What is the MLA?
The Medical Licensing Assessment (MLA) is a two-part evaluation comprising an Applied Knowledge Test (AKT) and a Clinical and Professional Skills Assessment (CPSA). From the academic year 2024–25 onwards, all students must pass the MLA as part of their degree to qualify for medical practice in the UK.
The MLA ensures that all doctors—whether they graduate from UK medical schools or train abroad—meet a consistent standard of safe practice appropriate for their entry into the medical register.
Why are medical student assessments changing?
Starting in the 2024–25 academic year, passing the MLA will be a graduation requirement for UK medical students. This change aligns with the General Medical Council’s (GMC) Outcomes for Graduates (2018) and standardizes expectations for domestic and international medical professionals entering the UK healthcare system.
For the first time, both UK graduates and international candidates will complete assessments drawn from the same resources (based on the GMC MLA content map). This approach introduces a consistent threshold for safe practice and ensures fairness in evaluating candidates’ readiness to practise medicine.
What does the MLA include?
The MLA consists of two components:
Applied Knowledge Test (AKT):
- A written exam testing applied clinical knowledge rather than rote factual recall.
- Comprises two 100-question papers taken on consecutive days, with single-best-answer (SBA) format questions.
- Questions are drafted by experts across UK medical schools and mapped to the GMC’s content guide.
- Delivered electronically under strict invigilation, with quality assurance by the GMC.
Clinical and Professional Skills Assessment (CPSA):
- A performance-based test using the Objective Structured Clinical Examination (OSCE) format (at Liverpool).
- Includes a mixture of consultation, examination, and procedural skills stations aligned with the MLA content map.
- Communication for clinical practice is integrated across stations.
- Utilizes a sequential testing format to ensure fairness and accurately determine pass/fail outcomes.
How has Liverpool adapted to the MLA?
Liverpool Medical School has progressively integrated the MLA into its assessments:
- Over the past three years, final-year students have participated in clinical exams, while AKTs have been included in the graduating process for two years.
- As of 2023–24, Year 5 students must pass both the AKT and CPSA, complete an e-portfolio, and undertake a Selective in Advanced Medical Practice (SAMP) to graduate.
The 2024–25 cohort will be the first to graduate under the MLA requirements as part of their primary medical qualification. At Liverpool:
- The AKT is held on campus using Liverpool’s established processes, with exam questions drawn from the Medical Schools Council (MSC) bank.
- The CPSA retains its OSCE-based format and is designed by Liverpool faculty clinical staff.
Throughout the transition, Liverpool documented compliance with GMC standards for the AKT and CPSA, submitting evidence of readiness to deliver the updated assessments.
Further Reading
For more information, explore the GMC website, which includes:
- The MLA Content Map, outlining the knowledge, skills, and behaviours required for assessment.
- The Outcomes for Graduates (2018), which guided the transition.
- MLA compliance reports for each UK medical school, including Liverpool.
For MLA-specific questions, contact the GMC at mla@gmc-uk.org. For Liverpool-related queries, email assessment.mbchb@liverpool.ac.uk.