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
A fantastic opportunity awaits Histopathologists seeking a fixed-term position. This Pathology Services provides support for CESR accreditation and facilitates entry into specialty training within the NHS. The department is both high-performing and supportive, particularly welcoming overseas doctors new to the NHS or UK-based doctors seeking career advancement. They deliver pathology services to their acute hospitals and local GPs, with some laboratories offering specialized services to the wider NHS and engaging in research studies. Serving 1.76 million patients and conducting 60 million tests, the partnership has resulted in 27,000 additional community phlebotomy appointments, improved turnaround times, and streamlined workflows.
The Pathology Service thrive on a dedicated workforce leveraging cutting-edge technologies, delivering exceptional clinical services centered on patient care.
What is the Pathology Service like?
The Pathology Services comprises four pathology laboratories. These laboratories are responsible for providing pathology services to both acute hospitals and local general practitioners. Additionally, certain laboratories within the network offer specialized services to the broader NHS and engage in research studies and trials. As part of a significant initiative within the NHS, pathology services in England are undergoing reorganization, transitioning into larger local network models. This restructuring has led to the establishment of 29 pathology units nationwide.
This development positions the pathology service as an exceptionally appealing workplace, situated at the forefront of NHS innovation and digitalization in pathology. Despite these advancements, this pathology service remains committed to delivering the latest tests and services, incorporating cutting-edge clinical science into modern patient care. Currently, they manage approximately 120,000 cases with a team of 36 consultants (augmented by some outsourcing), with the capacity to expand its consultant team to 40 full-time positions.
What is the department & team like?
The Pathology Service was established following the Lord Carter review of Pathology services in England, aiming to reduce overtesting, enhance resilience, and lower costs. amalgamates staff, services, and IT platforms from four trusts to enhance pathology quality in the Black Country, serving 1.4 million individuals and conducting 60 million tests annually. It underwent a comprehensive IT system overhaul to facilitate integrated services, embrace new technologies, and expedite laboratory results.
The pathology service operates three laboratories offering nationally accredited consultant-led pathology services. With state-of-the-art facilities and IT systems, they garnered commendation from Lord Carter for its efficiency and innovation in pathology. Notably, innovations showcased during Lord Carter\'s visit in 2021 included pre-barcoded tubes for sample tracking and digital automation in microbiology labs.
Lord Carter praised the service as a model of service integration and technological advancement, emphasizing the importance of technology, including artificial intelligence, in expediting diagnostics. He commended the leadership and dedication of the staff, highlighting their achievements and commitment to patient care. The evidence is there to be seen, as latest figures show they scored 92 per cent compliance on a dashboard provided by NHS Improvement, ranking it one of the best performing services in the country
Career Development & Opportunities Available
Career development opportunities are aplenty. The Centre is one of the highest performing centres in the UK, with excellent CQC scores, a fantastic leadership team, and highly advanced specialist reporting functions. All of this provides an excellent platform for anyone to excel and develop, whether it\'s a step towards specialisation in one anatomical area, or whether it\'s advancing yourself in the world of digital pathology, the right individual can really flourish here.
Digital Pathology and AI is a massive part of what the Group are doing, and part of what makes this opportunity so exciting. Working from home, working abroad, or taking on additional workload out of hours - digital pathology is taking off. They are the most advanced Digital Pathology Service in the UK, and this provides everyone with huge opportunity to grow and develop in a really exciting global field of pathology.
Life in the West Midlands
Based is a modern industrial city situated on the midlands. It is compact, with no boundary more than four miles from the centre and is approximately a 30-minute drive to Birmingham (15 miles), 1 hour 20 minutes to Manchester (60 miles). The city is an urban, multi-ethnic city with a population of around 250,000. The wider hospital catchment area has a population of in excess of 350,000. With more than 600 shops, bars, café and restaurants, the city is not only a great place to work but also somewhere to relax and enjoy. The city centre is just a 10-minute bus ride from the Hospital.
The nearby countryside of Staffordshire and Shropshire is delightful. To the north is Cannock Chase and to the west the Shropshire borders with attractions of Bridgnorth, the Clee Hills, the Long Mynd, Wenlock Edge, and the Severn Valley. South of Wolverhampton, the City of Worcester is easily accessible, and to the west north-Wales can be reached in just over an hour. The area has a large network of canals, the majority renovated, offering adjacent housing and popular for narrow boat holidays.
Am I eligible for this role?
To be eligible for this vacancy you will need the following:
EEA candidates:
- Recognised European Medical Degree
- Specialist Qualification in Histopathology
- IELTS or OET
Non-EEA candidates:
- FRCPath
- IELTS or OET
UK-based candidates:
- Within six months of CCT or CCT Holder
This is a great opportunity for any experienced histopathologist interested in specialisation, and with interest in digital pathology.
An excellent opportunity to join the dynamic team at an esteemed organization recognized for its excellence by the CQC. This is an opportune moment to become part of the Acute Medicine and Medicine Specialties Teams. With a strong history of achievements, they are committed to delivering exceptional patient-centered care. They are seeking dynamic and motivated specialists histopathologists to become part of their welcoming and enthusiastic gastroenterology team. This presents a chance to join a dedicated histopathology team committed to delivering the highest quality comprehensive service.
This is a great opportunity for overseas consultants or specialists who want to establish themselves in the NHS, and grow their consultant career. The post is suitable for candidates holding specialisation in the EEA, or for experienced IMGs looking to complete CESR.
What is the NHS Foundation Trust like?
