MLA update: approval for a university-led applied knowledge test

The General Medical Council (GMC) has approved a proposal from UK medical schools – coordinated by the Medical Schools Council (MSC) – to collaborate on a national, university-led applied knowledge test (AKT). The test will form one component of the new MLA for students at UK medical schools and will need to comply with the requirements published by the GMC in March in Assuring readiness for practice: a framework for the MLA

All students graduating from UK medical schools from 2024–25 onwards will be required to pass the MLA as part of their degree before they can join the medical register. It will have two components: the AKT and the clinical and professional skills assessment (CPSA). For students at UK medical schools, the AKT will be set and administered by medical schools working together, through the MSC, with their work overseen and regulated by the GMC. The CPSA for these students will be set by individual schools and quality assured by the GMC.

Medical schools can now begin to pilot the university-led AKT, subject to the directions made by the GMC’s Council as part of its approval. The GMC has already begun to pilot the quality assurance process for the CPSA. 

Professor Colin Melville, the GMC’s Medical Director and Director of Education and Standards, said:

‘The MLA will create a common threshold for safe practice across UK medical schools, improve the focus on readiness for practice and provide an opportunity to better understand and tackle attainment gaps. Our Council’s approval of the university-led AKT is an important milestone in the onward journey of the MLA. Members recognised and appreciated the hard work that went into the proposal, which evidently drew on the wide range of expertise within the medical school community.

'In our regulatory oversight role, we look forward to working with medical schools and the Medical Schools Council to ensure a robust, fair and high-quality assessment of which we can all be proud.’

Professor Malcolm Reed, Lead Co-Chair of the Medical Schools Council, said:

‘The approval of UK medical schools’ proposal to collaborate to develop and deliver a university-led AKT by the GMC Council is a landmark moment in the history of medical education in the UK. Together with the CPSA, it marks the first stage in the creation of a national exam which will help to ensure that UK medical graduates are not just knowledgeable but capable and safe doctors. I would like to thank medical school staff for sharing their commitment and expertise in developing the AKT based on years of working collaboratively in this area.

'Medical schools now look forward to working together through the Medical Schools Council to pilot the exam over the next three years. This will allow the AKT process to be scrutinised and amended to ensure that it meets the high standards of UK medical assessment, the regulator and the public. Medical schools will also work to ensure that medical students feel supported throughout this process and are prepared to sit an assessment that is deemed fair and reliable.’

From 2024, the MLA will also replace the GMC’s Professional and Linguistics Assessment Board (PLAB) tests for international medical graduates who want to work in the UK. The GMC will deliver the MLA for this cohort. 

Once implemented, the MLA will enhance patient confidence in doctors new to UK practice by providing the assurance that they have the knowledge, skills and behaviours needed for safe practice, wherever they were trained.