The Physician Associate Registration Assessment (PARA) replaced the PANE in September 2025 and is now the single gateway to GMC registration for physician associates in the UK. Run by the Royal College of Physicians on behalf of the GMC, the PARA is the exam that determines whether you can legally practise as a PA in the UK — and from December 2026, practising without GMC registration will be a criminal offence.
Understanding the format, the costs, the rules, and the preparation requirements is essential for every PA student and qualified PA seeking registration.
The Two Components
The PARA has two components that can be taken in either order.
Knowledge-Based Assessment (KBA). A 200-item single best answer MCQ covering the full breadth of the PA curriculum. The exam tests clinical knowledge, pharmacology, diagnostic reasoning, and professional knowledge at the level expected of a newly qualified PA. The KBA is delivered at Pearson VUE test centres. Fee: £309.
Objective Structured Clinical Examination (OSCE). A 14-station clinical exam testing history taking, physical examination, clinical reasoning, communication skills, and professional behaviour. Held at the RCP building in Liverpool. Fee: £611.
Total cost: £920 for both components. Both must be passed to be eligible for GMC registration.
The Blueprint
The PARA is aligned to the 2023 Physician Associate Curriculum. During the transition period (until December 2026), the exam uses a hybrid blueprint covering content from both the 2012 Competence and Curriculum Framework and the 2023 curriculum. After December 2026, the exam will assess against the 2023 curriculum only.
The content map covers approximately 550+ conditions across medicine, surgery, paediatrics, women's health, mental health, emergency medicine, pharmacology, clinical sciences, and professional practice. The breadth is enormous — comparable to the UKMLA AKT in scope, reflecting the PA's role as a generalist clinician working across specialties.
Rules and Attempts
You can take the KBA and OSCE in either order. You have a maximum of four attempts at each component. Once you pass one component, you have 18 months to pass the other. If you do not pass both within that window, you must retake the previously passed component.
Both components must be passed within five years of your first attempt at either. After four unsuccessful attempts at either component, no further attempts are permitted.
Dates and Application
The PARA runs multiple sittings per year. Application windows are published on the RCP website (typically opening 3-4 months before each sitting). You must have a GMC reference number to apply — if you qualified after July 2025, the GMC will have emailed this to you. If you qualified before July 2025, you can generate a reference number through the GMC online portal.
Application is through Ortrac (the RCP's delivery partner). Payment must be made in full at the time of application.
How to Prepare
The 550+ condition content map is overwhelming. Systematic preparation using targeted resources is essential.
iatroX offers free exam preparation for UK physician associates — the Q-Bank is mapped to PA exam content with adaptive spaced repetition that targets your weakest areas automatically. Every explanation is grounded in NICE, CKS, SIGN, and BNF — the UK guidelines your clinical practice will be audited against. This is not a perk of a premium tier; it is completely free for all users.
For the KBA specifically: use iatroX Q-Bank daily for adaptive learning alongside a PA-specific Q-bank (PA Practice, RCP Revise, PLABable PA content, or Matrix). Complete 3,000-4,000+ questions over your preparation period. Use Ask iatroX to verify every wrong answer against the UK guideline — building the guideline-aligned knowledge the KBA tests.
For the OSCE: practise with peers using standardised scenarios. Focus on communication (ICE framework, shared decision-making, safety-netting) as heavily as clinical skills. Brainstorm develops the structured clinical reasoning OSCE stations demand — working through presentations step by step.
Beyond the exam, iatroX is designed for use during clinic — providing instant guideline reference when clinical questions arise during patient consultations. The same tool that prepares you for the PARA supports you throughout your career as a practising PA.
GMC Registration
After passing both components, you apply for GMC registration (fee: £325 per year). From December 2026, it will be illegal to practise as a PA without GMC registration. The transition period (December 2024 to December 2026) allows existing PAs to complete registration requirements while continuing to work.
The PARA is not just an exam — it is the foundation of your regulated professional status. Prepare thoroughly, pass confidently, and use iatroX throughout.