The NHS Foundation Trust stands as one of the nation\'s largest integrated healthcare organizations, delivering both hospital and community services to a populace exceeding 650,000 individuals. Renowned for their ambition and innovation, they boast a skilled workforce comprising over 7,000 dedicated colleagues. Operating across two acute sites for hospital services and encompassing centers and community hospitals in six towns for planned care, they extend their services even to patients\' residences.
Recognized as a high-performing entity with a history of accomplishments, the Trust has functioned as an integrated acute and community services provider since 2011 and achieved foundation trust status in 2007. Guided by their strategic framework \"Our Patients Matter,\" they articulate their short- and long-term objectives and delineate the path to their realization. This framework underscores their commitment to providing the safest, most compassionate, and seamlessly coordinated care to the communities they serve.
Within this NHS Foundation Trust, medical professionals are presented with a plethora of career prospects and exposure to diverse care settings rarely encountered elsewhere. Additionally, they have the opportunity to reside and practice in some of the most culturally rich and picturesque locations across the country!
What is the Department & Team like?
The Histopathology department is dedicated to delivering precise diagnostic services crucial for patient care. Led by a team of experienced consultants and supported by junior doctors and skilled laboratory personnel, the department handles a wide array of cases across various medical disciplines. This includes examining tissue specimens for cancer diagnosis, assessing surgical margins, and identifying infectious diseases.
Equipped with advanced technology and instrumentation such as microscopes, tissue processing equipment, and digital imaging systems, the department ensures accurate diagnosis. The team collaborates closely with other departments like surgery, oncology, and radiology to ensure seamless patient care.
The department processes a significant volume of histopathology and cytology cases, providing essential information to clinicians for treatment planning and patient management. Committed to excellence and precision, the Histopathology team plays a pivotal role in delivering top-notch healthcare to the community.
What is life like in the area?
The North East of the UK offers a diverse mix of rural and urban settings, providing doctors with a range of living options. Residents can explore stunning coastal areas like Northumberland\'s beaches or venture inland to scenic national parks such as the North Pennines. The region is home to respected schools and universities, including Newcastle University. Transportation links are robust, with efficient road and rail networks connecting residents to major cities like Newcastle, Durham, and Sunderland, as well as international airports. Housing options range from quaint cottages in picturesque villages to modern apartments in vibrant city centers, catering to various lifestyles.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Histopathology
- Specialist Qualification in Histopathology
Non-EEA Candidates:
- FRCPath
- Experience of working in Histopathology
UK based applicants
- Experience of working in Histopathology
An exciting opportunity for a Consultant Breast Radiologist with expertise in breast and general radiology to work for a health board that aims to provide the best services to their patients. Ideal for overseas consultants looking to establish themselves in the NHS. The health board serves a population of 384,000 in several towns. They aim to improve healthcare by collaborating with local government and the third sector.
You will be a part of the Breast Radiology Department, which is a vital part of the healthcare service in the area, providing comprehensive diagnostic and interventional breast radiology services. Their team includes experienced consultants and junior doctors, ensuring high-quality care. The facility is well-equipped, and the successful candidate will lead and enhance the department\'s services. You will have a lot of growth opportunities as the Health Board is involved in education and research, with strong links to other universities. They aim to engage emerging clinicians in addressing Prudent Health Cares. Their Clinical Research Facility and initiatives in BioBanking and telemonitoring demonstrate their commitment to research and advancement.
It is situated in a town that offers a tranquil lifestyle with access to scenic coastal areas. It is a blend of rural and urban living. The region features quality schools and links to the University of Wales Trinity Saint David. Transportation connections are strong, and housing options are diverse, catering to different preferences. It\'s a balanced location for professionals and families.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Radiology
- Board Certified Specialist in Radiology
Non-EEA Candidates:
- Experience of working in Radiology
- FRCR
UK based applicants
- Experience of working in Radiology
- Within 6 - 12 months of completing CCT
An excellentHealth Board is actively seeking a Consultant Interventional Radiologist to join their innovative team. The role involves enhancing radiological services across the Health Board, reflecting their commitment to exceptional patient care. This opportunity is well-suited for overseas Consultants looking to establish themselves in the NHS or experienced IMGs seeking to complete CESR requirements.
The Health Board caters to 384,000 residents across several towns, delivering a wide spectrum of healthcare services. Their dedication to patient well-being includes a focus on continuous improvement, achieved through collaboration with local government and the third sector. The Health Board actively promotes education and research, fostering multi-profession teaching and supporting the development of up-and-coming clinicians. Their Clinical Research Facility and initiatives like BioBanking and telemonitoring reflect their commitment to advancing healthcare.
The Interventional Radiology Department is well-equipped and managed by experienced consultants and junior doctors. They provide comprehensive care, specializing in minimally invasive treatments for various conditions. Their advanced imaging technology ensures accurate diagnoses, and they handle a significant caseload of interventional radiology cases.
The hospital sits within a town that offers a balanced lifestyle with both urban conveniences and access to scenic rural areas. The region is known for its beautiful landscapes, high-quality schools, and strong transportation links to major cities and airports. Housing options are diverse, accommodating various preferences. This opportunity presents a holistic and enriching professional and personal life for healthcare professionals.
ARE YOU ELIGIBLE FOR THIS ROLE?
EEA Candidates:
- Experience of working in Radiology
- Board Certified Specialist in Radiology
Non-EEA Candidates:
- Experience of working in Radiology
- FRCR
UK based applicants
- Experience of working in Radiology
- Within 6 - 12 months of completing CCT
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