Road to NHS
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Independent educational service

Onto the GMC register, and into NHS practice

Revision and a step-by-step route to registration, for UK students sitting the applied knowledge test and international graduates taking PLAB — where nothing reaches you until a specialty-matched NHS doctor has signed it off.

See the route to registrationWrite or review with us

Not open yet. Be told when it is — and nothing here has been through clinical review yet, so no doctor is named on this page.

What this is

A route, not a shelf

The exam is one step of eleven

An English test, verification, good standing, a visa, an identity check, a first post. For most people the exam is not the part that goes wrong, so the route is here alongside the questions.

Every question is original

Written from scratch to the published blueprint. No recalled content, and we ingest nobody else’s material, in any format, from any source.

Educational, not clinical

Material for doctors sitting exams. Content cites the guideline rather than replacing it.

Not affiliated with, endorsed by, or part of the NHS, the General Medical Council, or any Royal College.

Who it is for

Two exams, two different problems

Not the same reader with a different postcode. Writing to the average of them serves neither.

UK medical students

You have a date and the map is published. The problem is coverage: which conditions you have genuinely met, and which you read about at one in the morning.

Coverage against the content mapContent map · 94published · development only · not written

One cell per condition seeded from the map. These figures count against the 94 conditions of MLA-2025 seeded so far, not the whole published map. An A–C slice of the published A–Z lists, seeded as a contiguous alphabetical run so that what is missing is describable rather than a judgement about which conditions matter. Level of expertise is not transcribed, and condition_presentation_links is empty.

Coverage against the content map

Coverage against the content map. one cell for every condition in the map governing the current sitting. One cell for every entry in the content map, grouped into 1 rows by area, 94 cells in all. Each row runs met first, then shaky, then unseen, so the length of the filled run is the coverage of that area at a glance: Content map, 0 met, 3 shaky, 91 unseen. Across the whole map that is 0 met, 3 shaky and 91 never seen, out of 94. Nothing is aggregated into a score. The point of a grid rather than a percentage is that revision goes where the gaps are, and a percentage hides which gaps they are. This is a schematic drawn from the values listed above, not a recording from a patient.

The condition reference

International medical graduates

The exam is one item on a list of eleven, and the expensive mistakes are administrative — an application in the wrong order, a certificate that expired while you waited.

The route to the register, in orderEnglish testfirst post

Filled is written. Open is not.

The route to the register, in order

The route to the register, in order. the steps an international medical graduate completes, with their prerequisites. 11 steps on one rail, in the order they have to happen, from English test at the left to first post at the right. In order: Routes to GMC registration, English language requirements, PLAB 1 and PLAB 2, Verifying your qualification through EPIC, Certificates of good standing, The GMC identity check, Visa routes and the application process, CREST forms and how to get one signed, Portfolio and evidence building, Finding a first NHS post and Induction and the first weeks. 5 of the 11 are written and drawn as filled nodes: Routes to GMC registration, English language requirements, PLAB 1 and PLAB 2, Verifying your qualification through EPIC and Certificates of good standing. The remaining 6 are drawn as open nodes because we have not written them: The GMC identity check, Visa routes and the application process, CREST forms and how to get one signed, Portfolio and evidence building, Finding a first NHS post and Induction and the first weeks. Filling them with plausible text would take an afternoon and is precisely what this product is meant not to do, so the gap is shown instead. This is a schematic drawn from the values listed above, not a recording from a patient.

The pathway to registration

How content is made

How a question gets made

Clinical governance is not a paragraph in our terms. It is the product, the database enforces it rather than good intentions, and it is what you are being asked to trust.

The editorial policy, in full

Two instruments, one heart, agreeingECG IISpO₂ pleth

One heartbeat, two instruments, one answer. That is what a second signature is.

Two instruments, one heart, agreeing

Two instruments, one heart, agreeing. Two traces run together on one time base in an adult at rest: an ECG, labelled ECG II, above a pulse oximeter plethysmogram, labelled SpO₂ pleth. Both are driven by the same cardiac cycle at 72 beats per minute, an R–R interval of 833 ms. The plethysmogram lags the ECG, and the lag is the point. The pressure pulse takes 210 ms to travel from the heart to the fingertip, so the foot of each pulse falls that long after the R wave. A plethysmogram drawn in phase with the QRS is the commonest error in a synthetic monitor display. Each pulse rises to its systolic peak in 110 ms, falls to the dicrotic notch at 300 ms — which is aortic valve closure, the end of ejection — rises again to the dicrotic wave at 355 ms, and then decays through diastole towards the foot of the next pulse. The notch sits at 44 per cent of the systolic peak and the dicrotic wave at 55 per cent. The plethysmogram has no calibrated amplitude and none is shown. That is why oximetry reports a saturation percentage and the waveform only as a signal-quality trace. An electrical potential at the skin and light absorbed at a fingertip are unrelated measurements of one event, and a nurse trusts the monitor because they agree. Two specialty-matched sign-offs are the same argument. This is a schematic drawn from the values listed above, not a recording from a patient.

  1. A doctor picks the source

    A clinician names the guideline passage the question must be true to. Not “write something about heart failure”.

