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My Experience of the UKMLA

Dr Daanish Mahmood · 8 min read

  • Abbreviations

    UKMLA = United Kingdom Medical Licensing Assessment

    PLAB = Professional and Linguistic Assessment Board Test

    AKT = Applied Knowledge Test

    CPSA = Clinical and Professional Skills Assessment

The UKMLA is the new exam that all UK medical graduates from 2025 onwards will need to pass before joining the medical register. It has replaced the formerly known PLAB.

I sat (and passed) the official UKMLA AKT on June 25th and 26th of 2024, below is my experience of the exam and how I prepared for it.

What is the exam:

  • Paper 1 Topics (100x MCQ Questions, 120 minutes)

    Please view the MLA content map for more details

    • Cardiovascular
    • Respiratory
    • Gastrointestinal
    • Medicine of Older Adult
    • Neurosciences
    • Opthalmology
    • Endocrine & Metabolic
    • Renal & Urology
    • Infection
    • Dermatology
    • Acute medicine, primary care, surgery and clinical imaging will be covered in both papers.
    • Paper 2 Topics (100x MCQ Questions, 120 minutes)

    Please view the MLA content map for more details

    • Cancer
    • Breast
    • Haematology
    • Palliative & End of Life Care
    • Peri-Op Medicine & Anaesthesia
    • Musculoskeletal
    • Emergency Medicine & Intensive Care
    • Ears, Nose & Throat
    • Child Health
    • Mental Health

Both papers are set by the Medical School Council and UK Medical Schools who choose when to set their internal exam dates. Both exam papers are combined to give an overall score which determines if you pass.

How I Studied for the UKMLA

  • Resources I used:
    • AMBOSS (To look up conditions, clinical features and definitions)
    • Anki (To memorise guidelines and facts)
    • Osmosis (To recap conditions)
    • ChatGPT (To create comparison tables)
    • Passmed (Question bank practice)
    • PLABABLE (Question bank practice)
    • MSCAA (Mock exams)
  • Resources I used but did not enjoy
    • Quesmed. I tried this for a week and the website had glitches, the question stems were too long and not representative of the real exam. The resources listed below were more than enough for this exam. Don’t overdo it with resources.
    • Medical School resources → My medical school gave us one 50 question mock exam via the MSCAA platform, but they gave us a specific date range to complete this in and wouldn’t give us the answers or let us see which questions we got wrong. I forgot to do it and they closed access 2 days before my exam so I never did it. Shoutout to my university for being useless in this regard.

ChatGPT

This is the prompt I used to create quick summary tables for similar conditions:

“Create a table with the conditions below in the columns. In the rows add a section for causes and risk factors, clinical features, diagnostic investigations and their presentations, management, treatment and differential diagnoses. Use the UK NICE CKS Guidelines wherever possible and highlight all the key information that helps to identify a condition in bold text.” Here are the conditions: Ulcerative colitis, Crohns, Colon cancer, Coeliac’s disease, IBS, Haemorrhoids, Diverticulitis

I would replace the conditions with clusters of diseases that are often confused together, then I used these tables to figure out how to differentiate between conditions before jumping into practice questions.

YouTube

In the weeks building up to my exam when I had a long commute, was brushing my teeth or washing dishes I watched a lot of short videos summarising conditions. I watched a lot of Ninja Nerd and Osmosis. I made a habit in my early years so save useful medical videos to a playlist which really came in handy in the revision period.

Passmed

I started by subscribing to Passmed and using the question bank section. I started by reading through the conditions that are in the UKMLA and refreshing my memory on those. After I felt a bit more confident with conditions I started doing practice questions. I personally try to do timed sessions from the beginning to emulate the exam conditions, so I would aim to spend no longer than 50 seconds per question.

I used the 2x and 3x hammer difficulty on Passmed for 100% of my studying. I did not do any of the 1x hammer questions unless I ran out of 2x and 3x for a specific section.

I found the 2x and 3x sufficient for the UKMLA exam → The difference between Passmed and the real exam was that Passmed is a little more obvious with which condition it’s speaking about. In the real exam the overlap between conditions was tricky at time, the questions are written very well so you need to know specifics to rule out an answer.

