PLAB 1 Format: 180 Questions, Three Hours and the F2 Standard Explained

The GMC describes PLAB 1 in one sentence that should guide every hour of preparation: it "tests your ability to apply your knowledge for the care of patients", not to recall facts. The paper is an applied knowledge test (AKT) of 180 single-best-answer questions, each beginning with a short clinical scenario, answered in three hours. It is built on the Medical Licensing Assessment content map and is "compliant with the MLA requirements". This article explains what that means in practice.

The paper

• 180 questions, five options each, one correct. Answers are recorded on a double-sided answer sheet at paper-based sittings.
• Three hours, which is one minute a question with no section breaks.
• The standard: the conditions a doctor starting Foundation Year 2 (F2) in the UK would be expected to manage, including common, important and acute presentations seen in emergency departments and the management of long-term conditions in primary care. It excludes the advanced duties of a GP.
• The reference frame: current best practice in the UK, equipment routinely available in UK hospitals, and published evidence rather than local arrangements.

The MLA content map

Since PLAB became MLA-compliant, "the questions and stations used in PLAB are based on the MLA content map", which the GMC says "sets out the core knowledge, skills and behaviours needed for UK practice". The map is organised around three themes: readiness for safe practice, managing uncertainty, and delivering person-centred care. The GMC calls it a live document and commits to timely revisions, so revision resources should follow the current map rather than an older syllabus. The regulator also notes that the compliance changes affected how the exam is built and quality-assured rather than what candidates must do; those who sat PLAB before compliance and retake it "will notice very little difference".

What "applied" means for revision

1. Learn presentations, not just diagnoses. Questions start from a patient, a symptom and a setting. Knowing the single next step for a presentation is worth more than knowing twenty facts about a disease.
2. Know UK pathways and drug names. Management follows UK guidance, and drug names follow the British National Formulary. Pakistani candidates lose marks on first-line choices that differ from home practice.
3. Cover the three themes deliberately. "Managing uncertainty" and "person-centred care" produce questions about safety-netting, communication, consent, capacity and prioritisation that a purely clinical revision plan misses.
4. Practise at one minute a question. The paper does not reward slow brilliance. Timed 180-question mocks are the only reliable rehearsal.

Booking, venues and attempts

PLAB 1 is booked through GMC Online and sat in UK, EU and overseas venues; Pakistan's venues are Islamabad and Karachi. The exam currently runs four times a year, with overseas sittings reducing to three from February 2027 and four overseas sites closing. A candidate may keep sitting until four failed attempts; a fifth requires an additional-attempt application. Registrations can close two to six weeks before a test date, so book early.

What this means for you

Prepare for PLAB 1 as a UK F2 doctor's working day in question form: common presentations, next steps, UK guidelines, and the professional judgement the content map's themes describe. FAME's PLAB 1 package maps its question bank to the MLA content map and includes three-hour, 180-question timed mocks.

Two questions candidates ask

How is the pass mark set? The GMC's "What is the PLAB 1 exam?" page does not describe the method; it points to its results and PLAB reports pages, which explain how results are reported for each sitting. Treat any fixed "pass percentage" quoted elsewhere as unverified.

How often can I sit it? The exam runs four times a year at present, in February, May, August and November, with overseas sittings reducing to three a year from February 2027. The attempt rules (four fails, then an additional-attempt application) apply across sittings.

Sources and references

• GMC: What is the PLAB 1 exam? (format, standard, reference frame)
• GMC: PLAB 1 and the MLA requirements
• GMC: Medical Licensing Assessment (content map themes)
• GMC: Information on booking a PLAB 1 place (attempts, booking windows)