AMC vs PLAB vs USMLE for Indian and Pakistani Doctors: Which Exam to Sit, Costs in Rupees, and Which Is Easier (2026)

Indian and Pakistani doctors ask “AMC or PLAB or USMLE” as if it were a question about which exam is easier, and it’s really a question about where you want to live. The three exams test the same medicine and mark different management correct, and each unlocks one country. Many candidates arrive at the AMC after half-preparing for PLAB or USMLE, and this comparison is written for them. Here’s the format, the cost in your currency, the pass rates, what each leads to, and the piece South Asian candidates most often miss: a PLAB or USMLE pass can get you into Australia without the AMC at all.

The exams look alike on paper and feel nothing alike in the room. The AMC exam pattern is a single 150-question CAT MCQ sat in 3.5 hours: adaptive, forward-only and without negative marking. PLAB 1 is a conventional paper of 180 single-best-answer questions in three hours, and you can flag a question and come back to it. The USMLE spreads the written work across two full days, Step 1, which is now pass/fail, and Step 2 CK.

The clinical stage differs just as much. The AMC Clinical is a 16-station exam in Melbourne, where 14 stations are scored and nine must be passed. PLAB 2 is an OSCE in Manchester. The USMLE has no separate clinical exam at all; its third paper, Step 3, is a two-day exam sat after graduation.

Where you sit the written paper matters for Indian and Pakistani candidates. AMC exam centres in India are Pearson VUE venues in most major cities, seats in Pakistan are limited, and Dubai is the usual fallback. PLAB 1 is also delivered at Pearson VUE in India and Pakistan, while the USMLE Steps run at Prometric centres in both countries.

On cost, the AMC sits in the middle. AMC exam fees are AUD 2,920 for the MCQ (about ₹1.6 lakh or PKR 5.3 lakh) and AUD 3,000 for the Clinical in person (about ₹1.65 lakh or PKR 5.4 lakh). PLAB is the cheapest of the three: from 1 April 2026, PLAB 1 costs £283 (about ₹32,000 or PKR 1.1 lakh) and PLAB 2 £1,036 (about ₹1.2 lakh or PKR 3.9 lakh). The USMLE charges USD 695 for each of Step 1 and Step 2 CK, plus an international surcharge that brings them to about USD 905 and USD 930 respectively (roughly ₹76,000 to ₹78,000, or PKR 2.5 to 2.6 lakh, per Step), and candidates testing in India pay 18% GST on the surcharge. There is no USMLE clinical fee.

The pass rates tell you which exam is hardest per sitting. The AMC exam pass rate is about 47% for the MCQ and about 21% for the Clinical. PLAB's rates fell in 2025 to 62% for PLAB 1 and 60% for PLAB 2. First-time international graduates pass USMLE Step 1 at about 73% and Step 2 CK at about 90%, though in any AMC exam vs USMLE comparison a pass is only half the story, because it is the Step 2 CK score that decides your Match.

Part of the difference is the standard each exam is set at. The AMC marks you against a graduating Australian medical student, PLAB against a UK Foundation Year 2 doctor, and the USMLE against a US medical graduate. The rest is the guidelines each one marks as correct: eTG, the RACGP Red Book and the Australian Immunisation Handbook for the AMC; NICE and the BNF for PLAB; ACC/AHA, ADA, CDC and the other US bodies for the USMLE.

Finally, each exam opens one door. An AMC certificate leads to provisional registration with Ahpra. PLAB leads to GMC registration. The USMLE leads to ECFMG certification and, from there, the residency Match.

Format: where the AMC is different

The AMC MCQ is adaptive and forward-only. Each question is chosen from your last answer, you can’t go back, and every one of the 150 must be answered because blanks can void your result. PLAB 1 and the USMLE Steps are conventional: fixed papers, flag and return within a block. Candidates coming from PLAB or a Step consistently say the adaptive format, not the content, was the shock. NEET-PG and FCPS habits (skip if unsure, come back later) fail in it, which is why AMC Academic’s mocks are forward-only by design. USMLE is the stamina exam: Step 2 CK runs about nine hours. PLAB 1 is the speed exam: a minute a question.

Which is easier?

By published pass rates, PLAB. The AMC MCQ’s 47% reflects an Australian-graduate standard, a management-heavy paper and an adaptive format nobody rehearses; the Clinical’s 21% reflects live consultation skills. But an Indian or Pakistani doctor who prepares to the AMC’s format with Australian sources for three to six months, on a bank like AMC Academic’s that explains the Australian answer on every option, passes it at well above the headline rate. The useful question isn’t which is easier; it’s which country.

Which to sit

Australia, and you hold none of them: the AMC. Direct route, exams sittable from India (and sometimes Pakistan, otherwise Dubai), jobs after Part 1 under limited registration. You hold PLAB plus UK Foundation Year 1 (or 12 months of UK supervised practice): you may qualify for Australia’s Competent Authority pathway and skip the AMC entirely. Same for the full USMLE sequence plus two years of accredited US residency, LMCC plus Canadian training, and NZREX. You hold PLAB 1 only, or Step 1 only: you’re not on Competent Authority. Finishing the other sequence plus the experience component, then coming to Australia, is longer than sitting the AMC now. Choosing between countries: compare the pathways, not the exams. Australia is two exams and 12 months supervised practice into a system with regional shortages and strong IMG pay; the UK is two cheaper exams into a system under strain; the US is three exams and a competitive Match. Family, visa policy and salary matter more than a pass rate.

