UKMLA – Transitioning from PLAB: a guide for IMGs
- October 14, 2022
The UKMLA or MLA (Medical Licensing Assessment) is a new assessment being introduced by the GMC to replace PLAB (Professional and Linguistic Assessments Board) for international medical graduates (IMGs) and UK medical students.
The UKMLA will be the new standard test of the core knowledge, skills and behaviours needed to practise safely in the UK.
In this blog we will be taking a closer look at the assessment and the transition from PLAB, focusing on some key questions:
- Why is the MLA being introduced?
- Who will need to take the UKMLA?
- What is the timeline for the transition?
- How will the UKMLA be structured?
Skip ahead to the relevant section if you know what you’re looking for.
Introducing the UKMLA
Currently, PLAB is the assessment used to ensure doctors who qualified abroad have the right knowledge and skills to practise medicine in the UK. Once an IMG has completed both parts of PLAB, they are eligible for full GMC registration.
For UK trainees however, full registration is gained on moving to the second year of the Foundation Programme (F2/ FY2) in an approved training programme.
There is therefore no standard used for both UK medical graduates and international doctors, so the GMC has created the MLA with the stated aim of setting a common threshold for safe practice in the UK, regardless of where a doctor was educated or trained.
UKMLA Candidates
From 2024, all IMGs who would have sat the PLAB test will take the MLA if they’re applying for registration with a licence to practise in the UK. This means that if you are an overseas doctor taking another route to GMC registration, this is still available to you if you are eligible.
UK medical students graduating in the academic year 2024-25 will also need to pass the MLA as part of their medical school degree, before they can join the medical register.
You can find more information about your possible routes to the UK as an international doctor in our detailed guide here.
Transitioning from PLAB to MLA
Until 2024, IMGs will still be able to apply for PLAB in order to gain GMC registration. As overseas doctors wanting to come to the UK through this route will be in different stages of the process, the GMC has laid out the following guidelines which will be in place during the transition to the UKMLA:
- I have passed both parts of PLAB
- I have passed PLAB 1, but not yet attempted PLAB 2
- I have attempted PLAB 1, but not yet passed it
- I have passed PLAB 1 and attempted PLAB 2, but not yet passed it
Passed both parts of PLAB
There will be no changes here: you will still have up to two years from the date that you passed PLAB to apply for full GMC registration with a licence to practise.
Passed PLAB 1, but not attempted PLAB 2
As long as you passed PLAB 1 within the past two years, you won't need to take the AKT. However, instead of PLAB 2, you will take the CPSA.
Once you pass the CPSA, you'll be able to apply for full registration with a licence to practise (this must be within two years of passing the CPSA).
Attempted PLAB 1, but not passed it
There will be a maximum number of attempts and any previous attempts at PLAB 1 will count towards this maximum number. The GMC is currently still finalising that maximum number.
After passing the AKT, you will need to take the CPSA within two years.
Passed PLAB 1 and attempted PLAB 2, but not passed
As long as you passed PLAB 1 within the past two years, you won't need to take the AKT.
Instead of PLAB 2, you will take the CPSA.
There will be a maximum number of attempts and any previous attempts at PLAB 2 will count towards this maximum number. The GMC is currently still finalising that maximum number.
Once you pass the CPSA, you'll be able to apply for full registration with a licence to practise (this must be within two years of passing the CPSA).
Structure & Format of the UKMLA
The UKMLA will be composed of two parts: the applied knowledge test (AKT) and the clinical and professional skills assessment (CPSA). Both components will assess a range of things, all of which are outlined in the MLA learning outcomes. The main purpose of the MLA is to assess the knowledge and competencies related to safe medical practice in the UK.
1. The applied knowledge test (AKT)
This is planned to be an on-screen exam, with multiple choice questions. It will test your ability to apply medical knowledge to different scenarios. The AKT will be similar to the current PLAB 1 exam.
The AKT for overseas doctors will be set by the GMC, whereas for UK medical students, the exam will be run by medical schools. Information from the UK exams will be used to ensure that the assessment is comparable and consistent, where appropriate.
The test is expected to be held four times a year for international candidates, at a number of locations worldwide.
You will need to pass the AKT before you can take the CPSA.
