GMC begins work to deliver Medical Licensing Assessment

GMC approves initial model for a Medical Licensing Assessment for doctors wishing to enter UK practice

The General Medical Council (GMC) has approved the initial model for a two-part Medical Licensing Assessment (MLA) that will provide more consistency in the ways doctors enter UK practice.

"We look forward to continuing our work with the community of experts that we have brought together from the undergraduate and postgraduate worlds"

Professor Terence Stephenson

GMC Chair

UK medical students and International Medical Graduates (IMGs) will take the same test of applied knowledge, while UK medical schools and the GMC will continue to deliver their own practical assessments of clinical and professional skills to these groups of doctors.

However, the GMC will introduce new standards and performance measures to drive consistency in the way these practical assessments are run, before it explores whether to bring in a single assessment for UK students and IMGs in the future.

UK medical students will begin taking the knowledge assessment as part of the MLA from 2022 onwards.

 Professor Terence Stephenson, the Chair of the GMC, said:

‘We have listened extremely carefully to the advice given to us by our partners and stakeholders in each country of the UK. While many support the aim of the MLA, there were some concerns about the original model we proposed – in particular the impact which it could have had on medical students and the supply of doctors into the UK.

‘The model that we have now agreed is pragmatic yet still progressive, building on the achievements made by medical schools in recent years but pushing for greater consistency in the standards of their assessments. This will give better assurance to patients and employers.

‘We are not ruling out moving to a single assessment of clinical and professional skills at some point in the future. However, we cannot begin to explore this without first making sure that we have the right foundations in place.

‘We will now develop the elements of the assessment in more detail, and we look forward to continuing our work with the community of experts that we have brought together from the undergraduate and postgraduate worlds.’

The GMC’s Council has agreed the initial model following a public consultation earlier this year on proposals. More than 400 consultation responses were received from medical schools, doctors and students, with almost two-thirds supporting the GMC’s aims.

 Professor Jenny Higham, Chair of the Medical Schools Council, said:

‘We share the GMC’s goal of designing high quality assessments that are fair to students and provide assurance to the public about the standard of doctors entering the medical register in the UK.

‘It is good to see the GMC has recognised our work in the development of common examination content in written assessment. However, delivering the original model proposed by the GMC for the CPSA presented many challenges. This is why I’m pleased the GMC has listened carefully to the views expressed by medical schools and agreed an initial approach that will be more proportionate in scope.

‘The hard work now begins to deliver the assessment by 2022. We look forward to continuing to work with the GMC next year as we develop the technical details of how the assessment will work in practice.’

Royal College of Physicians president Jane Dacre said:

‘The approval of the Medical Licensing Assessment (MLA) by the GMC is positive news for the profession. The MLA’s introduction should ensure that doctors entering the NHS are safe and fit to practise through the demonstration of core knowledge, clinical skills and professionalism.

‘This push by the GMC to create greater consistency in how doctors enter UK practice can only be a positive thing for the patients we treat and for the wider NHS. We look forward to working collaboratively with the GMC to aid in its implementation.’

At present, every one of the UK’s 32 medical schools has its own system and, although they work to common outcomes set by the GMC and share some written questions, there is no UK-wide process to set a common standard to pass.

 International medical graduates (IMGs) also have several means of entry to the register, while under current legislation doctors from the EU can secure a UK licence to practise without any test of their competence.

 Once there is greater clarity on the impact of Brexit on the movement of doctors from the EEA, following negotiations between the UK and EU, the GMC will further develop its approach to doctors from those countries.

 Professor Stephenson continued:

‘It remains our ambition that the system of entry into UK practice should be consistent and fair for every doctor – whether they qualified in the UK, from Europe or beyond.

‘However we have to be realistic and recognise the limits of what we can achieve while we are in the middle of the negotiations about Brexit.

‘When the time comes to develop our approach for EEA doctors, we will make sure the new arrangements give confidence to both patients and employers. It’s crucial that we maintain the standard of UK practice as well as maintain a healthy supply of good doctors into the UK.