The UK Medical Licensing Assessment (MLA) is a two-part test that all UK medical students and international medical graduates (IMGs) must pass if they want to practice medicine in the UK.
From the academic year 2024–2025 on, all UK medical students who graduate will have to pass the MLA as part of their degree before they can join the medical register. From 2024 on, international doctors who want to work in the UK will have to take the MLA instead of the PLAB.
It's a pretty important exam if you want to be a doctor and so we've put together this ultimate guide to the UKMLA to cover everything you need to know about the exam and how to pass the UKMLA first time.
What is the UKMLA?
The MLA will set a common threshold for safe medical practice in the UK. If you graduate from a UK medical school from the academic year 2024-25 and onwards, you'll take the MLA as part of your degree. It'll be an important milestone in your journey to becoming a doctor.
The MLA will make it easier for patients and employers to trust doctors who are new to the UK, no matter where they went to school or were trained.
The Professional and Linguistic Assessments Board (PLAB) exam will be replaced by the UKMLA, and all UK medical students will have to take it in order to graduate. If you want to be a doctor in the UK, you need to know about the UKMLA and how to get ready for it.
By putting in place the UKMLA exam, the GMC will be able to keep high standards for UK medical students and make sure they are ready to practise medicine. The UKMLA will also help keep patients safe by making sure that doctors have the knowledge and skills they need to do their jobs safely.
Who Is The UKMLA For?
Both medical students graduating in the UK and international medical graduates will need to pass the exam in order to practise medicine in the UK.
The UKMLA For UK Medical Students
The MLA will be a two-part exam taken by every student at a UK medical school and. It will replace the exam known as PLA, currently taken by doctors who qualified abroad and want to practice here. As such, the MLA will set a common threshold for safe medical practice in the uk.
If you're set to graduate from a UK medical school in the academic year 2024 to 25 and onwards, you'll take the MLA with your finals. When you apply to join the medical register, you'll need to have passed your degree, including a pass in the MLA in order to meet GMC requirements. As you approach your final exams, your medical school will let you know about the practical arrangements for taking the UKMLA.
The UKMLA for International Medical Graduates (IMGs)
International medical graduates who would have sat the Professional and Linguistic Assessments Board (PLAB) test will start to take the MLA when it is introduced in 2024.
Until the MLA is introduced in 2024, international medical graduates can still apply for the PLAB test if you want registration with a licence to practise in the UK. The information below explains what will happen if you have sat one or both parts of the PLAB test when we introduce the MLA:
Passed both parts of the PLAB test
This won't change: the same as now, you'll need to have your application for registration with a licence to practise in the UK to be approved within two years of passing PLAB 2.
Passed PLAB 1 but not attempted PLAB 2
If you have passed PLAB 1, instead of taking PLAB 2 you’ll take the CPSA. You’ll need to pass this within your PLAB 1 validity period, which is currently three years.
When you pass the CPSA, you'll be able to apply for registration with a licence to practise. You'll need your application to be approved within two years of passing the CPSA.
Attempted PLAB 1 but not passed it
You'll be able to sit the AKT. There will be a maximum number of attempts and any previous attempts at PLAB 1 will count towards the maximum number. We're finalising that maximum number and will let you know as soon as we can.
When you pass the AKT, you will need to take the CPSA within the AKT validity period.
Passed PLAB 1 and attempted PLAB 2, but not passed
You won’t need to take the AKT if your PLAB 1 pass is still valid. Currently, a PLAB 1 pass is valid for 3 years.
You'll be able to take the CPSA. There will be a maximum number of attempts and any previous attempts at PLAB 2 will count towards the maximum number. We're finalising that maximum number and will let you know as soon as we can.
When you pass the CPSA, you'll be able to apply for registration with a licence to practise. You'll need to do so within two years of passing the CPSA.
When will the UKMLA exams start?
For UK students graduating in 2025 the UKMLA will roll out in early 2024.
For international medical graduates the PLAB will be replaced by the UKMLA in 2024.
When is the UKMLA sat?
The UKMLA is sat twice a year, at the end of each academic year. The first time it's sat is in April, and then again in October.
How Do You Apply To Sit The UKMLA?
For UK medical students your medical school will help you prepare and send out details regarding when and where you will sit the UKMLA.
For international medical graduates you will need to apply
How much does the UKMLA cost?
For UK medical graduates the UKMLA will be free and will be part of your normal medical training. It will replace and sit alongside parts of your finals.
For international medical graduates the GMC have not officially announced the cost of the UKMLA but it is likely to be a similar cost to the PLAB exams.
What is the format of the UKMLA?
The MLA is made up of two parts: a test of applied knowledge and a test of clinical and professional skills.
1. The Applied Knowledge Test (AKT)
The AKT is a computer-based multiple choice exam. It tests your ability to apply medical knowledge to different scenarios. The AKT is similar to the current PLAB 1 exam.
You'll need to pass the AKT before you can take the clinical and professional skills assessment.
