Using the USMLE for GMC Registration

  • June 13, 2022

Many physicians trained in the USA can now register to work in the UK using their USMLE licensure. Whilst it is not a qualification, the GMC now accepts the United States Medical Licensing Exam (USMLE) as evidence of the appropriate skills and knowledge required to be granted registration with a license to practice. 

In this blog we will outline some key points in this process, and briefly explain how to apply for full registration, including the following:

Please note, the full process is a lengthy one, so for detailed guidance on registering with the GMC using your USMLE, we suggest you get in touch with us to learn more.

Eligibility for GMC Registration

You are eligible for this application if you: 

  • graduated from a medical school outside the UK or Switzerland 

and you: 

  • hold an acceptable primary medical qualification 
  • have completed an internship 
  • have passed the United States Medical Licensing Exam: 
    • Step 1 
    • Step 2 Clinical Knowledge AND 
    • Step 2 Clinical Skills 

Some important things to note: 

  1. Your pass for Step 2 Clinical Skills must be on or before 13 March 2020. This is because the in-person aspect of Step 2 Clinical Skills allows the USMLE to be comparable to the PLAB exam. Without this, the USMLE does not meet the GMC requirements for demonstration of skills and knowledge.
  2. If you attained the USMLE before 16 April 2004, you may have passed the former ECFMG Clinical Skill Assessment (CSA). This will not be accepted by the GMC for registration. Whilst we understand there are a lot of similarities between the two assessments (CSA and Step 2 CS) - only the Step 2 CS will be accepted. 
  3. You must have passed each part of the exam including the knowledge tests and clinical skills components in four attempts or less.
  4. If you have taken and failed PLAB Part 1 or 2 after you passed any component of an overseas registration exam, either a knowledge or clinical skills test, you will not be eligible for this application. 
  5. If your pass in the clinical skills component is more than two years old, you will need to have carried out medical practice for three of the last five years, including at least six out of the most recent 12 months before you submit your application. If your pass is over two years old and you haven’t completed this pattern of medical practice you will not be eligible to use the USMLE for GMC registration.

If you do not meet these criteria, your application may be rejected and you may need to find an alternative route to GMC registration. Depending on your specialty, you may have an overseas accepted qualification, or PLAB may be another alternative for you. 

GMC Registration Requirements

To gain full GMC registration with a license to practice in the UK, you must provide evidence of: 

Evidence of skills and knowledge - this would be your full USMLE (Step 1, Step 2 - CK & CS)


English language capabilities - either your IELTS, OET or an approved reference from your current employer (if you have been working in an English-speaking country for the last two years). 


Certificate of good standing - the certificate from your medical regulatory authority which demonstrates good standing.  

Evidence of Primary Medical Qualification (PMQ)

As part of your application with the GMC, you’ll need to send a copy of your Primary Medical Qualification. Some overseas medical degrees are not accepted by the GMC – if you are not sure – take a read of our blog on accepted primary medical qualifications here

Once you have checked your primary medical qualification meets the acceptability criteria, you’ll need to have it independently verified before you can be granted your registration with a licence to practise. You will need to do this if you qualified from a medical school outside the UK and are not already provisionally registered with the GMC. 

Read our article on verifying your medical degree here – or for a full and detailed guide on the steps required, contact the team via email at  

Evidence of an Acceptable Internship

An internship is formal training and experience after you've completed your primary medical qualification.

An acceptable internship must include at least 12 months' continuous medical practice in an approved training post in a public hospital. You must have done this either immediately before or after you graduated.

Your internship must have been at least 12 months in duration.

If your internship was completed over a 12 - 18-month period, it must have included at least three months in medicine and three months in surgery.

If your internship was completed in over 18 months, it must have included at least six months in medicine and six months in surgery.

You'll need to send the GMC a certificate or letter of completion from your institution, which gives details of the dates and specialties of your rotations.

If you completed an internship in the UK, you’ll need to read the online guidance for moving from provisional registration to full registration. 

I haven't competed an internship

If you didn't complete an internship, the GMC will accept evidence that you practised for two years continuously after you graduated.

The GMC will check that your experience:

  • was undertaken in a public hospital that meets the standards for regulation within its jurisdiction and has established supervision, safety and governance systems in place
  • includes at least three months of practising medicine, continuously and without interruption
  • includes at least least three months practising surgery, continuously and without interruption
  • was completed under supervision. 

You'll need to provide a letter from the hospital on letter headed paper, which gives details of the dates and specialties of your practice.

Evidence of your pass in the USMLE 

As part of your application, you'll need to: 

  • Email the GMC to express your interest in applying for registration through this route at
  • Complete the application form the GMC send you and return it by email.
  • Send them evidence which demonstrates you’ve passed an acceptable overseas registration exam. You can request this from the USMLE as per the instructions below. 

Requesting evidence from USMLE for the GMC 

  • First you should check that your college is listed on the World Directory of Medical Schools (WDOMS) - this is likely if you've completed the USMLE
  • You can request and download a transcript from the Federation of State Medical Boards
  • You need to select General Medical Council (UK) from the drop-down list 
  • If you are unable to access your account, call (817) 868-4041 or email  

Evidence of English Language Proficiency

All physicians, regardless of experience and country of origin, must demonstrate that they have sufficient grasp of the English language. This can be done by passing either the International English Language Testing System (IELTS) or Occupational English Test (OET). Detailed guides to these tests can be found below:

Experience in English-speaking countries

For doctors who have spent the last two years of their clinical experience in an English-speaking country, you can use a reference from your current employer(s) over these two or more years to demonstrate competence of the English language. This would exempt you from sitting an English language exam.

Certificate of Good Standing

All doctors registering with the GMC must provide a certificate of good standing from each medical regulatory authority they’ve been registered or licensed with in the last five years.  

The medical regulatory authority may send you a certificate of past good standing if you're not currently registered or licensed with them. If there's no medical regulatory authority in the country to issue a certificate, the GMC will give you further advice once your application has been assessed. You can find out which medical regulatory authority to contact via the GMC website here

Please note that each certificate is only valid for three months from the date it's signed and must be valid when the GMC approves your application. 

Other information you may need to provide

There are various other bits of information you will need to provide which includes your activities for the last five years, translations of any documents not in English, and any additional evidence the GMC may request when reviewing your application.  

Often this is different, dependent on each case, so our advice is to start the application and respond to the GMC’s queries as and when they come. 

Getting started

You will need to create a GMC Online account for the GMC to be able to send you an application form.

Once you've read and understood the evidence needed to support your application, you’re ready to apply. To start, contact the GMC where they will be able to check your eligibility and send you an application form to complete as mentioned above. 

Once you've gathered all the required evidence and started the process to have your PMQ verified by the ECFMG, send your completed application form by email to Once received, the GMC will ask you to call their contact centre to make payment.

If you are still unsure about the application process and wish to discuss your application with IMG Connect, feel free to get in touch. We understand the GMC registration process can be complicated, and IMG Connect are experts on the matter. Rest assured, we are always delighted to help overseas physicians through the GMC registration process and to find jobs in the NHS! 

For regular news and updates on the UK, including GMC registration, the royal colleges and the NHS, follow IMG Connect on social media using the links below.



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