UK Medical Student Finals: UKMLA (AKT & CPSA)

UK Medical Student Finals have evolved significantly with the introduction of the UK Medical Licensing Assessment (UKMLA) from 2024-2025. All UK medical students graduating from academic year 2024-25 onwards must pass the UKMLA as part of their medical degree before joining the GMC medical register and starting work as Foundation Year 1 doctors.

The UKMLA consists of two components: the Applied Knowledge Test (AKT) and the Clinical and Professional Skills Assessment (CPSA). This standardized assessment ensures all UK medical graduates meet consistent standards for safe medical practice, replacing the previous system of individual medical school finals.

Frequently Asked Questions

What is the UKMLA?

The UK Medical Licensing Assessment (UKMLA) is a new mandatory two-part exam introduced by the GMC for all UK medical students graduating from 2024-25 onwards. It replaces traditional medical school finals and ensures all graduates meet consistent standards for safe medical practice before joining the medical register.

How many questions are in the UKMLA AKT?

The UKMLA Applied Knowledge Test (AKT) contains 200 single best answer (SBA) questions split across two papers of 100 questions each. Students have approximately 3 hours to complete both papers, covering comprehensive medical knowledge across all specialties.

What happened to the SJT and PSA?

The Situational Judgement Test (SJT) for Foundation Programme applications was discontinued in 2024, replaced by Preference Informed Allocation (PIA). The Prescribing Safety Assessment (PSA) continues as a separate requirement alongside the UKMLA, focusing specifically on prescribing competencies.

When do UK medical students take the UKMLA?

The UKMLA is typically taken during final year (4th or 5th year) as part of medical school finals, between January and July. Your medical school will determine the specific dates within this window. Both AKT and CPSA must be passed to graduate.

How much does the UKMLA cost for UK students?

The UKMLA is free for UK medical students as it's integrated into their medical degree. Medical schools cover all costs associated with the assessment. Only international medical graduates pay fees for the UKMLA-aligned examinations.

What is the UKMLA CPSA?

The Clinical and Professional Skills Assessment (CPSA) is the practical component of the UKMLA, equivalent to traditional OSCEs. It assesses clinical examination skills, communication, professional behavior, and practical procedures through structured clinical stations.

Do I need to study anything new for the UKMLA?

No additional study is required beyond your medical school curriculum. The GMC has confirmed that the UKMLA only covers topics already taught in UK medical degrees. Your medical school education is the best preparation for the assessment.

What is the PSA and do I still need to take it?

Yes, the Prescribing Safety Assessment (PSA) remains a separate requirement for UK medical students. It's a pass/fail computer-based test focusing on prescribing skills, drug calculations, and medication safety that all final-year students must complete.

UK Medical Finals Key Information

Exam Format: UKMLA (AKT + CPSA) + PSA (separate)
AKT Duration: Approximately 3 hours (200 questions)
CPSA Format: OSCE-style clinical assessment
PSA Duration: 2 hours (60 questions)
Cost for UK Students: Free (covered by medical schools)
Timing: Final year (January-July window)

UKMLA Exam Structure

Applied Knowledge Test (AKT)

  • Format: 200 single best answer questions (2 papers of 100 each)
  • Duration: Approximately 3 hours total
  • Content: Comprehensive medical knowledge across all specialties
  • Question Style: Multi-step problems requiring applied clinical reasoning
  • Assessment: Data interpretation, diagnosis, management, pathophysiology

Clinical and Professional Skills Assessment (CPSA)

  • Format: OSCE-style practical examination with multiple stations
  • Integration: Delivered as part of existing medical school OSCEs
  • Content: Clinical examination, procedures, communication skills
  • Assessment: Professional behavior, patient interaction, clinical competencies
  • Quality Assurance: GMC oversight ensuring consistent standards

Prescribing Safety Assessment (PSA)

  • Format: 60 computer-based questions focusing on prescribing
  • Duration: 2 hours
  • Content: Drug calculations, prescription writing, medication safety
  • Assessment: Pass/fail with competency-based marking
  • Requirement: Separate from UKMLA but mandatory for graduation

UKMLA Content Areas

Clinical Presentations (AKT Focus Areas)

  • Acute medical emergencies and emergency department presentations
  • Cardiovascular, respiratory, and neurological conditions
  • Gastrointestinal, endocrine, and rheumatological disorders
  • Mental health, pediatrics, and women's health
  • Dermatology, ENT, ophthalmology, and musculoskeletal problems

Assessment Domains (CPSA)

  • History taking and clinical examination techniques
  • Practical procedures and clinical skills
  • Communication with patients, families, and colleagues
  • Professional behavior and ethical decision-making
  • Emergency management and acute care responses

PSA Competencies

  • Writing accurate prescriptions with correct drug, dose, route, frequency
  • Drug calculations and dosage adjustments
  • Identifying drug interactions and contraindications
  • Recognizing and managing adverse drug reactions
  • Reviewing and amending existing prescriptions

Changes from Previous Medical Finals

What's New with UKMLA

  • Standardized national assessment replacing individual school finals
  • More comprehensive scope covering all medical specialties
  • Multi-step questions requiring deeper clinical reasoning
  • Increased emphasis on data interpretation and investigation results
  • GMC oversight ensuring consistent standards across all medical schools

Foundation Programme Changes

  • SJT discontinued - replaced by Preference Informed Allocation (PIA)
  • Foundation jobs now allocated by computerized preference matching
  • No more Educational Performance Measure (EPM) ranking system
  • Random allocation within preference ranking system
  • Focus shifted from competitive scoring to preference satisfaction

Preparation Strategy for UK Medical Finals

UKMLA AKT Preparation

  • Use the MLA content map to guide revision across all clinical areas
  • Practice with question banks designed specifically for UKMLA format
  • Focus on clinical reasoning and multi-step problem solving
  • Master data interpretation: blood results, imaging, ECGs
  • Review NICE guidelines and current UK clinical practice

CPSA Preparation

  • Practice clinical examination techniques regularly
  • Develop strong communication and consultation skills
  • Review practical procedures and emergency management
  • Study GMC's "Good Medical Practice" guidance thoroughly
  • Practice with mock OSCE scenarios and standardized patients

PSA Preparation

  • Master drug calculations and dosage conversions
  • Practice prescription writing with correct formatting
  • Learn common drug interactions and contraindications
  • Study BNF guidelines and prescribing principles
  • Use PSA practice papers and interactive resources

UK Medical Finals Resources

Start Your Medical Finals Preparation

Ready to ace your UK medical finals? Access our comprehensive question banks with UKMLA-style AKT questions, PSA practice materials, and OSCE preparation resources designed specifically for the new assessment format.