How does a doctor from Pakistan get into the NHS?
A Pakistani MBBS graduate with a completed house job typically reaches GMC registration through PLAB 1 and 2, or through FCPS-II or MRCP if already specialising. Expect 12–18 months and around £4,000–£6,000 all in.
- Typical timeline
- 12–18 months from decision to first NHS post
- Typical cost
- £4,000 – £6,000
- Regulator
- Pakistan Medical and Dental Council (PMDC)
Step-by-step: MBBS to NHS post
- 1
Check your college's World Directory listing
Your MBBS must come from a school listed in the World Directory of Medical Schools with a GMC sponsor note. Some newer private colleges in Pakistan are not yet listed — confirm before spending.
- 2
Complete and document your house job
The GMC expects a full 12-month internship. Your certificate should name each rotation with dates. If your house job was split across institutions, gather a certificate from each.
- 3
Start EPIC primary source verification
PMDC responses to ECFMG can be slow, particularly during registration renewal periods. Submitting early is the single biggest time saver for Pakistani applicants.
- 4
Take IELTS Academic or OET
IELTS 7.5 overall with 7.0 in each element, or OET grade B across all four sub-tests. Both are available in Karachi, Lahore and Islamabad, and OET suits doctors who find academic writing harder than clinical writing.
- 5
Decide between PLAB and FCPS/MRCP
PLAB 1 runs in Pakistan; PLAB 2 is in Manchester. If you are mid-FCPS, weigh finishing it against switching to PLAB — FCPS-II holders can often use the postgraduate route, but only for specific specialties the GMC accepts.
- 6
Obtain a Certificate of Good Standing from PMDC
Valid for three months from issue. Request it once your other evidence is close to complete so it does not expire mid-application.
- 7
Apply for jobs, get a CoS and apply for the visa
Most first posts are trust grade or clinical fellow roles. Once you have a Certificate of Sponsorship, apply for the Health and Care Worker visa — no immigration health surcharge and a reduced application fee.
What catches Pakistani applicants out
- PMDC registration must be active and unexpired at the moment the GMC checks it; renew before you request your Certificate of Good Standing.
- Name mismatches between passport, MBBS degree and PMDC certificate cause frequent rejections — get an affidavit prepared early if yours differ.
- Priority visa services in Pakistan are not always available; plan for standard processing of three to eight weeks.
- Bring original documents to your GMC ID check; scanned copies alone are not accepted.
Pakistan to NHS: frequently asked questions
Is FCPS accepted by the GMC instead of PLAB?
FCPS-II is accepted for GMC registration only in specific specialties on the GMC's acceptable postgraduate qualification list. Check your specialty against the current list — if it is not there, PLAB remains the route.
Can I apply for the NHS before finishing my house job?
You can sit PLAB 1 and take your English test, but the GMC will not grant full registration with a licence to practise until you evidence an acceptable 12-month internship.
How much does the whole process cost from Pakistan?
Typically £4,000–£6,000 including English test, PLAB 1 and 2, EPIC verification, GMC fees, the trip to Manchester, visa costs and initial living expenses in the UK.
Which NHS jobs are realistic for a Pakistani IMG with no UK experience?
Trust grade SHO, clinical fellow and junior clinical fellow posts in medicine, surgery, psychiatry, emergency medicine and paediatrics are the most common first roles, often in district general hospitals outside London.
Not sure which route fits you?
Take the 2-minute pathway quiz and get a dated plan for your own situation, or work out the total spend with the cost calculator.