2. The clinical and professional skills assessment (CPSA)
The CPSA for international doctors will be held at the GMC’s clinical assessment centre in Manchester. The CPSA will be similar to the current PLAB 2 exam.
For UK medical students, the CPSA will be set and run by their medical school. Each UK medical school calls the CPSA something different e.g. an Objective Structured Clinical Examination (OSCE), however the GMC will set requirements that all CPSAs must meet.
Exam Structure
The MLA content map tells you more about the topics and areas that your AKT and CPSA assessments could cover.
The MLA 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 the GMC’s 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 e.g. 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 e.g. asthma and eating disorders
In the future, sample questions will be provided by the GMC for the AKT so that you can get a better feel for the test.
Other Key Information
Cost
Similarly to PLAB, you will have to pay a fee to sit the UKMLA as an IMG. The fees have yet to be set by the GMC, but will be published once determined.
EEA Graduates
Decisions about whether EEA graduates will need to sit the MLA from 2024 will be informed by government-led agreements and trade deals. The GMC will provide an update on this situation once there is more information about future arrangements.
English Language Requirements
The MLA won't change the GMC’s English language requirements for registration. You must still prove that you have the necessary knowledge of English to practise safely in the UK.
Sources
https://www.gmc-uk.org/education/medical-licensing-assessment
https://www.gmc-uk.org/education/medical-licensing-assessment/uk-students-guide-to-the-mla
The introduction of the UKMLA is a significant change to one of the most popular routes taken by IMGs wanting to work in the NHS. Despite the change, there are always several options available to overseas doctors wanting to relocate to the UK. Feel free to get in touch with our team to discuss your options.
Read more useful articles on exams, NHS jobs and salaries in our IMG Resources library.
Relevant Jobs
This is a good opportunity for any FRCPath or European-qualified histopathologists to join a friendly, high calibre department in the North East of England. The department are looking for experienced but hungry histopathologists to join them for a long-term post, and the trust will support candidates working on the Portfolio Pathway in Histopathology (formerly known as CESR). The trust will consider both UK and overseas applicants.
What is the NHS Foundation Trust like?
The NHS Foundation Trust serves as a district general hospital, providing essential healthcare services to the local population. Under its management, various healthcare facilities in the region. Consistent positive evaluations from the Care Quality Commission (CQC) underscore its commitment to delivering high-quality patient care, safety, and efficiency. The catchment area of this trust encompasses the north east, ensuring residents have access to comprehensive healthcare close to home. Through its services, the trust plays a vital role in promoting community health and well-being, contributing to a stronger, healthier population.
What is the department & team like?
The department have been centralized at a state-of-the-art Pathology Centre located at the NHS Foundation Trust\'s main hospital. These services cater to the local population in the North East. The consolidation of Cellular Pathology Services, completed in 2014, marks an innovative reorganization in pathology services. Satellite hot lab facilities are available at the NHS Foundation Trust\'s other sites. The NHS Foundation Trust leads this service, and the appointed individual will be contracted.
Pathologists are equipped with high-quality IT infrastructure to facilitate remote attendance at Multidisciplinary Team Meetings (MDTs). In cases where physical presence is required, a departmental electric car or a hopper service is available for transportation. Digital pathology implementation is underway progressively for pathologists interested in participation.
Career Development & Further Opportunities Available
The department will in time be moving towards a specialist reporting model and there will be opportunity to carve out your lead role in either the GI, head & neck, and urology sub-specialties.Life in North East
The North East of England offers a diverse mix of rural landscapes and urban centers, providing doctors with a range of living options. Residents can explore historic sites like Hadrian\'s Wall or enjoy scenic walks along the Northumberland coast. The area boasts reputable schools and universities such as Durham University. Transportation links are efficient, connecting the region to major cities like Newcastle and Sunderland, as well as airports for convenient travel. Housing options vary from picturesque villages to modern city apartments, accommodating different preferences and lifestyles.
AM I ELIGIBLE FOR THIS ROLE?
Non-EEA candidates:
- FRCPath
- Experience in Histopathology
EEA candidates:
- Specialist certification in Histopathology
- Experience in Histopathology
UK candidates:
- CCT, CESR or within 6-12 months of specialist registration
- Experience in Histopathology
This is a unique opportunity to work in a developing initiative that will bring immense social good to the local the people of Wales.