Test the Australian gap free before you choose

If Australia is on your list, the cheapest way to see how far your management is from Australian is a month of AMC Recalls: 100 recall-style questions rebuilt from a recent sitting’s reported topics, explained on every option with a recall tip, checked against Australian guidelines. It’s the best free AMC resource for an Indian or Pakistani doctor deciding whether the AMC gap is weeks or months. amcrecalls.com/tryout.

• Best first-attempt approach: AMC Academic as the main question bank

• Combine with the official free preparation app and the RACGP Red Book for screening ages and intervals

• Management-heavy items, month-specific mocks and performance tracking match the exam’s published weightings

More questions answered

Should I take the AMC, PLAB or USMLE?

Take the exam that leads to the country you want to work in, the AMC for Australia, PLAB for the UK or USMLE for the USA, because each tests the same medicine but marks its own country’s management as correct; PLAB has the highest published pass rates (historically 60–70% per part) and the AMC MCQ the lowest (about 47%), and doctors who already hold PLAB with UK Foundation Year 1, or the full USMLE sequence with two years of US residency, can usually reach Australia through the Competent Authority pathway without sitting the AMC. If Australia is the choice, AMC Academic’s explanations focus on where Australian management differs.

The formats differ more than people expect. The AMC MCQ is 150 questions in 3.5 hours, adaptive and forward-only; PLAB 1 is 180 questions in three hours with review allowed; USMLE Step 2 CK is a full nine-hour day, and Step 1 is now pass/fail. Costs differ too: AMC AUD 2,920 and AUD 3,000; PLAB roughly £270 and £1,000; USMLE roughly USD 1,000 or more per Step plus surcharges. And the answers differ where management is concerned: Australia screens for bowel cancer with iFOBT from 45 and cervical cancer with a five-yearly HPV test from 25, treats low-severity pneumonia with amoxicillin, and since July 2026 gives adults a single 21-valent pneumococcal vaccine.

Holding PLAB 1 or USMLE Step 1 alone doesn’t qualify you for the Competent Authority pathway, and finishing the other sequence is usually slower than sitting the AMC. An AMC certificate isn’t accepted in the UK or the USA.

Is the AMC the same as AHPRA, and is there an AHPRA licensing exam?

No, the AMC and AHPRA are separate organisations and there is no AHPRA licensing exam: the Australian Medical Council verifies medical qualifications, sets and runs AMC Part 1 and the Clinical exam, and issues the AMC certificate, while Ahpra, on behalf of the Medical Board of Australia, decides your pathway, applies the English and criminal-history standards, approves your job and supervisor, and grants registration. Of these steps, AMC Part 1 and the English test are the two you can prepare for, and AMC Academic covers both.

For a Standard pathway IMG the order is: AMC portfolio and ECFMG verification, AMC Part 1 (AUD 2,920), an English test, the AMC Clinical or a Workplace Based Assessment, the AMC certificate, a job offer, an application for provisional registration in the Ahpra portal, 12 months of supervised practice, and general registration. The Board can grant limited registration for a supervised job after Part 1 and the English test, before the Clinical. “AMC registration” only means opening an AMC account and portfolio; it isn’t permission to practise. Australia also doesn’t use the term “medical licence”; the equivalent is Medical Board registration in the provisional, limited, general or specialist category.

Contact the AMC through its online form (reception on +61 2 6270 9777 can’t help with IMG enquiries) about verification, authorisations and results; Pearson VUE about MCQ bookings; and Ahpra on 1300 419 495 about pathways, English, supervisors and registration. The AMC’s own contact page says it is not the registration authority.

Do overseas-trained doctors have to take the AMC exam to work in Australia?

Not all of them: only doctors on the Standard pathway sit the AMC exam, while doctors who graduated or were licensed in the UK, Ireland, Canada, the USA or New Zealand and completed the required supervised experience can usually use the Competent Authority pathway without it, and specialists may apply through the Specialist or Expedited Specialist pathways instead. Standard pathway doctors can prepare for Part 1 and IELTS together on AMC Academic.

The Medical Board recognises six assessing bodies as competent authorities: the UK’s GMC (including PLAB), the Medical Council of Ireland, the Medical Council of Canada (LMCC), ECFMG and NBOME in the USA (USMLE and COMLEX), and the Medical Council of New Zealand (NZREX). Doctors whose primary degree comes from anywhere else, including India, Pakistan, Bangladesh, Sri Lanka, Nepal, the Philippines, Egypt, Nigeria, Iran, most of Europe and Latin America, and who haven’t passed one of those licensing exams, are on the Standard pathway. NEET-PG, FMGE, FCPS, MD and MS aren’t treated as equivalents.

Whatever the pathway, everyone needs an AMC-verified degree, English to Ahpra’s standard, criminal history checks and a job offer. Check the pathway before paying anything: a UK graduate who books the AMC MCQ has spent AUD 2,920 on an exam they never needed to sit.