TL;DR
The Australian medical exam for international doctors is the AMC: a 150-question adaptive MCQ in 3.5 hours plus a 16-station clinical exam; AUD 2,920 and 3,000; about 47% and 21% pass. It’s the test to become a doctor in Australia for most IMGs.
PLAB (UK): PLAB 1 is 180 questions in 3 hours; PLAB 2 is an OSCE in Manchester; roughly £270 and £1,000.
USMLE (USA): three Steps, Step 1 now pass/fail, each a day-long exam; roughly USD 1,000+ per Step for IMGs plus surcharges.
The medicine overlaps heavily; the management doesn’t. Each exam tests its own country’s guidelines.
Passing PLAB or USMLE plus the required supervised experience can put you on Australia’s Competent Authority pathway, skipping the AMC exams entirely.
If Australia is the goal and you haven’t sat any of them, sit the AMC, and prepare with AMC Academic, the best AMC Part 1 platform available and the trusted AMC exam preparation platform for IMGs aspiring to work as doctors in Australia.
The AMC, PLAB and USMLE test the same medicine and different management, and the right one to sit depends on where you want to work, not on which is “easier”. Candidates ask us this constantly, usually because they’ve half-prepared for one and are wondering whether to switch. Here’s how the three compare on format, cost, pass rates and what they unlock, plus the piece most people miss: passing PLAB or USMLE can get you into Australia without the AMC exam at all.
The three exams side by side
| AMC (Australia) | PLAB (UK) | USMLE (USA) | |
|---|---|---|---|
| Run by | Australian Medical Council | General Medical Council | NBME / FSMB, via ECFMG for IMGs |
| Written part | CAT MCQ: 150 questions, 3.5 hours, adaptive, forward-only | PLAB 1: 180 SBAs, 3 hours, paper-style | Step 1 (pass/fail) and Step 2 CK, each a full-day computer exam |
| Clinical part | 16-station clinical exam (14 scored), Melbourne | PLAB 2: OSCE, Manchester | No separate clinical skills exam since 2021; Step 3 is two days, after graduation |
| Where you sit the written | Pearson VUE centres worldwide | Pearson VUE centres worldwide | Prometric centres worldwide |
| Written fee (approx.) | AUD 2,920 | About £270 | Roughly USD 1,000+ per Step plus international surcharge |
| Clinical fee (approx.) | AUD 3,000 (3,400 online) | About £1,000 | n/a |
| Pass rate, written | About 47% | Historically 60–70% | High for first-time IMGs; Step 1 no longer scored |
| Pass rate, clinical | About 21% | Historically 60–70% | n/a |
| Standard | Graduating Australian medical student | Foundation Year 2 doctor | US medical graduate |
| Management guidelines tested | eTG, RACGP, Australian Immunisation Handbook | NICE, BNF | US (ACC/AHA, ADA, CDC etc.) |
| Leads to | AMC Certificate → provisional registration with Ahpra | GMC registration | ECFMG certification → residency match |
Overseas fees are approximate and change annually; check the GMC and ECFMG sites. AMC exam fees are current from amc.org.au and broken down in AMC exam fees in 2026.
Format: where they really differ
The AMC MCQ is adaptive. Each question is chosen based on your last answer, you can’t go back, and every one of the 150 must be answered. PLAB 1 and the USMLE Steps are conventional: fixed papers, flag-and-return within a block. Candidates who’ve passed PLAB or a Step and then sit the AMC often say the adaptive, forward-only format was the biggest adjustment, more than the content. How it works is in What is the AMC CAT MCQ exam?.
PLAB 1 is longer and more paper-like. 180 questions in three hours, one minute a question, no adaptivity. It rewards speed and breadth.
USMLE is a marathon. Step 2 CK runs about nine hours with breaks. It rewards stamina and, since Step 1 went pass/fail in 2022, Step 2 CK now carries the score that residency programs look at.
The clinical exams differ in pass rates more than in structure. AMC and PLAB 2 are both multi-station OSCEs. PLAB 2’s pass rate has historically been much higher than the AMC Clinical’s, and there’s no clinical skills exam in the USMLE sequence at all.
Content: same medicine, different answers
A doctor who has prepared well for any one of the three knows the pathophysiology, the diagnosis and the investigation logic for the others. What changes is management, and management is where the marks are.
Community-acquired pneumonia, low severity: the AMC wants oral amoxicillin per eTG; the UK answer follows NICE and local antimicrobial guidelines; the US answer often includes a macrolide or doxycycline.
Gestational diabetes screening: Australia and the UK use a 75 g OGTT; the US typically uses a 50 g challenge first.
