidence of ‘12 months supervised practice/training in an Approved Practice Setting in the UK’. Acceptable evidence would include:
    a. confirmation in writing from the hospital(s) and/or employer(s) that you have satisfactorily completed 12 months supervised practice/training in the UK, and
    b. confirmation in writing from the hospital(s) and/or employer(s) that the practice setting is an ‘Approved Practice Setting’.

    OR

    2. Provide evidence of ‘a minimum of 12 months practice in the UK’2
    . Acceptable evidence would include:
    a. confirmation in writing and/or certificate of service from the hospital(s) and/or employer(s)that you have had a minimum of 12 months practice in the UK.

    You will also need to provide evidence that you have ‘successfully completed the Professional and Linguistic Assessments Board (PLAB) test since 1975’.

    Medical Board of Australia

    Question: Will I Need to do an English Test?

    Answer. This is a complex question. Its probably best to assume that you do. Even if you are coming from an English speaking country. Until you have established that you do not.

    Generally speaking if you can prove that you have been high-schooled in English and studied Medicine in English you will be fine.

    However, there are many circumstances where this has proven to not be the case. Even choosing to work for a small period in another country where English is not the first language can result in you having to sit an English test.

    For doctors who have completed the PLAB and NZREX. The Medical Board will generally exempt you from the need for an English Test. This is because the PLAB and NZREX include an examination of English.

    Question: Can I Count Part of My PLAB or USMLEs Towards the AMC Multiple Choice Examination?

    Answer. No. The AMC will not recognize partial completion of any of these examinations as a proxy for the exam here.