The UK medical training pathway runs from a five-year (or four-year graduate-entry) medical degree, through the UKMLA and provisional GMC registration, into the two-year Foundation Programme (with full registration granted after FY1), then specialty training — run-through or uncoupled core-then-higher — to the Certificate of Completion of Training (CCT) and entry to the GMC Specialist or GP Register. Internationally-trained doctors enter via the MLA-compliant PLAB (not a separate UKMLA), and specialists may register via the Portfolio Pathway.
At a glance
- Regulator
- General Medical Council (GMC)[1]
- Licensing assessment
- MLA — Applied Knowledge Test plus Clinical and Professional Skills Assessment[2]
- Shortest route to CCT
- General practice — three years of specialty training after the Foundation Programme[5]
- Full registration
- Granted after FY1, not at graduation[1]
- End point
- CCT, then entry to the GMC Specialist or GP Register[7]
- Overseas route
- MLA-compliant PLAB, not a separate UKMLA[11]
- Registration cost
- £26 provisional, £481 full, then £481 a year (discounts apply)[13]
How long it takes
10-16 years from starting training to full registration[8]
- Medical degree5 years
A five-year primary medical qualification, or four years by graduate entry. The MLA is taken during the degree, not after it — schools deliver the CPSA in the penultimate or final year.[4]
Unsalaried. Tuition and maintenance funding apply; figures vary by nation and entry route.
- Medical Licensing Assessment (MLA)milestone
Two parts: the Applied Knowledge Test, sat nationally, and the Clinical and Professional Skills Assessment, integrated into finals. A pass is required before joining the register.[3]
Sat during the degree — no separate salaried period.
- Provisional GMC registrationmilestone
Graduation confers PROVISIONAL registration only. It permits practice in an approved FY1 post and nothing else — the most commonly misunderstood step in the pathway.[1]
- Foundation Programme — FY112 months
The first salaried year. Satisfactory completion is what converts provisional registration to FULL registration.[1]
Salaried NHS post.
- Foundation Programme — FY212 months
The second foundation year, held with full registration, before entry to specialty training.[1]
Salaried NHS post.
- Specialty training3 years
Run-through, or uncoupled core training then higher specialty training. General practice is the shortest at three years; other specialties run considerably longer and the GMC publishes a minimum time for each.[5]
Salaried NHS post throughout.
- CCT and entry to the registermilestone
The Certificate of Completion of Training is awarded on completing a run-through or higher specialty programme, and admits the doctor to the GMC Specialist or GP Register.[7]
Ways in
- Standard-entry medical degree
- 5 years · School-leaver entry to a GMC-approved primary medical qualification. · not salaried[1]
- Graduate-entry medical degree
- 4 years · An existing degree, usually with an admissions test. · not salaried[1]
- Overseas-qualified doctor (PLAB)
- A recognised overseas primary medical qualification. · Entry is via the MLA-compliant PLAB rather than a separate UKMLA. · not salaried[11]
- Portfolio Pathway to the Specialist Register
- Experienced specialists who did not complete a UK training programme. · Awards entry to the Specialist Register without a CCT. · salaried[1]
Entry requirements & restrictions
What it costs to qualify
- Medical degree tuition
- not yet verified · Capped tuition varies by UK nation, entry route and fee status. Verifera publishes a figure only once it is checked against the primary source — an unverified number is worse than an absent one. · each year of study
- Provisional registration application
- £26 · on graduating, to take up an FY1 post[13]
- Full registration application
- £481 · on completing FY1[14]
- GMC annual retention fee
- £481 · A fixed-term discounted rate of £184 applies for the first years after full registration, and a 50% income discount applies below £38,500 worldwide income. · annually, on the anniversary of registration[12]
- Specialist or GP Register entry (CCT)
- £516 · on completing specialty training[15]
- PLAB Part 1 test fee
- £283[17]
- PLAB Part 2 test fee
- £1,036[18]
- GMC fee, Specialist or GP registration via portfolio pathway
- £1,974[19]
What you earn at each stage
What the regulator requires
The GMC registers doctors and licenses them to practise in the UK. Graduation from a GMC-approved primary medical qualification confers provisional registration, which permits practice only in an approved Foundation Year 1 post; full registration follows satisfactory completion of FY1. Entry to the Specialist or GP Register requires a Certificate of Completion of Training, or an approved alternative route. The GMC publishes a minimum UK training time for each specialty.
What changed, and what's changing
- 2024-09-01: The Applied Knowledge Test entered national delivery; more than 10,000 students sat it in the first year.