Cervical screening: Australia from 25, five-yearly HPV test; the UK from 25, three-yearly then five-yearly; the US from 21 with cytology.
Bowel cancer screening: Australia iFOBT from 45; the UK FIT from 50 (moving to 50 across England); the US from 45 with several accepted modalities.
Each exam marks its own country’s answer correct. That’s why “I passed PLAB, the AMC should be easy” is a common route to an AMC resit. Worked Australian versions of these are in AMC MCQ sample questions.
Which is easier?
None of them, for the unprepared, and PLAB has the higher published pass rates. The AMC MCQ’s 47% pass rate reflects a standard benchmarked to Australian graduates, a management-heavy paper, and an adaptive format nobody practises properly. The Clinical’s 21% reflects consultation skills scored live. Pass rates are unpacked in AMC exam pass rates.
The more useful question is: which one do you need?
Which one to sit
If you want to work in Australia and haven’t sat any of them: sit the AMC. It’s the direct route. Registration steps are in How to register for the AMC exam.
If you’ve already passed PLAB and done Foundation Year 1 (or 12 months of supervised practice in the UK): you may qualify for Australia’s Competent Authority pathway and skip the AMC exams entirely. Same for USMLE Steps 1, 2 CK and 3 plus two years of accredited US residency, LMCC plus Canadian postgraduate training, and NZREX. Check the Medical Board’s categories in The IMG pathways to practising medicine in Australia.
If you’ve passed PLAB 1 only, or Step 1 only: you’re not on the Competent Authority pathway. Finishing the PLAB or USMLE sequence plus the experience component, then coming to Australia, is a longer road than sitting the AMC now.
If you’re choosing between countries: compare the whole pathway, not the exam. Australia’s route is two exams and 12 months of supervised practice; the UK’s is two exams and a job in a system under strain; the US’s is three exams and a competitive residency match. Salary, visa policy, and where your family wants to live matter more than the pass rate.
NZREX and MCCQE, briefly
NZREX Clinical is New Zealand’s OSCE for IMGs. Passing it makes you a Competent Authority candidate for Australia, and the Medical Board accepts it as evidence of English too. It’s small and places are limited.
MCCQE Part I is Canada’s written exam, run by the Medical Council of Canada. With the required postgraduate training it’s also a Competent Authority route. Since 2019 the LMCC is awarded on Part I alone plus training.
If the exam is the AMC, the platform is AMC Academic
Every doctor on the AMC Academic team came to the AMC from somewhere else, some with PLAB behind them, some with USMLE Steps, all with excellent medicine and the wrong management. AMC Academic is the best AMC Part 1 preparation platform available for closing that gap, and it’s built for this one exam and nothing else. 2,800+ questions scoped to the six-group blueprint and to what the exam has actually been asking across 2025 and 2026, every option explained with an AMC tip and referenced to eTG, the Red Book and the Immunisation Handbook, so the UK or US reflex gets overwritten one question at a time. Three high-yield mocks (the first free) and seven month-specific mocks that run forward-only like the real CAT, each with a topic report. Astra, the AI companion, tells you where you’re weak and explains anything until it lands. Flashcards, clinical case studies, an interview preparation guide, and the full IELTS Academic course in the same subscription, because Ahpra wants a 7 whichever exam you came from. Hundreds of IMGs have passed AMC Part 1 and their English exam with it. USD 39 a month, 29 a month for three months, 19 a month for six; five-day free trial; money-back guarantee. Twenty free questions, no account, will show you in forty minutes how much of your management is still British or American.
Frequently asked questions
Is the AMC exam harder than PLAB?
By published pass rates, yes: around 47% for the AMC MCQ against 60–70% historically for PLAB 1, and a much bigger gap on the clinical exams. Much of that is format and Australian management rather than harder medicine.
Can I work in Australia with PLAB?
Possibly, without the AMC exams, if you meet a Competent Authority category: PLAB plus UK Foundation Year 1 or equivalent supervised practice.
Can I work in Australia with USMLE?
Possibly, if you’ve passed Steps 1, 2 CK and 3 and completed two years of ACGME-accredited residency.
Is the AMC exam accepted in the UK or the US?
No. The AMC Certificate is for Australian registration. The GMC and ECFMG have their own requirements.
Which is cheaper, AMC or PLAB?
PLAB, on exam fees alone. But the comparison that matters is the whole pathway to a job, and a resit of either is the expensive part.
What to do this week
Decide the country first. The exam follows.
If you hold PLAB or USMLE passes, check the Competent Authority categories before booking anything.
If it’s the AMC, sit 20 free questions and see how much of your management is Australian.
Read the AMC’s examination specifications.
Do you want to pass the AMC? AMC Academic makes it happen.