Overview
The Pre-Registration Examination System (PRES) is run by the Medical Council of Ireland for doctors who want to register to practise in Ireland. Doctors applying for the general or trainee specialist division may be required to sit it. It has two exams: Level 2 tests clinical knowledge and Level 3 tests clinical skills. Both assess competence in obstetrics and gynaecology, paediatrics, psychiatry, surgery, and medicine or general practice.
Who can apply
Whether you must sit PRES depends on your qualifications, so you apply online first and the Council assesses whether you are eligible for Level 2 or Level 3.
Passing the UK GMC's PLAB Part 2 can exempt a doctor from PRES, but PLAB Part 1 must be passed first, and the doctor must meet the GMC's own eligibility and language requirements, which differ from the Council's. The Council states that there is no reciprocal arrangement under which the GMC recognises PRES.
Levels or stages
PRES Level 2
A written exam of multiple-choice questions, to be answered in three hours. Each question gives a clinical scenario followed by answer options. The Council publishes an exam blueprint listing the knowledge, skills and behaviours expected, and 90 sample questions. Passing Level 2 makes you eligible to apply for Level 3. The Council also accepts certain alternative exams in place of Level 2, so that you can apply directly for Level 3: PLAB Part 1 (valid for 2 years from the exam date for passes from 31 March 2025), USMLE Steps 1 and 2 CK (within 7 years), MCCQE Part 1, and the Australian Medical Council MCQ.
PRES Level 3
A clinical assessment of communication, interpretation and practical skills. It has two parts: an interpretation exam, taken on paper or on computer, and a clinical exam in which you move through stations with different scenarios. A PRES Handbook and Blueprint describe the structure and the competencies assessed.
Syllabus
The syllabus is set out in the Council's published blueprints for each level, which cover knowledge and clinical skills across the main clinical disciplines. Read the current blueprint on the Medical Council website before you prepare.
Fees
Fees listed by the Medical Council for the 2026/2027 registration period:
| Item | Fee |
|---|---|
| PRES Level 2 exam | €352 |
| PRES Level 3 exam | €1,500 |
Refunds are not given if the documentation submitted is incomplete, if the applicant is ineligible for registration, or if the applicant withdraws.
How to apply
Make an online application to the Medical Council.
Submit the required documents for assessment.
Wait for the Council to decide your eligibility.
If eligible, book your exam place.
After the exam
A pass at Level 2 lets you apply for Level 3. Dates and booking details for each sitting are given by the Medical Council to eligible candidates.
Preparation tips
Download the PRES Handbook and the blueprint for the level you are sitting.
Work through the 90 published sample questions for Level 2 under timed conditions.
For Level 3, practise communication and practical skills in simulated scenarios.
What is PRES?
The Medical Council of Ireland's two-level exam system for doctors who need to show their clinical knowledge and skills before registration.
Do I have to sit both levels?
Not always. The Council assesses your application and decides whether you are eligible for Level 2 or Level 3.
Does a PLAB pass exempt me from PRES?
The Council says a pass in PLAB Part 2 can exempt you, after you have passed PLAB Part 1, subject to the GMC's own requirements.
Does the GMC accept PRES?
No. The Council states there is no reciprocal arrangement with the GMC to recognise PRES.