Whether you sit PRES Level 2 depends on the Medical Council's assessment of your application. You need a basic medical degree from a recognised school, verified through EPIC, plus a passport copy, evidence of communication skills and Certificates of Good Standing. If you hold an accepted alternative (PLAB Part 1, USMLE Step 1 and Step 2 CK, MCCQE Part 1 or AMC MCQ) you can go straight to Level 3. Passing PLAB Part 2 exempts you from PRES altogether. In June 2026 the Council consulted on widening these exemptions. We could not confirm the outcome. Checked 25 October 2026.
Who may be required to sit PRES
The Council says that doctors seeking registration in the general or trainee specialist division may be required to sit the PRES. The word "may" matters. The Council works out from your application whether you must sit Level 2, go to Level 3 or are exempt. All applicants on the PRES route apply online and submit documents so that the Council can decide.
The Council's rules are set out in a statutory instrument, S.I. No. 480/2010, Medical Council Rules Specifying Pre-Registration Examinations and Exemptions. It states, among other things, that Level 2 must be passed before Level 3, that a candidate has a maximum of three attempts at each level, and that a pass is valid for two years. The exam page and the Handbook put the same limits in plain language.
The documents the Council asks for
The Level 2 information page lists the documents. Read it carefully, because an application that does not meet the route requirements is closed and the fee is not refunded.
- A basic medical degree from a recognised medical school. The Council advises checking the World Directory of Medical Schools. Before you submit, upload the degree to EPIC and have it verified.
- A passport. After submitting, upload a notarised or attested copy of your current passport to your Doctor's Portal.
- Evidence of effective communication skills. Also uploaded to the Doctor's Portal.
- Certificates of Good Standing or Current Professional Status. An original, dated within the last three months, sent directly to the Council from every registration body where you have held registration in the last five years.
The Council says not to submit any documents by post. Certificates of Good Standing from several countries can take weeks, and they expire after three months. Order them so that they all arrive inside that window.
We do not set out which English test results the Council accepts as evidence of communication skills, because the Level 2 page we read does not list them. Check the Council's current requirements, and do not rely on forum advice.
Accepted alternatives to Level 2
If you already hold one of the exams below, you may not need to sit Level 2. The Council's Level 2 page lists these as accepted alternatives, and applicants with one can apply directly for Level 3.
| Alternative | What the Council page says |
|---|---|
| PLAB Part 1 | Listed with a two-year validity period tied to 31 March 2025. An earlier Council notice referred to three years. Check the live page for the rule that applies to your result date |
| USMLE Step 1 and Step 2 CK | Accepted if dated within seven years |
| MCCQE Part 1 | Listed as accepted |
| AMC MCQ | Listed as accepted. Validity is set by the awarding body |
The Council made this change for new applicants from 1 January 2016: an applicant who holds an accepted alternative no longer has to sit Level 2. That is why the candidates who actually sit Level 2 are mostly doctors with none of those results.
Full exemption: PLAB Part 2
The Council's overview page says you can be exempted from the PRES if you have passed PLAB Part 2. You must pass PLAB Part 1 before you can sit PLAB Part 2, so this route runs through both UK exams. The Council states that there is no reciprocal arrangement with the GMC: the GMC does not recognise PRES Level 2 or Level 3 for registration in the UK. If you want to keep UK and Irish options open, that asymmetry matters. Our comparison of PRES Level 2 and PLAB 1 works through the trade-offs, and the PLAB 1 hub covers the UK side.
The June 2026 consultation
News reports in 2026 described a public consultation in which the Council proposed recognising PLAB 1 as an exemption from PRES Level 2, and PLAB 2 as an alternative to PRES Level 3. According to the reports, the consultation closed on 22 June 2026. We searched for the outcome and could not find a Council page confirming that the rules have changed. Until the Council says so on its own pages, treat the existing list above as the rule.
If a decision is pending on the day you apply, do not assume a change will help you. Ask the Council in writing which rules apply to your application date, and keep the reply.
