MBBS to Practising Doctor: the Real IMG Pathway

The corridor, in one map

Almost everything written for Indian MBBS students stops at "which country should I study in." Almost nothing maps what happens after — how a degree earned in India (or a degree earned abroad by an Indian-origin student) actually turns into the legal right to practise medicine somewhere else. That corridor is longer and more procedural than the admissions process itself, and it's the same basic shape everywhere: a primary medical qualification, a screening or licensing exam set by the destination country, a formal registration with that country's medical regulator, and then a period of supervised practice before you're trusted to work independently. The names of each step differ by country. The shape doesn't.

Steps 2 and 3 are where this guide focuses, because they're the least-documented part in plain English. Step 5 — actually landing a training post, including a major recent UK legal change that affects it directly — is covered in its own guide: IMG Postgrad Training: Getting a Training Post in the UK or Australia. Treat this page as the map of how you become a registered doctor; treat that one as the map of what happens after.

The India side: FMGE, and what NExT actually is right now

If you did your MBBS abroad (Georgia, Philippines, the Caribbean, Central Asia, etc.) and want to practise in India, the current, in-force requirement is the FMGE (Foreign Medical Graduate Examination, also called the Screening Test), administered by the National Board of Examinations. This has not changed as of the time of writing.

You will see extensive coverage online of NExT (the National Exit Test), which the National Medical Commission has proposed as an eventual single exit exam replacing both FMGE and NEET-PG. Be careful with anything claiming a confirmed NExT 2026 date or format — as of when this page was last checked, the NMC had not issued an official NExT implementation notification, and reporting on exact dates or structure is based on drafts and third-party prediction, not a published regulation. Until the NMC publishes an official notification, treat FMGE as the exam that currently applies to you, and verify NExT's status directly on the National Medical Commission's own site before making any plan that depends on its timing.

The UK route: PLAB → GMC registration

For most international medical graduates, the UK route runs through the PLAB test (Professional and Linguistic Assessments Board), in two parts:

• PLAB 1 — a written knowledge exam.
• PLAB 2 — an OSCE-style clinical and communication skills exam, sat in the UK.

Both parts must be passed within a two-year window of each other to remain valid for full registration. Since 2025, the GMC has restructured PLAB so its content directly maps onto the UK Medical Licensing Assessment (MLA) framework — per the GMC's own explanation, PLAB has not been renamed or replaced, but PLAB 1 now meets the MLA's Applied Knowledge Test requirement and PLAB 2 meets its Clinical and Professional Skills Assessment requirement. In plain terms: IMGs still sit "PLAB," it's simply now built to the same national content standard as the assessment UK medical school graduates sit.

Beyond the exam itself, full GMC registration with a licence to practise requires, per the GMC's own application guide: evidence your primary medical qualification meets GMC standards, proof of an internship/clinical experience, English language proficiency (IELTS or OET, at GMC-specified scores), identity verification, a certificate of good standing from every medical regulator you've been registered with, a five-year history of your professional activity, and a fitness-to-practise declaration.

One route worth knowing has effectively closed: the Medical Training Initiative (MTI) — a scheme that let IMGs train inside the NHS for up to two years under a sponsored visa, historically a popular alternative on-ramp — is closed to new applicants from 31 March 2026, per the Academy of Medical Royal Colleges' own MTI site. If you've seen older guides recommending MTI as a way in, check its current status directly before planning around it; for now, the standard PLAB → GMC registration → open-market job application route is the one to plan around.

The Australia route: AMC → AHPRA registration

Australia's equivalent is the AMC Standard Pathway, run by the Australian Medical Council, for IMGs who don't qualify for the shorter Competent Authority Pathway (generally graduates of a small set of recognised countries/schools). The Standard Pathway has two components:

• AMC CAT MCQ exam — a computer-adaptive multiple-choice knowledge test, typically sat before you move.
• A clinical component — either the AMC Clinical Examination, or a Workplace-Based Assessment (WBA) completed over roughly 6–12 months once you're working in Australia.

Passing the AMC written exam gets you an AMC certificate and eligibility to apply for registration with the Medical Board of Australia (administered by AHPRA) — but that first registration is provisional or limited, not general. Per the Medical Board's own guidance, the path from there runs: secure a clinical position and a visa, complete an orientation to the Australian health system, then complete 12 months of specified supervised practice (minimum 47 weeks full-time equivalent) under a Board-approved supervisor, with a formal report after the first three months. Only after that supervised year — and the remaining AMC clinical assessment, if you haven't completed it already — can you apply for general registration, which allows unrestricted practice.

In short: for most IMGs, Australia's process front-loads the written exam before arrival and back-loads a full year of supervised, reported-on clinical work after arrival, before you're registered without restriction.

UK vs Australia, side by side

This table is a comparison of process shape, not a substitute for either regulator's own eligibility checker — school recognition, exam fees, and visa routes are individual to your specific medical school and nationality. Use the AMC's and GMC's own eligibility tools linked in Sources below before assuming either route applies to you as described.

What's genuinely unsettled right now

Three things on this page are moving targets, flagged here explicitly rather than glossed over:

• NExT's implementation date and format — not yet officially notified by the NMC as of writing. Anything you read with a confirmed date is reporting a prediction, not a regulation.
• The GMC's "modernise the name" plan for PLAB — the GMC itself says it intends to rename PLAB at some point to reflect its MLA alignment, with no timeline given. The exam content and requirement aren't changing; only a possible future name might.
• MTI's status beyond 31 March 2026 — closed to new applicants as of that date, per the Academy of Medical Royal Colleges. Whether it reopens, is replaced, or stays closed isn't stated on its own site as of writing — check mti.aomrc.org.uk directly before ruling it in or out of your plan.

A practical starting checklist

A working list, not an exhaustive one — check each item as you confirm it for your own situation. Your progress is saved in this browser only.

Sources & methodology

Every regulatory claim on this page is sourced directly from the relevant regulator's own site — the GMC, the AMC, the Medical Board of Australia, and the Academy of Medical Royal Colleges (for MTI) — not from prep-company or forum summaries. Where a fact is unconfirmed, pending, or subject to change (NExT's status, PLAB's possible future rename, MTI's status beyond March 2026), that uncertainty is stated explicitly above rather than presented as settled. Always verify current fees, dates, and eligibility directly with the regulator before making a decision that depends on them — these change without much public notice.

• GMC — Full registration for international medical graduates
• GMC — PLAB and the MLA, explained
• Academy of Medical Royal Colleges — Medical Training Initiative
• Australian Medical Council — Standard Pathway
• Medical Board of Australia — Standard Pathway registration requirements
• National Medical Commission (India) — official site, for current FMGE/NExT status