The PLAB 1 Q-Bank Content-Gap Checklist: What to Verify Before You Stop Doing New Questions

This is for international medical graduates preparing PLAB 1 and deciding whether more questions will help. The honest answer is that a bank percentage cannot tell you, and PLAB 1 has a trap specific to internationally-trained candidates: the medicine may be familiar, but the UK context — first-line choices, NHS pathways, and the GMC's ethical and legal framing — often is not. You have covered PLAB 1 when you can evidence six things: breadth across the content map, the right cognitive level, fluent data interpretation, current UK-referenced answers, genuine UK-context reasoning, and stable unseen performance. This checklist makes each verifiable.

The six-part coverage test

Here is the whole checklist in one view. A question bank has done its job for PLAB 1 only when you can tick all six rows honestly. The rest of the article is how to evidence each one.

#	What to verify	You can tick it when…
1	Content-map coverage	You have sampled every area of clinical practice in the GMC MLA content map, across its presentations and conditions.
2	Cognitive level	Your practice tests diagnosis, management and next-best-step reasoning, not only recall.
3	Data interpretation	You can read ECGs, imaging, laboratory trends, prescribing and statistics at exam pace.
4	Jurisdiction and currency	Your answers reflect current UK guidance and the updated MLA content map, each item dated and sourced.
5	UK and NHS context	You reason in UK first-line choices, NHS pathways and GMC ethical and legal framing — not your home system's.
6	Unseen measurement	Your readiness is proven on fresh, timed, mixed blocks — not on a re-tested bank percentage.

Row 5 is the one that separates PLAB 1 from a generic medical exam. A candidate can know the medicine and still lose marks by choosing the internationally reasonable answer over the UK-correct one.

What PLAB 1 actually tests

PLAB 1 is the written, single-best-answer paper of the GMC's two-part Professional and Linguistic Assessments Board route. It is 180 questions in three hours — one minute per item — and it is aligned to the same MLA content map that underpins the UK Medical Licensing Assessment. In other words, PLAB 1 is the international-graduate route to the Applied Knowledge Test, and the UKMLA content-gap checklist covers the same content map from the UK-student angle. PLAB 1 is pitched at the knowledge a doctor needs on entering the second year of the UK Foundation Programme, so it assumes practice at the level of a UK F2, not a specialist.

The content map is organised around areas of clinical practice, presentations and conditions, and it was updated in January 2026 with effect from September 2026 — so a current candidate must ensure their bank reflects the updated map. Two things follow for coverage. First, because the map is a coverage map rather than a fixed percentage weighting, the discipline is breadth: every area sampled, not a target share hit. Second, PLAB 1 sits inside a two-part exam; PLAB 2 is the OSCE-style clinical component, and no written bank can cover it. This checklist concerns PLAB 1 knowledge only.

Build a blueprint coverage matrix, not a percentage

The tool that makes this concrete is the blueprint coverage matrix, set out in the completion-is-not-coverage pillar. List each area of clinical practice as a row, then record questions attempted, first-attempt accuracy, the date last reviewed and a red/amber/green confidence flag. Because the map does not fix percentages, treat the weight column as "expected prominence" and confirm the exact list against the current GMC content map.

Area of clinical practice	Expected prominence	Questions attempted	First-attempt accuracy	Last reviewed	Confidence
Acute and emergency	High	—	—	—	R / A / G
Cardiovascular	High	—	—	—	R / A / G
Respiratory	High	—	—	—	R / A / G
Gastrointestinal including liver	High	—	—	—	R / A / G
Renal and urology	Core	—	—	—	R / A / G
Endocrine and metabolic	Core	—	—	—	R / A / G
Musculoskeletal	Core	—	—	—	R / A / G
Neurosciences	Core	—	—	—	R / A / G
Mental health	Core	—	—	—	R / A / G
Child health	Core	—	—	—	R / A / G
Obstetrics and gynaecology	Core	—	—	—	R / A / G
Sexual and reproductive health	Core	—	—	—	R / A / G
Cancer	Core	—	—	—	R / A / G
Clinical haematology	Core	—	—	—	R / A / G
Infection	Core	—	—	—	R / A / G
Dermatology	Core	—	—	—	R / A / G
Ear, nose and throat	Core	—	—	—	R / A / G
Ophthalmology	Core	—	—	—	R / A / G
Medicine of the older adult	Core	—	—	—	R / A / G
Palliative and end-of-life care	Core	—	—	—	R / A / G
UK context, ethics and law	Cross-cutting	—	—	—	R / A / G

The cross-cutting final row is where internationally-trained candidates most often carry a hidden gap: a strong clinical average can sit on top of shaky UK ethics, consent and safeguarding reasoning. Any area under-sampled and amber or red is a genuine content gap.

