USMLE vs PLAB: Which Path to Medical Practice in the US or UK Is Right for You?

When you’re a medical graduate from India looking to practice abroad, two names come up again and again: USMLE, the United States Medical Licensing Examination, a three-step process required to practice medicine in the United States. Also known as US Medical Licensing Exam, it’s the gatekeeper to residency and licensure in America. Then there’s PLAB, the Professional and Linguistic Assessments Board test, the pathway for international doctors to join the UK’s National Health Service. Also known as PLAB exam, it’s the official route to work as a doctor in Britain. These aren’t just exams—they’re life-changing decisions that shape where you live, how much you earn, and what your daily work life looks like for the next decade.

USMLE is longer, pricier, and more complex. You’re looking at three steps spread over months or even years, with fees adding up to over $10,000. Step 1 and Step 2 CK are multiple-choice, Step 3 is clinical case simulations. You need a visa, a residency match through the NRMP, and you’re competing with thousands of others for spots. But if you make it, you’re entering a system that pays doctors more than almost anywhere else—especially in specialties like surgery, radiology, or neurology. PLAB, by contrast, is simpler: two parts, one written, one clinical. Total cost? Around $3,000. You apply for a work visa after passing, and you can start working in the NHS faster. But pay is lower, hours are longer, and career growth can feel slower. The UK doesn’t have a residency match system—you get hired directly by hospitals.

It’s not just about the exam. It’s about your long-term goals. Do you want to work in a high-tech hospital in Boston or a community clinic in Manchester? Do you care more about salary or work-life balance? USMLE opens doors to research, private practice, and top-tier hospitals, but it demands relentless focus. PLAB gives you quicker entry, a stable job, and a path to permanent residency, but you’ll need to accept lower pay and less autonomy early on. Both paths require English fluency—USMLE tests medical English in detail, PLAB tests real-world communication with patients. Neither is easier. One is a marathon with a bigger prize. The other is a sprint to a quieter life.

Below, you’ll find real stories and data from doctors who took each route—what they wish they knew before starting, how they prepared, and whether they’d choose the same path again.