What Is the UKMLA? The UK Medical Licensing Assessment Explained for International Graduates

What is the UKMLA?

The UKMLA, the UK Medical Licensing Assessment, is the national exam that the General Medical Council uses to confirm that a new doctor is safe to practise in the United Kingdom. Students graduating from UK medical schools from the 2024/25 academic year onward must pass it before they can join the medical register. In 2026 it is a normal part of every UK medical degree.

Before the UKMLA, each UK medical school ran its own final exams, and the standard varied from school to school. The UKMLA puts one content map over all of them: about 430 core conditions and presentations since the GMC updated the map in January 2026. International graduates are measured against the same map. That is the point. One standard for everyone on the register.

What are the AKT and the CPSA?

The UKMLA has two parts in 2026. The AKT, the Applied Knowledge Test, is a computer-based exam of single best answer questions on clinical knowledge. The CPSA, the Clinical and Professional Skills Assessment, tests practical skills, communication and clinical reasoning at stations with real or simulated patients. UK students sit both during the final years of their degree.

The GMC sets the AKT questions and the pass standard. The medical schools run the CPSA themselves, and the GMC checks that each school's version meets its requirements. A UK student who fails cannot graduate. Retakes follow the rules of the individual medical school.

How does the UKMLA relate to PLAB for international graduates?

For international medical graduates, PLAB is the UKMLA. Since 2024, PLAB 1 and PLAB 2 follow the same content map and standard as the AKT and the CPSA, and the GMC treats a pass in both parts as meeting the UKMLA requirement. The exam names stayed the same in 2026, so booking still happens under PLAB.

PLAB 1 is a written exam of 180 single best answer questions in three hours, held several times a year in the UK and in overseas centres. PLAB 2 is a practical exam of 16 clinical stations, about eight minutes each, held at the GMC clinical assessment centre in Manchester. A candidate has to pass PLAB 1 before booking PLAB 2.

Before PLAB 1, candidates show their English. The GMC accepts IELTS Academic with 7.5 overall and at least 7.0 in each part, or OET Medicine with grade B in all four parts. Many graduates from Europe sit OET, because the tasks look like hospital work.

Who needs PLAB in 2026, and who does not?

In 2026, UK graduates sit the UKMLA inside their degree, graduates of medical schools outside the UK and the European Economic Area sit PLAB 1 and PLAB 2, and holders of a relevant European qualification from an EU or EEA medical school can apply for GMC registration without PLAB under the recognition arrangement that followed Brexit.

That arrangement matters for students of our partner universities in Bulgaria, Romania, Poland, Czechia, Hungary and Malta. In 2023 the UK government decided to keep it in place for a further five years and to review it from then on. English evidence is still required. Graduates of partner universities in Serbia or Bosnia and Herzegovina take the PLAB route, which is a planned and well-trodden path.

The UK can change the arrangement after its review. A student who starts in 2026 graduates around 2032, so Medschool Experts plans both routes from the start: direct registration as long as it applies, PLAB as the fallback that always exists.

How long does the PLAB route take?

A graduate who starts preparing straight after a medical degree in 2026 can usually move from the English test to GMC registration in about 12 to 18 months. The English result comes first, then PLAB 1, then PLAB 2 a few months later in Manchester, then the GMC application with identity checks and the first job offer.

Some time limits apply. PLAB 2 has to be passed within three years of passing PLAB 1, and the GMC application has to follow within two years of passing PLAB 2. Each part can be attempted up to four times. In practice the waiting time for a PLAB 2 seat in Manchester often decides the calendar more than the studying does.

Plan the gaps. Many graduates use the months between PLAB 1 and PLAB 2 for clinical work at home, which also helps the first UK job application.

What does the PLAB route cost?

The PLAB route costs about 2,500 euros in exam fees and travel in 2026, before preparation courses. PLAB 1 costs about 310 euros, PLAB 2 about 1,140 euros, and an English test about 280 euros. A trip to Manchester for PLAB 2, with flights and three nights in a hotel, adds roughly 800 euros.

The GMC registration fee comes on top once the licence is granted, and many candidates buy a question bank or a short course for PLAB 2. A realistic budget is 3,000 to 4,000 euros. Compared with six years of tuition, it is a small line.

How does a graduate of a European partner university work in the UK?

A graduate of a European partner university reaches a UK job in four steps in 2026: the medical degree, English evidence, GMC registration through the relevant European qualification or through PLAB, and an application to an NHS trust or a training programme. Visa sponsorship for doctors runs through the Health and Care Worker visa.

Most international graduates start in a non-training post, often called a trust grade or locally employed doctor role, and move into specialty training once they know the system. In 2025 the UK government announced plans to give UK graduates priority for specialty training places, so a first year in a service post is a sensible part of the plan.

The degree itself is the bigger decision. Six years of medicine at the Medical University of Varna in 2026 cost about 106,000 euros: 60,000 euros in tuition at 10,000 euros a year, 43,200 euros for living costs at 600 euros a month, and about 2,880 euros for four flights a year.

Faculties in Serbia and in Bosnia and Herzegovina charge less, and their graduates take the PLAB route. The local language of the country of study is part of every English-taught programme, which adds hours to the timetable but helps on the wards. The full list is on the universities page.

Does Medschool Experts place students at UK universities?

No. Medschool Experts does not place students at British or Irish universities. The route Medschool Experts offers leads through the 25+ partner universities in Europe and the Caribbean, where the place does not depend on a test score or on high-school diploma grades, and from there to a licence in the UK, the EU, the Gulf or the United States.

Which partner university fits a UK career plan depends on your profile, your nationality and the licence you want first. Book a free consultation and we look at it together, including the visa side.

International perspective: how this works in other countries

The UKMLA follows a pattern seen in several countries. The United States uses the USMLE, three steps taken by every doctor, US-trained or not, and international graduates add certification before residency. Canada uses the MCCQE Part I for its own graduates and for international graduates. Australia asks international graduates to pass the AMC exams, unless they come through a recognised competent authority pathway.

In the Gulf, licensing runs through the health authorities. A doctor who wants to work in Dubai applies to the Dubai Health Authority, in Saudi Arabia to the Saudi Commission for Health Specialties, and both check the degree and set a licensing exam. I worked on these files in Dubai, and the logic is the same as in London: one standard, verified documents, an exam where needed.

Inside the European Union there is no national licensing exam for EU graduates at all. Directive 2005/36/EC recognises medical diplomas from member states automatically, so a graduate from Sofia can register in Germany, Ireland or Sweden without a test. That is why an EU degree remains the most flexible starting point. It opens the EU directly and the UK either directly or through PLAB.

What should a student planning a UK career do now?

A student who wants to work in the UK after 2030 should choose a medical degree that keeps two routes open: direct GMC registration through a relevant European qualification, and PLAB as the fallback. An EU degree in English does both. Strong English, ideally at IELTS 7.5 level, helps from the first semester.

Documents need care too. The GMC verifies the primary medical qualification directly with the university, and transcripts, internship certificates and identity papers must match letter for letter. A name spelled two ways on two documents can hold a file for weeks. Medschool Experts checks these details during the degree, not after it.

Clinical placements abroad also count. Electives in the UK during the final years show NHS employers how the candidate works. The services page shows how Medschool Experts supports students from the first application to the licence.