GMC consults on plans for Medical Licensing Assessment

Views sought on plans to create single route to the medical register for all doctors.

The GMC has today started to consult on plans for a Medical Licensing Assessment (MLA) that will provide a single route to the medical register for all doctors who wish to practise in the UK.

"This is surely the moment to look at how we can improve assurance for patients that the standards at entry are consistent"

Professor Terence Stephenson

GMC Council Chair

The proposals aim to address the current variation in arrangements for medical students across the country and those wishing to join the register from outside the UK.

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

International medical graduates (IMGs) also have a number of means of entry, the most common of which is the GMC’s Professional and Linguistic Assessments Board (PLAB) test. Meanwhile, doctors from the EU can secure a UK licence to practise without any test of their competence.

A recent poll of patients for the GMC found that two-thirds would have greater confidence in the checks carried out on doctors if there was a single assessment taken to enter the profession.

Professor Terence Stephenson, Chair of the GMC, said:

‘Medical training in the UK is among the best in the world – our graduates do well here and when they work overseas. However, current arrangements do not allow us to assess whether UK graduates and overseas graduates have attained the same threshold of competence when they are seeking the same licence to practise in the UK.

‘We also know that there is evidence of disparity between medical schools in how prepared UK graduates are for practice. With a planned increase in medical students in the pipeline and new schools appearing, particularly in England, this is surely the moment to look at how we can improve assurance for patients that the standards at entry are consistent.’

Professor Neil Johnson, Chair of the Medical Schools Assessment Alliance, said:

'One of functions of the Medical Schools Council (MSC) is to provide leadership for the education and training of future generation of doctors and, through that, to protect the public. I am therefore really pleased to see MSC and its members demonstrating that leadership by working with the GMC to develop the UK medical licensing assessment.  

'This assessment will enable the GMC to demonstrate that all future doctors have met a common threshold for competence and safety and will therefore make an important contribution to protecting the public.'

The proposals out for consultation have been shaped by GMC visits to every UK medical school in 2016 and the expertise of those working in the field of education assessments. The Chair of the Medical Schools Council Assessment Alliance, Professor Neil Johnson, has agreed to head an expert reference group that will advise the GMC how it should develop the assessment in a way which does not subject medical students to over-examination.

The GMC hopes to incorporate the new assessment into existing testing by medical schools.

The UK’s decision to leave the European Union, following the referendum in June 2016, may make it possible for the GMC to test the knowledge and skills of EEA doctors.

Depending on the UK’s future relationship with the EU, it is possible that the MLA could be taken by doctors from the European Economic Area (EEA) alongside UK candidates and doctors from the rest of the world. The GMC has long argued that it should have the ability to check that doctors coming to practise in the UK from Europe meet the same standards as those who qualify in the UK and outside Europe. This would strengthen the protection of patients as well as ensure fairness in the way all doctors are assessed for entry to the register, regardless of where they qualified in the world.

In the meantime, while new relations with the EU are being agreed, the GMC will continue to work within the limitations of UK law to ensure all doctors practising medicine in the UK are safe and fit to practise.

Professor Stephenson added: ‘Introducing a new assessment will take some years to achieve and we can only do this by working closely with our partners and by harnessing the extensive expertise which exists in our medical schools in the field of assessment. But after visiting every medical school in the UK last year, we see growing confidence that we can create something that will become a marker of the excellence of UK medical education and UK medicine around the world.’

Our consultation ran from 31 January to 30 April 2017.