Medical licensing costs vary enormously by market: the US and Australian pathways run into thousands, while the UK PLAB route is comparatively light. Registration fees are only part of it, since question banks, self-assessments, and hidden extras like language tests and travel add up fast. Here is a market-by-market breakdown of what exams and preparation actually cost in 2026, in local currency, so you can budget realistically. Fees change often, so confirm current figures with each official body.
Key takeaways
- Registration fees range from a few hundred pounds (PLAB 1) to thousands (USMLE, AMC).
- Preparation tools are a large, separate cost, and often where students overspend.
- Hidden extras (language tests, visas, travel) can rival the exam fees themselves.
- Prep tool prices differ widely, so match spend to what you will actually use.
- Always confirm current fees with the official body, since they are revised regularly.
United States: the USMLE pathway
The USMLE is among the most expensive pathways. Each of Step 1 and Step 2 CK carries a base registration fee of roughly $675, with an international test delivery surcharge of around $205 for candidates testing outside the US, bringing each to about $900 for international graduates. Step 3 is around $895. On top of registration sit preparation costs: a year of UWorld is commonly cited around $560, the AMBOSS full annual bundle around $428, and NBME self-assessments about $60 each. Add First Aid, and for IMGs the ERAS application, and the true total climbs well past the headline fees. For the AMBOSS side of that, see our honest cost breakdown.
United Kingdom: PLAB and the UKMLA
The UK route is the most affordable of the major pathways. Following the GMC's April 2026 fee revision, PLAB 1 is around £270 to £285 and PLAB 2 around £1,000, so roughly £1,300 for both. For UK medical students, the UKMLA is embedded in the medical degree rather than charged as a separate IMG-style fee. Preparation is where UK candidates have the most affordable options: established question banks such as Passmedicine, Quesmed, and Pastest range from tens to low hundreds of pounds, BMJ OnExamination is often free to BMA members, and iatroX is £29 per month or £99 per year with free sample questions. The UK's lower exam and prep costs are a real advantage of the pathway.
Canada: the MCCQE
Canada's costs sit in the middle. The MCCQE Part I is the current computer-based written exam, with the MCCQE Part II historically suspended, so budget primarily for Part I, which runs to the equivalent of roughly £2,000 to £2,600, though you should confirm the current figure directly with the Medical Council of Canada, as its fee schedule is revised regularly. Preparation adds question-bank costs on top, with providers such as CanadaQBank among the commonly used options. Because the exam structure has changed, be careful to budget against the current format rather than older guidance.
Australia: the AMC pathway
Australia is the most expensive pathway overall. The AMC exam components together cost around AUD 8,150 (roughly £4,100), and the full pathway, including associated steps, is commonly estimated at AUD 8,000 to 12,000. Preparation adds question banks such as GdayDoctor's bank, though a free AMC MCQ preparation app with a couple of hundred questions is available to authorized candidates. The higher upfront cost is often justified by Australia's comparatively high junior doctor salaries, which can recover the outlay quickly, but the initial budget required is substantial.
The hidden costs no one budgets for
Across every market, the extras add up. Most IMG pathways require an English language test (IELTS or OET), which carries its own fee and possible retakes. Practical exams mean travel: PLAB 2 is sat in Manchester, and USMLE Step 3 only in the US, so factor flights, visas, and accommodation. Then there are rescheduling fees, score-report charges, registration fees payable to the regulator after you pass, and, for some, relocation costs. A realistic budget assumes the exam fee is a floor, not the total.
How to spend on preparation wisely
The controllable cost is preparation, and it is where students most often overspend. Start with free and official resources, use one primary question bank rather than collecting several, and buy self-assessments and add-ons only when you will use them. A lower-priced tool that covers your exams can free budget for the fixed costs you cannot avoid. iatroX, for instance, covers UK and international exams under one subscription at £99 per year with free sample questions, which keeps the prep line of the budget lean. See the free questions, and our related piece on whether AMBOSS is worth it.
Frequently asked questions
Which licensing pathway is cheapest? The UK PLAB route is the most affordable of the major pathways, at roughly £1,300 for both parts, with comparatively low prep costs. The AMC and USMLE pathways are the most expensive.
How much does the USMLE cost? Each of Step 1 and Step 2 CK is around $675 base, or about $900 with the international surcharge, and Step 3 is around $895, before preparation materials. Confirm current fees with the USMLE.
How much does PLAB cost in 2026? After the GMC's April 2026 revision, PLAB 1 is around £270 to £285 and PLAB 2 around £1,000, roughly £1,300 for both, before preparation and travel.
What are the hidden costs of licensing exams? Language tests, visas, travel to practical exams, rescheduling fees, score-report charges, and post-exam registration fees. These can rival the exam fees themselves.
How can I reduce preparation costs? Use free and official resources, stick to one primary question bank, and buy add-ons only when needed. A lower-priced tool covering your exams, such as iatroX at £99 per year, keeps prep spend down.