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What Is A Medical Licensing Assessment (MLA)?

Published on: 12 Aug 2022

Medical Licensing Assessment (MLA)

With an approximate 338,000 doctors listed on the General Medical Council (GMC) register, its existence confirms that those named have the training, skills and experience needed to meet the standards for good medical practice

Whether a graduate from a UK medical school, or a doctor who obtained their degree abroad, to be a medical practitioner in the UK, you must have a license to practice from the GMC.

Currently, UK medical school graduates are automatically eligible for GMC registration upon completion of their degree, medical graduates within the European Economics Area (EEA) are eligible with their relevant degree and acceptable 12-month internship, and those outside the EEA must sit the Professional and Linguistic Assessments Board (PLAB) test.

The introduction of the Medical Licensing Assessment (MLA) in 2024, aims to standardise the eligibility for all medical graduates seeking registration with the GMC, whether from the UK or internationally. This allows further assurance that all medical practitioners on the register have shown that they can meet a common and consistent threshold for safe practice.


How to become a registered doctor in the UK in 2021

To gain a license to practise medicine in the UK you must apply for registration with the GMC. 

Currently, UK medical students apply for provisional registration at the end of their medical degree. After completion of the first year of the foundation programme (F1) doctors must apply for full registration with the GMC to move on to the second year of the foundation programme (F2).

If you hold a medical qualification awarded in the EEA or Switzerland, it may be classed as a ‘relevant European qualification’. If this is the case, you can apply for full registration with the GMC so long as you have also completed an acceptable internship of at least 12 months of medical practice in a public hospital translatable to F1 in the UK. 

For medical graduates trained outside the UK, EEA or Switzerland, the most common route to become eligible to apply for full GMC registration is to pass the Professional and Linguistic Assessments Board (PLAB) as well as evidence of an acceptable internship. The PLAB test checks that you know and can do the same as a F2 doctor in the UK.

However, from 2024 the MLA will be incorporated in UK medical school finals and will also replace the PLAB. This means that graduates trained both in the UK and outside the EEA will sit the same exam to be eligible for GMC registration. The GMC hopes for medical graduates from outside the UK but within the EEA to also sit the standardised MLA from 2024, but confirmation of this will depend on the outcomes of the UK leaving the European Union.


The role of the GMC in Medical Education

The responsibility of the GMC as a public body encompasses the protection, promotion and maintenance of the health and safety of the public. With all graduating UK medical students obtaining provisional registration, the role of the GMC expands to oversee medical education and training, where standards must be upheld to ensure the training of competent doctors. 

The GMC sets the standards for medical education and training across the UK medical schools to be implemented by the Medical Schools Council (MSC). Though medical schools must set their final exams independently in line with the GMC’s Outcomes for Graduates, there is not currently a single standardised examination. 


What is the MLA?

The Medical Licensing Assessment (MLA) is a new concept ready to be introduced in early 2024. It will become a requirement for all graduating UK medical students when registering for a license to practice. 

The introduction of the MLA by the GMC fulfils the need for a standardised UK wide examination as part of the medical school curriculum. For the first time, this creates a common and consistent threshold for safe practice for qualified doctors working in the UK as a standard part of the medical degree. 

For UK medical students the MLA will be integrated with their final medical school exams and will demonstrate that graduates from each medical school have met an agreed standard of proficiency and are well prepared to practise medicine as Foundation Year doctors.

As a new concept, a process of phased introduction will begin from 2021 with robust testing and piloting, before the assessment will be fully implemented for students graduating from UK medical schools from the academic year 2024/25. 

The MLA is also set to replace the Professional and Linguistic Assessments Board (PLAB) sat by international medical graduates seeking UK registration as well as become a requirement for medical graduates from within the EEA seeking GMC registration. This would mean nearly all doctors working in the UK go through a common assessment. 


What the assessment involves

The MLA will consist of a two-part assessment made up of an applied knowledge test (AKT) and a clinical and professional skills assessment (CPSA) 

  1. AKT – An on-screen exam with multiple choice questions 

  2. CPSA- An in-person examination of clinical and professional skills


Key information for international graduates 

  • International medical graduates applying for UK GMC registration will need to sit the MLA from early 2024

  • It will replace the PLAB

  • If you have already passed Part 1 of the PLAB when the MLA is introduced, you do not need to sit Part 1 of the MLA. You can just sit Part 2 of the MLA - the CPSA

  • There is a fee to sit the MLA

  • There will be a maximum number of times you may attempt the MLA

  • The GMC English language requirement for registration is still in place 


Further information 

  • GMC Medical Licensing Assessment - Medical Licensing Assessment - GMC (

  • MSC Medical Licensing Assessment- Medical Licensing Assessment | Medical Schools Council (