Most people recommend completing the question bank once or twice, I personally only completed 2,000 questions and managed to pass comfortable. By 4th/5th year you should understand your own learning enough to gauge how many questions you need to do. If like me you have good recall, you use Anki a lot and have decent exam technique you can get away with doing less questions.

I would say, if you complete the question bank and average over 60% you’ll be good for the exam.

Anki

As I was going through Passmed whenever I got something wrong or came across a new piece of information I turned it into a flashcard. I had a Year 4 Anki Deck which I tagged by system. I kept this up until around 1-2 weeks before the exam when I just focussed on doing Passmed questions.

I used a combination of my own Anki decks, the Anking V12 deck and other UKMLA decks I found online for this exam.

AMBOSS

While this is an American/German platform it remains the best place to look up conditions, clinical features and differential diagnoses. It’s been my go-to resource for all of medical school so far.

The management and treatment is according to the American guidelines although most things are pretty similar. I would use the NICE CKS Guideline websites and PDFs whenever I felt like I needed exact info or I just looked up treatments on Passmed.

PLABABLE

Since the UKMLA is a replacement for the PLAB I figured it would be good to use a PLAB question bank. The questions here were more similar to the real exam than Passmed in my opinion. I noticed they had more vague/shorter stems in their questions which was good for preparation.

The comment section in PLABABLE is pretty useful too, a lot of IMGs post good explanations here in comparison to Passmed so I found that useful. It’s also a very cheap platform to use.

They had 36 mock exams in my subscription which is exactly what you need for an exam like this. That’s the biggest selling point of PLABABLE.

Their notes section is more concise and useful than Passmed too, if I was to do the exam again I would use this resource a little sooner, maybe 4 months out.

Check out my FREE Medical School Survival Guide + Anki Decks.

My Experience of the UKMLA

General

The spread of questions seemed pretty accurate compared to what was outlined by the GMC in both papers. Clinical imaging, ECGs, CXRs, blood results, surgical procedures were included in both papers as outlined.

Psychologically a lot of students seemed to come out of paper 1 feeling overwhelmed, but in actual reality a lot of these students passed overall and everything was fine.

The pass mark is below 60% from what I’ve seen in this exam, my medical school usually has a pass mark around 65% in our normal exams so this felt reasonable for our finals exams. Below is a little reflection on each exam, while I have included examples of questions these are completely made up and there is no reproduction of the exam in this post.

Paper 1

This paper was quite challenging. A lot of the stems were medium to long, not many short descriptions besides a few. Pretty much half of the questions had blood test results involved and there was a lot of second or third order thinking. So you would have to figure out the diagnosis, then give the appropriate management while factoring in contraindications (E.g. Asthma and Beta Blockers or pregnancy).

While the questions were difficult, if you studied well you could notice which condition the question was talking about. They had quite unique descriptions, for example instead of saying ‘Ptosis’ they might describe an eyelid drooping or loss of up gaze.

The challenge with this paper is trying to figure that out in a timely manner. You need to be proficient with analysing ABGs, FBC, LFTs, U&Es, ECGs along with clinical features. It was quite satisfying that you could come to an answer through pure clinical judgement rather than recall knowledge. Unlike Passmed questions that have pattern recognition and buzzwords, I felt there was less of that in the UKMLA → I do believe that the students who prepare and study well will do well in this exam.

The usual advice of read the question carefully, check all the answers and don’t jump to conclusions all applies. Watch out for distractors and misguiding information. Pay attention to age, race, risk factors such as recent travel etc too.

Paper 2

Paper 2 was noticeably easier than paper 1 in my experience. I think this is largely down to the fact that paper 1 has most of the acute medicine topics (Cardio, Resp, GI, Neuro) which involve the complex blood tests. Paper 2 had much more obvious diagnoses such as breast conditions, dermatology, paediatrics and so on.

The stems in paper 2 were shorter so this paper was easier to complete in the required time. I had more questions in this paper that I felt very confident with than paper 1.

I hope you find this useful, don’t forget to check out my UKMLA webinar where I share the best methods to prepare for this exam.

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