The ten blind spots self-selected practice hides

When candidates pick their own questions, the same weak points recur — and for IMGs several are context rather than knowledge. Treat these ten as high-suspicion gaps deserving deliberate attention, ideally checked against the GMC content map and official sample material rather than trusted on your own read.

UK ethics and law, including consent, the Mental Capacity Act, Gillick competence, confidentiality and data protection.
GMC Good Medical Practice framing, the professional-duty answer the exam expects.
NHS structures and referral pathways, primary-to-secondary-care routes and who does what.
UK first-line drug choices and thresholds, which frequently differ from home-country practice.
Safeguarding processes, the UK referral pathways for children and adults.
Prescribing safety in UK terms, checked against the SmPC/eMC and NICE/CKS rather than memory.
Palliative and end-of-life care, the UK approach to symptom control and communication.
Public health and screening, UK immunisation schedules, notifiable diseases and screening programmes.
Mental health law basics, the framework for assessment and detention.
The long tail of listed conditions, the less-common diagnoses the content map names that self-selected practice never surfaces.

Format checklist: coverage, UK framing, provenance

Doing questions is not the same as covering PLAB 1. Verify the following.

You have sampled every area of clinical practice in the content map, plus the cross-cutting UK-context, ethics and law themes.
Your bank reflects the updated MLA content map applying from September 2026.
Your reasoning uses UK first-line choices, NHS pathways and GMC framing, not your home system's defaults.
Every answer's guidance is UK-referenced, with clear provenance.
You can hold roughly one minute per item across 180 questions without a back-half collapse.

Interpretation checklist: can you read the data?

PLAB 1 rewards interpretation as much as recall. Confirm you can do each from the stem alone.

ECGs and the common, examinable abnormalities.
Imaging at the level expected of a doctor entering the second Foundation year.
Laboratory trends, interpreting a panel and its trajectory rather than a single value.
Prescribing and calculations, including safe UK dosing and interaction checks.
Statistics and evidence, including test performance and how a result changes practice.
Ethical and legal reasoning, reading the UK professional obligations embedded in a stem.

Recency checklist: is your knowledge in date?

PLAB 1 leans on current UK guidance, and the content map has just been updated.

You have flagged your guidance-sensitive topics — for example sepsis, diabetes, asthma, anticoagulation and mental-health law.
For each, you can name the source and date, from the UK stack: NICE, CKS, SIGN, the SmPC/eMC for medicines and NHS content.
You have confirmed your bank reflects the January 2026 content-map update applying from September 2026.
You have noted the jurisdiction of each source, so no non-UK guidance is silently carried into a UK exam.

Performance checklist: prove it on unseen questions

A percentage on a bank you have partly seen is inflated by memory of the items — the mechanism is explained in why your Q-bank percentage is not your exam score. Readiness needs a clean, unseen signal.

You have sat at least one fresh, unseen mixed block under timed conditions.
Your unseen score is stable across two or three blocks, not one good run.
Your pace-adjusted accuracy holds across all 180 items.
You have reviewed your high-confidence errors, the ones you were sure of and got wrong — often the UK-context items.
You have checked retention, re-testing topics from earlier revision.
You have calibrated against official GMC PLAB 1 sample questions, so your sense of difficulty and framing matches the real thing.

Revising on one bank and measuring on a separate, unseen bank is the two-Q-bank rule, and it keeps recall from inflating your readiness estimate. Be clear about scope: a written bank — iatroX included — can measure and build your PLAB 1 knowledge and does not prepare you for PLAB 2, which needs supervised OSCE practice.

Worked example: Sara, five weeks out

Sara qualified overseas, has completed 84% of a large PLAB bank at 76%, and feels the medicine is well within her. Her coverage matrix reframes it. The clinical rows are largely green. But the UK-context, ethics and law row is amber: she loses marks on consent and capacity scenarios, chooses a reasonable but non-UK first-line antihypertensive, and is unsure of the UK safeguarding referral route. Palliative care and public health are under-sampled. Her clinical strength is real; her UK framing is not yet automatic.

She sits a fresh, unseen, timed block and scores 68%, eight points under her bank average, with most of the lost marks on ethics, law and UK-specific management rather than on diagnosis. The gap was never her medicine — it was context.

