Passing the UKMLA is one key step towards becoming a licensed doctor in the UK, but it’s not the only step. Let’s put it in context of the journey from medical student (or international graduate) to fully licensed doctor:

UK Graduates: 

If you’re studying at a UK medical school, the MLA will be taken in your final year (or penultimate year for some) as part of your degree requirements​. You must pass both the AKT and CPSA to graduate with your medical degree in 2025 or later​. Once you graduate, you’ll receive your Primary Medical Qualification (your MBBS/MBChB degree), and assuming you’ve passed the MLA, you can then apply to the GMC for Provisional Registration with a licence to practise​. Provisional registration is the type of GMC registration that allows you to work as a Foundation Year 1 (FY1)doctor. So essentially, the MLA is now a graduation exit exam for UK students – no MLA, no medical degree (and thus no provisional license).

After passing the MLA and graduating, you’ll enter the Foundation Programme (FY1) with provisional registration. During FY1, you’ll work under supervision and complete a portfolio demonstrating your competencies. If everything goes well at the end of that first year of training, you’ll be signed off and will become eligible for Full Registration with the GMC. Full registration is necessary for you to work as a doctor beyond the foundation internship year.

In summary: UK med student → pass MLA → graduate → GMC provisional registration → complete FY1 → GMC full registration. The MLA serves as a crucial gatekeeper in this sequence, ensuring you meet the standard even before starting as an FY1.

International Medical Graduates (IMGs): 

If you graduated from a medical school outside the UK, the pathway is a bit different but converges at the MLA. To obtain GMC registration, IMGs traditionally have to: 

  • Prove they have an acceptable primary medical qualification, 

  • Demonstrate their medical knowledge and skills (historically via PLAB exams), and 

  • Show English proficiency, among other checks (like good standing certificates).

With the implementation of MLA, IMGs will fulfil the knowledge and skills requirement by taking the MLA (which, as noted, currently involves the PLAB 1 and 2 exams aligned to MLA)​. Thus, an IMG must pass the AKT (PLAB 1) and CPSA (PLAB 2) to be eligible for registration​. You also need to meet the English language requirement (usually IELTS or OET) separately – the MLA doesn’t test language, so this remains unchanged​. Once you’ve passed both parts of the MLA/PLAB and met all other criteria (acceptable medical degree, English, etc.), you can apply for GMC registration.

Depending on your experience, you might receive Full Registration immediately (for example, if you have completed an acceptable internship equivalent to FY1 abroad)​. If you have not completed an internship, the GMC may grant you Provisional Registration​, which means you would need to complete FY1 in the UK as a provisionally licensed doctor (just like UK graduates do) before progressing. After that, you would transition to full registration. One important recent change: doctors from the European Union/EEA, who were previously often exempt from PLAB due to automatic qualification recognition, now also have to pass the MLA from 2024 onward to register, just like any other IMG.

In summary, the UKMLA has become an essential hurdle on the path to practising in the UK for both UK graduates and international doctors. For UK graduates, it is integrated into medical school finals and must be passed to obtain that all-important provisional license and begin your foundation training​. For international graduates, passing the MLA (AKT + CPSA) is required along with other checks to gain registration to work in the UK. Once you have passed it (and completed any required training such as internship/FY1), you will be on a level playing field – you will hold the same license to practise as any UK-trained doctor. Think of the MLA as the new common doorway into UK medical practice.