PRES — Pre-Registration Examination System
Registration Routes
The Medical Council maintains a General Division, a Trainee Specialist Division and a Specialist Division, with formal transfer pathways between them. A Supervised Division also exists.
Routes for internationally trained doctors: EU/EEA recognition · Certificate of Experience · Higher Qualification · PRES · full PLAB · Specialist Registration · Supervised Registration.
The PLAB Exemption
The Medical Council states, under the heading PRES Alternative Exam, that you can be exempted from the PRES if you have passed the UK General Medical Council's Professional and Linguistic Assessment Board (PLAB) Part 2.
The exemption is from the PRES, not merely from Level 3. Since PLAB 1 must be passed before PLAB 2 may be sat, full PLAB removes the PRES requirement entirely.
Three qualifications the Council attaches:
PLAB has its own entry rules. Candidates seeking to sit the PLAB must meet all of the GMC's eligibility and language requirements, which differ from those of the Medical Council of Ireland.
The order is fixed. PLAB 1 before PLAB 2.
The recognition runs one way only. There is no reciprocal arrangement with the GMC to recognise the PRES exams — the GMC does not recognise either PRES 2 or PRES 3 for the purpose of registration.
So PLAB opens Ireland, but PRES does not open the UK. If you may want to work in both, that asymmetry should decide which exam you sit first.
PRES Level 2
| Feature | Details |
|---|---|
| Format | Written MCQ. Each starts with a short scenario followed by a question |
| Duration | Three hours |
| Location | Dublin only |
| Clinical disciplines | Obstetrics & Gynaecology, Paediatrics, Psychiatry, Surgery, Medicine/General Practice |
| Framework | The Eight Domains of Good Professional Practice |
| Blueprint | Published — downloadable from the Medical Council website |
| Question count | Not published |
| Pass mark | Not published |
| Recognition | Accepted by the Medical Council only. Not accepted by any other international regulator |
PRES Level 3
| Feature | Details |
|---|---|
| Structure | Two parts: Interpretation Skills, examined in one exam, paper-based or computer-based; and Practical and Communication Skills, examined in one clinical exam where candidates rotate through clinical scenarios or skill stations |
| Locations | Dublin, Cork, Galway or Limerick. No overseas centres |
| Frequency | Two to three times per year, depending on demand |
| Prerequisite | PRES Level 2 or an acceptable alternative must be passed before sitting Level 3 |
| Blueprint | Published |
| Station count and timing | Not published |
| Pass mark | Not published |
Accepted Alternatives to PRES Level 2
| Alternative | Validity |
|---|---|
| PLAB Part 1 | From 31 March 2025, valid 2 years from the exam date |
| USMLE Step 1 and Step 2 CK | Within 7 years |
| MCCQE Part 1 | As set by the awarding body |
| AMC MCQ | As set by the awarding body |
The accepted Canadian examination is the MCCQE Part 1. The MCCEE is not on the list and has been retired by the Medical Council of Canada.
Attempts and Validity
| Rule | Details |
|---|---|
| Attempts per level | Three |
| Level 2 window | Two years from the date you are declared eligible |
| Level 3 window | Two years from the date you are declared eligible to sit it |
| If Level 2 lapses | Eligibility expires. A new application is required |
| If Level 3 lapses or is failed three times | Eligibility expires. You must submit a new application for the Level 2 |
The two-year rule is not that a pass is valid for two years. It is that you have two years from being declared eligible in which to pass, using no more than three attempts. Once Level 2 is passed, a fresh two-year window opens for Level 3.
Exhausting Level 3 sends you back to Level 2.
English Language Requirements
| Test | Requirement |
|---|---|
| IELTS Academic | Overall 7.0, no band below 6.5 |
| OET | Overall Grade B, and Grade B in each component |
Both must be completed within 2 years before your application. Scores must usually be achieved in one sitting. The Level 3 application also requires documentary evidence of effective communication skills.
EPIC Verification
The basic medical degree must be uploaded to EPIC and verified before you submit.
Uploaded to your Doctor's Portal instead: a notarised copy of your passport and evidence of communication skills.
Sent directly to the Medical Council, not through EPIC: an original Certificate of Good Standing dated within the last 3 months, from every registration body you have held registration with in the past five years.
Documents must not be submitted via postal services.
Fees
| Item | Fee (EUR) |
|---|---|
| First-time application | €451 |
| PRES Level 2 | €352 |
| PRES Level 3 | €1,500 |
| Annual retention — under 3 years qualified | €560 |
| Annual retention — over 3 years | €665 in 2026 |
The €665 rate rose 10% from €605 and rises a further 10% to €732 in 2027. The €560 rate is frozen for 2026 and 2027. Doctors aged 70+ pay €75; doctors on leave retain a 50% refund.
The application fee is not refundable if you apply without the required documents or do not meet the PRES route requirements.
What we offer
PRES Level 2 preparation mapped to the five clinical disciplines and the published blueprint, and PRES Level 3 clinical preparation.
If you are taking an accepted alternative examination instead: