PLAB 1 Prep Guide 2026: Study Plan, Resources & Tips to Pass

PLAB 1 is the first step for international medical graduates (IMGs) seeking to practise medicine in the UK. It's a knowledge-based exam — 180 single best answer (SBA) questions in 3 hours — and the pass rate hovers around 70%, meaning roughly 3 in 10 candidates fail on their first attempt.

This guide covers everything you need to prepare: what the exam tests, the best resources, a week-by-week study plan, and the strategies that separate candidates who pass from those who don't.

What Is PLAB 1? (Quick Overview)

Format: 180 SBAs in 3 hours

PLAB 1 consists of 180 single best answer (SBA) questions across all clinical disciplines. Each question presents a clinical scenario and five answer options — you choose the single best answer.

The exam is delivered as a computer-based test at Pearson VUE centres worldwide. You have 3 hours to complete all 180 questions, which means roughly 1 minute per question. Time management is critical.

Pass mark and scoring

The pass mark is set by the GMC using standard-setting methods and varies slightly between sittings, but typically falls around 60–65% (approximately 108–117 correct answers out of 180). There's no negative marking — answer every question, even if you're guessing.

Who needs to take it (IMGs, eligibility)

PLAB 1 is required for international medical graduates who want to work as doctors in the UK and don't have a qualifying exam exemption (such as a recognised EU/EEA qualification before Brexit or certain other exemptions).

Eligibility requirements:

• A recognised medical qualification (listed in the World Directory of Medical Schools)
• IELTS Academic score of 7.0+ in each band (or OET B in each category)
• Registration with the GMC to sit the exam

When to Start Studying (And How Much Time You Need)

If you have 3 months

Three months of dedicated study is the most common timeline. This allows you to cover all subjects systematically while leaving time for practice exams and revision.

Recommended: 4–6 hours of study per day, 6 days per week, with increasing intensity in the final 2–3 weeks.

If you have 6 weeks (accelerated plan)

Six weeks is tight but achievable if you have a strong clinical foundation. This requires:

• 6–8 hours of study per day
• Prioritising high-yield subjects (medicine, surgery, OB/Gyn)
• Heavy emphasis on question practice from day one
• Skipping low-yield material and focusing on pattern recognition

Warning: The 6-week plan leaves no margin for error. If your diagnostic score is below 50%, consider extending to 8–10 weeks.

The Essential PLAB 1 Resource Stack

Oxford Handbook of Clinical Medicine

The Oxford Handbook is the core text for PLAB 1. It's concise, clinically focused, and covers the breadth of topics tested. Read it actively — don't just highlight. Summarise key points, annotate with notes from question practice, and use it as your primary reference.

Pro tip: Focus on the management algorithms and investigation hierarchies. PLAB 1 frequently tests "what is the most appropriate next step?" — and the Oxford Handbook's structured approach maps directly to these questions.

Passmedicine / PLABABLE (Qbanks)

Online question banks are essential for PLAB 1 preparation:

• Passmedicine — the most popular PLAB Qbank with extensive explanations. Complete it at least once; review incorrect questions twice.
• PLABABLE — newer Qbank with good SBA-format questions and a mobile app

Treat Qbank practice as your primary study method, not a supplement. Each question is a learning opportunity, and the explanations teach more efficiently than textbook reading.

Samson's Notes and other high-yield resources

• Samson's Notes — condensed, high-yield notes popular among PLAB candidates
• BMJ Best Practice — for clinical decision-making frameworks and evidence-based management
• NICE Guidelines — PLAB 1 tests UK-specific management, and NICE guidelines are the reference standard

Using AI tools for PLAB practice

PLAB 1 tests SBA questions — the same format that AI question generators produce. Upload your study notes on a topic (e.g., cardiology management from the Oxford Handbook) and generate additional SBA-format questions to supplement your Qbank practice.

This is particularly useful for:

• Topics where your Qbank has limited coverage
• Reinforcing weak areas identified by diagnostic tests
• Generating questions from NICE guidelines or specific protocols

Generate PLAB-style SBA questions from your notes →

8-Week PLAB 1 Study Plan (Week-by-Week)

Weeks 1–2: Medicine + Surgery Systems

Focus: The two highest-yield subjects for PLAB 1 — internal medicine and surgery.

Week 1: Cardiology, respiratory, gastroenterology, endocrinology Week 2: Neurology, rheumatology, haematology, general surgery

Goal: 50 Qbank questions per day. Focus on understanding UK management pathways.

Weeks 3–4: OB/Gyn, Paediatrics, Psychiatry

Focus: Three frequently tested specialties with distinct management patterns.

