The GMC opened a pathway for internationally qualified physician associates to seek UK registration from 2025. This is new territory — the pathway is barely established, dedicated guidance is almost non-existent, and the process involves multiple stages that must be completed in the correct order.
This guide covers every step.
Step 1: Qualification Assessment by the GMC
Before you can sit the PARA, the GMC must assess whether your international PA qualification meets UK requirements. You cannot book the PARA independently — the RCP will not accept your booking until the GMC has confirmed your eligibility.
Apply to the GMC for qualification assessment. Provide evidence of your PA qualification, including programme details, curriculum content, clinical training hours, and any postgraduate certifications. The GMC assesses whether your training is equivalent to the standard expected of a UK PA graduate.
If your qualification meets the requirements, you receive individual instruction from the GMC confirming your eligibility to sit the PARA. If it does not meet requirements, you may be advised on what additional training or evidence is needed.
Important: US-qualified PAs who have never been on the FPA's Managed Voluntary Register cannot use their PANCE pass as a substitute for the PARA. You must sit the PARA regardless of US certification.
Step 2: Sit the PARA
Once the GMC confirms your eligibility, you can apply to sit the PARA through the RCP. The exam is identical to that sat by UK graduates: KBA (200-item MCQ, £309) and OSCE (14 stations in Liverpool, £611).
You can take the components in either order. Maximum four attempts per component. Pass from one component is valid for 18 months.
The PARA assesses UK clinical knowledge and practice, so preparation should follow its current official framework and examples. iatroX can provide UK-focused question practice, and Ask iatroX can retrieve cited NICE and CKS guidance and medicines information from relevant SmPCs on eMC. Neither feature verifies every answer automatically; open the source and compare it with the official assessment scope.
Step 3: Apply for GMC Registration
After passing both PARA components, apply for GMC registration. Provide evidence of your qualification, PARA pass, English language proficiency (if applicable), and fitness to practise declarations. Fee: £325 per year.
Step 4: Right to Work
You must have the legal right to work in the UK. PA roles are eligible for Skilled Worker visa sponsorship through NHS trusts and other licensed sponsors. Ensure your visa status is confirmed before accepting employment.
Preparation Strategy for International PAs
Your clinical knowledge will have significant overlap with UK practice — PAs globally share a generalist clinical role. The areas of divergence are pharmacology (UK drug names and prescribing conventions), management pathways (NICE rather than international guidelines), professional practice (GMC standards, UK consent and capacity law, safeguarding frameworks), and the OSCE communication style (UK patient-centred consultation, ICE framework, shared decision-making).
Invest specifically in these areas. Use iatroX as your primary UK-alignment tool — the guideline-grounded clinical reference ensures every answer matches UK practice. The Q-Bank provides adaptive learning that identifies exactly where your international training diverges from UK expectations.
iatroX is also designed for use during clinic once you are practising in the UK — providing the same instant guideline reference during patient consultations that supports your exam preparation.