What Is the UKMLA?
Understand the UK Medical Licensing Assessment and how students can prepare.
Dr M. Sadler
6/17/202611 min read
A Guide to the MLA, AKT, CPSA and MLA Content Map
If you’re approaching your final years at medical school, you’ve probably heard plenty of talk about the UKMLA. You may also have heard people mention the MLA, MS AKT, CPSA, OSCEs and the MLA content map, sometimes in the same conversation. It can sound more complicated than it really is.
The Medical Licensing Assessment, officially shortened to the MLA, is designed to make sure doctors joining the UK medical register have the knowledge, clinical skills and professional judgement needed to begin practising safely.
For students at UK medical schools, it forms part of your medical degree. It isn’t an extra national exam that you sit separately after graduating.
The MLA has two parts:
the Applied Knowledge Test, or AKT;
the Clinical and Professional Skills Assessment, or CPSA.
Let’s look at what each part involves and what it means for your revision.
Take-home messages
UK medical students must pass the MLA as part of their degree before they can start foundation training.
The MLA has two parts: the Applied Knowledge Test (AKT) and the Clinical and Professional Skills Assessment (CPSA).
The AKT uses Single Best Answer questions to test how well you can apply medical knowledge to clinical scenarios.
The CPSA assesses practical clinical skills, communication, professional behaviour and safe decision-making.
Both parts are based on the GMC’s MLA content map.
Medical schools are still responsible for many practical details, including exam dates, local policies and how the CPSA is delivered.
International medical graduates following the PLAB route continue to take PLAB, which is compliant with MLA requirements.
Important date: The original GMC MLA content map applies to assessments taken up to and including 31 August 2026. An updated content map applies to assessments taken from 1 September 2026 onwards.
What is the purpose of the Medical Licensing Assessment?
Before the MLA, UK medical schools could assess their students in slightly different ways. Medical schools still run their own degree programmes and clinical assessments, but the MLA creates a common threshold that every new doctor must meet before starting foundation training.
It is intended to test more than your ability to memorise facts. You need to show that you can apply your knowledge to realistic situations, make safe decisions, manage uncertainty and provide patient-centred care. In practice, that means knowing the medicine while also being able to answer questions such as:
What is the most likely diagnosis?
Which investigation should happen next?
Does this patient need urgent treatment?
What is the safest initial management?
When should you ask for senior help?
That distinction is important. Reading notes may help you learn a condition, but the MLA is interested in whether you can use that knowledge when faced with a clinical scenario.
Who has to take the MLA?
Students at UK medical schools
All students graduating from UK medical schools must pass the MLA as part of their degree before they can join the medical register. Students normally complete the MLA towards the end of medical school. However, the timing can vary. Some schools may deliver the AKT in the penultimate year if their written final examinations occur at that stage.
Your medical school should tell you:
When you will sit the AKT
How the assessment will be delivered
What local examination policies apply
When and how you will complete the CPSA
How reasonable adjustments are arranged
International medical graduates
International medical graduates generally continue to take the Professional and Linguistic Assessments Board examination, better known as PLAB, when that is their route to UK registration. PLAB is not the same exam that UK medical students sit, but it is compliant with MLA requirements and aligned to the MLA content map.
PLAB 1 meets the requirements of the applied knowledge component, while PLAB 2 meets the requirements of the clinical and professional skills component. So, while the routes are different, they are designed around the same overall expectations for safe UK practice.
What is the Applied Knowledge Test?
The Applied Knowledge Test, or AKT, is the written component of the MLA. For students at UK medical schools, it is sometimes referred to as the Medical School Applied Knowledge Test, or MS AKT. The aim is to test applied clinical knowledge rather than simple factual recall. Questions are presented in the familiar Single Best Answer format.
The current MS AKT consists of:
two papers;
100 questions in each paper;
200 questions in total;
two hours for each paper under standard conditions;
five answer options for every question;
no negative marking.
The two papers are normally taken on consecutive days. Because there is no negative marking, you do not lose extra marks for an incorrect answer. It therefore makes sense to attempt every question, although good time management will help you avoid having to rush through the final section.
What does “Single Best Answer” mean?
In a Single Best Answer question, more than one option may initially appear reasonable. Your job is to choose the answer that best fits the exact wording of the question.
For example, a question might ask for the:
most likely diagnosis;
best initial investigation;
most appropriate next step;
immediate management;
definitive treatment.
These are not always the same thing. The best initial investigation may be different from the test that ultimately confirms the diagnosis. Similarly, the immediate treatment of an unstable patient may be very different from their longer-term management. This is why question practice matters. You are not only testing whether you know the topic, you are also learning to recognise what the examiner is actually asking.
What is the Clinical and Professional Skills Assessment?
