PRES Level 2 or PLAB 1? Two Written Exams Compared

Side by side

The PLAB 1 figures come from GMC pages summarised in our PLAB 1 hub. The PRES figures come from Medical Council pages. Where one side publishes a number and the other does not, the gap is real, not a gap in our research.

The key difference is what each exam unlocks

The two exams are not interchangeable in the direction you might hope. A PLAB Part 1 result can be accepted by the Medical Council in place of Level 2, according to the Council's Level 2 page, so you move straight to Level 3. A PRES result is worth nothing to the GMC. The Council's overview page states that there is no reciprocal arrangement with the GMC to recognise PRES Level 2 or Level 3.

Passing PLAB Part 2 exempts you from PRES entirely. So the UK route can open the Irish door, and the Irish route cannot open the UK door. That asymmetry is the main factor in the choice for doctors who may work in either country.

Which exam fits which doctor

• You want to work only in Ireland. If the Council requires you to sit Level 2 and you hold no accepted alternative, Level 2 is the direct route. If you already hold an accepted alternative, you may not need it.
• You want to work only in the UK. PRES does not help. Go to PLAB.
• You might work in either country. PLAB keeps both doors open, because a PLAB 1 pass can stand in for Level 2 and a PLAB 2 pass exempts you from PRES. The price is two exams and a larger total fee.
• You have USMLE, MCCQE Part 1 or AMC MCQ. The Council lists these as accepted alternatives. Check validity and see whether you can go straight to Level 3.

How the content differs

The clinical medicine is largely the same. Appendicitis, eclampsia and lithium toxicity do not change at the border. What changes is the surrounding practice. PLAB 1 questions are written to UK best practice and the MLA content map. PRES questions sit in an Irish setting: the HSE rather than the NHS, the GP and the emergency department, Tusla and the Garda in child protection, and Irish law for capacity, mental health and termination of pregnancy. The Council's Guide to Professional Conduct and Ethics frames professional questions.

If you prepare for one, you can reuse perhaps most of your medical knowledge for the other. That is our judgement, not a measured figure. You cannot reuse the local layer. Expect to spend extra time on:

1. Screening and immunisation. The ages and intervals differ from NHS programmes. See the Irish guidelines guide.
2. Law and consent. Different statutes, different bodies and different wording.
3. Prescribing sources. The Irish Medicines Formulary and HPRA guidance instead of the BNF, with NICE or BNF used only where Irish guidance is missing.
4. The exam's metrics. PLAB 1 gives a question count and a time; for PRES you pace by the clock alone.

Cost and time compared

The exam fees alone are not a full comparison. PLAB 1 is £283 and PLAB 2 is £1,036 from 1 April 2026, per GMC pages in our hub. PRES Level 2 is a listed €352 and Level 3 €1,500. Add application, verification, travel and accommodation. A route that needs one exam in Ireland can cost less than the UK pair, while a route that requires both countries' exams costs more than either. We have not converted currencies, because exchange rates move and the fee pages will be updated before this page is.

Time matters as much as money. Level 2 has had two published sittings in 2026, and PLAB 1 has four a year. Both have result delays of about six weeks. If you need to start work by a particular date, count back from the final exam in your route, not the first.

Sample scenarios

Three short cases show how the choice works in practice. Each is an illustration, not advice for your case.

• A doctor with no UK or US exam, aiming only for Ireland. If the Council requires Level 2, the straight route is Level 2 then Level 3. The costs are the Level 2 and Level 3 fees plus the document costs, and the timeline depends on sitting dates and eligibility.
• A doctor with a recent PLAB 1 pass, aiming for Ireland. The Council's Level 2 page lists PLAB Part 1 as an accepted alternative within its validity period, so Level 2 may not be needed. The doctor goes to Level 3 directly after checking validity. The open question is how the validity rule applies to the date of the result.
• A doctor with no results, unsure between the UK and Ireland. Choosing PLAB keeps both doors open at a higher total fee. Choosing PRES commits to Ireland. The doctor should decide the country first, then the exam, and not the reverse.

What stays the same

Whichever exam you sit, the underlying habits are the same. Learn the common conditions broadly. Practise single-best-answer questions under time. Review every miss. Treat the regulator's own pages as the final authority on fees, dates and rules. Keep your documents current. And avoid recalled questions, which both regulators treat as misconduct. Doctors who build these habits for one exam find the second easier, even though the local layer has to be learned again.

Things to check before you pay for either exam

• The current fee on each regulator's own page, because both change.
• Whether your qualification and documents meet that regulator's eligibility rules.
• The next sitting date and application deadline, and whether you can be ready.
• Whether any exam you already hold is accepted instead.
• Whether the Medical Council has changed its list of accepted alternatives since the June 2026 consultation.

Should you prepare for both?

Only if your plans require both. Studying for two exams at once splits your attention across two sets of local rules, and the local layer is where marks are lost. A better sequence is to settle your route first, then prepare for the exam that route needs, then reuse your notes if you later sit the second. If you do prepare for both, keep separate "local rules" notebooks for the UK and Ireland, so you never answer an Irish question with an NHS reflex or the reverse.

Questions to ask before you choose

1. Which country do you want to register in first? The first registration shapes the rest.
2. Do you already hold any accepted alternative? If so, check validity dates now.
3. What is your deadline? Registration, visa or job offer dates decide how many sittings you can afford to miss.
4. Do you want your options open? If yes, PLAB is the wider route, with a higher total fee.
5. Have you read both regulators' current pages this month? Rules and fees have both changed recently.

The booking and fees guide shows the Irish steps in detail, and the PLAB 1 hub does the same for the GMC's exam.

The bottom line

Choose the exam that matches the country where you need to register first, check whether an accepted alternative already covers you, and compare total costs rather than exam fees alone. The two exams look alike on the surface and differ in what they unlock, what is published about them and which local rules they test.