AMC vs PLAB | Australia or UK for doctors Published on Mar 27, 2023
You've decided to migrate to go abroad to pursue your medical career and you are thinking about Australia or UK, but how do choose between them in terms of licensing exams, and what is the difference? What factors should IMGs consider before choosing an exam? Today's EF blog offers helpful guidance in this regard. We will tell you what you need to know, but ultimately you're the one who makes the right decision for you. |
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The Australian Medical Council (AMC) and the Professional and Linguistic Assessment Board (PLAB) exams are two types of exams that are required in order to practice medicine in Australia and the UK, respectively.
You don't just take exams, you live the lifestyle that comes with these licensing exams so you should call it Medical Migration Australia vs UK instead of AMC vs PLAB.
This is similar to comparing apples to oranges. While the outcomes may be similar, the process of getting there is completely different, and each has its own unique set of benefits.
As the famous American pastor Francis Chan once wrote: “Our greatest fear should not be of failure but of succeeding at things in life that don't really matter.” So we should choose wisely knowing the pros and cons.
The medical migration process for most IMGs includes...passing licensing exams, obtaining a world-recognized specialty qualification, access to a better educational system for their children, and getting a passport that lets them travel visa-free to the US, UK, Europe, and popular tourist destinations.
When I graduated from medical college in 2001, all the top and talented students moved to the US or UK. There wasn't even a consideration for Australia. My first impression of migrant doctors in Australia was that they were mostly from the UK or GPs via AMC. The reason is that doctors had negative points in migration in the 1990s, the health system was so well-serviced that they did not require any doctors.
IMGs here in the last 10-15 years are mainly women who are married to migrant workers and are either staying home or working as GPs. During the COVID era, when more doctors were needed, these migrant lady doctors were easily available and with some effort, entered the medical profession, which I believe encouraged a large number of Indian, Srilankan, and Pakistani doctors to migrate to Australia.
It is important to note that this shift in Australia is happening in tandem with a crisis situation in the UK with NHS staff shortages, burnout, and poor wages, as well as in the United States with 40% of foreign doctors not being able to match, brand new migrant doctors from the subcontinent and the Middle East have NOW been given a third option.
They are now comparing PLAB with AMC or UK with Australia...And yes, as borders open and most developed countries compete for skilled migrant workers, Australia responds by easing visa rules and fast-tracking some of these skilled migrants, a trend I anticipate will continue for the next three years.
⚠️ I will do PLAB and then come to Australia via the competent authority pathway! First, let’s bust the first myth about the competent authority pathway because I get a lot of questions in this regard…. The most common question I get is, Sir, I will do PLAB and then come to Australia via the competent authority pathway. There is no problem with this. It is the most common registration pathway for migrant doctors from the UK in Australia. But statistically, most of these doctors are UK medical school graduates or British citizens, or predominantly white doctors. The number of migrant doctors from Pakistan and India who came to Australia from the UK is extremely low compared with white British graduates. Usually, when you pass PLAB and get your first job, then later join the training program, migrant doctors will adjust and keep moving forward on that pathway regardless of how hard it is. I think this is especially true if you have a wife who is also a professional maybe a doctor and kids in school and have developed some balance in the UK lifestyle. It's selfish to move an entire family for your professional development and that's why migrant doctors don't come here via the Competent Authority Pathway CAP). What about fresh migrant graduates without any family commitments who have passed PLAB and have worked in the UK for 12 months and might be single or have young kids? Exactly this was me when I moved here. I think this category would be better suited to come here through CAP. Just a word of advice, don't just come here for money's sake. When I came to Australia, I knew I wanted to join the Emergency Medicine training program, but I didn't even know what the salary was until I got my first paycheck. So, please don't do PLAB just because you're moving to Australia, do PLAB to explore every training and development opportunity, and if you're not getting anywhere, then yes, Australia will provide a very seamless move. Or do AMC right from the start, which is what we're going to cover in topics. |
Now, I will compare AMC and PLAB in the following categories
Real cost of Exams
Availability & Venue of exams
Pass rates
Job & Training opportunities
Financials
Working conditions (UK doctor strikes)
Lifestyle living index for Professionals
My conclusion and advice, based on 2 main categories
1. REAL COST OF EXAMs
Instead of exam fees, let's call it the actual cost of exams. In comparison with PLAB, the AMC is significantly more expensive. So why? Take a look at this.
| PLAB | +plus | AMC | + plus |
| PLAB 1 GBP 255 | OET GBP 320 | AMC part 1 MCQ Exam AUD 2,920 | EPIC verification AUD 600 |
| PLAB 2 GBP 934 | | AMC part 2 Clinical Exam AUD 4,130 | OET or IELTS AUD 550 |
Total fee | GBP 1,509 or (AUD 2,912) | | AUD 8,150 | |
For AMC,
you'll build a portfolio and get EPIC verification for about A$600. AMC1 cost A$2,920 and AMC2 is A$4,130 + OET $A550, so overall cost is A$8,150
For PLAB,
OET is £320, PLAB 1 is £255, and PLAB 2 is £934. In total, it's £1,509 or A$2,912
However, there is a catch. Unlike PLAB, you don't need AMC 2 to get the job. So cost to get registered AMC exam comes down to A$4,000 which is roughly half of the PLAB cost.