The Clinical and Professional Skills Assessment, or CPSA, is the practical part of the MLA. It assesses how you perform in clinical situations, including your communication, examination technique, clinical reasoning and professional behaviour. Your medical school sets and delivers its own CPSA. Depending on your university, it may be called an:
OSCE;
OSLER;
clinical examination;
final clinical assessment.
The precise format varies, but your school’s assessment must meet GMC requirements for quality, consistency and fairness. A CPSA might test your ability to:
take a focused history;
perform a clinical examination;
explain a diagnosis or treatment;
demonstrate a practical procedure;
develop a safe management plan;
communicate with a patient or colleague;
recognise a deteriorating patient;
escalate concerns appropriately.
The best source of information about your CPSA is your own medical school, as station length, marking systems and exam formats are not identical everywhere.
What is the MLA content map?
The MLA content map is the framework that underpins both the AKT and CPSA. It sets out the knowledge, skills, patient presentations and conditions that a doctor may be expected to understand when entering UK practice. It is useful for revision, but it should not be treated as a checklist of guaranteed exam questions.
The content map is not simply a long list of exam topics. It is informed by the GMC’s Outcomes for Graduates, its professional-capabilities framework and the sorts of situations newly qualified doctors are likely to encounter during the Foundation Programme.
Seeing a condition on the content map does not mean it will appear in your particular paper. Equally, being able to recognise every condition on the list does not necessarily mean you are ready to apply that knowledge in an exam.
A better way to use the map is to ask:
Have I covered every major area of clinical practice?
Which patient presentations am I less confident with?
Can I apply my knowledge to unfamiliar scenarios?
Am I also revising ethics, communication and professional practice?
Which practical skills still need work?
Which MLA content map should you use?
This is particularly important during 2026 because the GMC is moving to an updated version.
If your assessment is taken on or before 31 August 2026, the original MLA content map remains the relevant version.
If your assessment is taken from 1 September 2026 onwards, you should use the updated content map published by the GMC.
The updated version contains a larger number of conditions and presentations, and is organised into six domains:
Areas of clinical practice - i.e. surgery, Respiratory and Cardiovascular
Areas of professional knowledge - i.e. Biomedical sciences, Histopathology, microbiology
Clinical and professional capabilities - i.e. Assessing and generating management plans for chronic conditions or Manages pain
Patient presentations - a range of signs and symptoms patients commonly present with to primary or secondary care. From Abdominal distension to worried patient.
Conditions - the conditions commonly seen by doctors across all types of patient contact. From Abnormal blood film to Zoonotic infections.
If you are unsure which version applies to you, check the date of your assessment and confirm it with your medical school.
Is the MLA the same at every medical school?
Not entirely. The MS AKT has a shared structure and standard, but medical schools still make many local decisions about how it is delivered. Each medical school chooses its sitting from a selection of assessment dates provided by the Medical Schools Council, therefore, different universities may sit it at different points in the academic year. The CPSA also varies between schools because each university designs and delivers its own clinical assessment. The goal is to make sure that all graduating students meet the same minimum standard for safe practice.
Is the MLA nationally ranked?
No. The MLA is a pass-or-fail assessment.
The Medical Schools Council does not use MS AKT scores to create a national ranking of medical students, and your MLA result does not form part of your Foundation Programme application.
Your medical school may still use its own students’ results when awarding honours or prizes, depending on its local regulations.
The main purpose of the MLA is to decide whether you have met the required threshold, not to compare you with every other student in the country.
Do UK medical students have to pay for the MLA?
There is no separate fee for UK medical students to sit the AKT or CPSA. They are completed as part of the medical degree.
International medical graduates taking PLAB pay the relevant fees published by the GMC.
How should you prepare for the MLA?
The good news is that the MLA is not supposed to introduce an entirely new body of medicine on top of your degree. Your medical-school teaching and clinical placements remain the foundation of your preparation, the challenge is organising that knowledge and becoming confident at applying it.
Start with your medical school’s guidance
Before building a detailed revision plan, make sure you know:
your AKT date;
which content map applies;
how your CPSA is structured;
whether your university provides mocks;
what the local progression and resit rules are.
There is little value in relying on rumours from students at another university when your own school may use different arrangements.
Use the content map to find gaps
You do not need to memorise the content map line by line. Instead, use it to divide your revision into manageable areas and identify topics you have neglected.
Try marking each topic as:
confident;
needs revision;
unfamiliar.
That gives you a much more useful starting point than simply working through subjects in alphabetical order.
Practise applying your knowledge
Reading textbooks and notes has a place, but question practice helps you move from recognition to application. A good clinical question should make you decide what matters in the scenario, ignore irrelevant information and choose between several plausible options. As your exam approaches, gradually move from topic-based practice to mixed and timed question sets.