Both UK and IMG candidates need to pass the AKT first before moving on to the CPSA. Exams will be held four times a year, and the GMC will determine the pass mark. IMGs can take the exam in selected locations around the world, while UK medical students will take it at their university. All candidates will take a computer-based test.
The AKT will use single best answer (SBA) questions with questions will be similar to those on the current Section 1 of the PLAB exam. The total number of questions ranges from 150 to 200.
2. The Clinical and Professional Skills Assessment (CPSA)
The CPSA is a structured clinical exam (OSCE). It features clinical history-taking, examination and clinical skills. As with any OSCE exam your communication and clinical skills will be assessed by an examiner and you will be scored based on your performance.
The CPSA is similar in format to the PLAB 2 exam.
Where Can I Sit The UKMLA
The UKMLA will be sat at test centers throughout the UK depending on which medical school you are at.
UK medical schools are working together, through the Medical Schools Council (MSC), to set and administer a GMC-regulated national AKT. The medical school (MS) AKT will be delivered for all students graduating from UK medical schools in their penultimate, or final, year of study.
The MS AKT will be constructed centrally by medical schools collaborating together, and delivered locally. It will be regulated and quality assured by the GMC, and have a common format, test standard, delivery process and policy framework. UK medical schools will set and deliver the CPSA for students in their penultimate or final year of study.
For international medical graduates the AKT will be held at international test centers and the CPSA will be held at the GMCs center in Manchester, UK.
How is the UKMLA Scored?
The UKMLA is a pass/fail exam.
The AKT is computer-marked and results will be available soon after taking the exam. The CPSA is scored by examiners on the day.
What Is Tested On The UKMLA?
All content in the MLA will derive from the MLA content map.
The MLA content map sets out the core knowledge, skills and behaviours needed for UK practice. All applied knowledge test (AKT) and clinical and professional skills assessment (CPSA) content must derive from the content map.
The content map is based on Outcomes for graduates (2018), the Generic professional capabilities framework (2017), the relevant parts of the Foundation Programme curriculum and the situations typically faced by doctors working in the UK Foundation Programme.
It has three overarching themes: readiness for safe practice, managing uncertainty, and delivering person-centred care; and six sections, called domains:
- Areas of clinical practice, such as mental health and surgery.
- Areas of professional knowledge, such as biomedical sciences and medical ethics and law.
- Clinical and professional capabilities, such as assessing and managing risk and safeguarding vulnerable patients.
- Practical skills and procedures, as set out in the list of practical skills and procedures that supplements our Outcomes for graduates (2018).
- Patient presentations, which relates to signs, symptoms, investigation results and other relevant patient-related issues typically seen by doctors in a first appointment within the UK Foundation Programme. For example, a chronic rash or breast lump.
- Conditions, which are pathophysiological diseases or clinical diagnoses typically seen by doctors in a first appointment within the UK Foundation Programme. For example, asthma and eating disorders.
The MLA content map is organised into six domains:
How To Prepare For The UKMLA Exam
Your medical degree course is the best preparation for the UKMLA. Your medical school curriculum will cover everything that might come up in either of the MLA's two components. In addition to the topics and preparation provided by your medical school we also recommend the following to maximise your final UKMLA score:
Read the UKMLA Handbook Online
The GMC have mapped out their content map or syllabus for the UKMLA which covers the main medical curriculum equivalent to that of medical finals. The GMC website also features the latest information about the UKMLA and application system for IMGs.
Practice MLA AKT Questions Online
The best way to prepare is to practise realistic questions in the format of the final exam. For the AKT Shiken has a large bank of questions written by medical professionals and matching the MLA Content Map. The GMC offers free practice questions online to give you an idea of the format of the exam too.
Practice MLA CPSA Questions
Practising for the OSCE component of the MLA can be tough. The best way is to arrange in-person practice at your local hospital, attend a mock OSCE course or team up with other students or IMGs at your local hospital and practice examining interesting patients.
All of this can be time-consuming and so you might also like to try our online question bank of CPSA OSCE cases which you can work through alone or in pairs to test your knowledge and
When Should You Start Preparing For The UKMLA?
The UKMLA is the most important exam you will take if you want to practise medicine in the UK. It is not something that should be taken lightly and requires preparation and dedication. The sooner you start preparing for the exam, the better off you will be in the long run. The more time you have to prepare, the better prepared you will be when exam day comes around!
For the AKT we would recommend completing at least 2000 practise multiple choice questions online in order to cover as many topics and questions as possible. We would suggest beginning your preparation around 4-6-months before the exam to give you sufficient time to prepare around other commitments, especially if you are in full time employment as an IMG.
For the CPSA most OSCE exam preparation should begin 4-6 months before the exam and putting together a revision time table can be really helpful here too.
The UKMLA is an important step in your journey to becoming a doctor in the UK. It is essential that you prepare for it as best you can and practice as much as possible.