Guide to the UKMLA
While the exam content and standard are the same, the logistics and process of the UKMLA differ slightly for UK medical students compared to international medical graduates. Here are the main differences to note:
🗓 Timing and Integration:
For UK students, the MLA is taken during their medical degree, usually in the final year. It is essentially part of the finals – you cannot receive your degree without passing it. For IMGs, the MLA is taken after graduating from medical school in their home country, as a separate credential while applying for UK registration. IMGs typically schedule the AKT (PLAB 1) at their convenience, as it is offered in multiple exam sessions per year, and then the CPSA (PLAB 2) when slots are available, usually planning to travel to the UK for the OSCE portion. In short, UK graduates take the MLA as students, while IMGs take the MLA as graduates seeking a UK licence.
🏫 Exam Delivery and Location:
UK graduates take the MLA exams under the auspices of their medical school. The AKT will be administered by your university, often on-campus or at a designated exam site, on computers, likely alongside classmates. The CPSA is your med school’s OSCE exam, held in the clinical skills labs or simulation centre as is customary for finals, observed by your university examiners with external examiners moderating. In contrast, international candidates take the exams through the GMC. The AKT/PLAB 1 is conducted at authorized test centers worldwide in various countries, allowing you to choose a location when booking. The CPSA/PLAB 2 takes place in the UK (Manchester) at the GMC’s clinical assessment centre. Therefore, UK students have the convenience of taking the exam at their school, typically on a single date set by the school, while IMGs must handle booking and possibly traveling for the exam.
💰 Cost:
For UK medical students, the MLA will be free at the point of entry – you won’t pay an exam fee to the GMC. It is integrated into your course, with the costs covered by the medical school/GMC arrangement. (Please note: if a student fails and needs a resit, some medical schools might charge an exam resit fee, or you might have to pay for an extra year. However, there’s no standalone MLA fee for students taking it for the first time.) For international graduates, there are exam fees for both parts of the MLA (since it’s essentially PLAB). As of 2023, PLAB 1 costs around £255 and PLAB 2 around £934 – totaling roughly £1200, not including costs like travel or courses. These fees can vary slightly from year to year, so IMGs do need to budget for the exam. In summary: UK graduates’ MLA is covered by tuition, while IMGs pay out-of-pocket for PLAB/MLA exams.
📄 Registration Type after MLA:
Upon passing the MLA, UK graduates will be eligible for Provisional Registration with the GMC, as they still need to complete FY1. IMGs who pass the MLA and meet all other requirements can typically obtain Full Registration if they have completed an internship equivalent to FY1. If an IMG has not completed an internship, the GMC may only grant Provisional Registration, meaning the doctor would need to finish FY1 in the UK to then gain full licensure. Therefore, some IMGs will enter UK training at the FY1 level (provisional registration), while others will enter at FY2 or beyond (full registration), depending on their experience. By default, UK graduates all transition from provisional to full registration via FY1.
🌐 English Language Requirement:
UK graduates who have completed a medical degree in English do not need to take an English language test for GMC registration. However, international graduates must demonstrate English proficiency, usually by passing the IELTS or OET exam, as a separate requirement in addition to the MLA. The MLA itself does not assess language skills. Therefore, an IMG must pass the IELTS or OET, unless exempt, along with the MLA, while a UK graduate typically only needs to focus on the MLA, since their degree fulfills the language requirement.
📝 Exam Content & Name:
The actual content tested is the same for both groups – it all comes from the MLA content map and is held to the same standard. The naming difference (MLA vs. PLAB) is mostly transitional. Eventually, it is expected that PLAB will just become “the MLA for international doctors,” but at least initially, the GMC is still referring to the IMG route as PLAB, just “aligned to MLA.” Practically speaking, you can consider PLAB 1 = MLA AKT and PLAB 2 = MLA CPSA for IMGs. The common content map means there is a uniform standard: a UK student and an IMG are tested on the same knowledge and skills domains.
🔔 Results and Feedback:
A minor point – MLA results for UK students will likely be reported as pass/fail along with a score, which you will receive through your medical school. The GMC has indicated that the MLA will be pass/fail (without public ranking of students), and detailed feedback for individual students will be limited. For PLAB (IMG) results, the GMC provides a pass/fail outcome, a score, and some feedback (such as banding for PLAB 2 performance). Both UK students and IMGs must meet the same passing standard (this standard may be established using Angoff or similar standard-setting methods to ensure fairness across the board).
Those are the primary differences. The overarching concept is that the MLA establishes a unified standard, offering two delivery pathways: one through medical schools for domestic students and another through the GMC (PLAB exams) for international doctors. Once they pass, all candidates merge into the system as either provisionally or fully registered doctors, prepared to begin their work.