  2. A model drafts against it

    AI writes the first draft from that passage and the blueprint. Nothing from recall, and every edit is recorded.

  3. Triage sets the depth

    Checks decide one reviewer, two, or a specialty lead. They never decide whether.

  4. A matched doctor signs

    Right specialty, active registration, signed paperwork. A database constraint, not a checklist.

  5. It stays checked

    A job watches the sources we cite. Anything past its re-check date goes back into a queue.

Kept current

Every item says when it was last checked

This mark sits before the byline of anything reviewed, and it is a button. It opens the record — who reviewed it, their GMC number, the guideline cited, and when the next check is due.

An unreviewed draft renders the same mark with no step. Flat line, no calibration, not publishable.

What happens when a guideline movesJanMarMayJulSepNovJansource updateddue re-check

When a source publishes a new version, everything behind the line goes back into a queue.

What happens when a guideline moves

What happens when a guideline moves. every published item carries the date it was last checked against the source it cites. A time axis runs left to right through Jan, Mar, May, Jul, Sep, Nov and Jan, and every item sits on it at the date it was last verified against its source. A cursor crosses the axis: it is source updated being published. Everything behind it — 7 of 10 items, namely first-line investigation, antiplatelet timing, staging thresholds, fluid choice, time to antibiotics, escalation of therapy and rate control — is now standing on a version of a guideline that has been superseded, and each one changes state: it is drawn in the watch colour and gains a ring around it, so the reading survives greyscale. 3 items are still inside the re-check interval — anticoagulation, insulin infusion rate and rate of correction — and they stay unmarked. Nothing is deleted and nothing is hidden. Each flagged item goes back into a named doctor’s queue, ordered by how many people have seen it, and it keeps its published version until a new one is signed off. This is a schematic drawn from the values listed above, not a recording from a patient.

For international graduates

The route to the register, in order

Written steps link the body that decides them. The rest are listed anyway — a gap you can see is a gap you can plan around.

  1. Routes to GMC registration
  2. English language requirements
  3. PLAB 1 and PLAB 2
  4. Verifying your qualification through EPIC
  5. Certificates of good standing
  6. The GMC identity checknot written yet
  7. Visa routes and the application processnot written yet
  8. CREST forms and how to get one signednot written yet
  9. Portfolio and evidence buildingnot written yet
  10. Finding a first NHS postnot written yet
  11. Induction and the first weeksnot written yet

Both tracks, step by step

Where it stands today

What is not built yet

The machine exists and the standard is enforced in code. The library of reviewed content does not.

  • Nothing is clinically reviewed

    Every reviewer in the bank is a development fixture, and the database refuses to name one on the editorial board.

  • Seven pathway steps are unwritten

    5 of 12. Filling the rest with plausible text is the thing this is meant not to do.

  • Simulated patients are a schema

    The tables and the service boundary exist. Nothing runs, and no score is shown until the marking is calibrated.

  • No pass probability

    You get a cohort comparison, said plainly. An invented percentage changes what somebody revises.

What we will show instead of a probability of passing2nd9th25th50th75th91st98thweeks of revisionconcepts heldno cohort yet

A position against reference curves, never a percentage. Nobody is plotted yet.

What we will show instead of a probability of passing

What we will show instead of a probability of passing. the shape of the answer, drawn against a reference rather than a prediction. The horizontal axis is weeks of revision and the vertical axis is concepts held. 7 reference curves are drawn — 2nd, 9th, 25th, 50th, 75th, 91st and 98th — rising from left to right and fanning apart as they rise. They never cross, because each is the median curve scaled by the z-score of its own centile; the widening gap between them is the spread of the cohort growing with the median, which is what the fan on a centile chart means. At the left of the axis the 2nd and 98th curves span 24 to 56; at the right they span 117 to 279. No individual is plotted on this chart, and that is not an omission: no cohort yet. This is a schematic drawn from the values listed above, not a recording from a patient.

Be told when it opens

We will email you when Road to NHS opens, and when something we have said we are building actually exists. Nothing else. No newsletter, no marketing from anybody else, and your address is never sold, shared or passed on.

One field, one choice, and a real deletion route.

Which are you?

What we store: Your email address, which of these you picked, the date, and which version of this wording you agreed to. Not your name, not your IP address, not where you came from.

If you would rather write it

What the work is, what the paperwork involves, and what you get for it.

The record you would be signingNO CALIBRATION—REVIEWING CLINICIAN—DATE VERIFIED

The fields that appear before the byline of anything reviewed.

The record you would be signing

The record you would be signing. the fields that appear before the byline of anything reviewed. Where the calibration mark belongs there is a flat line. That is the same glyph with the step missing, and it means the opposite: no calibration, not publishable. Below it are 2 ruled fields: REVIEWING CLINICIAN, printed as — and DATE VERIFIED, printed as —. REVIEWING CLINICIAN and DATE VERIFIED are empty, and the emptiness is the record rather than a gap in it. Nothing here has been through clinical review, so there is no name to print and none is printed. This is a schematic drawn from the values listed above, not a recording from a patient.

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