UKMLA – Transitioning from PLAB: a guide for IMGs

  • April 06, 2023

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: 

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: 

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

You will sit the AKT. 

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


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. 


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. 



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