A decision guide
| If you hold | Likely route | Do first |
|---|---|---|
| Nothing from the list | Level 2, then Level 3 | Submit documents, wait for eligibility, prepare for Level 2 |
| PLAB Part 1 within its validity | Level 3 directly, per the Level 2 page | Confirm validity on the live page |
| USMLE Step 1 and Step 2 CK within seven years | Level 3 directly | Check dates on your transcripts |
| MCCQE Part 1 or AMC MCQ | Level 3 directly | Check validity with the awarding body |
| PLAB Part 2 passed | Exempt from PRES | Apply to the Council on that basis |
Questions to put to the Council in writing
Some points depend on your own history, and the Council pages cannot answer them. If your case is unusual, write to the Council and keep the reply with your records. Sensible questions include whether a particular exam result you hold is accepted and for how long, which rules apply if you sat an exam before a recent change, whether a document that is not in English needs a certified translation, and what happens to your timeline if you are waiting for a certificate from a registration body that is slow to respond.
Ask for answers in writing, and quote the date and your reference number in later emails. A short written answer from the Council is worth more than any amount of advice from forums or recruitment agencies, and it protects you if the rules change between the day you ask and the day you apply.
How eligibility connects to your timeline
Three clocks run side by side, and it helps to write them on one page. The first is the validity of any accepted alternative exam you hold, for example PLAB Part 1 or a USMLE result, which can lapse. The second is the three-month life of each Certificate of Good Standing. The third is your two-year attempt window, which starts when the Council declares you eligible. Candidates sometimes pass the first hurdle and lose time because a certificate expired while the Council was assessing another document. Order certificates late in the process, but not so late that they hold up the assessment.
Documents checklist
Print this list and tick it off. Degree uploaded to EPIC and verified before you submit. Passport copy notarised or attested. Evidence of effective communication skills ready to upload. Certificate of Good Standing ordered from every registration body in the last five years, each dated within three months. A note of every date, reference number and email you send. A plan for what to do if one body is slow, such as asking it early and asking the Council what it will accept in the meantime.
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Mistakes that cost candidates months
- Sitting an exam you did not need. Check your results against the accepted list before you pay for Level 2.
- Letting Certificates of Good Standing expire. They must be dated within three months of submission and come from every registration body in the last five years.
- Applying for a sitting before you are eligible. You can only book once the Council has told you in writing that you are eligible.
- Assuming the GMC will accept PRES. It does not.
- Using old information. The PLAB validity rule changed. The Handbook is dated May 2023. When the Handbook and a live page disagree, use the live page.
Where this fits in your plan
Eligibility comes before preparation in time, because your two-year window starts when the Council declares you eligible, not when you start studying. Do not begin your 16-week plan until you know your eligibility date and the next application deadline. The booking and fees guide shows the dates and the process once you are eligible, and the study plan shows how to time your preparation to them.
Why the rules keep moving
The list of accepted alternatives has changed more than once. A 2016 change removed the need for Level 2 for many applicants, the PLAB Part 1 validity period appears in two forms across Council pages, and a 2026 consultation proposed further changes. Treat any summary, including this one, as a snapshot with a date on it. The safest habit is to open the Council's Level 2 page and the exemptions page on the day you decide, and to save a copy of what they said.
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Frequently asked questions
Who has to sit PRES Level 2?
Doctors seeking registration in the general or trainee specialist division may be required to sit the PRES. The Council decides from your application.
Which exams can replace Level 2?
The Council's Level 2 page lists PLAB Part 1, USMLE Step 1 and Step 2 CK (within seven years), MCCQE Part 1 and AMC MCQ. Check validity on the live page.
Does PLAB 2 exempt me from PRES?
The Council's overview page says you can be exempted from the PRES if you have passed PLAB Part 2.
What happened with the June 2026 consultation?
News reports described a consultation on recognising PLAB 1 and PLAB 2. We found no Council page confirming the outcome, so treat the current list as the rule.
What documents do I need?
An EPIC-verified basic medical degree, a notarised or attested passport copy, evidence of communication skills, and Certificates of Good Standing dated within three months from every registration body in the last five years.