How to Work as a Doctor in the UK (NHS): Doctor Study Guide 2026

The UK is one of the most popular career options for Japanese doctors. Working in the National Health Service (NHS: National Health Service) in particular is highly attractive for its stable employment environment, international career and the chance to develop a high level of expertise.

At the same time, to work as a doctor in the UK you need to clear several hurdles, including **GMC registration, an English test, the PLAB exam and a visa**. The UK also has its own system, different from that of the United States (USMLE) or Australia (AMC), so a correct understanding and a clear strategy are essential.

In this 2026 edition, we explain the following in depth:

• The overall roadmap to working in the NHS
• Details of the PLAB exam and how to prepare
• The GMC registration process
• English requirements (IELTS / OET)
• How to find a job and the types of positions
• Salary, working environment and career paths
• The real challenges Japanese doctors face

This guide is structured to be as practical as possible for doctors who are now aiming for the UK.

Overview of the NHS

The NHS (National Health Service) is the UK's public healthcare system, with the following features:

• Healthcare is basically free (funded by taxes)
• A nationwide healthcare network
• A huge organisation employing over 1.5 million people

How Doctors Work

Doctors in the NHS are divided mainly into the following tiers:

• Foundation Doctor (first-stage training doctor)
• Core Trainee (early specialty training)
• Specialty Trainee (later specialty training)
• Consultant (specialist and supervising doctor)

Unlike the Japanese system, it features **clear training tiers and a competitive progression system**.

Step 1: English test (IELTS / OET)

The first hurdle is English.

Required scores:

• IELTS Academic: Overall 7.5 (7.0 or higher in each section)
• OET: B or higher in each sub-test

* For doctors, the OET is considered more realistic.

Step 2: PLAB exam

PLAB (Professional and Linguistic Assessments Board) is the main exam that allows overseas doctors to work in the UK.

• PLAB 1: written (MCQ)
• PLAB 2: OSCE format (clinical exam)

We explain these in detail below.

Step 3: GMC registration

Registration with the GMC (General Medical Council) is mandatory.

Once registration is complete:

• You gain the qualification to work as a doctor in the NHS
• You can actually apply for jobs

Step 4: Job hunting

Main routes to employment:

• NHS Jobs (official job site)
• Applying directly to Trusts
• Recruitment agency

Step 5: Obtaining a visa

The current mainstream route is:

• Skilled Worker Visa

Once you have an NHS job, it can be obtained with sponsorship.

PLAB 1 (written exam)

• 180 MCQs
• Basic plus clinical knowledge
• UK guidelines (NICE) are important

Characteristics

• Said to be easier than the USMLE
• Many questions are close to real clinical practice
• GP (general practice) topics appear frequently

PLAB 2 (OSCE)

• Practical exam (held in Manchester)
• About 18 stations

What is assessed

• Communication skills
• Examination skills
• Clinical judgement

The Real Difficulty

It is not about knowledge, but about:

• Ability to respond in English
• Patient-centred thinking
• Empathy skills

GMC registration requires the following:

• Proof of medical school graduation
• English test score
• PLAB pass
• Certificate of Good Standing

Types of registration

• Provisional Registration
• Full Registration

Via the PLAB route, the basic aim is **Full Registration**.

Features of IELTS

• General English
• Academic format
• Higher difficulty

Features of OET

• Healthcare-specific
• Content close to real practice
• Advantageous for doctors

Conclusion

For most doctors:

→ **The OET is overwhelmingly more efficient**

Where to find vacancies

• NHS Jobs (official)
• Trust websites
• Agencies

Main positions

FY2 equivalent (Junior Doctor)

• Initial position
• Entry point for overseas doctors

Trust Grade Doctor

• Non-training positions
• Flexible working

Specialty Training

• Highly competitive
• Suited to long-term careers

Salary guidelines

• Junior Doctor: £30,000 to £45,000
• Specialty Doctor: £50,000 to £80,000
• Consultant: £90,000 to £120,000+

Features

• Night-shift allowance
• Pension scheme
• Generous paid leave

Advantages

• Good work-life balance
• Working hours are managed
• A diverse workplace

Disadvantages

• Busy due to staff shortages
• A lot of paperwork
• The complexity of systems specific to the NHS

(1) English communication

• Conversations with patients
• Collaboration with colleagues

(2) Cultural differences

• Flat organisations
• Self-assertion is expected

(3) Differences in the healthcare system

• The GP system
• Referral-based care

Short term

• Gain experience at Trust Grade

Medium term

• Apply for Specialty Training

Long term

• Aim to become a Consultant

In addition, UK experience:

• Is valued in other countries too (Australia, the Middle East)

• A career that is recognised internationally
• Improved English ability
• Experience with a wide variety of cases
• Access to the European region

• The hurdle of initial entry
• Intense competition
• Changes in the visa system

(1) Make OET preparation your top priority

(2) For PLAB, focus on UK guidelines

(3) Start gathering information early

(4) Strengthen your clinical English

• Neglecting English preparation
• Insufficient PLAB 2 preparation
• Delaying job hunting

Working as a doctor in the UK is a very realistic and valuable option for Japanese doctors.

