Introduction to UKMLA – The New Licensing Exam for Doctors in the UK

The United Kingdom Medical Licensing Assessment (UKMLA) is a new exam system introduced in the UK starting in 2024 for doctors wishing to practice in the UK. It will replace the existing PLAB (Professional and Linguistic Assessments Board) exam taken by international medical graduates.

The UKMLA will also be a mandatory exam for UK medical graduates before they are granted full registration with the General Medical Council. This blog provides a comprehensive overview of UKMLA and how it will impact overseas and British candidates aspiring to work as doctors in the UK.

Purpose of UKMLA

The key objectives behind introducing the new UKMLA framework are:

1. To have a common assessment framework for UK and international medical graduates seeking medical registration in the UK.
2. To assess clinical competencies required for safe practice in the UK healthcare system.
3. To evaluate communication skills and professional capabilities.
4. To ensure standards are aligned with UK curriculum and regulatory guidelines.

So, in a nutshell, UKMLA aims to uniformly assess all doctors before granting registration to practice medicine in the UK.

Comparison with USMLE and PLAB

While the USMLE examination in the USA and existing PLAB in the UK also assess overseas doctors, the UKMLA has some fundamental differences:

1. UKMLA applies to both British graduates and international doctors, unlike USMLE, which is just for international candidates.
2. UKMLA focuses more on communication abilities and applied clinical knowledge, unlike PLA, which emphasises clinical skills lessons.
3. The standards of UKMLA are defined by UK medical schools and GMC, unlike USMLE, which is independent of medical schools.
4. UKMLA judges readiness for the UK workplace, not just theoretical knowledge.

So, UKMLA aims for a more holistic assessment tailored to medical practice requirements in the UK.

United Kingdom Medical Licensing Assessment (UKMLA) or Medical Licensing Assessment (MLA)

The terms United Kingdom Medical Licensing Assessment (UKMLA) and Medical Licensing Assessment (MLA) refer to the same licensing examination, with the specific terminology used depending on the context:

MLA: This is the general term used to refer to the new licensing assessment for both UK medical graduates and international medical graduates. It is the umbrella term that encompasses the assessment for all candidates seeking GMC registration.

UKMLA: This term is specifically used when referring to international medical graduates taking the Medical Licensing Assessment. The “UK” in UKMLA emphasizes that this is the assessment for international graduates seeking to practice medicine in the United Kingdom.

In essence, the MLA and UKMLA are the same examinations, with the following distinctions:

UK Medical Graduates: UK medical students graduating from universities in the UK will take the Medical Licensing Assessment (MLA) towards the end of their studies, typically in their final year. This is a new requirement replacing previous assessments like the AKT and CPSA.

International Medical Graduates: Doctors who obtained their primary medical qualification from outside the UK (international medical graduates) will take the United Kingdom Medical Licensing Assessment (UKMLA) to be eligible for GMC registration and practice medicine in the UK. The UKMLA replaces the previous PLAB exam for international graduates.

Both the MLA and UKMLA have the same format, consisting of a computer-based assessment (Part 1) and an objective structured clinical examination (OSCE) (Part 2). Candidates must pass both parts to complete the licensing assessment successfully.

When do I need to take the MLA?

UK medical students will take the MLA towards the end of their studies, typically in their final year. International graduates will need to pass the UKMLA before applying for GMC registration.

What will be assessed in the Medical Licensing Assessment (MLA)?

The Medical Licensing Assessment (MLA) is designed to comprehensively assess the knowledge, skills, and professional values required for safe and effective medical practice in the UK. Here’s what will be assessed in the MLA:

Part 1: Computer-Based Assessment This part will assess the following areas:

1. Clinical Knowledge: Knowledge of basic medical sciences (anatomy, physiology, pathology, etc.)
2. Knowledge of clinical medicine (diagnosis, management, treatment)
3. Application of clinical knowledge in various scenarios
4. Data Interpretation: Interpretation of clinical data (e.g., lab results, imaging, ECGs)
5. Analysis and synthesis of patient information
6. Professional Values and Ethical Principles:
7. Professionalism, integrity, and ethical behaviour
8. Legal and regulatory aspects of medical practice
9. Patient safety and quality of care

Part 2: Objective Structured Clinical Examination (OSCE) This part will assess the following clinical skills and competencies:

Communication Skills: History taking and communication with patients, Breaking bad news, obtaining informed consent

Communication with colleagues and inter-professional collaboration

Clinical Examination Skills:

1. Physical examination techniques
2. Procedural skills (e.g., CPR, suturing, injections)
3. Clinical Reasoning and Decision-Making:
4. Diagnostic reasoning and formulating management plans
5. Clinical judgment and decision-making abilities
6. Professionalism and Ethics:
7. Professional behaviour and attitudes
8. Ethical reasoning and decision-making
9. Respect for patient autonomy and diversity

The MLA aims to assess a wide range of competencies, including medical knowledge, clinical skills, professionalism, and ethical reasoning, to ensure that candidates are well-prepared to practice medicine safely and effectively in the UK healthcare system. It’s important to note that the specific content and weightage of different areas may vary, and candidates should refer to the official GMC guidelines and resources for the most up-to-date information on the MLA assessment.

What is the format of the UKMLA?

The United Kingdom Medical Licensing Assessment (UKMLA) for international medical graduates has the following format:

Part 1: Computer-Based Assessment Comprises around 180 single-best-answer questions

Questions cover a wide range of medical domains, including:

1. Clinical knowledge and its application
2. Data interpretation
3. Professional values and ethical principles

The questions are designed to test the candidate’s ability to apply medical knowledge in a clinical setting.

Part 2: Objective Structured Clinical Examination (OSCE)

Consists of approximately 14 OSCE stations Candidates rotate through these stations, each lasting around 8-10 minutes.

The stations assess various clinical skills, including:

1. History-taking and communication skills
2. Physical examination skills
3. Procedural skills (e.g., CPR, suturing, etc.)
4. Interpretation of clinical data (e.g., X-rays, ECGs, lab results)
5. Clinical reasoning and decision-making
6. Professionalism and ethical behavior

Both Part 1 and Part 2 of the UKMLA must be passed to complete the assessment and be eligible for GMC registration successfully.

Key Points:

Part 1 assesses medical knowledge and its application through a computer-based exam.

Part 2 assesses clinical skills, communication abilities, and professionalism through an OSCE.

The format is designed to comprehensively evaluate the competencies required for safe and effective medical practice in the UK.

It’s important to note that the exact number of questions/stations and other specifics may change slightly each year, so candidates should refer to the official GMC website for the most up-to-date information on the UKMLA format.

What is the medical licensing assessment in the UK?

The medical licensing assessment in the UK is a new examination that both UK medical graduates and international medical graduates will need to pass to obtain registration with the General Medical Council (GMC) and be licensed to practice medicine in the UK. This assessment is called:

For UK medical students graduating from UK universities, it is called the Medical Licensing Assessment (MLA).

For international medical graduates who obtained their primary medical qualification from outside the UK, it is called the United Kingdom Medical Licensing Assessment (UKMLA).

The MLA/UKMLA replaces previous assessments like the Professional and Linguistic Assessments Board (PLAB) exam for international graduates and the Applied Knowledge Test (AKT) and Clinical Skills Assessment (CSA) for UK graduates.

Key Points about the MLA/UKMLA:

It consists of two parts: Part 1 – Computer-based exam, Part 2 – Objective Structured Clinical Exam (OSCE)

Part 1 assesses clinical knowledge, data interpretation, professionalism and ethics through multiple-choice questions.

Part 2 (OSCE) evaluates clinical skills like history taking, examination, procedures as well as communication and professionalism.

Both parts must be passed to complete the licensing assessment successfully.

It ensures doctors, whether UK or internationally trained, meet the same standards of competence for practice in the UK.

What are the hardest medical licensing exams?

Some of the hardest and most challenging medical licensing exams globally include:

1. United States Medical Licensing Examination (USMLE) – This three-step exam is considered one of the most difficult licensing exams. It comprehensively assesses medical knowledge, clinical skills, and patient management abilities.
2. Medical Council of Canada Qualifying Examination (MCCQE) – This two-part exam evaluates medical graduates’ readiness to practice medicine in Canada. The clinical skills component involving standardized patient interactions is particularly challenging.
3. United Kingdom Medical Licensing Assessment (UKMLA/MLA) – The new licensing exam for the UK is expected to be quite rigorous, with a computer-based assessment and an OSCE component testing a wide range of competencies.
4. Australian Medical Council (AMC) Examinations: International medical graduates seeking registration in Australia must pass the AMC exams, which include a multiple-choice exam and a clinical examination, known for their high standards.
5. Professional and Linguistic Assessments Board (PLAB) Test – Until recently, the PLAB was the licensing exam for international medical graduates in the UK and was widely considered a challenging assessment.
6. National Medical Commission (NMC) Examinations: In India, the NMC conducts the NEXT exam, which includes theory and clinical components and is known for its competitive nature and high standards.