Short / mid / long-term ambitions for this role.
Short-term, there is the opportunity to work a close group of four international doctors, with specialist qualifications in histopathology including FRCPath. You\'ll have the opportunity to shape the careers of hungry pathologists ready to absorb all the knowledge and experience from an experienced NHS colleague like yourself.
Mid-term you\'ll be jointly responsible for the successful portfolio submissions for these individuals, helping the laboratory at Glangwili General Hospital to establish a newly qualified consultant team to provide stability and excellent pathological services for the patients of Wales, UK.
Long-term, the potential is enormous. As part of ‘A Regional Collaborative for Health’ or ARCH a regional hub for South and West Wales is being built in Swansea, to house a 30-35 consultant lead service for histopathology alone. Fully digitalised regional services for half the Welsh landmass would be provided via one central and digitalised hub.
Life in the area
It\'s a beautiful life with Wales offering beaches, beautiful forest, lakes and mountains all available to you in your free-time. It\'s a low cost of living and a a bit of a dream for the right person. We can chat more about that over our call.
The UK Lab is based in Surrey, and the facility is ISO 15189 accredited and ISO 27001 certified.
The department provides the latest technology and several years of extensive research offering highly effective treatment solutions to cancer patients for whom, multiple lines of treatment have failed.
The UK lab receives samples that are received from private practices around the UK, Europe and USA.
Responsibilities:
With roughly two hours of work needed per day, mostly remote, with twice weekly attendance onsite likely required, the pathologists responsibilities will be along the lines of the below.
- Authorisation of reports (molecular and tissue)
- Sectioning slides / assessing tumour content - to help identify which sections can be used for processing samples.
- Approving & signing reports.
- Signing out molecular reports - training will be given.
- Signing out solid organ cancer reports
- Turnaround time is required within 24-hours.
Eligibility:
- GMC registration
- Right to work in the UK
- Ability to travel twice per week to Surrey, UK.
- FRCPath or Specialist Registration is not required for this post
An exceptional NHS job opportunity awaits a Middle Grade Microbiologist to join the Microbiology Pathology Department at an \"outstanding\" rate NHS Trust.The role involves diagnosing and managing infections caused by microorganisms, contributing significantly to patient well-being.
This is an ideal chance for overseas Microbiologists or Middle Grade Doctors to establish themselves in the UK NHS system, with potential CESR support. Suitable for EEA-specialized candidates or experienced IMGs seeking career advancement.
What is the NHS Foundation Trust like?
This NHS Foundation Trust is a dynamic organization with an £180 million turnover, employing 12,000 staff to serve 500,000 people across acute and community healthcare services. Recognized for excellence by the CQC in 2016 and 2019, it primarily serves an urban population but extends its care across a rural expanse from the River Tyne to the River Tweed, offering picturesque landscapes. The Trust operates three major hospitals and numerous community facilities, including the state-of-the-art Specialist Emergency Care Hospital. With ongoing capital investments, it ensures modern, purpose-built facilities and expands its services to meet evolving healthcare needs.
They provide an extensive array of specialties, boasting some of the region\'s largest specialist departments. These include the foremost trauma and orthopaedics service, a significant cardiology department, and one of the region\'s most expansive units for colorectal surgery services.
The NHS Foundation Trust prioritizes supporting its staff in achieving a healthy work-life balance, irrespective of individual circumstances. Applicants unable to work full-time due to personal reasons will still be considered for the position, and adjustments to job responsibilities can be discussed on a case-by-case basis upon appointment.
What is the Department & Team like?
The Clinical Support and Cancer Services Business Unit manages Radiology, Pharmacy, and Pathology departments, as well as cancer services, across several hospitals. These services also extend to six community hospitals. With modern facilities and dedicated staff, the Pathology department, including the microbiology laboratory, benefits from significant capital investment and supports medical education initiatives.
The Microbiology team offers clinical consultation services through various channels such as ward rounds, telephone, email, and multi-disciplinary team meetings. They collaborate closely with Infectious Diseases, Infection Prevention and Control, Public Health teams, and the laboratory. Encouragement for networking with Consultant Microbiologists in the Newcastle area is given to improve patient care across organizational boundaries.