The key points are as follows:

• Meet the English requirement with the OET or IELTS
• Pass the PLAB exam
• Complete GMC registration
• Secure a position in the NHS

In particular, **the PLAB route is relatively realistic and can succeed with the right strategy**.

For doctors who want to broaden their careers internationally, the UK is a very attractive field.

Q1. Can Japanese doctors work in the UK?

Yes. Many Japanese doctors are actually working in the NHS through the PLAB route. However, you must meet requirements such as an English test (OET or IELTS), the PLAB exam and GMC registration.

Q2. How long does it take to work as a doctor in the UK?

It generally takes about 1 to 2 years.

• English test preparation: 3 to 6 months
• PLAB 1 preparation: 3 to 6 months
• PLAB 2 preparation and exam: 3 to 6 months
• Job hunting: 1 to 3 months

If everything goes smoothly, it can be done within a year, but most people take around a year and a half.

Q3. Should I choose IELTS or OET?

The OET is recommended for most doctors.

• It is specific to medical English
• The content is close to real practice
• Scores tend to be easier to achieve

Even if you are not confident in English, you can prepare more efficiently for the OET.

Q4. How difficult is the PLAB exam?

PLAB 1 is at a basic-to-clinical level and is said to be less difficult than the USMLE. PLAB 2, on the other hand, is in OSCE format, so English communication skills and clinical management are important, and it is a difficult exam without preparation.

Q5. What happens if I fail the PLAB exam?

You can retake it. Many people take PLAB 1 more than once in particular, and with solid preparation passing is quite realistic. However, there is a limit on the number of attempts, so it is important to plan your exams carefully.

Q6. Is GMC registration difficult?

It is not difficult if you meet the document requirements and conditions. However,

• Missing or incorrect documents
• An insufficient English score
• Problems with Good Standing

delays may occur if there are issues such as these. Advance preparation is important.

Q7. What will my first position in the UK be?

In most cases, it will be one of the following:

• FY2 equivalent (Junior Doctor)
• Trust Grade Doctor

Overseas doctors in particular often start in a non-training position (Trust Grade).

Q8. Is it difficult to get a job in the NHS?

In recent years, opportunities have increased compared with before because of the shortage of doctors. However,

• English ability
• Interview preparation
• The quality of your CV

Results vary greatly depending on these.

Q9. Do I have to obtain the visa myself?

Basically, the NHS hospital (Trust) acts as sponsor and supports your Skilled Worker Visa. Once you have a job offer, obtaining the visa is relatively smooth.

Q10. How much is the salary?

The guidelines are as follows:

• Junior Doctor: about £30,000 to £45,000
• Specialty Doctor: about £50,000 to £80,000
• Consultant: about £90,000 or more

Night-shift allowances and extra shifts can increase your income further.

Q11. Is the work-life balance good?

It is considered good compared with Japan. Working hours are regulated by law, and it is easy to take paid leave. However, some departments can be busy.

Q12. Can I use my Japanese medical licence as it is?

No. To work in the UK you need GMC registration, and to get it you must go through processes such as the PLAB exam.

Q13. Can I try even if I am not good at English?

You can, but English is the biggest hurdle. Communication with patients is extremely important in PLAB 2 and in actual clinical practice in particular, so you need to prepare thoroughly in advance.

Q14. Can I enter Specialty Training right away?

Basically, it is difficult. Most overseas doctors first gain experience in the NHS and apply afterwards. Competition is high, so preparation and a track record are important.

Q15. Is UK experience valued in other countries?

Yes, it is valued very highly. In Australia, the Middle East and Singapore in particular, NHS experience often works in your favour for career advancement.

Q16. What is the age limit for trying?

There is no clear age limit. In fact, some doctors take on the challenge in their late 30s to 40s. However, the earlier you start, the better for building your career.

Q17. Can I move with my family?

Yes. With a Skilled Worker Visa, you can bring your spouse and children. Education and living conditions are also well developed, so it suits family relocation.

Q18. Can I work in the UK long term?

Yes. After working for a certain period, there is also a path to obtaining permanent residency (ILR: Indefinite Leave to Remain).

Q19. Will it be a disadvantage if I return to Japan?

Not necessarily. On the contrary,

• English ability,
• international experience and
• clinical experience

are often valued, and they broaden your career options.

Q20. What is the most important point for studying medicine in the UK?

The following three are the most important:

• English ability (especially OET preparation)
• Practical preparation for PLAB 2
• Gathering information and preparing early

If you cover these three firmly, your chances of success rise greatly.