UKMLA Preparation: Thorough preparation is crucial for the UKMLA. Candidates should use a combination of resources, including official GMC materials, question banks, mock exams, and clinical skills practice, to ensure they are well-prepared across all assessed domains.

Pros and Cons associated with the UKMLA

The United Kingdom Medical Licensing Assessment (UKMLA) is a standardized Here are some pros and cons associated with the UKMLA:

Pros

1. Standardization of Assessment: The UKMLA creates a uniform standard for assessing the competencies of all medical graduates, whether they studied in the UK or abroad. This helps ensure that every doctor practicing in the UK meets the required safety and knowledge standards​
2. Integration into Medical Education: For UK medical students, the UKMLA is integrated into their university courses, which can streamline the path from education to professional practice.
3. Clear Structure and Comprehensive Content: The UKMLA covers a wide range of medical knowledge and skills, structured around key areas such as patient safety, clinical practice, and professional behavior. This comprehensive approach ensures that newly qualified doctors are well-prepared for the realities of medical practice​

Cons

1. High Stakes: The UKMLA is a high-stakes exam, with the requirement to pass before a medical graduate can be registered to practice. This can add significant pressure on students, particularly ​
2. Potential for Increased Stress and Anxiety: it increase stress and anxiety among medical students, who must ensure they are adequately prepared to meet its broad and strict standards​
3. Costs of Resits: While the initial exam fee is covered by medical schools, students who need to retake the UKMLA may face additional costs.

Will I have to pay for the UKMLA?

Here are some key points regarding fees and consequences of failing the UKMLA:

1. Paying for the UKMLA: The UKMLA is a fee-paid examination conducted by the General Medical Council (GMC). International medical graduates will need to pay an examination fee to register and take the UKMLA.
2. The fees may vary from year to year, and it’s essential to check the official GMC website for the latest fee structure and payment guidelines.
3. Typically, there are separate fees for Part 1 (the computer-based assessment) and Part 2 (the Objective Structured Clinical Examination, OSCE).

What happens if I fail the UKMLA?

Here’s what happens if you fail:

a) Failing Part 1: You will need to re-take and pass Part 1 before being allowed to attempt Part 2.

There may be a limit on the number of attempts allowed for Part 1.

b) Failing Part 2: You will need to re-take and pass Part 2, even if you have previously passed Part 1.

There may be a limit on the number of attempts allowed for Part 2.

c) Failing both parts: You will need to re-take and pass both Part 1 and Part 2 in subsequent attempts.

In some cases, there may be a mandatory waiting period before you can re-attempt the failed part(s) of the UKMLA.

When will I get my UKMLA results?

Candidates typically receive their UKMLA results within a few weeks after taking the exam. The GMC will provide specific timelines and methods for result delivery.

What score do i need for ukmla to pass?

The UKMLA does not have a specific numerical score requirement to pass. It operates on a pass/fail basis against minimum competency standards set by the General Medical Council (GMC).

To pass the UKMLA, candidates must meet the minimum passing standards determined by the GMC for both Part 1 (computer-based assessment) and Part 2 (Objective Structured Clinical Examination). The exact minimum passing standards are not made public,

For UK Medical Students?

1. They will take the MLA towards the end of their medical studies.
2. The MLA will replace the current exams like the Applied Knowledge Test (AKT) and the Clinical and Professional Skills Assessment (CPSA).

For International Medical Graduates?

1. The MLA, also known as the United Kingdom Medical Licensing Assessment (UKMLA), will replace the previous Professional and Linguistic Assessments Board (PLAB) exam.
2. International graduates will need to pass the UKMLA to be eligible for GMC registration.

Will the UKMLA be similar to PLAB?