Week 3: Obstetrics (antenatal, intrapartum, postpartum complications), gynaecology (menstrual disorders, pelvic pain, cervical screening) Week 4: Paediatrics (developmental milestones, common childhood illnesses, safeguarding), psychiatry (depression, psychosis, substance misuse, Mental Health Act)

Key insight: PLAB 1 tests UK-specific management for these specialties. NICE guidelines on depression, antenatal care, and child safeguarding are high-yield — read them.

Weeks 5–6: Pharmacology + Ethics + Statistics

Focus: Topics that are often undertaught in non-UK medical curricula but heavily tested on PLAB 1.

Week 5: Clinical pharmacology — prescribing, drug interactions, common medications used in UK practice. Focus on BNF (British National Formulary) prescribing conventions. Week 6: Medical ethics (capacity, consent, confidentiality, GMC duties), clinical statistics (sensitivity, specificity, NNT, study types), and ophthalmology/ENT/dermatology (short-answer high-yield topics).

Important: Ethics questions on PLAB 1 follow GMC guidance specifically — not general ethical principles. Read Good Medical Practice and the GMC's guidance on consent and confidentiality.

Weeks 7–8: Revision + Full Mock Exams

Week 7: Full revision of weakest subjects. Complete any remaining Qbank questions. Take a full timed mock exam (180 questions in 3 hours) to simulate real conditions.

Week 8:

• Days 1–2: Review mock exam mistakes intensively
• Days 3–4: Second timed mock exam + targeted revision
• Day 5: Light review — quick-read of Samson's Notes or flagged Oxford Handbook pages
• Day 6: Rest day — no studying
• Day 7: Exam day

How to Use Practice Questions Effectively for PLAB

Timed SBA practice vs. learning mode

Use both modes strategically:

• Learning mode (weeks 1–6): Unlimited time per question. Focus on understanding the reasoning behind correct and incorrect answers. Read every explanation thoroughly.
• Timed mode (weeks 6–8): 1 minute per question. Practise decision-making under time pressure. Simulate exam conditions.

Switch to predominantly timed practice in the final 2 weeks. The 3-hour exam is a stamina test as much as a knowledge test.

Generating topic-specific questions from revision notes

When you identify a weak area from Qbank practice, generate additional targeted questions:

1. Compile your notes on the weak topic (e.g., acute coronary syndrome management per NICE)
2. Upload to a question generator
3. Practise 10–20 focused questions on that specific area
4. Review mistakes and update your notes

This targeted approach is more efficient than re-reading the Oxford Handbook chapter for the third time.

Generate targeted SBA questions for your weak areas →

Common Reasons Students Fail PLAB 1 (And How to Avoid Them)

1. Not adapting to UK guidelines — your home country's management may differ significantly from NICE/BNF/GMC guidance. PLAB tests UK practice.
2. Relying on reading instead of questions — passive reading doesn't prepare you for SBA questions. Practise early and often.
3. Poor time management — 1 minute per question is tight. Practise under timed conditions starting from week 5 at the latest.
4. Neglecting ethics and statistics — these are "free marks" if you study them. Students who skip them often fail by a small margin.
5. Not taking full mock exams — the 3-hour duration is physically and mentally demanding. Simulate it at least twice before exam day.
6. Studying too broadly — PLAB has predictable patterns. Focus on high-yield topics and UK-specific management rather than trying to cover every rare disease.

Test Day Strategy

• Answer every question — no negative marking, so never leave a blank
• Flag and move on — if a question takes more than 90 seconds, flag it and come back. Don't let one hard question steal time from three easy ones
• Read the last line first — the lead-in question tells you what they're asking before you invest time in the clinical stem
• Watch for UK-specific traps — drug names (paracetamol not acetaminophen), investigation protocols (UK reference ranges), and management pathways (NICE, not UpToDate)
• Eat and hydrate — you can't leave and re-enter, so eat and drink before you start. The 3-hour block is continuous

FAQ

How many times can you take PLAB 1?

You can attempt PLAB 1 a maximum of 4 times. If you fail 4 times, you cannot retake it. Make each attempt count — don't rush to sit the exam before you're ready.

Is PLAB 1 harder than USMLE?

They're different exams. PLAB 1 is shorter (180 Qs vs. 280), and the questions tend to be more clinically straightforward with less basic science. However, PLAB 1 requires specific knowledge of UK clinical practice (NICE guidelines, GMC duties, BNF prescribing) that USMLE doesn't test. Students who've prepared for USMLE generally find PLAB 1 manageable with 4–6 weeks of UK-specific study.

Can I work in the UK on a student visa while preparing?

UK student visa (Tier 4) allows up to 20 hours of work per week during term time. However, most PLAB candidates come to the UK on a Standard Visitor visa for the exam itself, which does not permit work. Plan your finances accordingly. After passing PLAB 2, you'll apply for a Health and Care Worker visa to start working.