The microbiology laboratory holds a central position within the hospital complex. It comprises 240 m² of laboratory space and 74 m² of office space, established during the hospital\'s original construction in 1987. Specimens from clinical areas within the North East site are transported to the laboratory via a vacuum air tube system, while collections from GP practices and other hospital sites across the region are managed through regular courier and van services.
Life like in North East
The North East of the UK offers a diverse landscape, blending urban hubs like Newcastle and Sunderland with picturesque rural areas. Residents enjoy a vibrant cultural scene, from historic sites like Durham Cathedral to sandy beaches along the Northumberland coast. The region hosts reputable universities such as Newcastle University and Durham University, complemented by excellent schools. Transportation links are robust, with rail and road networks connecting to major cities and airports like Newcastle International Airport. Housing options range from city center apartments to suburban family homes and quaint countryside cottages, catering to varied lifestyles and preferences.
An outstanding opportunity for a psychiatrist to join Forensic Psychiatry Department as Specialty Doctor that has received outstanding ratings from the CQC on three occasions. You will offer psychiatric input and conduct assessments, both psychiatric and physical, for patients on two wards. One ward is a self-contained low secure rehabilitation unit situated away from the main hospital premises, while the other is a medium secure rehabilitation ward. This role offers exposure to a broad spectrum of clinical presentations, including personality, affective, anxiety, psychotic, neurodevelopmental, and substance-related disorders. Moreover, it provides a platform for developing knowledge and understanding of forensic mental health sections. This position also offers CESR support for those seeking progression within the UK NHS Jobs system.
This is a great opportunity for overseas Specialty Doctors who want to establish themselves in the NHS, and grow their career. The post is suitable for candidates holding specialisation in the EEA, or for experienced IMGs looking to complete CESR.
What is the NHS Trust like?
The Mental Health NHS Trust is a leading provider of mental health service serving a population of 1.2 million. With five main inpatient sites and 25 community locations, they offer comprehensive support for both mental and physical health needs, catering to young people and adults alike. From managing phobias and anxiety to addressing conditions like bipolar disorder and schizophrenia, their services are diverse and inclusive. They integrate community health services with mental health care, enabling simultaneous treatment of conditions such as diabetes and mental health issues, promoting holistic patient care.
Forensic Psychiatry Team & Department
The Forensic Service enjoys a stellar reputation, earning an \'Outstanding\' rating from the Care Quality Commission. The Forensic Service delivers care in low and medium secure environments, featuring specialized facilities such as the National Stalking Clinic and the Fixated Threat Assessment Centre (FTAC). These services focus on evaluating and managing risks for prominent individuals.
The inpatient service consists of one acute assessment and treatment medium secure male 4 4 ward, four treatment and intervention medium secure male wards, one female medium secure ward, one medium secure and one low secure male learning disability ward, one low secure male FICU ward and 4 low secure male wards. There are currently 25 Consultant Forensic Psychiatrists in post, working with 5 senior psychiatric trainees who rotate with posts at other forensic psychiatric services in the region. There are 5 junior psychiatric trainees, coming from the UCH training schemes. The service currently employs 10 specialty doctors, working in the prisons and in the rehabilitation parts of the service.
Life in the area
The area offers a blend of urban and suburban living, providing both rural escapes and city conveniences. Residents can explore scenic parks or enjoy activities at different parks. The area boasts a range of quality schools and easy access to universities like Middlesex University. Transport links are excellent, with frequent trains to central London and nearby cities, as well as efficient connections to major airports. Housing options vary from historic cottages to modern apartments, catering to diverse preferences and lifestyles.
Career Development and Opportunities Available
With an extremely active education/teaching programme supported by the consultant team, there is opportunity to work towards and complete CESR, RCPsych exams, get involved in active research and many aspects of CPD.
Participation in research and educational activities will be encouraged.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Forensic Psychiatry (Desirable)
Non-EEA Candidates:
- MRCPsych
- Experience of working in Forensic Psychiatry (Desirable)
UK based applicants
- Experience of working in Forensic Psychiatry (Desirable)