Yes, the United Kingdom Medical Licensing Assessment (UKMLA) is expected to be similar in format and structure to the previous Professional and Linguistic Assessments Board (PLAB) exam that it has replaced for international medical graduates seeking registration with the General Medical Council (GMC).

How to choose your UKMLA Question Bank?

It’s crucial to use high-quality question banks that accurately reflect the exam format and difficulty level. Look for question banks from reputable sources like publishers or exam preparatory companies. They should cover all the assessed competencies and provide detailed explanations.

How artificial intelligence technology can improve your UKMLA score?

AI Technology and UKMLA Score: AI-powered adaptive learning platforms can analyze your strengths and weaknesses, providing personalized study plans and practice questions tailored to your needs. This can help you focus on areas that require more work, improving your score.

Who is eligible for the PLAB exam?

Eligibility for PLAB Exam: The PLAB (Professional and Linguistic Assessments Board) test was previously used for international medical graduates but was replaced by the UKMLA in 2024.

Who is eligible for the UKMLA exam?

Eligibility for UKMLA Exam: To be eligible for the UKMLA, candidates must have a primary medical qualification that is acceptable to the GMC and meet the English language requirements.

What is the licensing exam for doctors in the UK?

Licensing Exam for Doctors in the UK: The UKMLA is the licensing exam for international medical graduates, while UK medical graduates take the MSRA (Medical Situational Judgment Test) and AKT (Applied Knowledge Test) as part of the MRCGP (Membership of the Royal College of General Practitioners).

Format of UKMLA

The UKMLA consists of two independent parts:

1. Applied Knowledge Test (AKT)

• Assesses basic medical concepts, knowledge and principles.
• Multiple choice questions testing problem-solving and clinical decision-making skills.
• Exam duration: 5 hours
• Conducted at accredited test centres on fixed dates.

2. Clinical Professional Skills Assessment (CPSA)

• Evaluates clinical, communication and diagnostic skills through role-playing scenarios.
• Involves interacting with trained patient actors.
• Assesses the capability to practice safely and ethically in the UK.
• Held in dedicated clinical simulation facilities in Manchester, London and Cardiff.

Both components independently test different facets of medical competence and readiness to practice in the UK.

Requirements for UK Medical Students

The GMC mandates passing UKMLA for UK medical students graduating in 2024-25 and onwards before granting full registration and licence to practice medicine in the UK.

Key Criteria for UK Graduates:

Must have completed UK-approved undergraduate medical qualification.

1. Need to pass both AKT and CPSA components of UKMLA.
2. No limit on attempts. Can retake failed components.
3. Expected to pass UKMLA final assessments before full registration.
4. UKMLA to be embedded in medical school curricula and final exams.

So, UKMLA will be integral to medical education and professional registration for British citizen doctors.

Requirements for International Medical Graduates

International medical graduates registering in the UK need to follow the below process:

Eligibility

• Primary medical qualification from a recognized institute abroad.
• Meet English language proficiency requirements (IELTS, OET, PTE).

Assessment Process

• From 2024, we need to pass both parts of UKMLA.
• Will first take AKT and, on passing, can apply for CPSA.
• Attempts limited to 4 for AKT and 3 for CPSA.
• Valid for five years after passing before applying for registration.

So, overseas doctors need valid qualifications and language skills and must pass UKMLA for GMC registration.

Phased Introduction of UKMLA

UKMLA will gradually replace the PLAB exam in a phased manner between 2024-2028:

1. In 2024, UKMLA will be mandated for UK students graduating that year.
2. From 2024, international doctors can take UKMLA or PLAB Part 1 and 2.
3. From 2025, PLAB Part 1 will be discontinued. Only PLAB 2 and UKMLA will run in parallel.
4. Final PLAB 2 to be held in late 2028. Only the UKMLA will continue after that.
5. Doctors who have passed PLAB 1 or 2 can apply for GMC registration until late 2030.

The transition from PLAB to UKMLA will be gradual and allow doctors who have cleared parts of PLAB to still be eligible for registration in the transition period.

Conclusion

In summary, the introduction of UKMLA in 2024 aims to modernize the licensing framework in the UK by having a common assessment tailored to British and international medical graduates seeking to practice in the UK. The new exam will evaluate the clinical knowledge, skills and professional attributes required for delivering safe patient care as per NHS standards. Passing UKMLA will be essential for full registration with a license to practice medicine in the UK.