- [9]
- 2025-01-01: Students graduating from UK medical schools from 2024-25 onwards must pass the MLA before joining the register.
- [3]
- 2026-09-01: An updated MLA content map takes effect.
- [10]
Where applications fail
- Assuming graduation means full registration
- Graduation confers PROVISIONAL registration only. It permits practice in an approved FY1 post and nothing else.[1]Applicants should treat full registration as an FY1 outcome, not a graduation outcome.
- Treating the CPSA as a separate exam to revise for
- The CPSA is integrated into medical school finals, not sat separately.[4]Candidates should confirm how their own school delivers it, in the penultimate or final year.
- Budgeting for a single specialty-training length
- Three years applies to general practice; other specialties run considerably longer.[8]Applicants should check the GMC's published minimum training time for the specific specialty.
Common myths
- Overseas doctors sit the UKMLA.
- Internationally-trained doctors take the MLA-compliant PLAB, not a separate UKMLA.[11]
- Becoming a doctor takes five years.
- Five years is the degree alone. Full registration follows FY1, and a CCT follows specialty training — three years for general practice and longer elsewhere.[5]
- The Foundation Programme is part of specialty training.
- The two foundation years sit between registration and specialty training, and are a separate stage.[1]
Where it can take you
Common questions
How long does it take to become a doctor in the UK?
When does a doctor get full GMC registration?
What is the UKMLA and who has to take it?
How long is GP training?
Sources & verification
- The pathway is: medical school → UKMLA → provisional GMC registration → Foundation Programme (full registration after FY1) → specialty training → CCT → Specialist/GP Register, source, Last verified 2026-06-09
- The Medical Licensing Assessment is a two-part assessment made up of an Applied Knowledge Test (AKT) and a Clinical and Professional Skills Assessment (CPSA), source, Last verified 2026-07-24
- All final-year medical students across the UK are required to pass the Medical Licensing Assessment as part of their degree before they can join the medical register, with the first national sitting of its Applied Knowledge Test delivered between September 2024 and August 2025, source, Last verified 2026-10-02 🔶
- The CPSA is not a separate exam from medical school finals; UK medical schools set and deliver it for students in their penultimate or final year of study, source, Last verified 2026-07-24
- Training for a CCT in general practice is three years of approved clinical training, or the equivalent part time, source, Last verified 2026-07-24
- Most GP training programmes include 18 to 24 months of general practice posts, with the remaining time in relevant hospital or integrated training posts; each post lasts between three and six months, source, Last verified 2026-07-24
- On successful completion of a run-through or higher specialty training programme, doctors are awarded a Certificate of Completion of Training (CCT), which allows entry onto the GMC specialist or general practice register, source, Last verified 2026-07-24
- The GMC publishes the minimum UK training time for each specialty, source, Last verified 2026-07-24
- Between September 2024 and August 2025 the Applied Knowledge Test was delivered to more than 10,000 medical students across the UK in its first national sitting, source, Last verified 2026-07-24
- An updated MLA content map applies from September 2026, source, Last verified 2026-07-24 🔶 ⚠ under review
- Internationally-trained doctors take the MLA-compliant PLAB, not a separate UKMLA, source, Last verified 2026-07-24
- The GMC annual fee for registration with a licence to practise is £481, effective from 1 April 2026, source, Last verified 2026-10-15 🔶
- The GMC fee to apply for provisional registration with a licence to practise is £26, effective from 1 April 2026, source, Last verified 2026-10-15 🔶
- The GMC fee to apply for full registration with a licence to practise is £481, effective from 1 April 2026, source, Last verified 2026-10-15 🔶
- The GMC fee to join the Specialist or GP Register via Certificate of Completion of Training (CCT) is £516, effective from 1 April 2026, source, Last verified 2026-10-15 🔶
- A fixed-term discounted GMC annual fee of £184 applies to doctors who moved from provisional to full registration in the past four years, or who are fully registered and passed their primary medical qualification within the past five years; a 50% income discount applies below a worldwide income threshold of £38,500, effective from 1 April 2026, source, Last verified 2026-07-24 🔶 ⚠ under review
- PLAB Part 1 test fee: £283, source, Last verified 2026-10-15 🔶
- PLAB Part 2 test fee: £1,036, source, Last verified 2026-10-15 🔶
- GMC fee, Specialist or GP registration via portfolio pathway: £1,974, source, Last verified 2026-10-15 🔶
Verified reference information, not professional, medical, legal or careers advice. Regulations change; always check the cited primary source before relying on it.