Sara's next moves are specific: deliberate practice of UK ethics, law and consent; a pass through UK first-line choices and referral pathways where they differ from her training; targeted blocks in palliative care and public health; and timed full-length practice. More diagnostic questions, her strength, would have changed nothing about the marks she was dropping.

The stop-or-continue decision tree

Choose the next activity from the measured gap, not the calendar.

Keep doing new questions where an area of the content map shows low attempts — you have not sampled it enough to trust your score.
Consolidate where attempts are healthy but accuracy is amber; focused review beats more new items on a half-known topic.
Close the UK-context gap deliberately whenever the ethics, law and framing row is amber or red, however strong your clinical score is.
Simulate full timed blocks when coverage is broadly green but your unseen or end-of-paper performance sags.
Seek teaching or a written resource for any area that stays red despite repeated attempts, especially UK ethics and law.
Rest and protect retention once your map is green, your UK framing is reliable and your unseen scores are stable.

Your one-page PLAB 1 content-gap checklist

Copy this and keep it beside your revision. You are ready to ease off new questions only when every box is ticked.

Frequently asked questions

How do I know whether I have covered the full PLAB 1 blueprint? You know it from a coverage matrix keyed to the GMC MLA content map, not from a percentage. Sample every area of clinical practice, work through the presentations and conditions the map lists, and give the cross-cutting UK-context, ethics and law themes their own row. Because the map is a coverage map rather than a fixed weighting, "covered" means breadth — every area genuinely sampled and your UK framing reliable — not a headline number that happens to look high.

Can one question bank be enough for PLAB 1? For the written paper, a single strong, up-to-date bank can carry most of your revision, provided it reflects the current content map and teaches UK framing rather than generic medicine. It cannot cover PLAB 2, which is a separate OSCE no written bank replaces. And even for PLAB 1, one bank is a weak measuring instrument once you have seen its items, so revise on one bank and keep a second, unseen bank purely to measure yourself on fresh questions.

What should I measure instead of my overall Q-bank percentage for PLAB 1? Measure coverage across every content-map area, your accuracy on the UK-context, ethics and law items in isolation, pace-adjusted accuracy across a full timed block, and unseen performance on questions you have never met. For internationally-trained candidates especially, a strong overall percentage can hide a soft UK-framing score, which the headline number will never show you.

When should I stop doing new PLAB 1 questions? Stop expanding when your content-map matrix is green across areas, your UK-context reasoning is reliable, your unseen timed scores are stable, and your remaining errors are careless rather than conceptual. Before that point, keep doing new questions aimed at confirmed gaps — often UK ethics, law and first-line management — rather than your strong areas. After it, more volume mostly adds fatigue, and your time is better spent consolidating or resting.

Which PLAB 1 resource should I use for my weakest component? Match the resource to the weakness. For an under-sampled content-map area, use a broad, current PLAB bank and target that area. For UK ethics, law and consent, use a resource built around GMC guidance and UK law rather than clinical questions alone. For UK-specific management and pathways, use material that teaches first-line choices and referral routes as the UK expects them. Confirm any resource reflects the updated content map and is UK-referenced, and compare options honestly on the iatroX comparison hub.

Editorial notes and references

Written by Dr Kolawole Tytler, NHS GP and founder of iatroX. Last checked 19 July 2026. The 180-question, three-hour format and the alignment to the MLA content map reflect the published PLAB arrangements at that date; the content map was updated in January 2026 with effect from September 2026, and the list of areas, presentations and conditions is periodically revised, so verify the current map and sample questions on the GMC site before relying on specifics. Any third-party question counts or features referred to here are vendor-reported and should be confirmed on the relevant product page.

Disclosure: iatroX operates its own question bank and clinical-knowledge tools and therefore competes with the resources discussed here. It is positioned in this article only for the job it suits — building and measuring PLAB 1 knowledge, including UK framing, and providing fresh, unseen questions for baseline and readiness measurement — and it does not replace supervised PLAB 2 preparation. Corrections are welcome through the feedback route on iatrox.com. This is the exam-level hub for the PLAB 1 content-gap intent; the closely related UKMLA checklist applies the same content map from the UK-student angle.

References: General Medical Council — PLAB 1 blueprint, the MLA content map and official sample questions (gmc-uk.org); NICE, CKS, SIGN, SmPC/eMC and NHS content for guideline currency; iatroX, why your Q-bank percentage is not your exam score and the completion-is-not-coverage blueprint-matrix method.

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