Country Comparison
Last verified 2026-09-08
| Factor | USA · USMLE | UK · PLAB | Australia · AMC | New Zealand | Canada · MCCQE |
|---|---|---|---|---|---|
| Exam structure | Step 1, Step 2 CK, Step 3 (sequential); ECFMG Certification required for IMGs before residency | PLAB 1 (written MCQ) then PLAB 2 (OSCE) | CAT MCQ, then Clinical Examination or Workplace Based Assessment | NZREX Clinical (OSCE-style), or accepted alternatives (PLAB/AMC) under the Examinations pathway | MCCQE (formerly MCCQE Part I) plus the NAC Examination for IMGs applying to residency through CaRMS |
| Assessment type | Computer-based MCQ (Step 1, Step 2 CK); Step 3 combines MCQ and case simulations | MCQ (Part 1) + OSCE (Part 2) | Computer-adaptive MCQ + OSCE-style Clinical Exam (or workplace-based alternative) | OSCE-style clinical exam | Computer-based MCQ (230 questions in two sections) + OSCE (NAC, 12 stations) |
| Preparation intensity (indicative only) | High, three sequential exams, each requiring dedicated preparation | Moderate-High, two-part sequence, shorter overall than USMLE's three-Step sequence | Moderate-High, two-part sequence (MCQ + Clinical/WBA) | Moderate, single clinical exam, but registration also requires independently securing a PGY1 role afterward | High, two exams followed by a competitive residency match |
| Country / registration authority | United States, no single national regulator; state medical boards license, informed by ECFMG/USMLE results | United Kingdom, General Medical Council (GMC), single national regulator | Australia, Medical Board of Australia, single national regulator (AMC assesses) | New Zealand, Medical Council of New Zealand (MCNZ), single national regulator | Canada, Medical Council of Canada for the exams; licences issued by provincial and territorial medical regulators |
| Typical eligibility considerations | Medical school must be listed appropriately in the World Directory of Medical Schools for ECFMG purposes | Not otherwise eligible via a UK/EEA qualification or an alternative GMC route (Portfolio Pathway, acceptable postgraduate qualification) | Medical school eligibility checked against WDOMS; not otherwise eligible for Competent Authority or Specialist pathway | No Comparable Health System or Competent Authority eligibility already established (these skip NZREX for qualifying candidates) | Medical school listed in the World Directory with a Canada Sponsor Note; degree source-verified through physiciansapply.ca; up to 4 MCCQE attempts |
| Major current risk / recent change | Residency match (via NRMP, not covered in this V1 comparison in detail) is separately competitive for IMGs, not guaranteed by ECFMG certification alone | The Medical Training (Prioritisation) Act 2026 now legally deprioritises non-UK/Ireland-trained doctors for Foundation/specialty training places | Internship (PGY1) is not guaranteed for international students who studied medicine in Australia, and is a separate, competitive state-run process for IMGs generally | Registration (Examinations pathway) requires independently securing a PGY1 role after passing NZREX, not automatic | Passing the exams does not guarantee a residency position; IMG places through CaRMS are limited and competitive |
Source (USMLE): USMLE Program, https://www.usmle.org/ · verified 2026-09-08
Source (USMLE): ECFMG, https://www.ecfmg.org/certification/ · verified 2026-09-08
Source (PLAB): General Medical Council, https://www.gmc-uk.org/registration-and-licensing/join-our-registers/registration-applications/application-guides/full-registration-for-international-medical-graduates · verified 2026-09-08
Source (PLAB): UK Government (legislation.gov.uk), https://www.legislation.gov.uk/ukpga/2026/7 · verified 2026-09-08
Source (AMC): Australian Medical Council, https://www.amc.org.au/pathways/standard-pathway/ · verified 2026-09-07
Source (AMC): University of Melbourne, https://medicine.unimelb.edu.au/study/current-student-resources/md-students-resources/internships/working-as-a-medical-practitioner-in-australia · verified 2026-09-07
Source (NZ): Medical Council of New Zealand, https://www.mcnz.org.nz/registration/getting-registered/registration-exam-nzrex/ · verified 2026-09-08
Source (CA): Medical Council of Canada (MCCQE), https://mcc.ca/examinations-assessments/mccqe-part-i/ · verified 2026-09-17
Source (CA): Medical Council of Canada (NAC Examination), https://mcc.ca/examinations-assessments/nac-examination/ · verified 2026-09-17
Fees, timelines and eligibility change over time. Always confirm current requirements with the official authority before deciding.