Spend time reviewing your answers
Completing hundreds of questions is not automatically useful if you move on without understanding your mistakes.
After an incorrect answer, ask yourself:
Did I not know the underlying medicine?
Did I misread the question?
Did I confuse the initial and definitive management?
Did I miss a clue in the clinical stem?
Was I distracted by a plausible but less appropriate option?
It is also worth reviewing questions you answered correctly through guessing. The aim is not simply to collect completed questions. It is to become less likely to make the same mistake again.
Use the official practice exam
The Medical Schools Council provides an official 200-question MS AKT practice exam, split into two 100-question papers. The questions are mapped to the MLA content map and are designed to reflect the style of the real assessment.
These papers are particularly helpful for getting used to:
SBA wording;
the level of clinical reasoning expected;
the breadth of the exam;
working at the required pace.
Consider saving at least one full paper until you are far enough into your revision to use it as a realistic timed practice.
Do you need to pay for an MLA revision course?
No. A paid course or subscription is not a requirement for preparing effectively.
Your medical school teaching should provide the foundation of your revision, and the Medical Schools Council offers free official resources, including its student handbook, webinars and practice questions. There is also a host of other free content available, check out our revision resources hub to see what's on offer.
Additional resources can still be useful if they help you organise your revision, practise applying knowledge and understand your mistakes, but spending more money does not automatically mean better preparation.
Prepare for the CPSA separately
Question-bank revision will not prepare you fully for a clinical examination. For the CPSA, you need to practise speaking, examining, explaining and responding in real time.
Where possible, practise with another student and take turns playing the candidate, patient and examiner. Feedback from friends, tutors and clinicians is usually more useful than repeatedly performing the same station alone.
What should you look for in an MLA question bank?
Not every question bank is organised in the same way. Before choosing one, check whether it's based on the MLA content map. A useful question bank should also help you learn from the questions rather than simply giving you a score. Look for:
clear explanations of why the correct answer is best;
discussion of why the other options are less appropriate;
coverage across different clinical areas and patient presentations;
a way to revisit incorrect or flagged questions;
progress tracking that helps you identify weaker topics;
mixed and timed tests for later in your revision.
Question banks work best when they guide your revision and not just becoming a target for how many questions you can complete each day.
How ReviseMD can help
ReviseMD is our free medical-revision platform designed around the official MLA content map.
The ReviseMD MLA app includes:
questions across 39 clinical topics, supported by clinical images
detailed explanations for each answer, with a link to a summary of the MLA condition the question relates to,
progress tracking by topic with heat maps that highlight stronger and weaker areas,
book marking questions with notes for later review,
random question selection, and weak area quiz generation,
customisable test lengths and a built-in exam timer,
a searchable library of more than 300 conditions.
a home screen widgets to keep you on track
Offline access and no login or account required
Early in your revision, you can work through individual clinical topics and build your understanding. Later, you can switch to mixed, random and timed tests to practise making decisions under exam conditions.
Check out our revision resources page for other great learning resources.
Frequently asked questions
Is the MLA separate from medical-school finals?
The MLA is completed as part of the UK medical degree. Medical schools incorporate its requirements into their assessment programmes, as part of finals, although the exact relationship with existing finals may vary between universities.
Do I have to pass both the AKT and CPSA?
Yes. The MLA contains both an applied-knowledge component and a clinical and professional-skills component.
When will I sit the MLA?
It is normally completed towards the end of medical school. Some students may sit the AKT in their penultimate year where others sit it in their final year. Some medical schools sit the MLA as a mock in several years (King's College London for example). Check with your medical school when your formal MLA date would be.
Is PLAB being replaced by the MLA?
International medical graduates continue to take PLAB when it is the relevant route to registration. PLAB has been made compliant with the MLA requirements rather than replaced by the university-delivered MS AKT and CPSA.
Can every condition on the content map be examined?
The content map provides the framework from which assessment content is drawn, but examining every condition across the 2 papers would not be possible It does not indicate that every listed condition, presentation or skill will appear in a single examination.
When will I receive my MLA results?
Your medical school is responsible for issuing your AKT and CPSA results, so the timing and way they are reported can differ between universities.
Your university should also explain its local rules on progression and resits. Check with your assessment team if this information has not already been provided.
Final thoughts
The MLA can feel overwhelming when you first open the content map and see the breadth of material it covers. Try not to think of it as a separate syllabus that suddenly appears at the end of medical school. It is better understood as a framework for bringing together the knowledge, clinical skills and professional judgement you have been developing throughout your degree.
Start by understanding the exam, check which content map applies to you and build a realistic revision plan. Then use question practice, careful review and regular clinical-skills sessions to turn your knowledge into safe decision-making.
That is ultimately what the MLA is trying to assess.
Helpful GMC links
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