The UKMLA is replacing PLAB. We explain what's changed, what's the same, and how to prepare if you're an international medical graduate sitting the new exam.
The UK medical licensing landscape is changing. The UKMLA (UK Medical Licensing Assessment) has been phasing in since 2024, and if you're an international medical graduate planning to sit the clinical skills component of the exam, you need to understand what's actually different — and what remains the same.
The short answer: for the clinical component, the change is less dramatic than the headlines suggest. The station format, consultation skills, and mark scheme are closely aligned with what PLAB 2 has always tested. But the context and candidate population have shifted.
The UKMLA is the GMC's new framework for assessing doctors who want to practise in the UK. It consists of:
The UKMLA applies to both UK medical graduates and international medical graduates (IMGs). Importantly, both groups now sit the same exam.
| Year | Change | |---|---| | 2022 | GMC announces UKMLA framework | | 2024 | UKMLA piloted for UK graduates | | 2025 | Full rollout; PLAB 2 continues for IMGs in parallel | | 2026 | Convergence phase — PLAB 2 transitions to CPSA |
The exact timeline varies and the GMC publishes updates on its website. Always check the GMC's UKMLA pages for the most current information.
The content remains closely aligned with PLAB 2 — 18 OSCE stations covering history-taking, counselling, examination, breaking bad news, ethics, and procedural skills.
The UKMLA blueprint has a slightly increased emphasis on:
PLAB 2 was exclusively for IMGs. The UKMLA CPSA is sat by both UK and international graduates. This has raised the pass standard over time, as the reference population for borderline mark-setting includes UK foundation doctors.
The pass mark is determined by the borderline group method — examiners identify the minimum acceptable performance and set the pass mark accordingly. As UK graduates are included, calibration has shifted slightly. The absolute difficulty for IMGs has not dramatically changed, but the benchmark has risen marginally.
The UKMLA places explicit weight on communication quality as a patient safety issue, not just a soft skill. Examiners are now trained to mark communication failures that affect patient safety as clinical failures, not just interpersonal score deductions.
This means an IMG who gives clinically correct advice but in a way the patient cannot understand or act on will now lose marks across all three domains, not just the interpersonal one.
For most IMG candidates, preparation strategy remains the same:
If you're preparing for the UKMLA CPSA as an IMG, everything that worked for PLAB 2 preparation still applies:
The opening, ICE, management, and closure sequence needs to happen naturally within 8 minutes. You can't be thinking about structure during the exam — it needs to be automatic.
The UKMLA's emphasis on communication as patient safety means being technically correct is not enough. Practise:
These are growing in prominence. Know the GMC's Good Medical Practice document, and be able to apply principles (autonomy, beneficence, justice) in novel scenarios.
Timed practice — with an AI patient or a study partner — is non-negotiable. The rhythm of 8-minute consultations only comes through repetition.
The UKMLA publishes a content guide and assessed conditions list. Reviewing this against your revision plan helps identify gaps, particularly in less familiar specialties (psychiatry, paediatrics, O&G).
Does PLAB 1 still exist? Yes, but it is being replaced by the AKT component of the UKMLA. The GMC is managing the transition carefully — check current GMC guidance for which exam to sit.
If I passed PLAB 2, do I need to resit the CPSA? No. A valid PLAB 2 pass continues to count towards registration. Only candidates sitting the exam for the first time need to sit the new CPSA format.
Is the CPSA harder than PLAB 2? Not significantly for well-prepared candidates. The content is the same; the communication expectations are marginally higher. Strong candidates who practise realistic simulations are not disadvantaged.
What practice resources work for UKMLA CPSA? Any resource that gives you realistic station practice with feedback on all three domains. AI-driven tools like Plabster are particularly useful because they allow unlimited practice without needing a study partner.
| Feature | PLAB 2 | UKMLA CPSA | |---|---|---| | Who sits it | IMGs only | IMGs + UK graduates | | Format | 18-station OSCE | 18-station OSCE | | Duration | 8 min/station | 8 min/station | | Mark scheme | 3 domains | 3 domains | | Communication weighting | High | Higher | | Ethics/safety weighting | Standard | Increased | | Location | Manchester | Manchester |
For most IMG candidates currently in preparation: your preparation strategy does not need to fundamentally change. Build your consultation skills, practise under time pressure, and ensure your communication is genuinely patient-centred — not just clinically accurate.
If you're starting fresh, Plabster's UKMLA/PLAB 2 scenario library gives you practise across all 18 station types in realistic conditions.
Put this into practice with AI-powered PLAB 2 scenarios. Your first 25 sessions are completely free.
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