So getting registered through the AMC exam will cost you A$4000. But PLAB registration costs GBP1,509 or A$2,912. So, PLAB is obviously cheaper.
2. AVAILABILITY & VENUE OF EXAMs
PLAB | AMC |
PLAB 1 Available four times a year, anywhere. View the availability & venue here. PLAB 1 places. | AMC part 1 MCQ Exam Available several times a month, anywhere. View the dates here/ View the venues here. |
PLAB 2 Available in the UK only, on multiple dates every month. You can only view dates once you have your PLAB 1 results. View when & where you can take PLAB 2. | AMC part 2 Clinical Exam Available in Australia only, on multiple dates every month.View them here. |
PLAB vs AMC (availability & venue of exams)
Dates,
PLAB
The GMC is taking PLAB 1 registrations 12-18 months in advance, so from 18th March 2023 to February-May 2024. The date availability for November (if there is capacity) is mentioned. So, the average wait for doctors to book PLAB 1 is 12 months.
PLAB 2 is available in the UK only, on multiple dates a month. Dates can't be viewed until you've got PLAB 1 results.
AMC
Dates for AMC part 1 MCQ Exams are available every month. The AMC part 2 Clinical Exam is only available in Australia, on multiple dates a month.
Both AMC Part 2 and PLAB2 dates are hard to get (6-8 months wait times), but as I said before, you don't need to pass AMC 2 to get a job. Recently, more doctors have registered after passing AMC 1. And It's also possible to bypass AMC 2 with the WBA program.
So it seems AMC is a winner here as there are plenty of states for AMC 1 which is the minimum requirement to apply for jobs.
Venues,
There are multiple centers around the world where you can take AMC 1 and PLAB 1.
However, AMC 1 is a computer adaptive test (CAT) conducted by Pearson Vue, and this test has a lot more centers across the world than PLAB 1. PLAB2 is only conducted in Manchester, while AMC 2 is in Melbourne. Additionally, AMC 2 has an online version. Therefore, AMC is clearly the winner in this case.
3. EXAM PASS PartRATEs
PLAB | AMC |
PLAB 1 65-70% | AMC Part 1 MCQ Exam 50% |
PLAB 2 45 -55% | AMC Part 2 Clinical Exam 30% |
Might look better (Unreliable) | |
PLAB vs AMC (pass rates)
Part 1,
In terms of numbers, AMC 1 has a 50% pass rate compared to PLAB 1, which has 65-70%. But, here's a catch to these numbers.
To make an accurate comparison, you have to compare apples to apples. Top overseas medical university graduates take PLAB and USMLE, and thus these exams reflect great passing scores.
In my personal observation, the AMC 1 exam is taken mostly by people with large career gaps, mainly female doctors trying to return to work after marriage or kids, and a 50% pass rate is amazing to them.
In my own AMC 1 exam, I prepared for 3 weeks with full-time emergency resident work and 3 days of study leave and passed with ease since the questions are all practice medicine related.
Part 2,
The pass rate for PLAB 2 is 45-55%. AMC 2 pass rates are half that at 30%, but AMC no longer publishes them.
While I work with some of these doctors in our AMC Clinical courses, I'd say they lack work experience and that's why they don't pass.
However, It's good to know that AMC 2 isn't necessary to get a first job. Once you get the job, you can join the WBA program and skip this AMC 2.
PLAB might look like the winner, but factually, I think this is a tie because we aren't comparing apples to apples.
4. JOBS & TRAINING OPPORTUNITIEs & CHOICE OF SPECIALITY
Job Opportunities | PLAB | AMC |
Training | ↑ | ↓ |
Non-training | ↑ | - |
Stress- Burnout | ↑ | ↓ |
Supervised Practice | ↓ | ↑ |
Overall | Better | |
PLAB vs AMC (job opportunities)
The UK has more openings for IMGs, both in training and in non-training. Overall, Australia has low training positions, and more competitive specialties are harder to get into. Although you can get a job on a visa in Australia, you must have full registration and permanent residency before you start training in almost all specialties. This usually takes about 12-18 months after your first job plus you also have to pass AMC2 or WBA or get permanent residency in another way to get it.
Click here to get a better idea of the number of training positions and competition. View Choose a career.
Generally, I think training in the UK and Aus is very similar, but extreme stress and burnout in the NHS could affect UK training.
The other thing is, trainees in Australia are very well supervised. Junior doctors are encouraged to run everything by their consultants. In every hospital, there's a trainee support department like DEPT and trainee well-being is a big part of the Australian work culture. Also, from my own experience and the trainees I've talked to, particularly in emergency medicine, the Australian system is more thorough and it doesn't work like a quick referral system in the UK. Australia also has more demand for specialties like Emergency Medicine, ICU, Paediatrics, Psychiatry, Acute Medicine, Geriatric Medicine, and General Practice.
