Will UKMLA be harder than PLAB?

If you’re a UK medical student or an International Medical Graduate (IMG) hoping to obtain General Medical Council (GMC) registration to practise in the UK, then you will have likely heard that the UKMLA is set to replace PLAB. 

 

This change has many candidates concerned, wondering if the new exams will become more challenging and create a barrier to IMGs practising in the UK. But fear not! 

We have all the information you need to fully understand the key differences between the UKMLA and PLAB and how best to prepare. This blog explores the distinctions between the UKMLA and PLAB, covering exam structure, content focus, and preparation requirements, helping you to understand if the UKMLA will be harder than PLAB, and if so, how. 

Overview of the PLAB and UKMLA

What is PLAB?

 

The PLAB (Professional and Linguistic Assessments Board) exams are conducted by the GMC in the United Kingdom. It serves to assess whether IMGs, who have received their medical training outside of the European Economic Area (EEA) and Switzerland, have the knowledge and skills necessary to practise medicine safely and obtain GMC registration to work in the UK. 

The PLAB exams consist of two different assessments: PLAB 1 and PLAB 2. 

PLAB 1

PLAB 1 is a multiple-choice exam with 180 single best answer questions, focusing on the application of medical knowledge in various scenarios. It covers common and important conditions, diagnosis, and initial management. 

This exam is offered multiple times a year at test centres worldwide, including outside the UK and EU.

PLAB 2 

PLAB 2 is an Objective Structured Clinical Examination (OSCE) that includes 18 scenarios, each lasting 8 minutes. It assesses practical skills, clinical communication, and professionalism in simulated real-life situations. 

You must first pass the PLAB 1 exam to sit this one, and it is only conducted in the UK at GMC’s Clinical Assessment Centre in Manchester.

What is the UKMLA?

The UKMLA (UK Medical Licensing Assessment) is a new licensing exam for all doctors wishing to practise in the United Kingdom - both international medical graduates (IMGs) and UK medical graduates. The goal of the UKMLA is to ensure a consistent standard of knowledge, skills, and clinical practice for all doctors entering the UK's medical system - outlined in the MLA learning outcomes.

Administered by the General Medical Council (GMC), the UKMLA is set to replace the PLAB for international doctors by 2024 and will also be mandatory for UK medical students from the same year. 

The UKMLA exams consist of two different assessments: AKT and CPSA. 

AKT 

The AKT (Applied Knowledge Test) is similar to PLAB 1. It is a multiple-choice exam that covers core medical knowledge, with a focus on applying this knowledge in clinical scenarios. It tests understanding across a broad range of medical areas, including ethics, professionalism, and patient safety. 

This test can be taken at various locations in the UK and internationally, making it accessible for international applicants.

CPSA

The CPSA (Clinical and Professional Skills Assessment) is similar to an OSCE, like PLAB 2.  This is a practical exam which assesses clinical skills, patient interaction, communication, and professionalism in simulated clinical settings. 

Like with the PLAB, you must first pass the AKT to take the CPSA. For IMGs, the CPSA will be conducted in the UK at GMC’s Clinical Assessment Centre in Manchester, however, UK medical schools will administer the CPSA for their own students.

When is PLAB changing to UKMLA?

As previously mentioned, the PLAB test is set to be replaced by the UKMLA in 2024. Starting from this year, the UKMLA will become mandatory for both UK medical students and IMGs looking to obtain GMC registration to practise in the UK. 

This transition to the UKMLA is part of the GMC's effort to implement a single, standardised assessment for all new doctors entering the UK's medical system. The UKMLA aims to ensure a consistent level of knowledge, clinical skills, and patient care across both UK-trained and internationally trained doctors.

After 2024, PLAB will no longer be available, and the UKMLA will be the sole licensing assessment for doctors entering practice in the UK.

How is UKMLA different from PLAB?

Differences in exam content

PLAB exams primarily cover foundational knowledge, clinical scenarios, and patient management for common conditions. UKMLA, on the other hand, also focuses on broader topics, including ethics, communication, professionalism, and UK-specific guidelines (such as NHS protocols and UK clinical standards) - things that were less prominent in PLAB.

Differences in exam structure

Whilst both exams consist of two parts, a multiple choice exam and a clinical skills exam, the UKMLA is set to expand upon PLAB. 

The UKMLA AKT will have higher-level MCQs covering knowledge and application, with case-based scenarios, compared to PLAB 1. The UKMLA CPSA will also have more rigorous clinical skills testing, similar to PLAB 2, but with a higher level of competency expected. 

Will UKMLA be harder than PLAB?

PLAB and UKMLA pass rates 

Historically, the PLAB pass rates have been fairly high, with a reported pass rate of around 70-80% for PLAB 1 and 65-75% for PLAB 2. This has made it accessible to a broad range of IMGs with adequate preparation.

However, whilst early data is limited, the UKMLA is anticipated to have lower pass rates initially - reflecting its higher standards and more rigorous assessment of both clinical skills and UK-specific knowledge. The GMC aims for a standardised pass threshold, which may be set higher than PLAB’s.

Depth of knowledge required

For the PLAB exams, testing was based on foundational-level UK clinical knowledge. However, UKMLA will cover more advanced clinical knowledge, reflecting recent medical advances and current UK healthcare practices. As such, clinical reasoning skills and decision-making standards in UKMLA may be higher, as they are tested similarly to UK medical students.

Study time required 

PLAB 

For PLAB 1, candidates generally require around 3-6 months of study time, however the exact duration depends on their familiarity with the UK healthcare system, clinical knowledge, and test-taking skills. Preparation for PLAB 2 usually requires an additional 1-3 months, given the practical nature of the OSCE-style exam and the need to practise clinical skills, communication, and patient interaction.

Many candidates find that 4-9 months of focused study is sufficient to prepare for both parts of the PLAB exam.

UKMLA 

Preparing for the AKT may require 4-6 months for most candidates, given the broader scope and the emphasis on ethics, professionalism, and patient safety in addition to clinical knowledge. Since the CPSA has a broader range and possibly more complex scenarios than PLAB 2, it might require an additional 2-4 months of dedicated practice - particularly for developing communication and ethical reasoning skills.

Overall, candidates might need around 6-10 months for thorough preparation for both components of the UKMLA, particularly since it covers a wider scope than the PLAB.

Study resources available

As PLAB has been going for many years, you may expect to find that far more online study resources are available for this set of exams, compared to the UKMLA. However, the GMC and UK medical schools are beginning to release UKMLA-specific guidance and prep materials to support upcoming candidates.

Whilst PLAB study resources may be a place to start in your UKMLA revision, remember that the UKMLA requires a deeper and broader understanding of medicine and UK-specific guidelines than PLAB. 

Our Pastest med student revision hub has a wide range of MLA- and UKMLA-specific resources developed by UK medical educators, including over 4,500 questions tailored to both pre-clinical and clinical content, interactive revision notes, OSCE practice stations, and anatomy videos. It also provides performance metrics and flashcards for spotting clinical signs - all designed to support students from early medical school through to UKMLA success, offering resources on key topics like diagnostics, professionalism, and clinical skills.

Key takeaways UKMLA candidates

For more information on the UKMLA, including a broad range of study resources available, we suggest checking out our Pastest Full Guide to the UKMLA.