The Physician Associate Registration Assessment (PARA) is the national examination UK physician associates must pass to register with the General Medical Council. It replaced the Physician Associate National Examination (PANE) from September 2025, and from 13 December 2026 GMC registration — which the PARA unlocks — becomes mandatory to work as a physician associate in the UK. The PARA has two components: a knowledge-based assessment (KBA) and an objective structured clinical examination (OSCE). This guide covers the format, fees, the GMC transition, and how to prepare for both parts.
What the PARA is and who sits it
The PARA is the national registration assessment for physician associates, delivered by the Royal College of Physicians on behalf of the GMC. It replaced PANE from September 2025 and is now the single gateway to GMC registration. UK candidates sit it after completing a UK physician associate programme; international physician associates can only sit it once the GMC has confirmed that their qualification meets UK requirements. The role's scope and title were the subject of an independent review during 2025, and some changes are expected, but the registration assessment itself remains the PARA.
The GMC transition, and why timing matters
The GMC now regulates physician associates, and from 13 December 2026 you must hold GMC registration to work as a PA in the UK. Transitional arrangements run from 13 December 2024 to 13 December 2026: KBAs and OSCEs held between September 2025 and November 2026 use a hybrid blueprint drawing on both the 2012 Competence and Curriculum Framework and the 2023 Physician Associate Curriculum. Once the transition ends, assessments map to the 2023 curriculum only. If you passed PANE or PARA more than two years before applying for registration, you may not need to retake an assessment during the transition, provided you can evidence recent, post-qualification UK practice.
Format: the KBA and the OSCE
The KBA comprises 200 best-of-five (single best answer) questions split into four papers of 50, with one hour for each paper and all four completed in a single day. It is sat online at an appropriate location, such as your home, with identity and facial-recognition checks at boarding. The fee is £309. The OSCE comprises 14 clinical stations of eight minutes each, with two minutes' reading before each station, held at the RCP Assessment Centre in Liverpool; the fee is £611, or £920 for the KBA and OSCE booked together. You must pass both components, you can take them in either order, a pass in one is valid for 18 months while you complete the other, and you have a maximum of four attempts per component.
What it tests
The KBA covers the breadth of clinical practice — medicine, surgery, paediatrics, obstetrics and gynaecology, psychiatry and emergency medicine — mapped to the GMC physician associate curriculum and aligned to the Physician Associate Scope of Practice framework, with a published content map and sampling grid you can revise against. The OSCE tests essential clinical skills: history-taking, examination, communication and procedural competence. In each station you face either a real patient with a given condition or a trained simulated patient, and you rotate through scenarios that sample the same clinical breadth as the written paper — focused history, examination, explanation and shared decision-making, and safe management. The eight-minute format rewards candidates who can structure a consultation quickly and communicate clearly under pressure. One important point of context: physician associates cannot currently prescribe independently in the UK, and while legislative change has been anticipated, it is not yet in force.
2026 dates and the international route
KBA and OSCE diets run across the year through the RCP; confirm the current dates and fees on the RCP and GMC pages before booking. International physician associates cannot book the PARA until the GMC has confirmed their qualification meets UK requirements, after which the assessment they sit is identical to the one taken by UK graduates. Last reviewed June 2026.
Pass rates
First-time pass rates have been reported at around 70%, but this varies by sitting and the blueprint has been refreshed for the transition, so treat any single figure as indicative and check the current data rather than relying on older numbers.
How to prepare
Start by obtaining the current content map and weighting your revision to match it. For the KBA, work through adaptive questions across every clinical domain and review each miss against the relevant UK guideline, building toward mixed, timed papers that rehearse four 50-question papers in a day. For the OSCE, practise stations with peers, because communication and examination skills cannot be built from a question bank alone; Geeky Medics remains the standard resource for the clinical component. Identify your three weakest domains early and weight your time toward them. The most common way to come unstuck is to over-prepare the written knowledge and under-rehearse the OSCE, or to leave the second component close to the 18-month deadline after passing component one; plan both from the start, because failing to complete the second within 18 months means retaking the component you had already passed.
Where iatroX fits
iatroX offers a PARA knowledge bank, free to practise, for the KBA. It leads with a Socratic tutor that works back through the reasoning behind a wrong answer rather than handing you the solution; questions mapped meticulously to the physician associate curriculum and its clinical domains; spaced repetition that returns missed material at widening intervals; adaptive sequencing that surfaces your weak areas across domain boundaries; and a mobile app for iOS and Android. For the OSCE, pair it with structured station practice.
A few common questions
Did the PARA replace PANE? Yes — from September 2025.
When does GMC registration become mandatory? From 13 December 2026.
How many parts are there? Two — the KBA and the OSCE; both must be passed.
Is iatroX's PARA bank free? Yes — the PARA bank is free to practise; iatroX's other banks sit on a £29/month or £99/year subscription.