Verified facts, with their sources
Each statement comes from the official source linked beside it and shows when EduPath last checked it.
Australia · AMC
- The AMC CAT MCQ examination has 150 single-best-answer questions in one 3.5-hour session: 120 scored and 30 unscored pilot questions.Australian Medical Council (AMC), AMC Examination Specifications (MCQ) · verified 2026-09-13
- An Australian medical degree does not guarantee an internship (PGY1) position for an international student; international graduates sit in a lower, non-guaranteed priority category in most states.University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, Working as a Medical Practitioner in Australia · verified 2026-09-07
- The AMC Standard Pathway requires primary source verification, the CAT MCQ examination, and either the Clinical Examination or Workplace Based Assessment before an AMC Certificate is issued.Australian Medical Council (AMC), Standard Pathway · verified 2026-09-07
New Zealand
- NZREX Clinical has 12 scored OSCE stations of 12 minutes each (2 minutes reading, 10 minutes in the station), plus pre-reading and rest stations. Seven domains can be assessed; communication, professionalism and cultural safety are assessed at every station.Medical Council of New Zealand (MCNZ), NZREX Clinical: Candidate handbook (September 2024) · verified 2026-09-13
- International medical students at Otago should expect to complete registration requirements in their home country, as New Zealand training places for international graduates are limited.University of Otago, Information for international medical students · verified 2026-09-08
- NZREX Clinical is the examination-pathway route to MCNZ registration for international graduates; after passing, a candidate must secure a PGY1 role before registration is granted.Medical Council of New Zealand (MCNZ), NZREX Registration Exam · verified 2026-09-08
UK · PLAB
- PLAB 1 is a written exam of 180 single-best-answer questions, each with five options, answered in 3 hours.General Medical Council (GMC), A guide to the PLAB test · verified 2026-09-13
- PLAB is a two-part test (PLAB 1 written, PLAB 2 OSCE) used by the GMC to assess international medical graduates. Alternative routes include the Portfolio Pathway and acceptable postgraduate qualifications.General Medical Council (GMC), Full registration for international medical graduates · verified 2026-09-08
- UK and Ireland (and named EEA) medical graduates must be offered Foundation and specialty training places before other applicants, including PLAB-route international graduates.UK Government (legislation.gov.uk), Medical Training (Prioritisation) Act 2026 · verified 2026-09-08
USA · USMLE
- USMLE Step 2 CK weights physician tasks as: Diagnosis 16-20%, Laboratory/Diagnostic Studies 13-17%, Mixed Management 12-16%, Pharmacotherapy 8-12%, Clinical Interventions 6-10%, Health Maintenance and Prevention 5-10%, Professionalism 5-7%, Patient Safety 5-7%.USMLE Program (FSMB and NBME), Step 2 CK Content Outline and Specifications · verified 2026-09-13
- USMLE Step 1 applies foundational science to medicine; its official system bands include Reproductive and Endocrine 12-16%, Behavioral Health and Nervous Systems 10-14%, Cardiovascular 7-11% and Respiratory with Renal/Urinary 11-15%.USMLE Program (FSMB and NBME), Step 1 Content Outline and Specifications · verified 2026-09-13
- ECFMG Certification is required before an international medical graduate can enter ACGME-accredited residency training in the United States.Educational Commission for Foreign Medical Graduates (ECFMG), ECFMG Certification overview · verified 2026-09-08
- USMLE consists of Step 1, Step 2 CK and Step 3. International medical graduates must also obtain ECFMG Certification.USMLE Program (sponsored by FSMB and NBME), USMLE Step Exams overview · verified 2026-09-08
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