Applicable to all MLA exams and assessments taken from September 2026 onwards.
Domain 3: Clinical and professional capabilities
This domain outlines the skills, behaviours, and attributes required for delivering safe, effective, and compassionate care, while acting as a competent and responsible member of the healthcare team.
Capabilities are grouped into:
- Professional skills.
- Professional values and behaviours.
These categories align with Outcomes for graduates and the Generic professional capabilities framework, both of which reflect the professional principles, values and standards set out in Good medical practice.
In addition to direct patient care, these capabilities include self-awareness, clinical reasoning, communication, teamwork, leadership, and ethical decision making. A newly qualified doctor must be able to assess, diagnose, and manage patients, communicate effectively, and engage in reflective practice to support ongoing professional development.
Doctors are expected to uphold professional values and behaviours, eg by acting fairly, avoiding discrimination, and supporting patients in making informed decisions. MLA candidates can develop and test their understanding of Good medical practice (and the more detailed guidance derived from it) using the following resources:
- Good medical practice
- The professional standards - including Good medical practice and the more detailed guidance
- Professional standards in action: interactive online tool
- Welcome to UK Practice: case studies
- Achieving Good medical practice: guidance for medical students - illustrates how Good medical practice principles apply to medical students)
Some areas in this domain include descriptors to offer additional context about what each heading covers. These descriptors are intended to guide understanding and should not be viewed as exhaustive or limiting in scope.
Professional skills
Obtains and evaluates relevant information about the patient through appropriate history and physical and/ or mental health examination, formulating a prioritised list of problems and differential diagnoses
Includes establishing a therapeutic relationship with the patient, taking into account—and acting appropriately in response to—relevant contextual factors, such as:
- social factors (eg employment and fitness for work, housing, migration status)
- lifestyle factors (eg smoking cessation, physical activity, diet)
- barriers to accessing care or managing health (eg digital literacy, access to transport)
- characteristics protected by legislation—including age, disability, gender reassignment, race, marriage and civil partnership, pregnancy and maternity, religion or belief, sex, and sexual orientation—and how these may intersect
- other relevant personal characteristics not protected by legislation (eg gender identity, cultural background).
- Good medical practice (‘Providing good clinical care’)
- Outcomes for graduates (‘Communication and interpersonal skills’ and ‘Diagnosis and medical management’)
Identifies and requests relevant investigations, interprets results and ensures they are acted on appropriately in the context of the clinical situation, avoiding over-investigation, over-diagnosis and over-prescription
Includes requesting and acting upon clinical imaging.
- Good medical practice (‘Providing good clinical care’)
- Outcomes for graduates (‘Communication and interpersonal skills’ and ‘Diagnosis and medical management’)
Generates management plans in emergency and acute presentations, and manages patients perioperatively
Includes recognising the possibility of serious illness and initiating initial management, and managing patient medications.
- Outcomes for graduates (‘Diagnosis and medical management’)
Generates management plans for chronic conditions
Includes recognising the possibility of serious illness and initiating initial management, and rehabilitation.
- Outcomes for graduates (‘Diagnosis and medical management’)
Generates management plans to promote health and prevent disease
Includes individual patient and the population, and in partnership with the patient, consideration of:
- social and lifestyle factors
- barriers to accessing care and managing their health
- occupation and fitness for work
- rehabilitation.
- Good medical practice (‘Providing good clinical care’, ‘Sharing information with patients’ and ‘Caring for the whole patient’)
- Outcomes for graduates (‘Health promotion and illness prevention’)
Communicates effectively with patients, relatives, partners, carers and other advocates
Includes demonstrating person-centred consultation and management skills, such as:
- finding out what matters to the patient
- sharing appropriate information about treatment options—including the option to take no action
- identifying communication differences and needs, making appropriate adjustments, and seeking support where necessary.
- See Good medical practice (‘Domain 2: Patients, partnership and communication’) and Decision making and consent for guidance on the dialogue with patients that leads to a decision, including sharing information (including patients lacking capacity and when to involve others in decision making)
- Outcomes for graduates (‘Communication and interpersonal skills’ and ‘Diagnosis and medical management’)
Demonstrates understanding of patient capacity, consent and confidentiality in delivering care
- Good medical practice (‘Domain 2: Patients, partnership and communication’)
- See Decision making and consent for guidance on conducting conversations with patients, sharing the information they need to make decisions, and ensuring you have informed consent from the patient. This includes decision making for patients who lack capacity.