In general, the UK has more job and training opportunities than Australia. Therefore, PLAB wins here due to more openings.
5. FINANCIALs
| PLAB | AMC |
Average Job Salary | ↓ | ↑ |
PLAB vs AMC (financials)
These days, this might be the most important factor for IMGs to consider in Australia.
A first-year resident's salary in Australia is around AUD 120K, compared to AUD 71K for FY2 in the UK. Australia has 2-3x higher consultant salaries than the UK, which is why many doctors and GPs want to migrate there. Australia also has a lot of private work. So, here, Australia wins.
6. WORKING CONDITIONs
Perhaps this is the most important reason to choose between Australia and the UK. Here's why you should choose Australia over the UK.
I worked as a Senior House Officer (SHO) in Alexandra Hospital Redditch Emergency Department in 2005. From 2 am until 8 am, I was the only junior emergency doctor there. It was like I'd run head over heels putting catheters and cannulas in, working in resuscitation, and calling specialty doctors who have the patients admitted and want everything done. It was well before COVID, but I sensed the cracks ... soon after that, I left for Australia.
Since then, the NHS staff crisis has steadily gotten worse, especially after 2018:
Brexit (the UK's withdrawal from the European Union in 2020) will limit EU staff's ability to come and work.
A lack of pay raises
Staff leaving because of stressful CoVID situations and an ongoing shortage of staff
In late 2022, Nuffield Trust, an independent think tank, published a report saying Brexit has left NHS short of 4000 doctors in key areas. However, the BBC reported in July 2022 that the NHS was understaffed by 12,000 hospital doctors and 50,000 nurses and midwives.
Various surveys and polls in the UK show doctors are overworked, underpaid, unappreciated, and have no supervision. There is an average wait time of 12-16 hours for patients in EDs, according to my colleagues. Without a doubt, with these staff deficiencies, the training and well-being of all staff is at risk, if not short-term then long-term.
Now how about Australia ...how's the health sector doing?
As per ACEM, there are 28% specialist trainee positions, 30% junior doctor positions, and 10% senior doctor positions open in Emergency. Sometimes the ED waitlist is unmanageable, and sometimes it's manageable. It's fair to say Australia doesn't have the same shortages as the NHS.
Australians have quickly realized they can't get UK and Irish staff anymore due to covid restrictions, so they started hiring local IMGs and gladly that trend continues along with the opening of borders, which eases some of the pressure. Plus, there's a smaller population here than in the UK, and there's also a private health system which reduces some pressure. However, nursing shortages are a problem, and aged care is the worst hit.
In the past year, I've been getting calls from emergency consultants in the UK and Qatar who want jobs in Australia. Still, Australia seems to be doing much better than the UK at this point. So Australia (AMC) wins here.
7. LIFESTYLE LIVING INDEX FOR PROFESSIONALs
It can be very personal and there's no right or wrong answer here. Australia is a huge country with 80% of the population living near the coast. There are more outdoor activities and pleasant weather. So the lifestyle is more relaxed and nature-loving. In addition to high wages, the quality of living is among the best in the world. Australia's migrant communities are well established, there are a lot of Chinese, Middle Eastern, South East Asian, British, and European immigrants, so new migrants feel more at home. Australians have also become more accepting of new cultures and religions in the last decade.
There was a concern that Australia is very far away from other migrant and tourist countries, I think this isn't true… Airports in Sydney and Melbourne are the busiest in the region, and Sydney is building another airport in the West that will take over the main Sydney Airport. Most capital city airports have daily direct flights to major connecting hubs like Dubai, Singapore, and much of Europe. If I want to go to Karachi, I can catch a flight every day and be there in 18 hours. Also, nearby tourist destinations are Malaysia, Thailand, Singapore, Japan, South Korea, Indonesia, New Zealand, etc. It's kind of like the US in that way.
As well, the UK has a very well-established migrant community. It's closer to Europe and the US and it's got direct flights to most subcontinental countries. However, the wages, working conditions, and weather make the overall lifestyle meaningless. I mean, if you don't want to know there are better options, you can be happy there. So overall, Australia definitely takes the cake here, in my opinion.
8. My CONCLUSION AND ADVICE BASED ON 2 MAIN CATEGORIEs
Which is better, UK/ PLAB or Australia/ AMC? Well, it depends on your situation. You decide. What I can say is…
Still, the UK would be a better option if you're a fresh junior doctor looking to leave your country of origin after your internship or first year of residency. You're young, probably single, and you don't mind a bit of extra work to take PLAB (but finding a date might still be an issue)...And yes, you can choose to come to Australia later via the competent authority pathway if you don't like the UK ...but will you? As humans we're creatures of habit ... & statistically, migrant doctors who have done PLAB and come to Australia via CAP are far fewer than British medical graduates doctors.
On the other hand, Australia is a great place for you, if you've got 2-3 years of clinical experience after your internship and want long-term financial and professional stability along with a relaxed lifestyle.
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