- Confidentiality: good practice in handling patient information sets out principles of confidentiality and provides a framework to help determine when and why patient information should be shared. It also includes guidance on managing and protecting information, as well as sharing information after a patient has died.
- Outcomes for graduates (‘Professional and ethical responsibilities’)
Prescribes, reviews, communicates and monitors the effects of medicines safely and effectively
Includes:
- stopping or changing medications where appropriate
- complex prescribing (polypharmacy)
- safe prescription of fluids and blood products.
- and safe administration of medicines (including medical gases) where appropriate.
- Good practice in proposing, prescribing, providing and managing medicines and devices provides more detailed guidance on professional standards for proposing, prescribing, or providing and managing medicines and medical devices
- Outcomes for graduates (‘Prescribing medicines safely’)
Manages pain
- Good medical practice (‘Treating patients with kindness, courtesy and respect’)
Performs procedures safely
- Outcomes for graduates (‘Diagnosis and medical management’, Outcome 13)
Participates in holistic management of palliative and end of life patients
Includes symptomatic management of patients approaching end of life:
- Treatment and care towards the end of life: good practice in decision making provides a framework to support doctors to meet the needs of patients approaching the end of life
- Outcomes for graduates (‘Diagnosis and medical management’, Outcome 15)
Professional values and behaviours
Behaves in accordance with legal and ethical responsibilities (including equality, diversity and inclusion principles)
Includes:
- understanding and applying the ethical and legal responsibilities set out in Good medical practice and more detailed guidance—such as professional boundaries, personal beliefs, use of social media, raising and acting on concerns, the duty of candour, and managing conflicts of interest
- recognising both conscious and unconscious bias towards individuals and groups, and developing strategies to address it
- See Good medical practice and the range of more detailed guidance which expands on some of the standards set out in Good medical practice
- Outcomes for graduates (‘Professional behaviours’, ‘Professional and ethical responsibilities’, and ‘Legal responsibilities’)
Safeguards vulnerable patients
Includes recognising and identifying vulnerable patients and taking appropriate action in line with local and national guidelines.
- See Good medical practice (‘Safeguarding children and adults who are at risk of harm’) for safeguarding principles alongside the Children and young people guidance and our Adult safeguarding hub.
- See also Decision making and consent for guidance on: if you’re concerned a patient may not be able to make a decision freely, and decision making when patients lack capacity
- Outcomes for graduates (‘Safeguarding vulnerable patients’)
Deals appropriately with complexity and uncertainty including managing multimorbidity and prioritising tasks
Includes situational awareness and knowing how and when to ask for help, eg:
- if you have doubts about a task that has been delegated to you
- if you feel a delegated task may be beyond the limits of your competency
- if you believe you do not have an appropriate level of clinical supervision.
- See also Good medical practice (‘Delegating safely and appropriately’): “If a task is delegated to you by a colleague but you’re not confident you have the necessary knowledge, skills or training to carry it out safely, you must prioritise patient safety and seek help, even if you’ve already agreed to carry out the task independently.”
- Outcomes for graduates (‘Dealing with complexity and uncertainty’)
Communicates and works effectively, respectfully, and supportively as a member of the team
Includes leadership and recognising and reflecting on poor behaviour (of self and colleagues) and taking any appropriate follow up actions.
- Good medical practice (‘Domain 3: Colleagues, culture and safety’)
- Outcomes for graduates (‘Leadership and team working’)
Manages risk
Includes working in challenging conditions, knowing how and when to raise concerns about patient safety, and using safety reporting systems.
- Good medical practice (‘Domain 3: Colleagues, culture and safety’)
- Raising and acting on concerns about patient safety explores who the best person or organisation is for you to raise concerns with and how to raise your concerns
- Outcomes for graduates (‘Professional and ethical responsibilities’)
Uses and records information safely and effectively
- Confidentiality: good practice in handling patient information includes guidance on managing and protecting patient information
- Outcomes for graduates (‘Using information effectively and safely’)
Effectively uses relevant guidelines and critically evaluates information and evidence when assessing a patient
Includes information and evidence shared by the patient.
- Outcomes for graduates (‘Using information effectively and safely’)
Demonstrates reflective practice
Includes seeking feedback.
- Good medical practice (‘Maintaining, developing and improving your performance’)
- See The reflective practitioner for guidance on the principles of reflective practice
Demonstrates understanding of the importance of self-care and personal wellbeing
- Good medical practice (‘Managing risks posed by your health’)
- Outcomes for graduates (‘Professional and ethical responsibilities’)
